Ethnic Differences in Perceived Impairment and Need for Care

Latino children in the U.S. have high rates of unmet need for mental health services, perhaps due to biased perceptions of impairment and need for care by parents and providers. We tested this argument using an experimental vignette design. Vignettes described children with problems that varied on severity (mild vs. serious), nature of the problem (internalizing vs. externalizing), as well as gender and ethnicity (Latino vs. Anglo). Raters were Latino and Anglo parents (N = 185) and providers (N = 189). Vignettes with Latino names were viewed as more impaired by both parents and providers, and this effect was significantly stronger in Latino vignettes with less severe problems. Severity and Latino features of vignettes also interacted with judgments of need for service. At higher severity, vignettes with Anglo names were judged to need service more than vignettes with Latino names, despite the same judged levels of impairment. Results are discussed in the light of the unmet need for Latinos.     

UNDERSTANDING WOMEN'S RISK FOR HIV INFECTION USING SOCIAL DOMINANCE THEORY AND THE FOUR BASES OF GENDERED POWER

Theoretical models to date have fallen short of accounting for the alarming worldwide rates of HIV infection in women through heterosexual contact. In this article, social dominance theory and the four bases of gendered power—force, resource control, social obligations, and consensual ideologies—are used to organize and explain international research findings on women's risk of contracting HIV from male sexual partners. Research suggests that the four bases of gendered power contribute to women having less power than men in heterosexual relationships, resulting in challenges to preventing HIV transmission from male partners. Social dominance theory also recognizes the intersections among various group-based hierarchies, such as race and class, thereby helping explain why women of color and low-income women are disproportionately affected by HIV. The intergroup focus of social dominance theory points to gender inequality as increasing men's risk of HIV infection as well, and the construct of social dominance orientation helps to explain individual differences in HIV risk behavior. We discuss the ways the current theoretical framework can prove useful in helping to guide future research addressing the connections between power and HIV risk, including exploring mediators and links to other theoretical models. We also discuss the implications the framework has for intervention efforts aimed at reducing HIV rates worldwide, such as supporting efforts at increasing women's representation in hierarchy-enhancing positions, incorporating empowerment issues into current interventions, promoting use of female condoms, and targeting heterosexual men for interventions.     

Messages about the uniqueness and similarities of people: Impact on U.S. Black and Latino youth

This experiment examined the impact of messages about uniqueness and similarity between groups of people on Black and Latino children's social attitudes. Children (ages 11–14) read two brief science books embedded with a similarities message (“all people are basically the same”), unique message (“each person is unique”), combined similar-unique message (“all people are the same in a way, but each person is also unique”), or no additional message (control). Relative to the other conditions, the combined condition increased general social tolerance and decreased desired social distance from White children. No message appeared to negatively impact participants' attitudes toward their own group. Implications of these results for basic and applied anti-bias work on promoting similarities, differences, or both are discussed.     

Reduction of disrupted caregiver behavior using modified interaction guidance

The present study is a reanalysis of a preexisting study examining the usefulness of the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE; Bronfman, Parsons, & Lyons‐Ruth, 1999) measure as an indicator of efficacy in reducing disrupted caregiver behavior in two brief interventions. The current study examines the rate of change in the display of disrupted caregiver behavior over the course of an attachment‐based intervention (Modified Interaction Guidance) in a group of 11 caregiver‐infant dyads referred to a tertiary care clinic for feeding problems. The AMBIANCE was utilized as an indicator of change in disrupted behavior following an assessment feedback session and three intervention sessions. Results showed a significant decrease in the total display of disrupted caregiver behaviors, as well as a change in classification from disrupted to not‐disrupted, after receiving both feedback from the assessment and the first treatment session. A qualitative analysis of the data further revealed different patterns of change between caregivers. These findings provide preliminary empirical support suggesting that a reduction of disrupted caregiver behavior can be observed relatively quickly after the commencement of the Modified Interaction Guidance intervention.     

To Join or Not to Join: School Counselors as a Case Study in Professional Membership

School counselors were surveyed regarding their choice to join or not join their professional organization. Members and nonmembers differed on the following: whether participants' graduate program emphasized professional membership, membership status of colleagues, the belief that professional organizations advance the field, and the belief that being a professional means joining professional associations. A model is proposed that includes major themes in the decision‐making process identified in the qualitative comment data. Implications for professional counseling organizations are discussed.     

Reward prediction error signals by reticular formation neurons

As a key part of the brain’s reward system, midbrain dopamine neurons are thought to generate signals that reflect errors in the prediction of reward. However, recent evidence suggests that “upstream” brain areas may make important contributions to the generation of prediction error signals. To address this issue, we recorded neural activity in midbrain reticular formation (MRNm) while rats performed a spatial working memory task. A large proportion of these neurons displayed positive and negative reward prediction error-related activity that was strikingly similar to that observed in dopamine neurons. Therefore, MRNm may be a source of reward prediction error signals.The capacity of an organism to respond appropriately to environmental stimuli depends on the ability to detect changes in the outcome of its behavior. The mesocorticolimbic dopamine system is thought to be central to this function (Wise 2004; Fields et al. 2007). Dopamine neurons in the ventral tegmental area (VTA) and substantia nigra pars compacta (SNc) increase activity relative to the presentation of cues that predict rewards and rewards of greater value than expected, and decrease activity relative to rewards of less value than predicted (Nakahara et al. 2004; Bayer and Glimcher 2005; Pan et al. 2005; Tobler et al. 2005). This activity is thought to be involved in a computation about errors in the prediction of reward (Schultz and Dickinson 2000) that can be used to correct behavior. A central issue relevant to the behavioral and computational interpretation of dopamine signals is whether prediction error signals are generated by dopamine neurons, per se, or by cells in “upstream” brain areas.Recent data suggest that brain areas afferent to dopamine neurons generate, or participate in, reward prediction error computations. Lateral habenula, which has been shown to inhibit the activity of VTA and SNc dopamine neurons (Herkenham and Nauta 1979; Christoph et al. 1986), has recently been identified as a potential source of reward prediction error signals (Matsumoto and Hikosaka 2007). A similar finding has been demonstrated in the pedunculopontine tegmental nucleus (PPTg), which is an important regulator of dopamine neuron activity (Floresco et al. 2003). PPTg neural responses varied according to whether or not the animal received expected rewards (Kobayashi and Okada 2007).As part of a larger study investigating the role of VTA in context-dependent spatial working memory (C.B. Puryear, M.J. Kim, and S.J.Y. Mizumori, in prep.), we recorded the activity of neurons in the magnocellular region of the midbrain reticular formation (MRNm according to the method of Swanson [2003]) at the level of the diencephalon. The reticular formation is thought to be important for modulating arousal and vigilance levels necessary for attending to and acting upon salient stimuli (Pragay et al. 1978; Mesulam 1981), and it has recently been shown that this portion of the reticular formation provides glutamatergic input to VTA (Geisler et al. 2007). Thus, MRNm is in a prime position to modulate the activity of VTA dopamine neurons when the outcome of behavior does not meet expectations and therefore may be a source of reward prediction error signals. Accordingly, we investigated whether MRNm neurons exhibited reward related activity, and whether this activity was related to the ability to predict acquisition of reward.Four male Long-Evans rats (4–6 mo old from Simonson Laboratory, Gilroy, CA) were housed individually in Plexiglas cages in a temperature- and humidity-controlled environment (12:12 h light:dark). Rats were provided with food and water ad libitum for 5 d prior to being handled daily and reduced to 85% of ad libitum feeding weights. Animal care and use was conducted according to University of Washington’s Institutional Animal Care and Use Committee guidelines.Rats were habituated to the testing environment and trained to perform a differential reward, win-shift spatial working memory task using radial maze procedures reported previously (Pratt and Mizumori 2001; C.B. Puryear, M.J. Kim, and S.J.Y. Mizumori, in prep.). Briefly, prior to the start of each trial, the end of each of the eight maze arms was baited with either a large (five drops) or small (one drop) amount of chocolate milk on alternating arms. Maze arms containing large or small amounts of reward were counterbalanced across rats and held constant throughout training. Trials started with a sample phase by presenting four maze arms (two large and two small reward arms; individually and randomly selected) to the rat. Immediately after presentation of the fourth arm, a test phase began by making all maze arms accessible so the rat could collect the remaining rewards. The trial ended once all arms were visited. The rat was then confined to the center of the maze for a 2-min intertrial interval. Arm re-entries were counted as errors. Once the rat was able to perform at 15 trials in less than 1 h for seven consecutive days, recording electrodes were surgically implanted.Details concerning the construction of recording electrodes and microdrives and surgical procedures can be found in previous works (McNaughton et al. 1983; Puryear et al. 2006; C.B. Puryear, M.J. Kim, and S.J.Y. Mizumori, in prep.). Briefly, rats were chronically implanted with either eight stereotrodes (four/hemisphere) or four tetrodes (two/hemisphere) made from 25-μm lacquer-coated tungsten wire (California Fine Wire), centered on the following coordinates relative to bregma: −5.25 mm posterior, 0.7 mm lateral, 6 mm ventral. One week of free feeding was allowed for rats to recover from surgery before recording experiments began.Recordings were performed as described previously (Puryear et al. 2006; C.B. Puryear, M.J. Kim, and S.J.Y. Mizumori, in prep.). If no clear spontaneous neural activity was encountered, electrodes were lowered in ∼25-μm increments (up to 175 μm/d) until unambiguous, isolatable units were observed. Single units were isolated from multiunit records using standard cluster-cutting software (MClust; A.D. Redish, University of Wisconsin). A template-matching algorithm was also used to facilitate separation of unique spike waveforms. We only included cells that had a high signal-to-noise ratio (>3:1), exhibited stable clusters throughout the recording session, and had clear refractory periods in the interspike interval histograms following cluster cutting.The final position of each stereotrode was marked by passing a 25-μA current through each recording wire for 25 sec while rats were under 5% isofluorane anesthesia. Rats were then given an overdose of sodium pentobarbital and transcardially perfused (0.9% buffered saline, followed by 10% formalin). Electrodes were retracted, and the brain was removed and allowed to sink in 30% sucrose-formalin. Coronal sections (40 μm) were sliced with a cryostat and stained with cresyl violet. Recording locations were verified by comparing depth measurements and reconstructions of the electrode tracks. Only cells determined to be located in MRNm (Swanson 2003) were considered for analysis.Rats were well trained on the spatial working memory task, committing 0.86 ± 0.2 (mean ± SEM) errors per trial during the first five trials (baseline trials). Importantly, rats demonstrated the ability to discriminate large and small reward locations. There was a significant negative correlation between the first four test phase arm choices (i.e., first, second, third, and fourth arm choice) and the probability that the arm chosen contained a large reward (Fig. 1B; Spearman’s ρ = −0.65, P < 0.001), indicating that rats reliably visited large reward arms before small reward arms during the test phase of each trial.Open in a separate windowFigure 1.Histology and basic firing properties of MRNm neurons. (A) Distribution of cells localized to MRNm. Each dot may represent the location of more than one neuron. Coronal slices adapted from Swanson (2003) (reprinted with permission from Academic Press ©2003). (B) Rats displayed preference for arms that contained large amounts of reward. Plotted is the average probability of choosing a large reward arm during the first four arm choices of the test phase of each trial. Error bars represent SEM. (C) Distribution of average firing rates and spike duration of MRNm neurons. Most cells fired less than 10 spikes/sec and exhibited waveform durations between 1.5 and 2.0 msec. (D) Examples of two MRNm neurons. Top row shows their average waveform on each wire of the tetrode. Scale bar = 1 msec. Middle and bottom rows depict their interspike interval and autocorrelation histograms, respectively.A total of 18 cells localized to MRNm were recorded while rats performed the task. Of these, one cell was omitted from analysis due to a very low average firing rate (∼0.2 spikes/sec), yielding 17 cells included in the following analyses. Figure 1A depicts the distribution of cells localized to MRNm. These cells exhibited a range of average firing rates, spike durations (defined as the time from the start to the end of the action potential) (Fig. 1C), and firing patterns (for representative interspike interval and autocorrelation histograms, see Fig. 1D).Reward-related neural activity was obtained by placing rewards in small metal cups mounted to the end of each maze arm and connected to the recording equipment (custom designed by Neuralynx, Inc.), which served as “lick detectors.” An event marker was automatically inserted into the data stream when the rat licked the cup, providing an instantaneous measurement of the time the rat first obtained reward.In order to determine whether MRNm neurons exhibited significant reward-related activity, peri-event time histograms (PETHs) were constructed (50 msec bins, ±2.5 sec around each reward event). A cell was considered to have a significant excitatory reward response if it passed the following two criteria: (1) The cell had a peak firing rate within ±150 msec of reward acquisition and (2) the peak rate was >150% of its average firing rate for the block of trials. These criteria were applied to PETHs collapsed across reward amounts and separately for large and small reward events. Overall, 47% (eight of 17) of MRNm neurons were found to exhibit significant excitatory responses upon acquisition of reward (Fig. 2D). Of these cells, most (88%, seven of eight) were found to fire relative to acquisition of only large rewards (e.g., Fig. 2A–C), while the remaining neuron fired relative to acquisition of both reward amounts. No cells were found to fire preferentially to acquisition of only small rewards. Aspects of animals’ movement (e.g., velocity) were not found to be a major contributor to the firing patterns of MRNm neurons during performance of the spatial working memory task (data not shown). Therefore, it appears that MRNm unit activity is predominantly biased to represent higher reward values.Open in a separate windowFigure 2.Reward-related activity of MRNm neurons. (A) Peri-event time histograms of one cell that exhibited a short-latency, excitatory response upon acquisition of rewards (t₍₀₎, bin width = 50 msec). Left histogram shows only a modest excitatory response when considering all rewards together. However, top and bottom right histograms show that the reward-related firing occurred upon acquisition of large and not small rewards. Gray-shaded areas indicate time periods analyzed for significant increases in firing rate. (B) Population summary of the proportion of MRNm neurons that demonstrated significant reward-related activity.In order to determine whether MRNm reward-related activity was associated with reward prediction, we tested unit responses to unexpected alterations of reward outcome or elimination of visuospatial information important for reward prediction. To do this, we allowed the rat to perform a second block of five trials with either the locations of large and small rewards switched (reward location switch condition), with two rewards (one large and one small, randomly selected) omitted from the study phase of each trial (reward omission condition), or with the maze room lights extinguished (darkness condition). Importantly, each of these manipulations created situations in which reward prediction errors likely occurred. Overall, these three testing conditions created the following situations, respectively: a mismatch between the locations of large and small rewards, a decreased probability of obtaining a reward, and a situation in which rats are not able to discriminate between arms associated with large and small amounts of reward (C.B. Puryear, M.J. Kim, and S.J.Y. Mizumori, in prep.). Therefore, positive prediction errors could occur when the animal received a large amount of reward on an arm previously associated with a small amount, when the rat retrieved rewards after visiting arms in which reward had been omitted, and when the rat obtained a large reward in darkness. Negative reward prediction errors could occur when the animal received a small amount reward on a maze arm previously associated with a large amount, when the rat visited an arm that did not contain a reward, and when the rat obtained a small reward in darkness.Eight cells with significant responses to large rewards were recorded during these tests (two during reward location switch, four during reward omission conditions, and two during darkness conditions). In order to determine whether the reward manipulations affected the reward-related activity of these cells, a reward activity value (RA) was first calculated, which was the average firing rate in the ±150 msec around the time of acquisition of rewards, expressed as a percentage in change relative to the cell’s average firing rate for each block of trials. These values were normalized to the maximum RA value observed, yielding a normalized RA value for the first and second block of trials (RA_n1 and RA_n2, respectively). These calculations were made for large and small rewards separately, and for non-rewarded arms in the reward omission condition.We then created scatterplots of RA_n’s for each block of trials. If reward-related activity was independent of the expectation of the reward received, RA_n1 and RA_n2 should be similar in each block of trials. As can been seen in Figure 3A, the reward-related activity was consistently higher when rats received more reward than expected in the second block of trials. Conversely, Figure 3B clearly shows that neural activity was consistently suppressed when rats received less reward than expected. These differences in reward-related firing were quantified by calculating the distance of each data point to the diagonal (i.e., the reward activity change index, or RACI): Directionality of the change in reward activity was taken into account in order to discern between increases and decreases in firing rate. A one-sample t-test (α = 0.05) indicated that average RACI values were significantly increased when rats received more reward than expected (t₍₇₎ = −2.73, P < 0.03) and were significantly decreased when rats received less reward than expected (t₍₇₎ = −4.88, P < 0.001). These results are consistent with positive and negative reward prediction error signals, respectively. An example of an MRNm neuron that exhibited both positive and negative prediction error-related activity in the reward location switch condition is depicted in Figure 3D.Open in a separate windowFigure 3.Reward prediction errors in MRNm neurons. (A) Plotted is each neuron’s normalized large reward activity (RA_N, defined in text) for each block of trials. The reward activity during block 2 (y-axis) represents activity at times when more reward than expected was obtained. Note that reward-related activity during these times is consistently more robust than during times in which the rat received the expected reward (block 1), indicating that positive reward prediction errors occurred. (B) Plotted are RA_N values for rewarded and devalued arms in block 2 (x- and y-axes, respectively). Devalued arms include arms associated with a large amount of reward but baited with a small amount of reward, arms in which reward was omitted, and arms containing small rewards visited in darkness. Note that reward-related activity on devalued arms is consistently suppressed, indicating that negative reward prediction errors occurred. (Symbols in A,B: ● indicates cell recorded in darkness condition; o, cell recorded in reward omission condition; and x, cell recorded in reward location switch condition.) (C) Average changes in reward activity (RACI, defined in text) for times in which the rat obtained more and less reward than expected. Asterisks indicate significant differences (P < 0.05). Error bars indicate SEM. (D) An example of one neuron that did not respond to acquisition of rewards during the first block of trials. When the locations of large and small rewards were switched, however, the cell developed an excitatory response to acquisition of large rewards on arms previously associated with small amounts of reward (positive reward prediction error). Furthermore, the firing of the cell was inhibited upon acquisition of small rewards on arms previously associated with large amounts of reward (negative reward prediction error).We demonstrate here that a large proportion of MRNm neurons may be involved in computations about reward acquisition. Similar to dopamine neurons (Tobler et al. 2005), the majority of reward-related MRNm neurons preferentially fired relative to acquisition of large amounts of reward. To our knowledge, this is the first demonstration of discriminative reward responses of reticular formation neurons and highlights a novel role for the reticular formation in reward value representations. Furthermore, these data suggest that MRNm neurons represent similar reward prediction error signals as dopamine neurons (Nakahara et al. 2004; Bayer and Glimcher 2005; Pan et al. 2005; Tobler et al. 2005). It is important to note that in this initial sample, there was remarkable overall consistency and reliability of the positive and negative reward prediction error signals by MRNm neurons. This is similar to the homogeneity of dopamine neuron responses, suggesting that reward prediction may be a major function of the overall population of MRNm reward-related neurons. Nevertheless, further parametric studies are necessary to determine whether MRNm neural activity conforms to the same basic firing profiles that have been well-described for dopamine neurons (i.e., predictive cues and reward probabilities).The reticular formation has traditionally been thought to be important for initiating general arousal states. This is in part due to initial reports of changes in unit activity during transitions from sleep to wakefulness (Huttenlocher 1961; Kasamatsu 1970; Manohar et al. 1972). In addition, a more specific role for the reticular formation in attention has been described in primates performing visual discrimination tasks (Pragay et al. 1978; Fabre et al. 1983). This is consistent with reports of sensory neglect following reticular formation lesions (Watson et al. 1974). Together, these foundational data suggest that reticular formation may function to enhance the overall level of arousal and vigilance necessary for attending to and acting upon salient stimuli (Mesulam 1981). Accordingly, changes in reward-related MRNm neuronal activity could provide an important signal indicating that the contingencies of recently executed behaviors have changed.The striking similarity of the reward prediction error signals of MRNm neurons reported here suggests that MRNm, along with brain regions such as lateral habenula (Matsumoto and Hikosaka 2007), pedunculopontine nucleus (PPTg) (Kobayashi and Okada 2007), and dorsal raphé nucleus (Nakamura et al. 2008) may contribute to the generation of reward prediction error signals observed in dopamine neurons. Furthermore, these data suggest the possibility that such signals are a general property of a large network of midbrain structures. Given that the projections from the reticular formation to VTA are glutamatergic (Geisler et al. 2007), it is possible that the changes in reward-related activity of MRNm neurons, in concert with PPTg, could provide an excitatory component of the reward prediction error signal. In combination with inhibitory inputs from lateral habenula, this may then selectively activate dopamine neurons to initiate the coordinated selection of appropriate behaviors in response to changes in reward outcome (Humphries et al. 2007).     

An Acceptance-Based Psychoeducation Intervention to Reduce Expressed Emotion in Relatives of Bipolar Patients

Expressed emotion (EE) is a robust predictor of outcome in bipolar disorder. Despite decades of research, interventions to reduce EE levels have had only modest effects. This study used an expanded model of EE to develop an intervention. Research has demonstrated a strong link between attributions and EE in families of patients with psychiatric disorders. There is also substantial research to suggest that anger can drive blaming attributions. Combining these ideas, this study built on previous psychoeducation interventions through the addition of an acceptance component designed to decrease anger and blaming attributions among family members of those with bipolar disorder. Twenty-eight family members attended a 1-day or 2-evening multifamily group workshop and completed a follow-up assessment 1 week later. At follow-up, participants demonstrated more knowledge about bipolar disorder. Anger, blaming attributions, and number of criticisms remained unchanged. Results of this study are consistent with others in that it is difficult to change EE. Implications for future clinical research in this area are addressed.     

Sexual body esteem and mindfulness in college women

Literature suggests that many young women hold negative perceptions of their sexual bodies and facial features. This may be related to deficits in mindfulness, manifested by rigid and automatic thoughts, feelings, and behavior about one's sexual body. The present study examined the relationships between the five factors of mindfulness measured by the Five Factor Mindfulness Questionnaire (FFMQ) and sexual body esteem, measured by the Sexual Attractiveness subscale of the Body Esteem Scale (BES) in 79 college women. A multiple regression was performed to examine the relationship between sexual body esteem and the factors of mindfulness. The Observing and Describing subscales were significantly and positively predictive of sexual body esteem while Non-reactivity to Inner Experience was significantly and negatively predictive of sexual body esteem. This relationship may have implications for future research and clinical practice.     

Effects of laboratory-induced controllable and uncontrollable stress on Rorschach variables m and Y.

The research literature regarding stress and the Rorschach has frequently produced contradictory results. A possible explanation for the lack of consensus may be that past research has failed to consider the nature of the stressor. A potentially important dimension is whether the stressor is perceived as controllable or uncontrollable, particularly because these two types of stressors invoke distinctive sets of biobehavioral reactions. We examined the effects of experimentally induced uncontrollable and controllable stress on m and Y Rorschach responses. Uncontrollable laboratory stress was associated with an increase in both m and Y variants, whereas controllable laboratory stress was associated with an increase only in m. Potential implications and directions for future research are discussed.