The collaborative assessment and management of suicidality (CAMS) versus enhanced care as usual (E-CAU) with suicidal soldiers: Moderator analyses from a randomized controlled trial

Given historically high rates of suicide among military personnel over the past decade the present study analyzed whether key demographic, military, and research-based variables moderated clinical treatment outcomes of 148 suicidal active duty US Army soldiers. This is a secondary analysis of data from a randomized controlled trial comparing the collaborative assessment and management of suicidality (CAMS) to enhanced care as usual (E-CAU; Jobes et al., 2017). Nine potential moderator variables were derived from the suicidology literature, military-specific considerations, and previous CAMS research; these were sex, age, marital status, race, lifetime suicide attempts, combat deployments, time in service, initial distress, and borderline personality disorder diagnosis. The clinical outcomes included six suicide- and mental health-related variables. Six of the eight significant moderator findings in this study showed CAMS outperforming E-CAU in certain subgroups with medium to large effect sizes ranging from 0.48 to 1.50. Collectively, the results suggest that CAMS was associated with the greatest improvement among lower complexity soldier patients, particularly those with lower initial distress and fewer deployments. Those who were married or older generally responded better to CAMS, although the results were not entirely consistent with respect to age. CAMS’s effectiveness for married soldiers and those with lower initial distress was a particularly robust finding that persisted when adjusting more stringently for multiple testing. This study sheds light on several factors associated with the success of CAMS among suicidal soldiers that can assist in matching the treatment to those that may benefit the most.     

Occurrence of imagery and its link with early memories in agoraphobia

Recent cognitive models suggest that mental imagery can help us understand the maintenance of anxiety disorders (e.g., de Silva, 1986; Hackmann, Surawy, & Clark, 1998). However, imagery is relatively unexplored within agoraphobia. Such images are also thought to be useful in uncovering memories that occurred around the onset of a disorder (Hackmann, Clark, & McManus, 2000). A total of 20 patients with agoraphobia and 20 matched controls took part in this investigation. Participants described any recurrent images they experienced in agoraphobic situations, and also any associated memories. All patients with agoraphobia (but no control participants) reported having distinct recurrent images in “agoraphobic situations”. Most images involved several sensory modalities and in the majority of cases appeared to be linked with unpleasant memories of events experienced many years previously. While these exploratory findings require replication, potential treatment implications are discussed.     

Errors in Creative Problem-Solving: Identify,Deliberate, and Remediate

It is often assumed creative performance is error free. Even a cursory inspection of eminent, creative, individuals indicates errors permeate creative efforts. In the present effort, the impact of error management on creative problem-solving is examined. Undergraduates, 136 in all, were asked to work through 10 potential problem solutions where half the solutions evidenced errors and half did not. Participants were asked to identify potential errors, deliberate on these errors, and remediate, or fix, errors prior to providing solutions to a problem calling for creative thought. It was found the number of errors correctly identified, and the quality of error remediation was positively related to the quality, originality, and elegance of problem solutions. More extensive deliberation, however, was found to be especially important for the production of original problem solutions. The implications of these observations for understanding the importance of error management in creative problem-solving are discussed.     

Televised Sexual Content and Parental Mediation: Influences on Adolescent Sexuality

Little research has been conducted to examine the influence of exposure to televised sexual content on adolescent sexuality or how parental intervention may reduce negative effects of viewing such content. This study uses self-report data from 1,012 adolescents to investigate the relations among exposure to sexually suggestive programming, parental mediation strategies, and three types of adolescent sexuality outcomes: participation in oral sex and sexual intercourse, future intentions to engage in these behaviors, and sex expectancies. As predicted, exposure to sexual content was associated with an increased likelihood of engaging in sexual behaviors, increased intentions to do so in the future, and more positive sex expectancies. Often, parental mediation strategies were a significant factor in moderating these potential media influences.     

The face in the crowd effect unconfounded: happy faces, not angry faces, are more efficiently detected in single- and multiple-target visual search tasks

Is it easier to detect angry or happy facial expressions in crowds of faces? The present studies used several variations of the visual search task to assess whether people selectively attend to expressive faces. Contrary to widely cited studies (e.g., ?hman, Lundqvist, & Esteves, 2001) that suggest angry faces "pop out" of crowds, our review of the literature found inconsistent evidence for the effect and suggested that low-level visual confounds could not be ruled out as the driving force behind the anger superiority effect. We then conducted 7 experiments, carefully designed to eliminate many of the confounding variables present in past demonstrations. These experiments showed no evidence that angry faces popped out of crowds or even that they were efficiently detected. These experiments instead revealed a search asymmetry favoring happy faces. Moreover, in contrast to most previous studies, the happiness superiority effect was shown to be robust even when obvious perceptual confounds--like the contrast of white exposed teeth that are typically displayed in smiling faces--were eliminated in the happy targets. Rather than attribute this effect to the existence of innate happiness detectors, we speculate that the human expression of happiness has evolved to be more visually discriminable because its communicative intent is less ambiguous than other facial expressions.     

Using story contexts to bias children’s true and false memories

The effects of embedding standard Deese/Roediger-McDermott (DRM) lists into stories whose context biased interpretation either toward or away from the overall themes of the DRM lists on both true and false recognition were investigated with 7- and 11-year-olds. These biased story contexts were compared with the same children’s susceptibility to false memory illusions using the standard DRM list presentation paradigm. The results showed the usual age effects for true and false memories in the standard DRM list paradigm, where 11-year-olds exhibited higher rates of both true and false recognition compared with the 7-year-olds. Importantly, when DRM lists were embedded in stories, these age effects disappeared for true recognition. For false recognition, although developmental differences were attenuated, older children were still more susceptible to false memory illusions than younger children. These findings are discussed in terms of current theories of children’s false memories as well as the role of themes and elaboration in children’s memory development.     

Processing emotional category congruency between emotional facial expressions and emotional words

Facial expressions are critical for effective social communication, and as such may be processed by the visual system even when it might be advantageous to ignore them. Previous research has shown that categorising emotional words was impaired when faces of a conflicting valence were simultaneously presented. In the present study, we examined whether emotional word categorisation would also be impaired when faces of the same (negative) valence but different emotional category (either angry, sad or fearful) were simultaneously presented. Behavioural results provided evidence for involuntary processing of basic emotional facial expression category, with slower word categorisation when the face and word categories were incongruent (e.g., angry word and sad face) than congruent (e.g., angry word and angry face). Event-related potentials (ERPs) time-locked to the presentation of the word-face pairs also revealed that emotional category congruency effects were evident from approximately 170 ms after stimulus onset.     

Contextual information and memory for unfamiliar tunes in older and younger adults

We examined age differences in the effectiveness of multiple repetitions and providing associative facts on tune memory. For both tune and fact recognition, three presentations were beneficial. Age was irrelevant in fact recognition, but older adults were less successful than younger in tune recognition. The associative fact did not affect young adults' performance. Among older people, the neutral association harmed performance; the emotional fact mitigated performance back to baseline. Young adults seemed to rely solely on procedural memory, or repetition, to learn tunes. Older adults benefitted by using emotional associative information to counteract memory burdens imposed by neutral associative information.     

The effect of question expectedness and experience on lying about intentions

In recent years researchers have started to focus on lying about intentions (Granhag, 2010). In the present experiment participants were interviewed about their forthcoming trip. We tested the hypothesis that liars (N=43) compared to truth tellers (N=43) would give fewer details to unexpected questions about planning, transportation and the core event, but an equal amount or more detail to expected questions about the purpose of the trip. We also tested the hypothesis that participants who had previously experienced the intention (i.e., they had made such a trip before) would give more detail than those who had never experienced the intended action. The unexpected question hypothesis was supported, whereas the previous experience effect only emerged in interactions. The benefit of using different types of questions for lie detection purposes is discussed.