A Brief,Hospital-Initiated Motivational Interviewing and Acceptance and Commitment Therapy Intervention to Link Postpartum Mothers Who Use Illicit Drugs With Treatment and Reproductive Care: A Case Report

Maternal substance use during the prenatal period often results in infants with compromised health outcomes. The American College of Obstetrics and Gynecology recommends screening, brief motivational interviewing, and referral to existing treatment for women who use illicit substances prenatally. However, many of these women do not present for prenatal care and are not identified as using substances until delivery of their infants, many of whom are admitted to the neonatal intensive care unit (ICU). We describe a case from a novel, hospital-initiated intervention study, Moms in ACTion (MIACT) that combines motivational interviewing (MI) and acceptance and commitment therapy (ACT) to target new mothers with an infant in the neonatal ICU who screen positive for illicit substance use prenatally or at delivery. The MIACT program consists of an adaptive intervention that includes up to three sessions. Initiation of substance use treatment and reproductive care via a gynecological visit are the primary targets of the intervention. Urine samples were collected at 2- and 6-month follow-up visits. The participant successfully completed the program, achieved both treatment outcomes, and had negative urine drug screens at follow-up visits. Improvements in readiness to change and psychological flexibility were also observed. The present case report of a new mother who used substances demonstrated feasibility for combining MI and ACT treatments and the potential for MIACT to increase treatment and contraception initiation, ultimately preventing future substance-exposed pregnancies.     

Cookson,R., Griffin,S., Norheim,O. F., & Culyer,A. J. (Eds.). (2020). Distributional Cost-Effectiveness Analysis: Quantifying Health Equity Impacts and Trade-Offs. Oxford: Oxford University Press, 2020. Paperback (ISBN-13: 9780198838197). £ 28.03. 365 pp

Ethical Theory and Moral Practice -     

A FURTHER EVALUATION OF PICTURE PROMPTS DURING AUDITORY‐VISUAL CONDITIONAL DISCRIMINATION TRAINING

This study was a systematic replication and extension of Fisher, Kodak, and Moore (2007 ), in which a picture prompt embedded into a least‐to‐most prompting sequence facilitated acquisition of auditory‐visual conditional discriminations. Participants were 4 children who had been diagnosed with autism; 2 had limited prior receptive skills, and 2 had more advanced receptive skills. We used a balanced design to compare the effects of picture prompts, pointing prompts, and either trial‐and‐error learning or a no‐reinforcement condition. In addition, we assessed the emergence of vocal tacts for the 2 participants who had prior tact repertoires. Picture prompts enhanced acquisition for all participants, but there were no differential effects on tact emergence. The results support a generality of the effect reported by Fisher et al. and suggest that a variety of learners may benefit from the incorporation of picture prompts into auditory‐visual conditional discrimination training.     

Strategies and Techniques to Maintain Sexual Desire

The new mantra in sex therapy is desire, pleasure, eroticism, and satisfaction. There is growing acceptance that the prime sexual factor influencing the couple’s relationship is sexual desire. This conceptual/clinical paper explores two core concepts for maintaining sexual desire in committed, long-term relationships: (1) Establishing a comfortable, functional couple sexual style which balances each person’s sexual autonomy with being an intimate, erotic team and (2) adopting the Good Enough Sex model which promotes a variable, flexible sexual repertoire and recognizes the value of both mutual (synchronous) and asynchronous sexual experiences.     

Construal level mind-sets moderate self- and social stereotyping

Construal level theory suggests that events and objects can be represented at either a higher, more abstract level involving consideration of superordinate goals, desirability, global processing, and broad categorizations or a lower, more concrete level involving consideration of subordinate goals, feasibility, local processing, and narrow categorizations. Analogously, social targets (including the self) can be represented more broadly, as members of a group, or more narrowly, as individuals. Because abstract construals induce a similarity focus, they were predicted to increase the perceived fit between social targets and a salient social category. Accordingly, placing individuals into a more abstract construal mind-set via an unrelated task increased the activation and use of stereotypes of salient social groups, stereotype-consistent trait ratings of the self, group identification, and stereotype-consistent performance relative to more concrete construal mind-sets. Thus, nonsocial contextual influences (construal level mind-sets) affect stereotyping of self and others.     

Integrating Social Identity and the Theory of Planned Behavior: Predicting Withdrawal from an Organizational Recruitment Process

This study develops and tests a model of applicant withdrawal. Drawing on tenets from social identity theory and the theory of planned behavior, this study proposes that applicants who highly identify with an organization will experience higher pursuit intentions and subsequently be less inclined to withdraw from recruitment. Data were collected from a sample of 669 applicants to the U.S. military at 2 intervals, separated by 3 months. Strong support was found for the proposed theoretical model. Implications for research and practice will be discussed.     

Consciously identified attachment hierarchies: cognitive accessibility of attachment figure names as a function of threat primes in a lexical decision task

Studies have linked the subliminal priming of threat-related words to heightened cognitive accessibility directed towards the names of identified attachment figures. The present study used a lexical decision task to examine the cognitive accessibility of names of individuals who formed part of participants' self-reported attachment hierarchies. We did not find support for heightened accessibility in relation to the names of (a) consciously identified attachment figures in general, (b) full-blown attachment figures, or (c) primary attachment figures. However, our data revealed that participants showed increased accessibility to mothers' names in response to threat primes. This effect was even identified in individuals who did not consider mothers to occupy a primary position in their attachment hierarchy. Results are discussed in the context of attachment system activation in early adulthood.     

Gay, Lesbian, and Bisexual Patients’ Recommendations for Genetic Counselors: A Qualitative Investigation

Gay, lesbian, and bisexual (GLB) individuals comprise a growing patient population in genetic counseling. However, only one article from a genetic counseling journal provides empirical data on GLB patients' genetic counseling experiences and genetic counselor attitudes and practices regarding GLB patients. The present study, an extension of the aforementioned article, gathered further information about patients' genetic counseling experiences through semi-structured telephone interviews. Twelve of the previous study's 29 patient respondents (n?=?10 lesbian women, n?=?1 gay man, n?=?1 bisexual woman) participated. Interview questions concerned the use of medically inclusive forms, factors influencing patient disclosure, counselors' ability to relate to them, and their expectations of genetic counselors. Inductive analysis of the interviews yielded seven themes: 1) Medically inclusive forms with gender neutral terms are important; 2) Genetic counselor ability to relate to a GLB person depends more on the relationship established during the session and less on external symbols; 3) The presence of GLB-friendly symbols increases comfort when disclosing one's orientation; 4) Inclusion of the patient's partner is important and best done by encouraging their active participation in sessions; 5) When GLB patients disclose their orientation, they expect to be treated like any other patient; 6) Providers should ask about orientation if medically pertinent and the remaining discussion should take orientation into consideration; and 7) When a provider inquires about orientation it should be done in a safe and appropriate way. Illustrative quotations, genetic counseling practice implications, and research recommendations are presented.