What is the right thing at the right time? Interactions between stages and processes of change among smokers who make a quit attempt.

C. A. Perz, C. C. DiClemente, and J. P. Carbonari (1996) claim support for the transtheoretical model notion that success in smoking cessation involves doing the right thing at the right time: emphasising experiential change processes during the contemplation and preparation stages and shifting to behavioral process activities during action. A key methodological limitation of Perz et al. was their failure to control for stage of change, a measure that has been shown to be predictive of cessation. This study replicates the prospective findings of Perz et al. in a different data set, then controls for stage of change when it is predictive of cessation, and finds that the measures of "appropriate" change process use developed by Perz et al. no longer predict cessation. The authors conclude that stage of change, in particular the distinction between smoking and not smoking, is more important than change process use in predicting cessation outcomes.     

The tripartite model of anxiety and depression: symptom structure in depressive and hypertensive patient groups

The structure of self-reported symptoms representative of the tripartite model was examined using data drawn from the Medical Outcomes Study (Tarlov et al., 1989). Participants were persons who had been diagnosed 48 months previously as suffering from either depression (N = 315) or hypertension (N = 403). Results of confirmatory factor analyses were broadly consistent with the tripartite model (L. A. Clark & Watson, 1991). Factors emerged corresponding to each of the 3 posited first-order dimensions of negative affect, positive affect, and physiologic arousal. Nonetheless, some discrepancies were found between the observed data and the hypothesized tripartite model. First, the obtained physiologic arousal factor was best viewed as reflecting nonspecific somatic distress rather than physiologic arousal. Finally, although differentiable in the strictest statistical sense, all three domains were significantly correlated (.36 to.86, absolute value). In particular, contrary to the tripartite model, positive and negative affect covaried markedly (-.81 to -.86). Findings raise issues concerning the utility of the tripartite model as a heuristic framework for enhancing understanding of individual differences in normal mood as well as mood disorders.     

Examining the construct validity of the Eating Disorder Inventory

The construct validity of the Eating Disorder Inventory (EDI) was examined in 3 samples. An archival clinic sample (n = 318) of women completed the EDI, a structured interview, and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Confirmatory factor analyses (CFAs) indicated that neither null nor 1-factor models of the EDI fit item-level or item-parcel data. The proposed 8-factor model did not fit at the item level but did fit item-parcel data. Reliability estimates of the 8 scales ranged from .82 to .93, and low-to-moderate interscale correlations among the eating and weight-related scales provided partial support for convergent validity. EDI personality scales showed moderate interscale correlations and were associated with MCMI-II scales. A final CFA of the EDI scales supported a 2-factor model (Eating and Weight, Personality) of the 8 EDI scales. Strong associations between depression and several EDI scale scores were found in a treatment study sample (n = 50). The archival clinic sample scored significantly higher on the 8 EDI scales than the nonpatient college comparison sample (n = 487).     

An age-embedding effect: time sensitivity and time insensitivity when pricing health benefits

Benefits are often extended over time. One determinant of this benefit duration is how long a person will live to enjoy them. In four studies, we investigated whether people are sensitive to age when pricing benefits that will last for the remainder of one's life. In Study 1 drivers gave their willingness-to-pay (WTP) to cure a medical condition which would stop them from driving. Results showed an age-embedding effect: WTP was unrelated to the estimated number of driving years left. Study 2 tested whether age-embedding arose because people have a lot of information about themselves which dilutes the impact of age on their valuations. In Studies 3 and 4 we investigated whether people believed that age was an important consideration, or if they failed to properly incorporate it into their judgment. Results indicate that little weight is given to age when making individual pricing decisions, although people did not believe it was normatively irrelevant.     

Course of Treatment During a Cohort-Based Inpatient Program for Posttraumatic Stress Disorder

This study examined one group of veterans with post-traumatic stress disorder (PTSD) over the course of a four month inpatient treatment program. The aim of the study was to examine treatment process factors that may contribute to the generally poor outcome reported in previous studies. Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Results contrasted with clinical assumptions usually made regarding the treatment process in these programs. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. Additional factors of race, combat exposure, childhood abuse, and application for disability had no effect on the process variables measured.     

The impact on pastoral care of structural, organisational and statutory changes in schooling: Some empirical evidence and a discussion

Against the historical background of institutionalised pastoral care in schools, the results are reported of a questionnaire survey of 159 members of the National Association for Pastoral Care in Education (NAPCE) with regard to the impact of post-1988 changes on pastoral care and personal and social education (PSE). Five hypotheses are generated concerning the likely effects of the 1988 Education Reform Act, the National Curriculum and associated developments in educational policy and management. The data reveal that, for the sample surveyed, the importance, time and resources given to pastoral care and PSE are considered not to have declined in the way predicted. Respondents were also more positive than expected about the impact of a range of related changes, including school-centred initial teacher training, teacher mentoring, the introduction of statutory training days, National Curriculum cross-curricular elements, and SCAA and OFSTED guidance. However, there were some developments which were considered to have had a negative effect. These included the National Curriculum programmes of study and key-stage assessments, published league tables and collective acts of worship. Respondents were divided as to the impact of other developments, including the advent of local financial management (LMS), grant-maintained status and OFSTED inspections. There was little visible effect on the role structures in schools, with traditional 'horizontal' arrangements of years and schools-within-schools predominating. In sum, the picture as regards the impact on pastoral care and PSE of a decade of educational policy change is more optimistic than might have been supposed.     

Memory systems within a cognitive architecture

This article addresses the division of memory systems in relation to an overall cognitive architecture. As understanding the architecture is essential to understanding the mind, developing computational cognitive architectures is an important enterprise in computational psychology (computational cognitive modeling). The article proposes a set of hypotheses concerning memory systems from the standpoint of a cognitive architecture, in particular, the four-way division of memory (including explicit and implicit procedural memory and explicit and implicit declarative memory). It then discusses in detail how these hypotheses may be validated through examining qualitatively the literature on memory. A quick review follows of computational simulations of a variety of quantitative data (which are not limited to narrowly conceived “memory tasks”). Results of accounting for both qualitative and quantitative data point to the promise of this approach.     

An integrated approach to delivering exposure-based treatment for symptoms of PTSD and depression in OIF/OEF veterans: preliminary findings

Combat-exposed military personnel from the wars in Iraq and Afghanistan report high rates of PTSD and associated psychiatric problems. A formidable body of research supports exposure therapy as a front-line intervention for PTSD; however, relative to studies of civilians, fewer investigations have evaluated the effectiveness of exposure therapy using military samples. Specifically, barriers to care (e.g., stigma associated with receiving mental health services ) may compromise utilization of evidence-based psychotherapy. As such, researchers have argued that veterans with PTSD may require an integrated and innovative approach to the delivery of exposure techniques. This paper presents the rationale for and preliminary data from an ongoing clinical trial that compares the home-based telehealth (HBT) application of a brief, behavioral treatment (Behavioral Activation and Therapeutic Exposure; BA-TE) for veterans with PTSD to the standard, in-person application of the same treatment. Forty OIF/OEF veterans with PTSD and MDD were consented, enrolled, and randomized to condition (BA-TE in-person, or BA-TE HBT) and symptoms of anxiety and depression were assessed at pre- and posttreatment. Participants in both conditions experienced reductions in depression, anxiety, and PTSD symptoms between pre- and posttreatment, suggesting that HBT application of an integrated PTSD treatment may be feasible and effective.     

Agentic and Communal Personality Traits: Their Associations with Depression and Resilience among Transgender Women

Research reports the perpetuation of communal traits by transgender women, possibly to affirm their core gender identity. Transgender women in the United States are nearly 6 times more likely than the general population to experience significant depressive symptoms. Studies among non-transgender individuals in the United States demonstrate that agentic traits are associated with less depressive symptoms, while studies on communal traits are more inconsistent in their association with indicators of depression. Our study’s central objective was to examine the associations of agency and communion with depression and resilience (i.e., personal competence and acceptance of self and life) among transgender women living part-time and full-time in the female gender role. Participants in the United States were recruited through online and offline purposive sampling. One hundred and twenty-two transgender women (primarily Caucasian; ages ranging from 22 to 75) completed a web-based questionnaire. Results indicated that agentic and communal traits were significantly associated with decreased symptoms of depression and increased levels of resilience. One component of resilience – acceptance of self and life – mediated the relationship between agentic/communal traits and depression, however, for communal traits this pattern was only found for transgender women living in the female role full-time. There were no significant differences on depressive symptoms and one component of resilience - personal competence – among transgender women living full-time compared to transgender women living in the female role part-time. Transgender women living full-time in the female gender role reported higher levels of agentic/communal traits and acceptance of self and life compared to those living part-time in the female gender role. Our findings are discussed in the context of mental health among transgender women.