Acceptance and Commitment Therapy for generalized anxiety disorder in older adults: a preliminary report

Some evidence suggests that acceptance-based approaches such as Acceptance and Commitment Therapy (ACT) may be well-suited to geriatric generalized anxiety disorder (GAD). The primary goal of this project was to determine whether ACT was feasible for this population. Seven older primary-care patients with GAD received 12 individual sessions of ACT; another 9 were treated with cognitive-behavioral therapy. No patients dropped out of ACT, and worry and depression improved. Findings suggest that ACT may warrant a large-scale investigation with anxious older adults.     

Models provide specificity: Testing a proposed mechanism of visual working memory capacity development

Numerous studies have established that visual working memory has a limited capacity that increases during childhood. However, debate continues over the source of capacity limits and its developmental increase. Simmering (2008) adapted a computational model of spatial cognitive development, the Dynamic Field Theory, to explain not only the source of capacity limitations but also the developmental mechanism. Capacity is limited by the balance between excitation and inhibition that maintains multiple neural representations simultaneously in the model. Development occurs according to the Spatial Precision Hypothesis, which proposes that excitatory and inhibitory connections strengthen throughout early childhood. These changes in connectivity result in increasing precision and stability of neural representations over development. Here we test this developmental mechanism by probing children's memory in a single-item change detection task. Results confirmed the model's predictions, providing further support for this account of visual working memory capacity development.     

Healthcare Policy in the United States: A Primer for Medical Family Therapists

As family therapists increasingly practice in healthcare settings, they need to be aware of forthcoming changes in healthcare policy and the impact of these changes on their clinical work and the lives of their clients. In this paper, we provide a primer on healthcare policy for family therapists, which describes current and proposed changes in healthcare that will potentially revolutionize healthcare delivery for families. We describe three key initiatives: (1) Triple Aim; (2) the Accountable Care Organization; and (3) the Patient Centered Medical Home. We conclude with a discussion about future directions and healthcare policies that include families.     

Pornography,Religion, and the Happiness Gap: Does Pornography Impact the Actively Religious Differently?

Club good models developed by economists suggest that the club provides a benefit to members by fostering the provision of semi-public goods. In the case of religion, churches create enforcement mechanisms to reduce free riding. Consequently, the psychic costs of deviant activity should be higher for individuals who belong to religious groups with strong social norms. Data from the General Social Survey are used to examine whether the cost of using pornography is greater for the more religiously involved. We measure the cost of using pornography as the happiness gap or the gap between the average happiness reported by individuals who do and individuals who do not report using pornography. The happiness gap is larger for individuals who regularly attend church and who belong to religious groups with strong attitudes against pornography.     

Parental Problem-Solving Abilities and the Association of Sickle Cell Disease Complications with Health-Related Quality of Life for School-Age Children

Children with sickle cell disease (SCD) are at risk for poor health-related quality of life (HRQOL). The current analysis sought to explore parent problem-solving abilities/skills as a moderator between SCD complications and HRQOL to evaluate applicability to pediatric SCD. At baseline, 83 children ages 6–12 years and their primary caregiver completed measures of child HRQOL. Primary caregivers also completed a measure of social problem-solving. A SCD complications score was computed from medical record review. Parent problem-solving abilities significantly moderated the association of SCD complications with child self-report psychosocial HRQOL (p = .006). SCD complications had a direct effect on parent proxy physical and psychosocial child HRQOL. Enhancing parent problem-solving abilities may be one approach to improve HRQOL for children with high SCD complications; however, modification of parent perceptions of HRQOL may require direct intervention to improve knowledge and skills involved in disease management.     

Emotional Abuse and Psychosis: A Recent Review of the Literature

This article evaluates the published empirical findings on childhood emotional abuse and its proposed relationship with psychotic symptoms. Research and governmental policy indicates that emotional abuse is present in all forms of abuse and neglect, suggesting it is the form of abuse most frequently linked to mental health problems. Literature searches were conducted in 3 peer-reviewed electronic databases and relevant papers were reviewed. Results suggest childhood emotional abuse is statistically related to psychosis in adulthood. This adds tentative support to the hypothesis that emotional abuse is related to psychotic experiences; in particular to hallucinations and persecutory delusions. A number of studies also provide tentative support to the dose–response effect proposed between cumulative trauma and a greater risk of positive psychotic symptoms.     

The Appropriate Use and Misuse of Social Media in MFT Training Programs: Problems and Prevention

Directors of accredited marriage and family therapy programs were surveyed to determine what problems they had experienced resulting from student, faculty, and client misuse of social media. Approximately 40 % of the programs had encountered a problem resulting from student misuse of social media. The directors were also asked what efforts were made by their program and university to promote the appropriate use of social media, with programs assuming primary responsibility for addressing this issue. The study also assessed attitudes among directors regarding how to handle potential issues that may arise in training programs regarding the use of social media. Implications for training programs are provided.     

A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: Results of the Pleasant Events Program (PEP)

Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention's effects.     

Systematic Changes in Families Following Prevention Trials

A selective prevention design was applied to 238 recently separated families. Of these, 153 mothers randomly assigned to the experimental (E) group participated in 14 group sessions focused on Parent Management Treatment (PMT). Prior analyses showed that, over time, the group of families in the untreated group deteriorated in both parenting practices and in child outcomes. In keeping with the classic prevention pattern, families in the E group showed modest improvements in parenting and in child outcomes. Improvements in parenting were associated with significant reductions in problem behavior. The data showed that those mothers who improved their parenting skills during the first 12 months also showed significant reductions in maternal depression during that same interval. A cross-lagged panel analysis showed that a reduction in maternal depression during the first year of the study was a significant predictor of maintenance or improvements over the next 18 months. The findings are consistent with the concept of the family as a system.