Increased wait-list time predicts dropout from outpatient enhanced cognitive behaviour therapy (CBT-E) for eating disorders

Between 30 and 70% of patients with eating disorders drop out from outpatient treatment. However, research has been unable to identify factors that consistently predict dropout from eating disorder treatment. Most studies have exclusively investigated the role that individual patient characteristics play in dropout and have ignored more process-based factors such as expectations about treatment, the therapeutic alliance, or time spent on a treatment waiting list. This study aimed to investigate the roles of both individual patient characteristics and process-based factors in dropout from outpatient treatment for eating disorders. The study involved data collected from consecutive eating disorder referrals to the only public specialist eating disorder service for youth and adults in Perth, Western Australia. The standard treatment provided at this service is Enhanced Cognitive Behaviour Therapy on an individual basis. The study involved 189 patients referred to the service between 2005 and 2010. Forty five percent of this sample dropped out of treatment. Results showed that, in this sample, two individual factors, lowest reported weight and the tendency to avoid affect, and one process-based factor, time spent on the wait list for treatment, were significant predictors of dropout. These findings are valuable because a process-based factor, such as wait-list time, may be easier to address and modify than a patient's weight history or the trait of mood intolerance. Increased resources for eating disorder services may reduce waiting list times which would help to reduce dropout and maximize treatment outcomes.     

Assessment of children's receptive vocabulary using event-related brain potentials: Development of a clinically valid test

The combined verbal and motor impairments characteristic of children with disorders such as Cerebral Palsy (CP) frequently compromise the accuracy of standard psychometric assessments. What is needed is a test to measure language that does not require verbal or motor responses. This study was designed to determine whether single-word receptive vocabulary could be assessed in young children without CP, using an ERP-compatible test based on Form M of the Peabody Picture Vocabulary Test-Revised (PPVT-R). Fifteen 10-year-old children with normal levels of psychometric intelligence participated. Ninety pictures were selected from the PPVT-R (Form M), representing three levels of single-word receptive vocabulary (Preschool, Child-Adolescent, Adult). Each picture was presented twice (pseudo-random), once paired with a spoken word that was semantically congruent with the picture and once paired with a semantically incongruent word. The children's N400 was significantly larger to incongruent than to congruent pairs, but only when the vocabulary was within their repertoire. The results are discussed in terms of electrophysiologic correlates of acquired language and the clinical use of this ERP test as an adjunct to assessing patients with moderate to severe communication and/or motor impairments (e.g., cerebral palsy, autism, head injury).     

Simultaneous Semipermeable Groups for Mothers and Their Early Latency-Age Boys

Abstract

Bonding is an ongoing aspect of intersubjective experience, a type of mental relationship to oneself and others. As a behavioral mode, bonding utilizes verbal and nonverbal communication primarily to establish a basic feeling of connection between individuals. Bonding is the floor, a cognitive-affective state that precedes and prepares the way for the complex processes underlying identification. The concept relates to Bion’s early theory of basic assumptions, and takes on new and different meanings according to his later ideas regarding social communication. Bonding is also a therapeutic posture or technique, an element in the establishment of group cohesion, the positive transference, and therapeutic and group alliance. Case examples illustrate how the therapist and other group members bring a complex of bonding needs and anxieties that must be negotiated to establish and maintain bonding, which is a necessary condition for successful therapeutic work.     

A longitudinal investigation of the mediating role of self-esteem and body importance in the relationship between stress and body dissatisfaction in adolescent females and males

Body dissatisfaction is particularly prevalent during adolescence and has recently been linked to stress in females and males. However, prospective studies are needed to better understand the relationship between stress and body dissatisfaction. The present study investigates the direction of this association and the mediating role of self-esteem and body image importance. A sample of 298 adolescent females and males in Grades 7 to 10 (ages 12 to 17 years) were surveyed at two time points over a one-year period. Hierarchical regression analyses revealed that stress significantly predicted body dissatisfaction one year later. Furthermore, a multiple mediation analysis controlling for gender revealed a significant indirect effect in both cross-sectional and longitudinal models, indicating that stress predicts reductions in self-esteem and increases in body importance, which in turn predict body dissatisfaction. These findings suggest that stress, self-esteem, and body importance should be included in programmes aimed at improving body dissatisfaction.     

Behavioral effects of delayed timeouts from reinforcement

Timeouts are sometimes used in applied settings to reduce target responses, and in some circumstances delays are unavoidably imposed between the onset of a timeout and the offset of the response that produces it. The present study examined the effects of signaled and unsignaled timeouts in rats exposed to concurrent fixed‐ratio 1 fixed‐ratio 1 schedules of food delivery, where each response on one lever, the location of which changed across conditions, produced both food and a delayed 10‐s timeout. Delays of 0 to 38 s were examined. Delayed timeouts often, but not always, substantially reduced the number of responses emitted on the lever that produced timeouts relative to the number emitted on the lever that did not produce timeouts. In general, greater sensitivity was observed to delayed timeouts when they were signaled. These results demonstrate that delayed timeouts, like other delayed consequences, can affect behavior, albeit less strongly than immediate consequences.     

Measuring episodic memory: A novel approach with an indefinite number of alternative forms

Both clinical practice and clinical research settings can require successive administrations of a memory test, particularly when following the trajectory of suspected memory decline in older adults. However, relatively few verbal episodic memory tests have alternative forms. We set out to create a broad‐based memory test to allow for the use of an essentially unlimited number of alternative forms. Four tasks for inclusion in such a test were developed. These tasks varied the requirement for recall as opposed to recognition, the need to form an association between unrelated words, and the need to discriminate the most recent list from earlier lists, all of which proved useful. A total of 115 participants completed the battery of tests and were used to show that the test could differentiate between older and younger adults; a sub‐sample of 73 participants completed alternative forms of the tests to determine test–retest reliability and the amount of learning to learn. Copyright © 2009 John Wiley & Sons, Ltd.     

Trait Entitlement and Perceived Favorability of Human Resource Management Practices in the Prediction of Job Satisfaction

Purpose  

Inconsistency in offerings of human resource management (HRM) practices across organizations is potentially problematic for employees with high levels of entitlement as they tend to believe they get less than they deserve. The purpose of this study was to examine the moderating effect of trait entitlement on the relationship between the favorability of HRM practices and job satisfaction.