Building Alliances with (In)Voluntary Clients: A Study Focused on Therapists’ Observable Behaviors

This study aimed to compare therapists’ observable behaviors to promote alliances with involuntary and voluntary clients during brief family therapy. The therapists’ contributions to fostering alliances were rated in sessions 1 and 4 using videotapes of 29 families who were observed in brief therapy. Using the System for Observing Family Therapy Alliances, trained raters searched for specific therapist behaviors that contributed to or detracted from the four alliance dimensions: engagement in the therapeutic process, an emotional connection with the therapist, safety within the therapeutic system, and a shared sense of purpose within the family. The results showed that when working with involuntary clients, therapists presented more behaviors to foster the clients’ engagement and to promote a shared sense of purpose within the family. However, in the fourth session, the therapists in both groups contributed to the alliance in similar ways. The results are discussed in terms of (a) the therapists’ alliance‐building behaviors, (b) the specificities of each client group, and (c) the implications for clinical practice, training, and research.     

The Defeasibility of Knowledge‐How

Reductive intellectualists (e.g., Stanley & Williamson 2001; Stanley 2011a; 2011b; Brogaard 2008; 2009; 2011) hold that knowledge‐how is a kind of knowledge‐that. If this thesis is correct, then we should expect the defeasibility conditions for knowledge‐how and knowledge‐that to be uniform—viz., that the mechanisms of epistemic defeat which undermine propositional knowledge will be equally capable of imperilling knowledge‐how. The goal of this paper is twofold: first, against intellectualism, we will show that knowledge‐how is in fact resilient to being undermined by the very kinds of traditional (propositional) epistemic defeaters which clearly defeat the items of propositional knowledge which intellectualists identify with knowledge‐how. Second, we aim to fill an important lacuna in the contemporary debate, which is to develop an alternative way in which epistemic defeat for knowledge‐how could be modelled within an anti‐intellectualist framework.     

Bound to remember: Infants show superior memory for objects presented at event boundaries

Following Event Segmentation Theory (EST) adult memory is enhanced at event boundaries (EB). The present study set out to explore this in infancy. Sixty‐eight 21‐month‐olds watched a cartoon with one of two objects (counterbalanced) inserted for 3s either at EB or between EB. Ten minutes later they watched both objects (familiar and novel) in a 10s Visual Paired Comparison (VPC) test while being eye‐tracked. Furthermore, they were asked to point to the previous object. Based on EST, we hypothesized that objects inserted at EB would be processed more fully, resulting in improved memory compared to objects inserted between EB. Only infants with objects at EB exhibited memory evidenced by a transient familiarity preference for the first 3s of the test. Only 18 infants completed the pointing test, but all infants presented with objects at EB (10/10) pointed to the correct (familiar) object, which was not the case for the infants presented with objects between EB (5/8).     

Neuropsychological Measures that Predict Progression from Mild Cognitive Impairment to Alzheimer's type dementia in Older Adults: a Systematic Review and Meta-Analysis

This study aimed to determine the extent to which cognitive measures can predict progression from mild cognitive impairment (MCI) to Alzheimer’s type dementia (AD), assess the predictive accuracy of different cognitive domain categories, and determine whether accuracy varies as a function of age and length of follow-up. We systematically reviewed and meta-analyzed data from longitudinal studies reporting sensitivity and specificity values for neuropsychological tests to identify individuals with MCI who will develop AD. We searched articles in Medline, Cochrane, EMBASE, PsycINFO, and the Web of Science. Methodological quality was assessed using the STARDem and QUADAS standards. Twenty-eight studies met the eligibility criteria (2365 participants) and reported predictive values from 61 neuropsychological tests with a 31-month mean follow-up. Values were pooled to provide combined accuracy for 14 cognitive domains. Many domains showed very good predictive accuracy with high sensitivity and specificity values (≥ 0.7). Verbal memory measures and many language tests yielded very high predictive accuracy. Other domains (e.g., executive functions, visual memory) showed better specificity than sensitivity. Predictive accuracy was highest when combining memory measures with a small set of other domains or when relying on broad cognitive batteries. Cognitive tests are excellent at predicting MCI individuals who will progress to dementia and should be a critical component of any toolkit intended to identify AD at the pre-dementia stage. Some tasks are remarkable as early indicators, whereas others might be used to suggest imminent progression.     

The Role of Metacognitions in the Association between Children’s Perceptions of Maternal Control and Anxiety

We aimed to bring a developmental perspective to metacognitive theory. The metacognitive model (MCM) was originally developed for adults. However, an increasing number of studies demonstrate the MCM is relevant to child anxiety. Therefore, it is important to understand the origins of anxiety-specific metacognitions. Given the role experiences of controlling parenting play in maintaining and perhaps forming anxious cognitions or a cognitive vulnerability we focused on maternal behavioral and psychological control. Using a cross-sectional design, Danish school children (9–17 years old; N?=?1062) rated their levels of anxiety and anxiety-specific metacognitions, and their mothers' controlling behavior. Child-perceived maternal psychological control was positively correlated with each anxiety specific metacognition (positive and negative worry beliefs, cognitive confidence, need to control, and cognitive self-consciousness). Child-perceived autonomy-granting was negatively correlated with all metacognitions except cognitive self-consciousness. Child perceived maternal psychological control was indirectly associated with anxiety via total metacognitions. Child-perceived autonomy-granting, but not psychological control, was directly related to anxiety. Given the differential findings for psychological control and autonomy-granting, we suggest that specific types of parenting behavior may be related to specific elements of (meta-) cognitive vulnerability. Our findings are theoretically important because they propose maternal psychological control is an environmental factor that may play a role in the development of a metacognitive vulnerability related to anxiety. A potential clinical implication of our findings is that metacognitive therapy for children should include a parental component.     

Family Disruption and Social,Emotional and Behavioral Functioning in Middle Childhood

The association between family disruption and child socio-emotional and behavioral development is a relatively well-examined but as yet unresolved issue, and the conclusions of previous research have been ambiguous. Further, some studies have indicated that associations may depend on other risk factors, yet the question of heterogeneity has been relatively little discussed. The purpose of this cross-sectional study was to assess associations between family disruption on the one hand and teacher-rated and self-reported outcomes on subscales from the Behavior Assessment System for Children, 2nd edition (BASC-2) and the Behavior and Emotional Screening System (BESS) on the other, among a Danish sample of 817 normally developing schoolchildren. Specifically, we assessed (a) the extent to which background factors explained unadjusted associations and (b) whether associations were heterogeneous across the distribution of outcome measures. Results from ordinary least squares (OLS) models showed that relative to children from intact families, children from disrupted families had higher problem scores on BASC-2 subscales Externalizing Problems, Study Skills and School Problems even after controlling for a wide range of background factors. Quantile regression (QR) models showed that associations with Externalizing Problems and Study Skills were stronger among children with higher problem scores. Certain behavioral problems may therefore indicate increased vulnerability towards adverse events, such as family disruption. General screening for such problems could provide an opportunity to identify children in need of special attention and support against the potentially negative outcomes of family disruption for their school experience.     

Service Delivery Outcomes in ASD: Role of Parent Education,Empowerment, and Professional Partnerships

Children with Autism Spectrum Disorder (ASD) utilize a greater number of healthcare services compared to children with other developmental disabilities. Despite this, children with ASD remain at high risk for unmet service needs, which are compounded by differences in socioeconomic status (SES). Both empowerment and parent-professional partnership play a role in service outcomes and may be especially important in understanding these service disparities. Our goal was to better understand the contributions of these variables to service disparities in families of children with ASD. Two-hundred forty-nine parents of children with ASD between the ages of 3 and 20 participated in this online survey. Results support previous research highlighting high levels of unmet needs that are exacerbated by differences in parent education, a common indicator of SES. Empowerment and parent-professional partnership also predicted service delivery outcomes. While high quality partnership predicted greater service adequacy, empowerment was inversely related to services. Furthermore, an interaction found that highly empowered families experiencing poor quality partnerships reported worse service delivery outcomes, while empowerment was not a factor in services for families experiencing high quality partnerships. Parent-professional partnership partially mediated the relationship between parent education and service delivery outcomes. As such, increasing parent-professional partnerships through family-centered care and professional training may help to reduce education-related service disparities and improve satisfaction with care for families and children with ASD.