Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

Temporal experience as a core quality in mental disorders

Phenomenology and the Cognitive Sciences - The goal of this paper is to introduce Phenomenology and the Cognitive Sciences’ thematic issue on disordered temporalities. The authors begin by...     

Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents?

Applied Research in Quality of Life - This study identified associations between perceived neighborhood stress and adolescents’ perceptions of life satisfaction. African American adolescents...     

Enhancing young people's social competence and health behavior: An important challenge for educators, scientists, policymakers, and funders

Large numbers of America's young people engage in multiple high-risk behaviors that may jeopardize their health and social development. Given the gravity of this situation, many federal agencies and national organizations have called for the implementation of school-based K-12 social competence and health promotion programs. Unfortunately, there is a gap between the comprehensive programs that policymakers are asking educators to implement and the limited scope, duration, and intensity of state-of-the-art health promotion programs that scientists have developed and evaluated. As a result, most schools currently adopt well-marketed programs that lack documented effectiveness. Although current research indicates that brief, well-designed, theory-driven competence promotion and health education programs produce short-term benefits, there have been no controlled, longitudinal field studies to evaluate the long-term effects of K-12 efforts. This paper proposes that policymakers and funding agencies support long-term collaborations among educators and scientists to develop and evaluate K-12 comprehensive social competence and health education programs and identifies critical issues that funded projects should address.     

Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory.     

Alcohol and the prior residence effect in male convict cichlids (Cichlasoma nigrofasciatum)

A series of experiments were undertaken to demonstrate the dominance advantage of a territorial resident over an intruder (the prior residence effect) in the adult male Convict Cichlid (Cichlasoma nigrofasciatum) and to evaluate the effects of alcohol (ethanol) on this phenomenon. After successfully demonstrating the prior residence effect, additional experiments were conducted in which the resident or intruder was given one of three different doses of ethanol (0.15%, 0.20%, 0.35%). These doses have previously been shown to reduce or increase intraspecific aggression in this species Over the entire dosage range, drugging the intruder produced no changes in the dominance advantage of the resident. However, drugging the resident at the higher doses (0.20%, 0.35%) resulted in loss of the resident's dominance advantage. These effects were not due to impaired locomotor behavior of the drugged fish, as no abnormal motor behaviors were noted. In general, as reported in previous studies, the resident fish, whether drugged or not, typically attacked first. Also as has been previously shown, the fish that attacked (bit) first typically showed eventual dominance. The present results show that the dominance advantage of the territorial resident is not altered by giving an intruder a hypo- or hyperaggression-producing dose of alcohol. Changes in the dominance advantage occur only as a function of drugging the resident, thereby providing evidence that the behavior of the territorial resident is either directly or indirectly (reaction of the intruder to these changes) responsible for the prior residence effect. The present studies also provide some pharmacological approaches for determining the variables important in a laboratory analog of a naturally occurring instance of intraspecific aggression.     

Young children's social networks as a function of age and dysfunction

Social networks provide a larger context than that of the nuclear family in which the child develops. In order to examine the networks of young children, mothers of 75 handicapped children, aged 3 to 6 years, and a matched sample of normal children were surveyed in terms of people in the child's network and frequency of daily contact. The effects of age of subject and handicapping condition on social network composition and contact were of interest. Handicapping condition played a much greater role in the network composition than did chronological age. Handicapped children had larger networks, although they did not have daily contact with network members compared to normal children. Handicapped children thus were not isolated, but appeared to have a large network composed of relatives and adults and, to a lesser extent, peers. Normal children showed a developmental shift, in terms of an increase in the proportion of peers to adults, from 3 to 6 years, whereas handicapped children did not show this change. It is suggested that the handicapped child's developmental delay and caregiving demands may necessitate greater and more prolonged adult contact, which, consequently, constrains the nature of the social network in terms of adult and peer composition. Insufficient peer contact may restrict the handicapped child's opportunity to learn important social skills.