The evidence missing from evidence-based practice

Comments on the report by the APA Presidential Task Force on Evidence-Based Practice entitled Evidence-based practice in psychology. Regrettably, the task force report was largely silent on three critical issues. As a consequence, it omitted much of the evidence necessary for a complete picture of evidence-based practice. First, the task force report did not operationalize "evidence." Second, the task force report did not address the crucial problem of iatrogenic treatments. Third, the task force report said little about the necessity for ongoing objective evaluation of clinical cases, which is critical to ethically responsible services. Current debate centers on how research findings should be factored into interventions, not on whether it is necessary to do so. Rather than waiting for the resolution of competing views on the matter, psychologists bear an ethical obligation to offer evidence-informed services. Three critical steps that were largely neglected by the task force report can go far toward helping psychologists honor that commitment: (a) providing a clearer operationalization of scientific evidence, (b) using current research to rule out the use of potentially harmful methods, and (c) using objective criteria to evaluate all of their cases on an ongoing basis. These steps, in turn, clarify the menu of options available to therapists, help protect clients from harm, and offer the advantage of allowing clinicians to contribute to the growing body of knowledge about what does and does not work in psychotherapy.     

Different action patterns for cooperative and competitive behaviour

The aim of the present study is to elucidate the influence of context on the kinematics of the reach-to-grasp movement. In particular, we consider two basic modes of social cognition, namely cooperation and competition. In two experiments kinematics of the very same action - reaching-to-grasp a wooden block - were analyzed in two different contexts provided by a cooperative task and competitive task. For the 'cooperation' tasks two participants were required to reach and grasp their respective objects and to cooperate to join the two objects in specific configurations in the middle of the working surface. For the 'competition' tasks, the two participants had to compete to place their own object first in the middle of the working surface. Results revealed specific kinematic patterns for cooperation and competition which were distinct from similar actions performed by each participant in isolation. Further, during the cooperation tasks, a high level of correlation between key kinematical parameters of the two participants was found. In accordance with evidence from neuroimaging, developmental and social psychology our results suggest the existence of motor patterns which reflect the intention to act in a social context.     

Reduction of interindividual-intergroup discontinuity: the role of leader accountability and proneness to guilt

Two experiments contrasted interactions between group leaders with interactions between individuals in a mixed-motive setting. Consistent with the idea that being accountable to the in-group implies normative pressure to benefit the in-group, Experiment 1 found that accountable leaders were more competitive than individuals. Consistent with the idea that being unaccountable to the in-group implies normative pressure to be cooperative and that high guilt proneness provides motivation to be moral, Experiment 2 found that when guilt proneness was high, unaccountable leaders were less competitive than accountable leaders and did not differ significantly from individuals. In other words, the robust interindividual-intergroup discontinuity effect was eliminated when groups had unaccountable leaders who were high in guilt proneness.     

Detection of malingering of psychiatric disorder with the personality assessment inventory: an investigation of criminal defendants

To assess the diagnostic accuracy of the Personality Assessment Inventory (PAI; Morey, 1991) Validity scales for the detection of malingered psychiatric disorders, we divided a sample of criminal defendants referred for forensic evaluation by the federal courts into malingering and not malingering groups based on their performance on the Structured Interview of Reported Symptoms (Rogers, Gillis, & Bagby, 1990). Logistic regression analyses (LGAs) revealed that there were no differences between the malingering and not malingering groups with respect to age, race, years of education, history of drug abuse, or number of previous felony convictions. LGA with malingering versus not malingering as the criterion revealed that the PAI Negative Impression Management (NIM) scale but not the Rogers Discriminant Function (RDF; Rogers, Sewell, Morey & Ustad, 1996) nor the Malingering index (MAL; Morey, 1996) significantly differentiated the malingering from the not malingering group. Receiver operating characteristics analyses demonstrated acceptable sensitivity and specificity for the NIM scale but not the RDF scale or the MAL index. We discuss the results in terms of the suggested cutoff scores for the PAI Validity scales in detecting criminal defendants who are attempting to feign psychiatric disorder.     

The Varieties of Forgiveness Experience: Working toward a Comprehensive Definition of Forgiveness

The definition of forgiveness was explored in a group of 270 young adults, and the underlying dimensions of their definitions compared with those of philosophers, theologians and psychological researchers. Three dimensions were identified: orientation (self, other), direction (passive letting go of negative experiences, active enhancement of positive experiences) and form (emotion, cognition and behavior). Definitions employing a passive letting go of negative experiences were associated with more state forgiveness. Gender differences were found in state forgiveness and in the employment of passive vs. active dimensions of forgiveness. Dr. Kathleen A. Lawler-Row is Professor of Psychology at East Carolina University. Her work focuses on the physiological and health correlates of forgiveness. Correspondence to Dr. K. A. Lawler-Row, e-mail: rowk@ecu.edu. Cynthia Scott and Meirav Edlis-Matityahou are graduate students in the Experimental and Counseling (respectively) programs at the University of Tennessee. Rachel Raines and Erin Moore are undergraduate students working with Dr. Lawler-Row in the department of psychology.     

Plasma interleukin-6 and soluble IL-6 receptors are associated with psychological well-being in aging women.

OBJECTIVE: This study tested the hypothesis that psychological well-being would predict lower plasma levels of inflammatory factors in aging women. DESIGN: One hundred thirty-five women ages 61-91 years (M = 74.5 years) participated in this study. After completing self-administered questionnaires in their homes, participants stayed overnight at the General Clinical Research Center (GCRC) at the University of Wisconsin-Madison. Blood samples for cytokine analyses were obtained in participants' homes after the GCRC visit. MAIN OUTCOME MEASURES: Psychological well-being and ill-being, history of health problems, and health behaviors were assessed via self-administered questionnaires. Detailed medical history and concurrent health measures were obtained during the GCRC stay. Enzyme-linked immunosorbent assays were used to determine interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) concentrations in plasma. RESULTS AND CONCLUSION: Regression analyses showed that plasma IL-6 levels were lower in women scoring higher on positive relationships, whereas sIL-6R levels were lower in women scoring higher on purpose in life, even after a variety of sociodemographic and health factors were controlled. These outcomes, combined with the absence of significant links with other measures of well-being and ill-being, suggest selective patterns of association between later life inflammatory processes and psychological factors, particularly those focused on positive ties with others and purposeful engagement.     

Ongoing physical activity advice by humans versus computers: the Community Health Advice by Telephone (CHAT) trial.

PURPOSE: Given the prevalence of physical inactivity among American adults, convenient, low-cost interventions are strongly indicated. This study determined the 6- and 12-month effectiveness of telephone interventions delivered by health educators or by an automated computer system in promoting physical activity. DESIGN: Initially inactive men and women age 55 years and older (N = 218) in stable health participated. Participants were randomly assigned to human advice, automated advice, or health education control. MEASURES: The validated 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity. Physical activity differences by experimental arm were verified on a random subsample via accelerometry. RESULTS: Using intention-to-treat analysis, at 6 months, participants in both interventions, although not differing from one another, showed significant improvements in weekly physical activity compared with controls. These differences were generally maintained at 12 months, with both intervention arms remaining above the target of 150 min per week of moderate to vigorous physical activity on average. CONCLUSION: Automated telephone-linked delivery systems represent an effective alternative for delivering physical activity advice to inactive older adults.     

Environmental-genetic interactions in experimental hypertension: the Dahl rat model

Dahl selected lines of salt-sensitive rats respond to hypertensinogenic stimuli such as sodium or behavioral stressors with marked elevations in blood pressure. In contrast, Dahl salt-resistant rats do not. The two lines appear to differ in terms of heart-rate reactivity and central nervous system organization.