Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

Non-Naturalist Moral Realism,Autonomy and Entanglement

It was something of a dogma for much of the twentieth century that one cannot validly derive an ought from an is. More generally, it was held that non-normative propositions do not entail normative propositions. Call this thesis about the relation between the natural and the normative Natural-Normative Autonomy (or Autonomy for short). The denial of Autonomy involves the entanglement of the natural with the normative. Naturalism entails entanglement—in fact it entails the most extreme form of entanglement—but entanglement does not entail naturalism. In a ground-breaking paper “The autonomy of ethics” Arthur Prior constructed some intriguing counterexamples to Autonomy. While his counterexamples have convinced few, there is little agreement on what is wrong with them. I present a new analysis of Autonomy, one which is grounded in a general and independently plausible account of subject matters. While Prior’s arguments do establish shallow natural-normative entanglement, this is a consequence of simple logical relationships that hold between just about any two subject matters. It has nothing special to do with the logical structure of normativity or its relation to the natural. Prior’s arguments (along with several others) leave the fundamental idea behind natural-normative Autonomy intact. I offer a new argument for deep entanglement. I show that in any framework adequate for dealing with the natural and the normative spheres, a purely natural proposition entails a purely normative proposition, and vice-versa. But this is no threat to non-naturalist moral realism. In fact it helps ameliorate the excesses of an extreme non-naturalism, delivering a more palatable and plausible position.     

In the grip of fear: Dissociations in attentional processing of animal fearful individuals

Using a modified attention paradigm we investigated specific attentional mechanisms in processing animal feared stimuli. In this paradigm arrays of four pictures were displayed and after its disappearance from view a probe (a letter, X or P) then followed unpredictably in the location of one of the four pictures. The results showed that discriminations of probes tended to be impeded by spider stimuli, compared to snake stimuli. This effect was potentiated by high anxiety but only for those individuals fearful of spiders, since no such effect was observed for snake fearful individuals. Moreover, the discrimination of the probes was not facilitated when presented after the feared stimuli. The implications of these findings are discussed as a function of the cognitive bias involved in specific fear.     

“Reading” Paintings: Evidence for Trans-Symbolic and Symbol-Specific Comprehension Processes

Art-based reading instruction and interventions for elementary and middle school students are growing in popularity despite scant theoretical rationale and empirical research support. This study explored the degree to which painting comprehension processes map onto text comprehension processes in this population. In particular, we used think aloud protocols to examine the painting comprehension processes used by 35 fourth-grade and 34 eighth-grade students and compared the manifest processes to the literature on text comprehension. Protocol analysis revealed six painting comprehension processes—observing, activating prior knowledge, inferring and interpreting, elaborating, evaluating and responding, and monitoring—comprising 23 subprocesses. Of the identified painting comprehension subprocesses, 17 are commonly associated with text comprehension. These findings suggest that compositions—be they encoded visually, linguistically, or in another symbol system—may entail comprehension processes that transcend symbol systems, as well as processes that are particular to a given symbol system.     

Gender Differences in Experiences with Couples Treatment for IPV

Evidence suggests that conjoint treatment can be effective for certain violent couples in certain situations (Finkel in Rev Gen Psychol 11:193–207, 2007; LaTaillade et al. in J Cogn Psychother 20:393–410, 2006; Fals-Stewart et al. in J Consult Clin Psych 73:239–248, 2005; Stith et al. in J Marital Fam Ther 29(3):407–426, 2003). However, not as much is known about which aspects of conjoint treatment make a difference, nor if male and female participants experience these elements of treatment differently. Knowing which components of couples’ treatment clients perceive as helpful—and whether their perceptions differ by gender—will allow us to redefine models with an eye toward making them more effective. In this study we used qualitative methods to examine the aspects of a particular couples’ treatment program (Stith and McCollum in Aggress Violent Beh 16(4):312–318, 2011) that clients found useful while also considering the differences between men’s and women’s responses. Fourteen couples, in which the male had been identified as the primary aggressor, were interviewed multiple times to gain their perspectives about components of the program they found helpful and their suggestions for program improvement. Themes are analyzed by gender. Implications for treatment and future research are provided.