Community Implementation of MI-Enhanced Behavior Therapy for Adolescent ADHD: Linking Fidelity to Effectiveness

Evidence-based behavior therapy for adolescent ADHD faces implementation challenges in real-world settings. The purpose of this trial was to investigate the relationship between implementation fidelity and outcomes among adolescents receiving services in the active treatment arm (N = 114; Motivational Interviewing [MI]-enhanced parent-teen behavior therapy) of a community-based randomized trial of adolescent ADHD treatment. Participants received therapy from community clinicians (N = 44) at four agencies in a large, ethnically diverse metropolitan setting. Therapists provided self-report of session-by-session adherence to content fidelity checklists and audio recordings of sample sessions that were coded for MI integrity. Parents provided report of ADHD symptoms and family impairment at baseline, posttreatment, and follow-up, while academic records were obtained directly from the local school district. Results indicated that content fidelity significantly waned across the 10 manualized sessions (d = -1.23); these trends were steepest when therapy was delivered outside the office-setting and parent attendance was low. Community therapist self-report of content fidelity predicted significantly greater improvements in academic impairment from baseline to follow-up. MI delivery quality was not associated with improved outcomes; contrary to hypotheses, lower MI relational scores predicted significantly greater improvements in family impairment over time. Findings indicate that community-based outcomes for evidence-based ADHD treatment are enhanced when treatment is implemented with fidelity. Future work should revise community-based implementation strategies for adolescent ADHD treatment to prevent declines in fidelity over time, thereby improving outcomes.     

A longitudinal study on depressive symptoms and physical activity during the Spanish lockdown

Background/Objective: The aim was to evaluate the evolution of depressive symptoms and to explore the influence of physical activity (PA) practice during the home confinement due to the COVID-19 outbreak in Spain. Method: Information was collected from 595 confined participants who reported personal and contextual information, depressive symptoms and PA levels at four time points. Results: The changes in depressive symptoms were analyzed using a linear mixed model with cubic splines. Results showed a significant increase, with a significant rise between T1 and T2 (OR = 2.38, 95% CI = 1.83-3.10). It continued growing until T4 (OR = 2.93, 95% CI = 1.97-4.38). A negative relationship was observed between the increase in depressive symptoms and moderate-to-vigorous physical activity (MVPA) levels, with a significant slope up to 4 hours of MVPA per week (OR = 0.51, 95% CI = 0.29-0.90) that tended to increase until 16 hours per week of MVPA (OR = 0.41, 95% CI = 0.20-0.87). Conclusions: Results from a partition model showed that moderate intensity of PA could be enough to prevent an increase of depressive symptoms during home isolation.     

Evaluating Arguments from a Play about Ethics in Science: A Study with Medical Learners

Developing critical thinking ability is one of the main goals of medical education, in part because it enhances clinical reasoning, a vital competence in clinical practice. However, there is limited evidence suggesting ways to effectively teach critical thinking in the classroom. Here, we describe the use of a drama-based critical thinking classroom scenario. The study used a mixed-methods approach with both quantitative and qualitative analysis of questionnaire responses. Ninety-one medical students (56 females; 35 males; ages 16–30 years) in Colombia were asked to identify and evaluate arguments regarding a dilemma between ethics, social responsibility and scientific work presented in the play Should’ve by the Nobel laureate Roald Hoffmann. Chi square analyses of responses to closed-ended questions showed that the drama-based classroom scenario provided learners with opportunities to make decisions, and to identify and evaluate arguments from the play. Qualitative analysis of responses to open-ended questions confirmed these findings and illustrated the processes underlying the decisions. Students were able to evaluate arguments in an impartial way. Our findings support the use of drama-based scenarios in the classroom as an approach to fostering medical students’ critical thinking. This approach could contribute to a classroom pedagogy in which all students have an active role in responding to controversial questions, evaluating arguments and critically responding. This would support the development of critical thinking and promote deeper understanding of the dilemmas involved in scientific work.     

Projective Geometry in Logical Space: Rethinking Tractarian Thoughts

Customary interpretations state that Tractarian thoughts are pictures, and, a fortiori, facts. I argue that important difficulties are unavoidable if we assume this standard view, and I propose a reading of the concept taking advantage of an analogy that Wittgenstein introduces, namely, the analogy between thoughts and projective geometry. I claim that thoughts should be understood neither as pictures nor as facts, but as acts of geometric projection in logical space. The interpretation I propose thus removes the root of the identified difficulties. Moreover, it allows important clarification concerning some central aspects of the Tractarian theory of representation, and it yields a unifying elucidation regarding Wittgenstein’s remarks on the solipsistic thesis.     

Is a bad will a weak will? Cognitive dispositions modulate folk attributions of weakness of will

In line with recent efforts to empirically study the folk concept of weakness of will, we examine two issues in this paper: (1) How is weakness of will attribution (WWA) influenced by an agent’s violations of best judgment and/or resolution, and by the moral valence of the agent’s action? (2) Do any of these influences depend on the cognitive dispositions of the judging individual? We implemented a factorial 2?×?2?×?2 between-subjects design with judgment violation, resolution violation, and action valence as independent variables, and measured participants’ cognitive dispositions using Frederick’s Cognitive Reflection Test (CRT). We conclude that intuitive and reflective individuals have two different concepts of weakness of will. The study supports this claim by showing that: (1) the WWA of intuitive subjects is influenced by the action’s (and probably also the commitment’s) moral valence, while the WWA of reflective subjects is not; (2) judgment violation plays a small role in the WWA of intuitive subjects, while reflective subjects treat resolution violation as the only relevant trait. Data were collected among students at two different universities. All subjects (N?=?710) answered the CRT. A three-way ANOVA was first conducted on the whole sample and then on the intuitive and reflective groups separately. This study suggests that differences in cognitive dispositions can significantly impact the folk understanding of philosophical concepts and thus suggests that analysis of folk concepts should take cognitive dispositions into account.     

Effects of belief in luck on the attractiveness of loyalty programmes

The aim of this article is to demonstrate that the perception of belief in luck affects loyalty programmes, causing people making cognitive (affective) choices to feel more (less) attracted. To validate our hypotheses, we conducted 3 related experiments (2 laboratory tests and 1 in the field). We found that the perception of belief in luck (bad or good) affects the relationship between loyalty programmes and attractiveness (Study 1). We study this effect considering the mechanisms of points‐pressure and rewarded behaviour. Thereafter, we established that cognitive (affective) decisions promoted an increase (decrease) in attractiveness when consumers were exposed to continuous loyalty programmes because their belief in luck was lower (Studies 2 and 3). We believe that these changes occur because the consumer's belief in luck masks the uncertainty in the decision‐making process.     

The effect of self-affirmation in nonthreatening persuasion domains: timing affects the process

Most research on self-affirmation and persuasion has argued that self-affirmation buffers the self against the threat posed by a persuasive message; thus, it increases the likelihood that participants will respond to the message favorably. Little research, in contrast, has looked at the effects of self-affirmation on persuasive messages that are not threatening to the self. This research examines mechanisms that can operate under these conditions. Consistent with the idea that self-affirmation affects confidence, the article shows that self-affirmation can decrease information processing when induced prior to message reception (Experiment 1) and can increase the use of self-generated thoughts in response to a persuasive message when induced after message reception (Experiment 2). In addition, Experiment 3 manipulates the timing of self-affirmation to replicate both effects and Experiment 4 provides direct evidence for the impact of self-affirmation on confidence.     

Attitudes, learning experience and performance in mathematics: gender differences

In this paper, we used the data of Mathematics achievements from the sample of 13- year-old Spanish boys and girl who took part in the Second National Assessment of Educational Progress, carried out by the Educational Testing Service. With the aim of identifying variables related to high achievement, our goals are: 1) to analyse whether there are significant differences in 13-year-old Spanish boys and girls in their attitudes towards mathematics, their study strategies, and their performance; 2) to analyse the influence of their attitudes and study strategies on their performance, and to examine whether these relations are the same in boys and girls; 3) to propose a theoretical model that explains the relationship among the variables defined by means of structural equation modelling. The results show that: a) there are significant differences between boys and girls in the variables studied; b) it is not possible to reject the proposed model that relates study strategies and attitudes towards performance in mathematics; and c) the model tends to be stable both among boys and girls.     

Can research influence clinical practice?1

After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment.     

Resistance to persuasion as self-regulation: Ego-depletion and its effects on attitude change processes

Counterarguing persuasive messages requires active control processes (e.g., generation and application of contradictory information) similar to those involved in other forms of self-regulation. Prior research has indicated that self-regulation ability is a finite resource subject to temporary depletion with use, and so engaging in self-regulatory tasks could impair individuals’ ability to subsequently counterargue. Participants completed an initial task designed to deplete or not deplete their regulatory resources. Following the manipulation, participants read a message supporting a counterattitudinal policy. Results indicated that prior self-regulation reduced subsequent resistance, primarily when the message arguments were specious. Counterargument appears to be a self-regulatory process that can be undermined when self-regulatory resources have previously been diminished.