Healing from Moral Injury: A Qualitative Evaluation of the Impact of Killing Treatment for Combat Veterans

This paper evaluates the Impact of Killing (IOK) treatment—a psychological intervention designed to address moral injury and trauma associated with killing in war. Using qualitative data from interviews with 28 combat veterans, we examine IOK’s impact, how it differs from other trauma-focused treatments, and how it can be improved to better meet veterans’ needs. We found that many veterans processed their killing experiences for the first time in IOK, even though all had previously completed evidence-based treatments for posttraumatic stress disorder. Several described killing in war as the most distressing and transformative trauma of their lives, and all affirmed the value of an intervention focused directly and explicitly on moral injury and killing. IOK helped veterans to acknowledge their grief, shame, and distress; gently but critically examine their thoughts and beliefs about killing in war; and make strides toward acceptance, reconciliation, and forgiveness.     

Achievement Motivation,Expected Coworker Performance,and Collective Task Motivation: Working Hard or Hardly Working?1

Social loafing is the tendency of individuals to work less hard collectively than individually. The present study examined the joint influence of achievement motivation and expected coworker effort on collective task performance. Participants (N= 107) who qualified and were available after pretesting on an achievement motivation scale were randomly assigned to a work condition and coworker effort condition. Dyads were asked to generate as many uses for a knife as possible within a 12‐min time period. Participants low in achievement motivation engaged in social loafing, but only when expected coworker effort was high, whereas participants high in achievement motivation did not engage in social loafing, regardless of expected coworker effort. The implication of achievement motivation for collective task performance settings is discussed.     

Processes underlying the cross-race effect: an investigation of holistic, featural, and relational processing of own-race versus other-race faces

Adults are often better at recognising own-race than other-race faces. Unlike previous studies that reported an own-race advantage after administering a single test of either holistic processing or of featural and relational processing, we used a cross-over design and multiple tasks to assess differential processing of faces from a familiar race versus a less familiar race. Caucasian and Chinese adults performed four tasks, each with Caucasian and Chinese faces. Two tasks measured holistic processing: the composite face task and the part/whole task. Both tasks indicated holistic processing of own-race and other-race faces that did not differ in degree. Two tasks measured featural and relational processing: the Jane/Ling task, in which same/ different judgments were made about face pairs that differed in features of their spacing, and the scrambled/blurred task, in which test faces were scrambled (isolates memory for components) or blurred (isolates memory for relations). Both tasks provided evidence of an own-race advantage in both featural and relational processing. We conclude that even when adults process other-race faces holistically, other manifestations of an own-race advantage remain.     

Interpersonal Psychotherapy for Co-occurring Depression and Chronic Pain

Up to 37% of individuals experience chronic pain during their lifetimes. Approximately one-fourth of primary care patients with chronic pain also meet criteria for major depression. Many of these individuals fail to receive psychotherapy or other treatment for their depression; moreover when they do, physical pain is often not addressed directly. Women, socioeconomically disadvantaged individuals, African Americans and Latinos all report higher rates of pain and depression compared to other groups. This article describes a version of Interpersonal Psychotherapy tailored for patients with comorbid depression and chronic pain, Interpersonal Psychotherapy for Depression and Pain (IPT-P). While IPT-P potentially could be delivered to many different patient populations in a range of clinical settings, this article focuses on its delivery within primary care settings for socioeconomically disadvantaged women. Adaptations include a brief 8-session protocol that incorporates strategies for anticipating barriers to psychotherapy, accepting patients' conceptualization of their difficulties, encouraging patients to consider the impact of their pain on their roles and relationships, emphasizing self-care, incorporating pain management techniques, and flexible scheduling. In addition, IPT-P is designed as an adjunct to usual medical pain treatment, and seeks to engage non-treatment seeking patients in psychotherapy by focusing on accessibility and relevance of the intervention to concerns common among patients with pain. Identifying patients with comorbid depression and chronic pain and offering IPT-P as a treatment option has the potential to improve clinical outcomes for individuals with depression and chronic pain.     

Contributions of Studies on Alcohol Use Disorders to Understanding Cerebellar Function

Neuropathological, neuropsychological, and neuroimaging studies of human alcoholism provide evidence for degradation of frontal, pontine, thalamic, and cerebellar brain sites and disturbed associated functions. Current studies using neuroimaging combined with examination of executive functions, traditionally considered the sole purview of the frontal lobes, have identified a role for the cerebellum serving as a compensatory processing adjunct to enable normal performance on challenging tasks tapping executive functions. This overview proposes that disruption of an executive frontocerebellar network is a major contributor to characteristic behaviors of alcoholism that, on the one hand, enable alcohol use disorders, and on the other hand, lead to compensation for dysfunctions in alcoholism traditionally considered frontally-based.     

Working Alliance as a Moderator of the Impact of Mentoring Relationships Among Academically At‐Risk Students

This study examined the role of the working alliance between teacher mentors and student protégés on protégés' academic functioning. High‐risk students (n = 25) participated in an educational program involving a major mentoring component (experimental group) and were matched on academic records, gender, and study program with 25 students who did not participate (control group). Students in the experimental group who agreed with their mentors that their working alliance was productive (i.e., agreement on goals, positive bonding) were more likely than were other mentored students and students in the control group to improve their academic competence, participation in class, tendency to seek help from teachers, and academic perseverance. Results are discussed in line with relationship‐based processes operating in mentoring relationships.     

Research Report: Antenatal HIV testing from the perspective of pregnant women and health clinic staff in South Africa—implications for pre- and post-test counselling

HIV testing is not routinely available at present in health clinics in Umtata, South Africa. However current statistics indicate that up to 25% of the population may be infected. Such findings imply that HIV testing and counselling should be introduced in health clinics as a means of promoting HIV prevention and reducing the risk of vertical transmission. However this would only be beneficial if staff are prepared to implement it and patients are willing to test. The issues are couched in a background of political activity surrounding HIV that may question approaches to HIV testing and a lack of availability of interventions to prevent mother to infant transmission. Furthermore the infrastructures of counselling training and provision may not be universally available, especially in pressured rural clinics. Therefore, a group of clinic staff and pregnant women, in rural and urban health centres in Umtata, were asked to participate in focus group discussions to elicit attitudes to HIV testing and counselling. In principal the majority of women, particularly in the rural clinic, were willing to have an HIV test, and strongly articulated the desire to test with their partners. Women who were reluctant to test emphasized their fear of receiving the result. The rural women appeared to be far more willing to disclose their HIV status to clinic staff, than urban women. Nevertheless, the discussions illustrated the impact of the stigma surrounding HIV, with clinic staff reporting cases where patients who were suspected to be positive were avoided by health workers. However staff in both clinics were willing to make the effort to implement HIV tests if they were to be made available. Despite the non-availability of rapid testing and interventions to reduce mother to child transmission most women saw advantages to HIV test provision. Pessimism and fear were underlying emotions associated with HIV for both staff and women. The implications for pre- and post-test counselling are discussed.     

Where is the phenomenology of attention that Husserl intended to perform? A transcendental pragmatic-oriented description of attention

For the most part, attention occurs as a theme adjacent to much more topical and innovatingly operating acts: first, the intentional act, which represents a destitution of the abstract opposition between subject and object and which paves the way for a detailed analysis of our perceptive horizontal subjective life; second, the reductive act, specified in a psycho-phenomenological sense as a reflective conversion of the way I am looking at things; third, the genetic method understood as a genealogy of logic based on our experiential affective pre-discursive world-life. In this respect, here are some of the leading questions of my investigation: What are the differences and the proximities between these methods and attentional activity? Why is the latter not put to the fore as a method? To what extent is this secondary part played by attention linked to the constitution of phenomenology as opposed to psychology (for which attention is a central theme), and what does it mean for the impossibility of phenomenology to freeing itself completely from psychology?     

First impressions online: The inclusion of transgender and gender nonconforming identities and services in mental healthcare providers' online materials in the USA

Background: When accessing mental healthcare services, transgender and gender nonconforming (TGNC) individuals face systemic barriers to gender-affirmative care. Initial points of contact, like intake forms, may show limited consideration for the heterogeneity of TGNC identities and can lead to negative consequences prior to face-to-face interaction with providers. Aims: The first aim was to mimic a likely pathway a TGNC individual may follow to seek mental healthcare services in the USA and to describe the extent to which they may encounter enacted stigma or affirmative messages that may impede or facilitate access to care. The second aim was to determine if a positive State legal climate for TGNC people was associated with more affirmative provider materials. Methods: Content analysis was used to examine a national sample of websites and intake forms of mental healthcare providers who advertise online as working with TGNC clients. Intake forms were coded for usage of affirmative language in gender/sex questions and including questions for a client's pronouns and preferred name. Websites were coded for mentioning a variety of services or resources for TGNC clients. Results: While provider websites were found through Google searches for a “gender therapist,” only 56.6% of websites stated a provider specialty to work with TGNC clients and 32.1% of websites had no mention of services or resources for TGNC people. Additionally, a significantly larger proportion of intake forms from States with legal protections for TGNC people used affirmative language in gender/sex questions and asked for a client's pronouns than intake forms from States without legal protections. Discussion: Barriers to affirmative healthcare for TGNC people within patient and provider interactions have been identified in previous research and these data show TGNC individuals may face enacted stigma even in their search for a provider, particularly those TGNC people living in States without legal protections.