Muscle dysmorphia: Current research and potential classification as a disorder

ObjectiveTo review the literature for scientific evidence in support of inclusion of Muscle Dysmorphia (MD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).DesignThe criteria proposed by Blashfield, Sprock, and Fuller (1990) were used for determining whether scientific evidence supports the introduction of MD as a new disorder into a disease classification system.MethodPeer-reviewed journal articles were identified by searching databases for articles published (in print and electronically) from 2001 to 2011.ResultsThe search identified 59 journal articles that specifically focused on MD, of which 39 were empirical journal articles. There is ample literature on MD, including a common set of diagnostic criteria and assessment instruments to measure MD. However, questions remain about the diagnostic reliability and validity, including inter-rater reliability, and whether MD represents a disorder that consists of symptoms that frequently co-occur. Also, evidence of syndrome differentiation is lacking. Only two of the five criteria proposed by Blashfield et al. have been met.ConclusionLiterature suggests that MD is associated with several indicators of clinical significance and distinctiveness. However the current review has found significant limitations and gaps in the scientific literature on MD. Possible options regarding the status of MD in the DSM-5 are proposed, including introducing MD as an example of an eating disorder not otherwise specified, retaining MD as a body dysmorphic disorder, introducing MD as a new disorder, or introducing MD as a provisional diagnosis in need of further study.     

A Survey of Dynamic Principles Governing Memory

A triadic coalition game was structured as an achievement-oriented situation by inclusion of a skill-based game task. Deductions regarding coalition partner choices were derived from Atkinsons' model of achievement motivation with the expectation that achievement-oriented players (Ms < Maf) would prefer moderate-risk strategy options while failure-avoidant players (Maf < Ms) would avoid moderate-risk strategies.

Observation was made of the coalition partner preferences of 126 college sophomore males and females who played the game in same-sex triads. The Ss were categorized into motive configuration groups on the basis of scores derived from the Test of Insight and the Test Anxiety Questionnaire.

The results were supportive of the hypotheses, since the Ms < Maf group chose moderate-risk coalition options more frequently than did the Maf < Ms group. By contrast the Maf < Ms group chose low-risk strategies and tended to avoid moderate-risk coalition options. While other coalition-game studies have shown differences in strategy behavior between males and females, sex differences did not occur in the present game. The lack of sex differences was explained by the high level of concern for winning among members of both sexes generated by the achievement nature of the game task.     

The experiences of therapy from the perspectives of carers of people with dementia: An exploratory study

Design: Interviews were conducted with six carers of people with dementia about their experience of receiving counselling/psychotherapy. Interviews were conducted in the carer's own home, and data were analysed thematically using a narrative approach. Findings: Three themes were identified from the data: ‘Still doing the best I can’ (identified as losses and processes of personal growth); ‘Feeling connected and being understood’ (identified as attributes believed to be important within the therapeutic relationship); and ‘Wanting to share information’ (identified as sharing information with someone ‘neutral’). Carers placed emphasis on the age of the therapist and the amount of therapist self‐disclosure. Attending counselling and/or psychotherapy also helped the carer to find a ‘safe space’ to disclose and share concerns. Discussion: Carer loss and personal growth are explored, together with the importance of building therapeutic relationships and, for the therapist, seeking supervision when managing personal self‐disclosure. The theme of therapist self disclosure is explored together with the importance of therapists seeking supervision when managing personal self‐disclosure.     

A Pilot Randomized Trial of Community-Based Parent Training for Immigrant Latina Mothers

This paper reports on the development and piloting of the Madres a Madres (Mothers to Mothers) program, a new, community-based parent training program designed for immigrant Latina mothers and their children. Promotoras, or female community health workers of Latina background, delivered the program in a home visitation format. A total of 194 mothers and 194 focal children (87 male, 107 female) ages 7–12 were randomized to the intervention (113 mother–child dyads) or wait-list control condition (81 mother–child dyads) over the study period. Outcomes of interest were mother-reported parenting skills, broad family functioning, and child externalizing and internalizing behaviors. Data collection occurred at pretest, 3-month posttest, and 9-month follow-up periods. Multilevel growth models revealed increases in intervention mothers’ reported parenting skills, family support, and family organization, and reductions in child internalizing behavior from pretest to follow-up, relative to the control condition. Outcomes did not vary by focal child age, gender, nativity status, or mother acculturative status (years in the United States). Findings are discussed in the context of future directions for research on the Madres a Madres program and on the implementation and dissemination of empirically-supported parent training practices to culturally diverse families.     

Dissertation experiences of doctoral graduates from professional psychology programs

Worldwide, dissertation experiences are acknowledged to be challenging endeavors for students and the faculty members who advise them, and dissertation completion continues to be a concern when seeking to improve overall doctoral graduation rates. Although a number of factors have been associated with completion rates across disciplines, further research is needed within professional psychology graduate programs to understand overall student dissertation experiences. In this USA-based investigation, a mixed-method design was used to examine the experiences of 25 professional psychology doctoral graduates’ dissertation experiences, 12 of which were self-identified as positive and 13 as negative. Participants with positive experiences typically had supportive relationships with their dissertation chairs and committee members, which enhanced their research confidence and professional development. Participants with negative dissertation experiences typically had difficult relationships with dissertation chairs and committee members, which was associated with immediate and long-lasting negative consequences for participants’ professional growth and emotional well-being. The advisory working alliance was stronger for graduates with positive than negative experiences, although research attitudes and self-efficacy beliefs were not different between the two groups.     

Physiological and behavioral signatures of reflective exploratory choice

Physiological arousal, a marker of emotional response, has been demonstrated to accompany human decision making under uncertainty. Anticipatory emotions have been portrayed as basic and rapid evaluations of chosen actions. Instead, could these arousal signals stem from a “cognitive” assessment of value that utilizes the full environment structure, as opposed to merely signaling a coarse, reflexive assessment of the possible consequences of choices? Combining an exploration–exploitation task, computational modeling, and skin conductance measurements, we find that physiological arousal manifests a reflective assessment of the benefit of the chosen action, mirroring observed behavior. Consistent with the level of computational sophistication evident in these signals, a follow-up experiment demonstrates that anticipatory arousal is modulated by current environment volatility, in accordance with the predictions of our computational account. Finally, we examine the cognitive costs of the exploratory choice behavior these arousal signals accompany by manipulating concurrent cognitive demand. Taken together, these results demonstrate that the arousal that accompanies choice under uncertainty arises from a more reflective and “cognitive” assessment of the chosen action’s consequences than has been revealed previously.     

Therapists’ experiences with internal representations of clients

Fourteen therapists were interviewed via telephone regarding their experience of “carrying around” their clients with them between sessions (i.e. internal representations, or IRs, of clients), a phenomenon about which little empirically based knowledge exists. Data were analyzed using consensual qualitative research. Findings indicated that overall, therapists have IRs infrequently, most often have IRs of clients struggling with severe or challenging presenting problems, and do receive some training about IRs. When describing a specific IR experience, therapists typically noted a strong therapy relationship, and stated that the IRs typically had specific triggers. The IRs generally consisted of feelings about the client, and typically consisted of thoughts about the client or the felt presence of the client. The IRs generally yielded positive effects, typically both personally and professionally, and were typically discussed with supervisors/consultants. Implications for research, training, and practice are presented.