Popular or unpopular? Therapists' use of structured interviews and their estimation of patient acceptance

An accurate diagnosis is an important precondition for effective psychotherapeutic treatment. The use of structured interviews provides the gold standard for reliable diagnosis. Suppiger et al. (2009) showed that structured interviews have a high acceptance among patients. On a scale from 0 (not at all satisfied) to 100 (totally satisfied) patients rated overall satisfaction with a structured interview at M = 86.55. Nevertheless, therapists rarely seem to use structured interviews in clinical practice. The aim of this study was to assess how frequently therapists use structured interviews in daily practice. Secondly, we hypothesized that therapists underestimate patient acceptance of structured interviews. As a third goal, we explored further reasons why therapists choose not to use structured interviews. We conducted an online survey of 1,927 psychiatrists and psychotherapists in Switzerland and asked them how frequently they used structured interviews and how they estimated patient satisfaction with these interviews. Furthermore, we asked therapists why they chose to use or not use structured interviews. Therapists reported using structured interviews on average with about 15% of their patients. Furthermore, therapists estimated significantly lower patient acceptance than patients themselves indicated (M_therapist = 49.41, M_patient = 86.55). Our data suggest lack of familiarity with these instruments as well as an overestimation of the utility of open clinical interviews as further reasons for not using structured interviews.     

Aberrant asociality: how individual differences in social anhedonia illuminate the need to belong

The need to belong, a fundamental concept in psychology, organizes a wide range of findings in the study of interpersonal relationships. We suggest that human belongingness needs can be illuminated by examining when they go awry. We review research on social anhedonia, a trait that involves a marked disinterest in interpersonal contact. Social anhedonia has a long history in clinical psychology, particularly in the study of schizotypy and schizophrenia-spectrum disorders, but it is just starting to get attention from social and personality psychologists. Three lines of research-cross-sectional studies of individual differences, longitudinal studies of risk for psychopathology, and experience-sampling studies of interpersonal behavior-suggest that (1) social anhedonia represents genuine social disinterest, not merely shyness, introversion, or social anxiety, and (2) people high in social anhedonia have consistently poorer functioning, including a higher risk for developing schizophrenia-spectrum disorders. Just as satisfied relatedness needs promote flourishing, dysfunctional social needs promote psychopathology.     

Analyzing temporal patterns of infant sleep and negative affective behavior: a comparison between different statistical models

Objective

Variability in infant sleep and negative affective behavior (NAB) is a developmental phenomenon that has long been of interest to researchers and clinicians. However, analyses and delineation of such temporal patterns were often limited to basic statistical approaches, which may prevent adequate identification of meaningful variation within these patterns. Modern statistical procedures such as additive models may detect specific patterns of temporal variation in infant behavior more effectively.

Method

Hundred and twenty-one mothers were asked to record different behaviors of their 4–44 weeks old healthy infants by diaries for three days consecutively. Circadian patterns as well as individual trajectories and day-to-day variability of infant sleep and NAB were modeled with generalized linear models (GLMs) including a linear and quadratic polynomial for time, a GLM with a polynomial of the 8th order, a GLM with a harmonic function, a generalized linear mixed model (GLMM) with a polynomial of the 8th order, a generalized additive model, and a generalized additive mixed model (GAMM).

Results

The semi-parametric model GAMM was found to fit the data of infant sleep better than any other parametric model used. GLMM with a polynomial of the 8th order and GAMM modeled temporal patterns of infant NAB equally well, although the GLMM exhibited a slightly better model fit while GAMM was easier to interpret. Besides the well-known evening clustering in infant NAB we found a significant second peak in NAB around midday that was not affected by the constant decline in the amounts of NAB across the 3-day study period.

Conclusion

Using advanced statistical procedures (GAMM and GLMM) even small variations and phenomena in infant behavior can be reliably detected. Future studies investigating variability and temporal patterns in infant variables may benefit from these statistical approaches.     

Friendship factors and suicidality: common and unique patterns in Mexican American and European American youth

Research suggests a link between friendships and suicidality among U.S. youth, but this link has not been confirmed across ethnicities. The relationship between friendships and suicidality among Mexican American and European American adolescents was examined in this study. Specifically, the role of friendship problems (i.e., social isolation, poor quality friendships) and problematic friends (i.e., friends who were disconnected from school, delinquent friends) was explored. Participants were 648 community youth. Friends' school disconnection was related to Mexican American girls' suicidal ideation, while friends' delinquency was associated with European American youth suicidal behavior. Friendship factors were no longer associated with suicidality after controlling for suicidality correlates such as depression. These findings indicate that the relationship between friendships and suicidality varies by gender and ethnicity. They also suggest a dominant role of depression.     

Psychometric Properties of the Wisconsin Schizotypy Scales in an Undergraduate Sample: Classical Test Theory,Item Response Theory,and Differential Item Functioning

The Wisconsin Schizotypy Scales are widely used for assessing schizotypy in nonclinical and clinical samples. However, they were developed using classical test theory (CTT) and have not had their psychometric properties examined with more sophisticated measurement models. The present study employed item response theory (IRT) as well as traditional CTT to examine psychometric properties of four of the schizotypy scales on the item and scale level, using a large sample of undergraduate students (n = 6,137). In addition, we investigated differential item functioning (DIF) for sex and ethnicity. The analyses revealed many strengths of the four scales, but some items had low discrimination values and many items had high DIF. The results offer useful guidance for applied users and for future development of these scales.     

Self-focused attention,performance expectancies,and the intensity of effort: Do people try harder for harder goals?

Many theories argue that goal striving is more intense when people have optimistic expectancies for achieving the goal and when attention is self-focused. Brehm’s motivational intensity theory, however, predicts that the intensity of motivation is only as high as necessary, so people will try harder for difficult tasks than for easy tasks, all else equal. The present experiment compared these two approaches by manipulating two levels of self-focused attention (low and high self-awareness, via a mirror) and two levels of task difficulty (easy and difficult). Effort was assessed as cardiovascular reactivity, particularly change in systolic blood pressure. Neither high self-focus nor an easy task per se caused increased effort; instead, high self-focus significantly increased systolic reactivity when the task was difficult. Effort was thus higher despite less optimistic goal expectancies, a finding that is predicted by Brehm’s motivational intensity theory but not by traditional self-regulation models.     

Vigilance and Avoidance of Threat in the Eye Movements of Children with Separation Anxiety Disorder

The vigilance-avoidance attention pattern is found in anxious adults, who initially gaze more at threatening pictures than nonanxious adults (vigilance), but subsequently gaze less at them than nonanxious adults (avoidance). The present research, using eye tracking methodology, tested whether anxious children show the same pattern. Children with separation anxiety disorder or no mental disorder viewed pairs of pictures, while the direction of their gaze was tracked. Each picture pair showed one picture of a woman separating from a child, the other picture of a woman reuniting with a child. The results supported the vigilance-avoidance model in children. Although the two groups’ gaze direction did not differ during the first second of viewing, anxious children gazed significantly more at separating (threatening) pictures than nonanxious children after a period of 1 s. But after 3 s the pattern reversed: anxious children gazed significantly less at the separating pictures than nonanxious children.     

Facial expressions of singers influence perceived pitch relations

In four experiments, we examined whether facial expressions used while singing carry musical information that can be “read” by viewers. In Experiment 1, participants saw silent video recordings of sung melodic intervals and judged the size of the interval they imagined the performers to be singing. Participants discriminated interval sizes on the basis of facial expression and discriminated large from small intervals when only head movements were visible. Experiments 2 and 3 confirmed that facial expressions influenced judgments even when the auditory signal was available. When matched with the facial expressions used to perform a large interval, audio recordings of sung intervals were judged as being larger than when matched with the facial expressions used to perform a small interval. The effect was not diminished when a secondary task was introduced, suggesting that audio-visual integration is not dependent on attention. Experiment 4 confirmed that the secondary task reduced participants’ ability to make judgments that require conscious attention. The results provide the first evidence that facial expressions influence perceived pitch relations.     

Reactance and the dynamics of disagreement: multiple paths from threatened freedom to resistance to persuasion

Many experiments show that threats to attitudinal freedom create reactance, but the underlying dynamics of reactance‐based disagreement have not received much attention. The present experiments identified two paths from threats to disagreement. In one path, threats to attitudinal freedom directly motivate disagreement; in the other, negative cognitive responses mediate the threat's effect on disagreement. Two experiments demonstrated the causes and consequences of each path from threat to persuasion. When a communicator threatened freedom at the beginning of the message, unfavorable cognitive responses (counterarguing, negative perceptions of the source's credibility) fully mediated the effect of threat on disagreement. When the threat appeared at the end of the message however, threat had a direct, unmediated effect on disagreement (Experiment 1). The two paths had different consequences for sleeper effects: disagreement rooted in negative cognitive responses persisted, whereas disagreement directly motivated by the threat declined when the threat was removed (Experiment 2). Implications for reactance and for threat‐based sleeper effects are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

A Brain-Based Account of the Development of Rule Use in Childhood

ABSTRACT— The ability to follow explicit rules improves dramatically during the course of childhood, but relatively little is known about the changes in brain structure and function that underlie this behavioral improvement. Drawing from neuroscientific studies in human adults and other animals, as well as from an emerging literature in developmental cognitive neuroscience, we propose a brain-based account of the development of rule use in childhood. This account focuses on four types of rules represented in different parts of the prefrontal cortex: simple rules for reversing stimulus–reward associations, pairs of conditional stimulus–response rules (both univalent and bivalent), and higher-order stimulus–response rules for selecting among task sets. It is hypothesized that the pattern of developmental changes in rule use reflects the different rates of development of specific regions within the prefrontal cortex.