Cognitive behavioral therapy for panic disorder and comorbidity: more of the same or less of more?

This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with "straying" to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focused only on panic disorder yielded more substantial improvement in the most severe baseline comorbid condition, although not in intent-to-treat analyses, and a greater proportion of individuals in this treatment condition were rated as having no comorbid diagnoses, even in intent-to-treat analyses. These findings raise the possibility that remaining focused on CBT for panic disorder may be more beneficial for both principal and comorbid diagnoses than combining CBT for panic disorder with 'straying' to CBT for comorbid disorders.     

Aging and a benefit of distractibility

Under instructions to ignore distraction, younger and older adults read passages with interspersed distracting words. Some of the distractors served as solutions to a subsequent set of verbal problems in which three weakly related words could be related by retrieving a missing fourth word (i.e., the Remote Associates Test [RAT]; Mednick, 1962). Older adults showed significant priming from the distraction, whereas younger adults did not. In this study, we present a case in which age-related reductions in attentional control over information that was not initially relevant can actually lead to superior performance for older adults. The RAT materials may be downloaded from www.psychonomic.org/archive.     

Development and validation of the HIV Medication Readiness Scale

Excellent medication adherence (>95%) is required for optimal HIV treatment success. This study aimed to develop and validate a brief scale to assess psychological readiness for successfully starting and adhering to HIV medications. HIV-positive men and women (N = 142) from an HIV outpatient clinic completed the proposed HIV Medication Readiness Scale (HMRS) prior to starting HIV medications. The 10-item HMRS demonstrated high internal consistency (alpha = .90), test-retest reliability (r = .83), and sensitivity to change following a standardized 4-session psychoeducational intervention designed to increase readiness for successful adherence. Predictive validity was supported by higher readiness scores on the day starting HIV medications, predicting higher treatment adherence at 1-month follow-up. The HMRS is a brief, easy-to-use, clinically relevant tool that can assist in identifying people living with HIV at high risk of nonadherence, who might benefit from tailored readiness counseling prior to initiating HIV medications.     

The discovery of southern childhoods: psychology and the transformation of schooling in the Jim Crow South

Although the psychology of race in America has been the subject of significant research, psychological science in the principal region of racial interaction before Brown v. Board of Education-the South--has received little attention. This article argues that the introduction of psychological ideas about children by means of school reform in the South during the half-century before the Brown decision established a cultural foundation for both Black resistance to segregated schools and White determination to preserve them. In 1900, southern children and their schools were an afterthought in a culture more committed to tradition and racial stability than innovation and individual achievement. The advent of northern philanthropy, however, brought with it a new psychology of childhood. Although the reformers did not intend to subvert segregation, their premises downplayed natural endowment, including racial inheritance, and favored concepts highlighting nurture: that personality is developmental, childhood foundational, and adversity detrimental. Decades of discussion of children in their learning environment gave southern Blacks a rationale for protest and Whites a logical defense for conservative reaction.     

Anterior cingulate cortex and conflict detection: An update of theory and data

The dorsal anterior cingulate cortex (ACC) and associated regions of the medial frontal wall have often been hypothesized to play an important role in cognitive control. We have proposed that the ACC's specific role in cognitive control is to detect conflict between simultaneously active, competing representations and to engage the dorsolateral prefrontal cortex (DLPFC) to resolve such conflict. Here we review some of the evidence supporting this theory, from event-related potential (ERP) and fMRI studies. We focus on data obtained from interference tasks, such as the Stroop task, and review the evidence that trial-to-trial changes in control engagement can be understood as driven by conflict detection; the data suggest that levels of activation of the ACC and the DLPFC in such tasks do indeed reflect conflict and control, respectively. We also discuss some discrepant results in the literature that highlight the need for future research.     

COMT val158Met and executive control: a test of the benefit of specific deficits to translational research

The role of catechol-O-methyltransferase (COMT) val158met in prefrontal cortical deficits associated with the liability to schizophrenia remains controversial. This study evaluated 464 healthy adult participants using three measures of executive functions in working memory: a 3-back version of the N-back continuous performance task (CPT) and two variants of the AX-CPT. The interpretability of N-back performance was confounded by possible generalized deficits, whereas the AX variants included internal controls for uncovering specific deficits. There was no relationship between the COMT genotype and N-back performance, whereas val/val individuals had a specific deficit on a dot-pattern version of the AX-CPT. In this case, a specific executive function known as context processing appeared to be compromised. These data suggest that the interpretability gained by including task manipulations to uncover specific deficits can enhance associations between cognitive and genetic levels of analysis.     

Effects of delayed constructed-response identity matching on spelling of dictated words

We studied the effects of delayed constructed-response identity matching on spelling with 6 first graders with histories of school failure. After training, the children learned to spell words to dictation and their cursive writing improved. These results replicate studies showing that delayed constructed-response matching establishes spelling. For 2 children, spelling of generalization words--words formed by recombining the syllables of training words--also improved. These results extend studies that have shown recombinative generalization in reading and spelling.     

The impact of left and right intracranial tumors on picture and word recognition memory

This study investigated the effects of left and right intracranial tumors on picture and word recognition memory. We hypothesized that left hemispheric (LH) patients would exhibit greater word recognition memory impairment than right hemispheric (RH) patients, with no significant hemispheric group picture recognition memory differences. The LH patient group obtained a significantly slower mean picture recognition reaction time than the RH group. The LH group had a higher proportion of tumors extending into the temporal lobes, possibly accounting for their greater pictorial processing impairments. Dual coding and enhanced visual imagery may have contributed to the patient groups' similar performance on the remainder of the measures.     

Is there any "free" choice? Self and dissonance in two cultures

Four experiments provided support for the hypothesis that upon making a choice, individuals justify their choice in order to eliminate doubts about culturally sanctioned aspects of the self, namely, competence and efficacy in North America and positive appraisal by other people in Japan. Japanese participants justified their choice (by increasing liking for chosen items and decreasing liking for rejected items) in the standard free-choice dissonance paradigm only when self-relevant others were primed, either by questionnaires (Studies 1-3) or by incidental exposure to schematic faces (Study 4). In the absence of these social cues, Japanese participants showed no dissonance effect. In contrast, European Americans justified their choices regardless of the social-cue manipulations. Implications for cognitive dissonance theory are discussed.     

The morality of money

Pastoral Psychology -