An Intensive Outpatient Program for Veterans With Posttraumatic Stress Disorder and Traumatic Brain Injury

Post-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes.     

On the locus of visual dominance

A series of six experiments explored the dominance of vision over audition reported by Colavita (1974). We first confirmed the existence of visual dominance in a paradigm somewhat different from Colavita’s: Mean reaction time (RT) to a light was found to be faster than to a simultaneously presented tone, even though the stimuli were equated in subjective intensity and even though RT to the tone presented alone was faster than to the light presented alone. Additional experiments showed that when subjects did not have to respond to light, tone RT was equal or faster (intersensory facilitation) when a light was present than when it was not. These findings suggest that sensory or perceptual processing of the tone is not affected by the light, i.e., that visual dominance is nonsensory in locus and depends on the relevance of the light stimulus. This interpretation was reinforced by other findings which showed that the degree of visual dominance was sensitive to the probability of light, tone, and light-plus-tone trials and to instructions to attend to a specific modality, but was not sensitive to the intensity of the light.     

Development of a Brief Cognitive Screen for Mild Cognitive Impairment and Neurocognitive Disorder

Abstract

The purpose of this study was to develop and evaluate a brief cognitive screen for possible Mild Cognitive Impairment (MCI) and other neurocognitive impairment in a sample of general medical patients. Two hundred community-dwelling general medical patients aged 65 or older participated in this study. Age and education corrected scores from the Rey Auditory Verbal Learning Test and Mattis Dementia Rating Scale were used to classify participants into three groups: MCI, neurocognitive disorder, cognitively intact. Groups were then compared on an independent set of measures: the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery, Mini-Mental State Examination, and Clock Drawing Test. The MCI group constituted 9% of the sample, while 10.5% of the sample was classified into the neurocognitive disorder group. The CERAD Verbal Category Fluency and CERAD Word List Memory Test Delayed Recall measures were individually and collectively the most effective in differentiating cognitively intact elders from persons in both the MCI and neurocognitive disorder groups. We conclude that these two brief measures appear to be effective for detecting possible MCI or neurocognitive disorder, thereby facilitating identification of candidates who would benefit from more detailed neuropsychological assessment.     

Point: Salespeople and Senior Management: Not a “Match Made in Heaven”

This article reports the results of an examination of the Selling Orientation-Customer Orientation scale to determine if the number of items could be reduced while still maintaining the scale's dimensionality and consistency. Analysis of a new Australian data set was undertaken using data from 250 salespeople, 157 of their managers and 276 of their customers in a range of business to business markets. The findings provide evidence that salespeople's customer orientation, as defined by Saxe and Weitz (1982), can be measured with little information loss by ten items, rather than the twenty-four items originally suggested. This significant reduction in length may contribute to a more reliable and valid scale by reducing response fatigue and acquiescence bias, as well as making it possible to include the construct in larger studies with other multiple item scales. Further research is suggested to test the revised scale across a number of industries and consumer groups, to verify its generalizability.     

The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis

Neuropsychology Review - Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This...     

Teen Line: a descriptive analysis of a peer telephone listening service

Teen Line is a peer telephone listening service for adolescents. During its first year of operation, 2,270 phone calls were received. After an initial novelty effect, counts document a consistent level of use of the service. Two-thirds of the callers were female. Although 4% of topics discussed dealt with crisis situations (suicide, physical abuse), 96% were concerned with common, less urgent adolescent issues, such as peer relationships, family dynamics, and the need to have someone "just to talk to." This paper presents a model for an adolescent listening service and provides data garnered over a year's utilization. Consistent use documents its acceptance as a source of information for teenagers.     

Asymmetric integrality with dimensions of visual pattern

Subjects performed speeded classification tasks with visual patterns that varied in two dimensions: the elements used to construct the patterns (the letters X, Y, V, and 0) and the configurations formed by the spatial arrangement of the elements. Neither dimension could be attended to selectively without interference from the other, indicating that the dimensions are integral. But the amount of interference between the two dimensions was asymmetrical; irrelevant variation of elements (while classifying by configuration) was harder to ignore than irrelevant variation of configuration (while classifying by elements). This held true whether the element or the configuration discrimination was easier in tasks with no irrelevant variation. It is concluded that the asymmetry is due to attentional strategies in the processing of these patterns and not to the discriminabilities of the dimensions used.

     

The Variability of Criterion‐Related Validity Estimates Among Interviewers and Interview Panels

The authors examined differences in criterion‐related validity estimates among ratings from individual interviewers and interview panels within a structured interview. Senior non‐commissioned officers (NCOs) in the U.S. Army (N=64) conducted panel interviews with 944 junior NCOs during a concurrent validation project. Analysis of the data revealed considerable variation in interviewer validity coefficients in relation to multiple performance criteria. Results also indicated the importance of adopting a multivariate perspective when evaluating interviewer validity differences in that the amount of variation in validity coefficients differed both by interview dimension and criterion. A similar pattern of findings emerged when analyses were performed on ratings averaged within interview panel. Nonetheless, when meta‐analysis was used to estimate the amount of true variance in interviewer‐ and panel‐level validity coefficients, most or all of the variance for some interview‐criterion combinations appeared to be due to statistical artifacts.     

Simultaneous auditory and tactile information processing

Subjects were required to perform perceptual tasks when stimuli were presented simultaneously in the auditory and tactile modalities and when they were presented in one of the modalities alone. The results indicated that when the demands on cognitive processes are small, auditory and tactile stimuli presented simultaneously can be processed as well as when stimuli are presented in only one modality. In a task which required a large amount of cognitive processing, it became difficult for subjects to maintain high levels of performance in both modalities and the distribution of attention became an important determinant of performance. The data were consistent with a theory that cognitive, but not perceptual, processing is disrupted when subjects have difficulty performing two perceptual tasks simultaneously.