The cost-effectiveness of cognitive behavior therapy for borderline personality disorder: results from the BOSCOT trial

Borderline personality disorder places a significant burden on healthcare providers and other agencies. This study evaluated the cost-effectiveness of cognitive behavior therapy plus treatment as usual compared to treatment as usual alone for patients with borderline personality disorder. The economic analysis was conducted alongside a multi-center, randomized controlled trial. The costs of primary and secondary healthcare utilization, alongside the wider economic costs, were estimated from medical records and patient self-report. The primary outcome measure used was the quality-adjusted life year (QALY), assessed using EuroQol. On average, total costs per patient in the cognitive behavior therapy group were lower than patients receiving usual care alone (-689 pounds sterling), although this group also reported a lower quality of life (-0.11 QALYs). These differences were small and did not approach conventional levels of statistical significance. The use of cognitive therapy for borderline personality disorder does not appear to demonstrate any significant cost-effective advantage based on the results of this study.     

The Eyelink Toolbox: Eye tracking with MATLAB and the Psychophysics Toolbox

The Eyelink Toolbox software supports the measurement of eye movements. The toolbox provides an interface between a high-level interpreted language (MATLAB), a visual display programming toolbox (Psychophysics Toolbox), and a video-based eyetracker (Eyelink). The Eyelink Toolbox enables experimenters to measure eye movements while simultaneously executing the stimulus presentation routines provided by the Psychophysics Toolbox. Example programs are included with the toolbox distribution. Information on the Eyelink Toolbox can be found at http://psychtoolbox.org/.     

Skill acquisition in music performance: relations between planning and temporal control

We investigated the acquisition of music performance skills in novice and expert pianists. Temporal disruptions in novice performances coincided with constraints in planning capacities. Child and adult pianists ranging in age (9-26 years), training (3-15 years) and sight-reading ability learned to perform a novel musical piece in eleven practice trials. Computer-detected pitch and timing errors revealed: (1) gradual improvements in performance tempo and pitch accuracy with skill level and practice, generally fitting a power function; (2) a relative-timing/pitch accuracy trade-off and high incidence of simultaneous pitch/time errors; (3) improvements in relative timing (temporal continuity, underlying beat, metrical structure) with skill and practice; and (4) increased anticipatory behavior and a greater range of planning with skill and practice. A strong positive relationship between the mastery of temporal constraints and planning abilities within performance suggests that these two cognitive indicators are closely related and may arise from segmentation processes during performance. Examination of sequence timing may explicate planning abilities that underlie many complex skills.     

When to intervene and take a stand: Evaluating bystander roles in intergroup name-calling contexts

Children (n = 121, M = 9.86 years, SD = 0.64) and adolescents (n = 101, M = 12.84 years, SD = 0.69) evaluated proactive and passive bystander behaviour to intergroup name-calling (N = 222, 54% female). Scenarios depicted ingroup perpetrators and outgroup victims who were from a stigmatized group (ethnicity) or a non-stigmatized group (school affiliation), with bystanders depicted as being proactive (intervening to help) or passive (failing to challenge the aggression), counter to their own group's norm. Children and adolescents personally evaluated proactive bystanders more favourably than passive bystanders. However, adolescents, more than children, expected their peers to be more positive about proactive bystanders than passive bystanders in the stigmatized context. Results are discussed in terms of the complexities of bystander decisions and implications for anti-bullying interventions.     

Inverting the Object of Study: Recalibrating the Frame of Reference in Study Abroad Experiences

This essay is concerned with study abroad experiences as opportunities for student cognitive development, using the interpretive lens of educational psychologist William G. Perry. A standard and often valuable assignment in courses on world religions is a site visit to a religious institution in one's local area. This may concretize otherwise abstract materials and help students reflect on ways in which the lived experience of religion differs from its presentation in course texts and other academic materials. Increasingly, study abroad trips are being offered as extended and more intensive ways of bringing this material to life, offering students opportunity to see lived religion within another cultural framework. At the heart of this paper is the contention that such study abroad experiences function not simply as longer, more intense versions of site visits but, rather, as experiences that invert the subject and object of study. The worldview of the student becomes a primary object of study, which is examined, as it were, by the particulars of the religion(s) under investigation and the cultures of which said religion(s) are a part. Where site visits offer students an opportunity to visit the strange amidst the familiar, study abroad trips provide opportunities for students to become the strange within a recalibrated familiar. The subject becomes the object and is interrogated by the context of study. While local, stateside site visits can offer a degree of such dislocation, their brevity, together with some degree of assimilation to the larger culture flows on the part of the local religious institution being visited, most often mitigates any significant inversion. Students generally see such institutions as either mildly or wildly exotic, but always within their frame of reference, which constitutes the norm. When abroad, the normative experience of students is often subverted in ways that lay bare the assumptions behind such views and makes possible another world in which to live. Simply put, the subject and object of study change places. If this inversion is carefully attended to, it can provide rich insight into not only the topics nominally being studied but also occasion opportunity for real cognitive development on the part of the student. This essay is published alongside of six other essays, including a response from John Barbour, comprising a special section of the journal (see Teaching Theology and Religion 18:1, January 2015).     

Reflecting Resiliency: Openness About Sexual Orientation and/or Gender Identity and Its Relationship to Well-Being and Educational Outcomes for LGBT Students

For lesbian, gay, bisexual, and transgender (LGBT) youth, coming out (i.e., disclosure of LGBT identity to others) can be a key developmental milestone, one that is associated with better psychological well‐being. However, this greater visibility may come with increased risk of peer victimization. Being out, therefore, may reflect resilience and may unfold differently depending on ecological context as some spaces may be more or less supportive of LGBT youth than others. This article explores a model of risk and resilience for outness among LGBT youth, including whether it varies by community context. We tested our hypothesized model with a national dataset of 7,816 LGBT secondary school students using multi‐group structural equation modeling. Consistent with our hypotheses, outness was related to higher victimization but also to higher self‐esteem and lower depression. Greater victimization was related to negative academic outcomes directly and indirectly via diminished well‐being. The increases in victimization associated with outness were larger for rural youth, and benefits to well‐being partly compensated for their lower well‐being overall. This article suggests that being out reflects resilience in the face of higher risk of victimization, in addition to promoting well‐being in other ways. Nonetheless, contextual factors influence how this model operates among LGBT youth.     

Savoring with Intent: Investigating Types of and Motives for Responses to Positive Events

To contribute to a growing literature on positive affect (PA) regulation, we report on two studies investigating college students’ responses to hypothetical positive events using a new measure, the Positive Events and Responses Survey (PEARS). The PEARS includes various responses, including savoring (up-regulating PA) and dampening strategies (down-regulating PA), and novel responses (e.g., mass-sharing using Facebook). We examined its convergent and concurrent validity, its relationship with the value of happiness, and motives underlying savoring. Factor analyses supported a 3-factor model: natural savoring (e.g., expressing PA), intentional savoring (e.g., reflecting on the self), and dampening (e.g., minimizing the event). Both natural and intentional savoring were linked to other savoring behaviors, but only natural savoring was linked to perceived savoring ability and (in some bivariate results) to well-being. In contrast, dampening was consistently linked to less savoring and more dampening on other measures, lower well-being, and more depressive symptoms. People reporting valuing happiness more reported higher likelihood of all three types of responses. Qualitative data provided partial support for the hypothesis that intentional savoring strategies are more often used for instrumental reasons (e.g., boosting self-esteem), whereas natural savoring responses may sometimes be more automatic or stem from feeling PA. These studies validate a new measure and suggest that reasons underlying people’s savoring matter.     

Intrinsic motivation and attentional capture from gamelike features in a visual search task

In psychology research studies, the goals of the experimenter and the goals of the participants often do not align. Researchers are interested in having participants who take the experimental task seriously, whereas participants are interested in earning their incentive (e.g., money or course credit) as quickly as possible. Creating experimental methods that are pleasant for participants and that reward them for effortful and accurate data generation, while not compromising the scientific integrity of the experiment, would benefit both experimenters and participants alike. Here, we explored a gamelike system of points and sound effects that rewarded participants for fast and accurate responses. We measured participant engagement at both cognitive and perceptual levels and found that the point system (which invoked subtle, anonymous social competition between participants) led to positive intrinsic motivation, while the sound effects (which were pleasant and arousing) led to attentional capture for rewarded colors. In a visual search task, points were awarded after each trial for fast and accurate responses, accompanied by short, pleasant sound effects. We adapted a paradigm from Anderson, Laurent, and Yantis (Proceedings of the National Academy of Sciences 108(25):10367-10371, 2011b), in which participants completed a training phase during which red and green targets were probabilistically associated with reward (a point bonus multiplier). During a test phase, no points or sounds were delivered, color was irrelevant to the task, and previously rewarded targets were sometimes presented as distractors. Significantly longer response times on trials in which previously rewarded colors were present demonstrated attentional capture, and positive responses to a five-question intrinsic-motivation scale demonstrated participant engagement.