The motivational effects of thinking and worrying about the effects of smoking cigarettes

We tested a strategy to encourage cigarette smokers to think more frequently about the negative consequences of smoking, reasoning that increased thought might lead to greater worry and motivation to quit. College students who smoked daily were randomly assigned to one of three conditions in which they wore watches for one week that sounded an alarm randomly four times each day. When alerted, the students read one of eight cards that either had a written statement about studying (control condition), a statement about the negative effects of smoking behaviour (text condition), or a negative smoking statement accompanied by a picture (e.g., a blackened lung; image condition). Measures collected at week's end revealed that the smoking cards had no effects on perceived risk, but they increased worry and reports of intrusive thoughts, and had a small but reliable effect on plans to quit. Correlational data also supported the relationship between worry and motivation to quit, and we discuss the possible benefits of “normal” worrying and strategies for capitalising on the worry–motivation relationship to encourage smokers to abandon cigarettes.     

Emotion Regulation in Youth with Emotional Disorders: Implications for a Unified Treatment Approach

Given the relationship between internalizing disorders and deficits in emotion regulation in youth, the emotion science literature has suggested several avenues for increasing the efficacy of interventions for youth presenting with anxiety and depression. These possibilities include the identification and addition of emotion-regulation skills to existing treatment packages and broadening the scope of those emotions addressed in cognitive-behavioral treatments. Current emotion-focused interventions designed to meet one or both of these goals are discussed, and the developmental influences relevant to the selection of emotion-focused treatment goals are explored using the framework of a modal model of emotion regulation. These various lines of evidence are woven together to support the utility of a novel emotion-focused, cognitive-behavioral intervention, the Unified Protocol for the Treatment of Emotional Disorders in Youth, a transdiagnostic treatment protocol that aims to treat the range of emotional disorders (i.e., anxiety and depression) simultaneously. Avenues for future directions in treatment outcome and assessment of emotion regulation are also discussed.     

Top Ten Questions Male Sexual Abuse Survivors Want to Know from Health Care Research

Sexual abuse is an often overlooked public health issue for boys and men. Given its prevalence and well-documented connection to mental and physical health disorders, the relevance of male survivor input and engagement in health care research is profound. Using a community-based participatory research design, an in-person focus group with male survivors of sexual abuse and researchers was conducted. This paper describes the top ten research questions male sexual abuse survivors would like to have answered. Survivors were most interested in knowing how sexual abuse and assault impact men’s emotional and sexual functioning, what factors are involved in preventing and treating sexual assault-related emotional distress, and what can be done to prevent sexual abuse of boys and men. The fact that some of the questions survivors expressed an interest in knowing about have actually previously been investigated by researchers suggests a disconnect in translating evidence-based findings. Clinical and research implications include designing outreach interventions and gender-specific psychoeducation to increase engagement and access to care for men.     

Meta-Analysis of the Effects of Computerized Cognitive Training on Executive Functions: a Cross-Disciplinary Taxonomy for Classifying Outcome Cognitive Factors

The growing prevalence of neurodegenerative disorders associated with aging and cognitive decline has generated increasing cross-disciplinary interest in non-pharmacological interventions, such as computerized cognitive training (CCT), which may prevent or slow cognitive decline. However, inconsistent findings across meta-analytic reviews in the field suggest a lack of cross-disciplinary consensus and on-going debate regarding the benefits of CCT. We posit that a contributing factor is the lack of a theoretically-based taxonomy of constructs and representative tasks typically used. An integration of the Cattell-Horn-Carroll (CHC) taxonomy of broad and narrow cognitive factors and the Miyake unity-diversity theory of executive functions (EF) is proposed (CHC-M) as an attempt to clarify this issue through representing and integrating the disciplines contributing to CCT research. The present study assessed the utility of this taxonomy by reanalyzing the Lampit et al. (2014) meta-analysis of CCT in healthy older adults using the CHC-M framework. Results suggest that: 1) substantively different statistical effects are observed when CHC-M is applied to the Lampit et al. meta-analytic review, leading to importantly different interpretations of the data; 2) typically-used classification practices conflate Executive Function (EF) tasks with fluid reasoning (Gf) and retrieval fluency (Gr), and Attention with sensory perception; and 3) there is theoretical and practical advantage in differentiating attention and working-memory tasks into the narrow shifting, inhibition, and updating EF domains. Implications for clinical practice, particularly for our understanding of EF are discussed.     

Finding a Balance: Reconciling the Needs of the Institution,Patient, and Genetic Counselor for Optimal Resource Utilization

The current practice of cancer genetic counseling is undergoing widespread change and scrutiny. While there are clinical resources for genetic counselors (GCs) regarding the delivery of cancer genetic services, there is limited literature regarding effective management of a genetic counseling clinical program. We have developed administrative tools to manage a large team of GCs at a single academic medical center over a period of increasing demand for genetics services, with the initial aim of decreasing wait time for urgent genetic counseling visits. Here, we describe the three main elements of the clinical operations: Balancing patient volume between GCs, scheduling tracks for both routine and urgent appointments, and a team of triaging GCs to ensure appropriate patient referrals. For each of these elements, we describe how they have been modified over time and present data to support the utility of these strategies. The preliminary evidence offered here suggests that these tools allow for an equitable distribution of patient volume between team members, as well as the timely and accurate scheduling of urgent patients. As a result of the experiences presented here, other genetic counseling programs grappling with similar issues should be aware that it is possible to shift clinical operations to serve certain patient populations in a more timely fashion while keeping both providers and GC staff satisfied.     

New Directions in the Cognitive-Behavioral Treatment of OCD: Theory,Research, and Practice

The beneficial effects of cognitive-behavioral interventions (particularly exposure and response prevention) for OCD are among the most consistent research findings in the mental health literature. Nevertheless, even after an adequate trial, many individuals experience residual symptoms, and others never receive adequate treatment due to limited access. These and other issues have prompted clinicians and researchers to search for ways to improve the conceptual and practical aspects of existing treatment approaches, as well as look for augmentation strategies. In the present article, we review a number of recent developments and new directions in the psychological treatment of OCD, including (a) the application of inhibitory learning approaches to exposure therapy, (b) the development of acceptance-based approaches, (c) involvement of caregivers (partners and parents) in treatment, (d) pharmacological cognitive enhancement of exposure therapy, and (e) the use of technology to disseminate effective treatment. We focus on both the conceptual/scientific and practical aspects of these topics so that clinicians and researchers alike can assess their relative merits and disadvantages.     

Supervision in Community Mental Health: Understanding Intensity of EBT Focus

The goal of the present study was to examine clinician, supervisor, and organizational factors that are associated with the intensity of evidence-based treatment (EBT) focus in workplace-based clinical supervision of a specific EBT, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Supervisors (n = 56) and clinicians (n = 207) from mental health organizations across Washington State completed online self-report questionnaires. Multilevel modeling (MLM) analyses were used to examine the relative influence of nested clinician and supervisor factors on the intensity of EBT focus in supervision. We found that 33% of the variance in clinician report of EBT supervision intensity clustered at the supervisor level and implementation climate was the only significant factor associated with EBT supervision intensity. While individual clinician and supervisor factors may play a role in EBT coverage in supervision, our results suggest that an implementation climate that supports EBT may be the most critical factor for improving intensity of EBT coverage. Thus, implementation efforts that address the extent to which EBTs are expected, rewarded, and supported within an organization may be needed to support greater coverage of EBT during workplace-based supervision.     

Moral Emotions Toward Others at Work and Implications for Employee Behavior: a Qualitative Analysis Using Critical Incidents

We propose a theoretical framework for and, via critical incidents, inductively investigate (a) the situations that trigger moral emotions toward others at work and (b) worker responses to these situations. Critical incidents were collected from a heterogeneous sample of 423 workers. Participants described an incident that caused each of four moral emotions (gratitude, anger, admiration, and contempt) and their response. Incidents and responses were coded, and frequencies, differences across the moral emotions, and associations between incidents and responses were analyzed. Several morally relevant situations at work were found to trigger the moral emotions. Participants responded in ways that had implications for their performance and their own well-being. The incidents largely align with moral foundations theory (Haidt and Graham in Social Justice Research, 20, 98–116, 2007). Responses also show evidence for social exchange, social learning, and rational expectancy-based processes and behavior. The incidents specify several practices for managers and organizations to encourage and avoid. This was the first qualitative study of moral emotions at work and one of the few workplace studies to examine these emotions empirically. Several understudied factors and behavioral responses emerged.