Avoidant coping in panic disorder: a yohimbine biological challenge study

Few studies have addressed whether the use of avoidance-oriented coping strategies is related to the development of panic in patients with panic disorder(PD). Self-report, clinician-rated, and physiological data were collected from 42 individuals who participated in a yohimbine biological challenge study, performed under double-blind, placebo-controlled conditions. Participants included 20 healthy controls and 22 currently symptomatic patients who met DSM-IV-TR diagnostic criteria for PD. Consistent with prediction, patients with PD who had higher perceived efficacy of avoidance-oriented strategies in reducing anxiety-related thoughts reported increased severity in panic symptoms during the yohimbine challenge condition as compared to the placebo. Further, patients with PD who had more fear of cognitive dyscontrol, cardiovascular symptoms, and publicly observable anxiety also reported increased severity in panic symptoms during the challenge. Healthy controls who had more fear of cardiovascular symptoms similarly reported increased severity in panic symptoms during the challenge. No effects were found for heart rate response to the challenge agent. These results provide support for the role of avoidance-oriented coping strategies and fear of anxiety-related symptoms as risk and maintenance factors in the development of panic symptoms, particularly within a biological challenge model.     

Student Healthcare Clinicians' Illness Narratives: Professional Identity Development and Relational Practice

ABSTRACT

In this qualitative, grounded theory study we examine how the intersection of self-reflection, illness narratives and perceived messages of professional identity inform care provided by medical, nursing, and medical family therapy students to patients and families. We discovered four common challenges students faced navigating personal experiences of illness and connecting to patients: 1) discrepancies between ideal and lived experiences, 2) challenges of healthcare work and culture, 3) navigating power and hierarchy, and 4) developing a shell of privacy. Discussion and implications include interdisciplinary training and collaboration and the unique role of medical family therapists in healthcare.     

The anxious believer: Macaulay’s prescient theodicy

Recent feminists have critiqued G.W. Leibniz’s Theodicy for its effort to justify God’s role in undeserved human suffering over natural and moral evil. These critiques suggest that theodicies which focus on evil as suffering alone obfuscate how to thematize evil, and so they conclude that theodicies should be rejected and replaced with a secularized notion of evil that is inextricably tied to the experiences of the victim. This paper argues that the political philosophy found in the writings of Catherine Macaulay (1731–1791) can serve as a support to Leibniz’s larger claims and can also offer a more concrete, situated notion of evil that escapes the contemporary feminist critique. Macaulay’s work on natural and moral political evil, especially, will be presented as an early modern precursor to feminism, which defends divine perfection and a pre-established harmony in the face of political evil. I then identify three unique theodicical arguments in Macaulay’s work: the pragmatically beneficial defense, the eschatalogical defense, and the redemptive defense.     

Age of acquisition and word frequency: determinants of object-naming speed and accuracy

The combined contributions of word age of acquisition (AoA) and word frequency (rated and objective) to word retrieval speed and accuracy were investigated, using a picture-naming paradigm. Results from two fully factorial studies revealed that both AoA and word frequency reliably facilitate the speed and accuracy of word retrieval. Furthermore, word frequency and AoA interacted across delay (0, 750, 1,500, and 2,250 msec) in Experiment 2. This resulted in word frequency's playing a stronger role for late-acquired words across delays. It is concluded that both AoA and word frequency play a fundamental role in lexical retrieval. The results are also consistent with the view that both factors affect the same processing stages.     

Within- and between-language priming differ: evidence from repetition of pictures in Spanish-English bilinguals

In the current study, the authors used an immediate repetition paradigm with pictures to observe whether repetition enhances word production in bilinguals. In Experiment 1, participants were asked to name pictures that were named previously in the same language (Spanish-Spanish or English-English) or in the opposite language (Spanish-English or English-Spanish). Results revealed a repetition effect both within languages and between languages. Furthermore, there was an asymmetry within language, with repetition priming being larger in Spanish than in English. Experiments 2 and 3 revealed that lag interacted with language for both within- and between-language priming. However, lag resulted in a decrease in the asymmetry for within- but not between-language priming. The results are consistent with the view that within- and between-language repetition priming are mediated by different mechanisms.     

The Career Trinity: Puerto Rican College Students and Their Struggle for Identity and Power

A pilot ethnographic study of Puerto Rican male college students found a powerful connection between family, community, and self-concept as mediators in the development of a personal concept of career for the participants and for their subsequent career development and decision-making processes. Implications for the counseling process are discussed.     

Gender and lexical access in Italian

Two new procedures were employed to investigate the effects of semantic and grammatical gender on lexical access in Italian and to investigate the interaction of gender with other factors that are known to influence lexical access in other languages. The gender-monitoring task requires a conscious decision about the gender of each noun, whereas the word repetition task does not require explicit attention to gender. In both tasks, single words are presented out of context, under speeded conditions. Both procedures proved to be sensitive indices of word recognition, with reaction times that are closely tied to the point at which words can be uniquely identified (although some processing before and after the uniqueness point was seen). In both tasks, reaction times were strongly affected by phonological factors (e.g., length, number of syllables, and presence of frication on the initial consonant). Phonological transparency of gender marking had a reliable effect on gender monitoring but had no effect on word repetition, suggesting that explicit attention to gender may be a factor affecting utilization of this phonological cue. Semantic factors (including semantic gender) had no effect on performance. Frequency and age of acquisition had very small effects when other factors were controlled. Implications for current models of lexical access are discussed, with special reference to the role of gender.     

Group Psychotherapy in the Context of Cultural Diversity

The authors review the salient issues involved in therapy with culturally diverse populations. They present a framework where group therapy addresses those issues. Clinical vignettes from each of the authors serve to illustrate the power of group therapy with ethnocultural populations.     

In search of the language switch: An fMRI study of picture naming in Spanish-English bilinguals

For many years, researchers investigating the brain bases of bilingualism have concentrated on two basic questions. The first concerns the nature of language representation. That is, are a bilinguals' two languages represented in distinct or overlapping areas of the brain. The second basic question in the neuropsychology of bilingualism concerns the neural correlates of language switching, that is, the areas that are active when bilinguals switch from one language to the other. Performance between single-language and dual-language picture naming was compared in a group of six Spanish-English bilinguals using behavioral measures and functional magnetic resonance imaging. Participants showed slower reaction times and increased activation in the dorsolateral prefrontal cortex in the mixed language condition relative to single language condition. There was no evidence that each language was represented in different areas of the brain. Results are consistent with the view that language switching is a part of a general executive attentional system and that languages are represented in overlapping areas of the brain in early bilinguals.     

Racial and cultural in-betweenness meet in the consulting room: the case of ‘Anna’

An upper-middle-class black woman, who grew up adapting to a white-dominated environment, entered the consulting room of a multicultural ‘white-passing’ analyst, and here unique emotional experiences were reflected in dream images of racial disorganization, internal racism, and identity confusion. While sorting through the analysand’s internal dynamics, the external world erupted in May 2020 with the murder of George Floyd, catapulting both analysand and analyst (and the nation) into a transformative confrontation with their mutual, deep-seated woundings of American racial and cultural inequities. The analysand’s racial complexity directly impacted the analyst’s ‘white-passing’ privilege, bringing into question established classifications of American whiteness. Overlapping dynamics and experiences as ‘in-betweeners’ and ‘outsiders’ – a black woman subsumed by a white-dominated society and an immigrant refugee acculturated to American life – provided a common exilic ground for mutual understanding and mirroring. The analyst explores the racial and multicultural straddling that served as a lens into the analysand’s fragmented racial identity during the eruption of American racial unrest.