Progression along the bipolar spectrum: a longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders

Little longitudinal research has examined progression to more severe bipolar disorders in individuals with "soft" bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a nonpatient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of "soft" bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts.     

Does understanding relational terminology mediate effects of intervention on compare word problems?

The purpose of this study was to assess whether understanding relational terminology (i.e., more, less, and fewer) mediates the effects of intervention on compare word problems. Second-grade classrooms (N=31) were randomly assigned to one of three conditions: researcher-designed word-problem intervention, researcher-designed calculation intervention, or business-as-usual (teacher-designed) control. Students in word-problem intervention classrooms received instruction on the compare problem type, which included a focus on understanding relational terminology within compare word problems. Analyses, which accounted for variance associated with classroom clustering, indicated that (a) compared with the calculation intervention and business-as-usual conditions, word-problem intervention significantly increased performance on all three subtypes of compare problems and on understanding relational terminology, and (b) the intervention effect was fully mediated by students' understanding of relational terminology for one subtype of compare problems and partially mediated by students' understanding of relational terminology for the other two subtypes.     

COMPUTER‐ASSISTED MEASUREMENT OF WOUND SIZE ASSOCIATED WITH SELF‐INJURIOUS BEHAVIOR

We evaluated an inexpensive, efficient, and noninvasive technique for measuring tissue damage produced by self‐injurious behavior (SIB). The technique involved computerized measurement of wound surface area (WSA) based on digital photographs. In Study 1, we compared photographic measurement to a more commonly used procedure, transparency measurement, in estimating WSA of 20 wound models. Results showed that both methods were reliable and that there was a high degree of correspondence between the 2 sets of measures. In Study 2, we compared photographic WSA measures to direct‐observation measures in documenting changes over time in the SIB exhibited by a woman with Prader‐Willi syndrome. Results showed that increases and decreases in observed SIB during baseline and treatment conditions corresponded with changes in WSA measures, indicating that the computer‐assisted photographic technique may be useful as a corroborative measure or as a primary measure when direct observation of SIB is not feasible.     

Health Programming for Clergy: An Overview of Protestant Programs in the United States

The health of clergy is important, and clergy may find health programming tailored to them more effective. Little is known about existing clergy health programs. We contacted Protestant denominational headquarters and searched academic databases and the Internet. We identified 56 clergy health programs and categorized them into prevention and personal enrichment; counseling; marriage and family enrichment; peer support; congregational health; congregational effectiveness; denominational enrichment; insurance/strategic pension plans; and referral-based programs. Only 13 of the programs engaged in outcomes evaluation. Using the Socioecological Framework, we found that many programs support individual-level and institutional-level changes, but few programs support congregational-level changes. Outcome evaluation strategies and a central repository for information on clergy health programs are needed.     

Race/ethnicity and mental health in the first decade of the 21st century

Recent empirical studies on mental health generally report racial/ ethnic differences in depression rates but typically do not control for potential confounding by sample contextual variations in historical epoch, geographical location, and social demography. An empirical study of race/ethnicity differences in psychological distress is reported as an attempt to control these contexts by using a sample that is homogeneous in age, historical epoch, geography, and social demography (954 youth ages 18-19 living in a single, large urban community). No mean differences in psychological distress were observed among four racial/ethnic groups: Asians, African Americans, Latinos, and non-Hispanic Whites. A second analysis compared 17 different racial/ethnic groups defined in terms of family national origin. No differences in psychological distress were found among these groups. The findings are consistent with the view that race/ethnicity itself is not related to disparities in mental health.     

Everettian quantum mechanics without branching time

In this paper I assess the prospects for combining contemporary Everettian quantum mechanics (EQM) with branching-time semantics in the tradition of Kripke, Prior, Thomason and Belnap. I begin by outlining the salient features of ??decoherence-based?? EQM, and of the ??consistent histories?? formalism that is particularly apt for conceptual discussions in EQM. This formalism permits of both ??branching worlds?? and ??parallel worlds?? interpretations; the metaphysics of EQM is in this sense underdetermined by the physics. A prominent argument due to Lewis (On the Plurality of Worlds, 1986) supports the non-branching interpretation. Belnap et?al. (Facing the Future: Agents and Choices in Our Indeterministic World, 2001) refer to Lewis?? argument as the ??Assertion problem??, and propose a pragmatic response to it. I argue that their response is unattractively ad hoc and complex, and that it prevents an Everettian who adopts branching-time semantics from making clear sense of objective probability. The upshot is that Everettians are better off without branching-time semantics. I conclude by discussing and rejecting an alternative possible motivation for branching time.     

Using a Training-of-Trainers Approach and Proactive Technical Assistance to Bring Evidence Based Programs to Scale: An Operationalization of the Interactive Systems Framework’s Support System

Bringing evidence based programs to scale was a major initial impetus for the development of the Interactive Systems Framework for Dissemination and Implementation (ISF). The ISF demonstrates the importance of the Support System in facilitating the uptake of innovations in the community (the Delivery System). Two strategies that members of the Support System commonly use are training‐of‐trainers (TOT) models and technical assistance (TA). In this article, we focus on the role of the Support System in bringing evidence‐based programs (EBPs) to scale in the Delivery System using a case example, with special attention on two strategies employed by Support Systems—training‐of‐trainers (TOT) and proactive technical assistance. We then report on findings from a case example from the Promoting Science Based Approaches to Teen Pregnancy Prevention project that furthers our conceptualization of these strategies and the evidence base for them. We also report on the limitations in the literature regarding research on TOTs and proactive TA and provide suggestions for future research on TOTs and proactive TA that will enhance the science and practice of support in the ISF. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Bicultural adolescents' anger regulation: in between two cultures?

This study explored the anger-regulation strategies of bicultural individuals who are brought up with two distinct cultures that might carry contradictory demands about how to regulate emotions. With a sample of 525 adolescents in the Netherlands and Morocco, we found that bicultural Moroccan-Dutch adolescents' anger regulation in response to hypothetical peer conflict were largely similar to those of their Dutch peers. In fact, both the Dutch and the Moroccan-Dutch adolescents' anger regulation differed in the same ways from the Moroccan group, with greater acting out and less calm verbalisation, reflection, and diversion in the former than in the latter. Additionally, our findings indicate that Moroccan-Dutch adolescents' identification with the Dutch as well as with the Moroccan culture is related to more anger verbalisation and less externalising anger regulation. These results are interpreted in light of the complex cultural position faced by bicultural adolescents.     

Looking Ahead: Questions for and About Behavioral Scientists and Practitioners

In this article Robin B. Jarrett reflects on the early years in which female investigators were a minority in the field and on her participation in the Trailblazers' panel discussion at the Association for Behavioral and Cognitive Therapies on November 29, 2009. Dr. Jarrett writes these reflections in the form of a letter to current and future professionals (of all demographics) dedicated to behavioral science and its practice; she poses questions about what the future may hold.