A Review of REBT Research in Alcohol Abuse Treatment

Clinical outcome studies have shown that cognitive-behavioral approaches to alcohol abuse are efficacious. As the research continues to be refined, practitioners can work with clients based on better science. REBT practitioners have developed a number of theoretical and treatment manuals to promote better practice. The empirical literature on REBT treatment for alcohol abuse does not provide strong evidence of its effectiveness. The present article comprehensively reviews the REBT outcome literature and identified six studies. Of these, three met the inclusionary criteria. The findings demonstrated change in endorsement of irrational thinking, with limited behavioral change. Limitations of the present research base for alcohol abuse are discussed and suggestions offered for conducting and reporting REBT research on alcohol abuse.     

Predictors of Appraisal and Psychological Well-Being in Alzheimer's Disease Family Caregivers

The objective of this study was to test a model of stress, appraisal, and adaptation in 114 family caregivers of patients diagnosed with dementia of the Alzheimer's type (white non-Hispanic, N = 64; Hispanic-American, N = 50). Results of structural equation analysis show that appraised caregiver burden played a central role in determining the psychological well-being of family caregivers. The findings indicate that this mediating variable, negative caregiver appraisal, was predicted by increased functional limitations and behavioral disturbances in the patient, poorer perceived physical health, and lower levels of perceived emotional support. Contrary to a priori hypotheses, functional limitations in the patient also exhibited a direct association with caregiver depression. Further, patient cognitive impairment and caregiver ethnicity were not related to caregiver appraisal. Overall, these results support the role of appraised burden in mediating the relationships between caregiving factors and the adaptational outcome of depression. The implications of these findings, limitations of the study, and future directions are discussed.     

A violation of dominance and the consumption value of gambling

We document an apparently widespread violation of dominance in the horse‐racing betting market in the UK, and use the systematic variation in the incidence of this violation to estimate the consumption value of gambling. Betting‐shop gamblers in the UK face a tax on gambling of 10%, but have the choice of paying the tax either at the time of wager or on any return on a successful bet. It can be shown, however, that the latter act is strictly dominated by another action in which tax is paid on the wager. Despite this, more than 18% of bets appear to be placed by gamblers who choose to pay tax on the return. We explore the hypothesis that this apparent violation of rationality may be explained by a component of utility which represents the consumption value of gambling, which in turn varies with the amount wagered. We then estimate this component from a dataset consisting of a record of 25,000 individual bets using probit analysis of the tax decision. Copyright © 1999 John Wiley & Sons, Ltd.     

THE DIRECT AND GENERALIZED EFFECTS OF SELF INSTRUCTIONS AND PICTURE PROMPTS ON VOCATIONAL TASK PERFORMANCE

We evaluated the effects of self instructions and picture prompts on vocational task performance of three workers with mild to moderate mental retardation. The workers were asked to perform a packaging task that changed daily. Picture prompts were always present. In the verbal training phase, workers learned self instructions regarding the use of picture prompts to cue their performance on the packaging task. In the verbal and task training phase, workers learned to use the self instructions and picture prompts together to guide their task performance. The results showed that verbal training was sufficient for one worker, but that the other two workers required the combined verbal and task training to improve their task performance. For all subjects, there was evidence of generalization of the self management strategies and task performance and maintenance of both over time.     

Application of the Minority Stress Theory: Understanding the Mental Health of Undocumented Latinx Immigrants

This paper applies the Minority Stress framework to data collected from an ongoing community-based participatory research project with health and social service agencies in Southeast Michigan. We examine the stressors and coping strategies employed by undocumented Latinx immigrants and their families to manage immigration-related stress. We conducted in-depth interviews with 23 immigrant clients at Federally Qualified Health Care Centers (FQHC) in Southeast Michigan and 28 in-depth interviews with staff at two FQHC's and a non-profit agency serving immigrants. Findings suggest that immigrants face heightened anxiety and adverse mental health outcomes because of unique minority identity-related stressors created by a growing anti-immigrant social environment. Chronic stress experienced stems from restrictive immigration policies, anti-immigrant rhetoric in the media and by political leaders, fear of deportation, discriminatory events, concealment, and internalized anti-immigrant sentiment. Though identity can be an important effect modifier in the stress process, social isolation in the immigrant community has heightened the impact of stress and impeded coping strategies. These stressors have resulted in distrust in community resources, uncertainty about future health benefits, delayed medical care, and adverse mental health outcomes. Findings provide a framework for understanding the unique stressors experienced by immigrants and strategies for interventions by social service agencies.     

Social discounting of pain

Impatience can be formalized as a delay discount rate, describing how the subjective value of reward decreases as it is delayed. By analogy, selfishness can be formalized as a social discount rate, representing how the subjective value of rewarding another person decreases with increasing social distance. Delay and social discount rates for reward are correlated across individuals. However no previous work has examined whether this relationship also holds for aversive outcomes. Neither has previous work described a functional form for social discounting of pain in humans. This is a pertinent question, since preferences over aversive outcomes formally diverge from those for reward. We addressed this issue in an experiment in which healthy adult participants (N = 67) chose the timing and intensity of hypothetical pain for themselves and others. In keeping with previous studies, participants showed a strong preference for immediate over delayed pain. Participants showed greater concern for pain in close others than for their own pain, though this hyperaltruism was steeply discounted with increasing social distance. Impatience for pain and social discounting of pain were weakly correlated across individuals. Our results extend a link between impatience and selfishness to the aversive domain.     

Evaluating the influence of time of day on activity engagement in persons with dementia

Dementia is a serious disease affecting a growing number of people. With the onset of dementia comes a decline in social activity engagement that can negatively impact multiple aspects of a person's life. Research suggests that time of day may influence a person with dementia's behavior, including activity engagement, but such research is limited. The purpose of this study was to evaluate the influence of time of day on engagement in activities in persons diagnosed with dementia. An alternating treatments design was used with three participants to measure activity engagement during two times of day, morning and afternoon, and during two activities, a moderately preferred and a low preferred. Results showed no differentiation in engagement between morning and afternoon activities for all three participants, with high levels of engagement during both times of day. For two participants, results showed no differentiation in engagement between moderately preferred and low preferred activities. For one participant, levels of engagement were higher during moderately preferred activities than during low preferred activities.