Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

Family Therapy with Couples and Individuals with Parkinson’s Disease

Family therapists are increasingly called upon to work with individuals and families with medical issues, but often do not have sufficient background on the issue to be most helpful. The purpose of this paper is to help family therapists understand Parkinson’s Disease (PD) and its impact on the individual and his or her family. PD is the second most prevalent neurodegenerative disorder in the United States, following Alzheimer’s disease (Hirtz et al., Neurology 68:326–337, 2007). According to the Parkinson’s Disease Foundation, approximately 60,000 individuals are diagnosed with PD every year, and approximately one million Americans are currently living with PD. In this paper, we provide an overview of PD based on research and the second author’s many years of providing services for individuals with PD, as well as offer specific recommendations for providing family therapy using narrative, solution-focused and emotionally focused therapy based on the first author’s work as a family therapist with individuals, groups, and couples dealing with PD.     

An Approach‐Inhibition Model of Employee Silence: The Joint Effects of Personal Sense of Power and Target Openness

When employees consciously withhold potentially important suggestions or concerns from those who may be able to act on that information, it can have serious implications for organizational performance. Yet there is research suggesting that, when faced with the choice of whether or not to raise an issue, employees often choose to remain silent. Our objective in this paper is to expand current theoretical understanding of why employees often remain silent and of situational factors that can lessen this tendency. Drawing on the approach‐inhibition theory of power, we argue that an employee's personal sense that he or she is lacking in power in relation to others at work is a key factor contributing to the decision to remain silent but that this effect is moderated by perceived target openness. We took a multimethod approach, testing these relationships across 3 studies: a laboratory experiment, a survey study of healthcare workers, and a survey study of employees working across a wide range of industries. Our findings suggest that, although silence is indeed rooted in the psychological experience of powerlessness, perceived target openness mitigates this relationship, encouraging employee to speak up when they would not otherwise do so.     

Non‐Bayesian Noun Generalization in 3‐ to 5‐Year‐Old Children: Probing the Role of Prior Knowledge in the Suspicious Coincidence Effect

It is unclear how children learn labels for multiple overlapping categories such as “Labrador,” “dog,” and “animal.” Xu and Tenenbaum (2007a) suggested that learners infer correct meanings with the help of Bayesian inference. They instantiated these claims in a Bayesian model, which they tested with preschoolers and adults. Here, we report data testing a developmental prediction of the Bayesian model—that more knowledge should lead to narrower category inferences when presented with multiple subordinate exemplars. Two experiments did not support this prediction. Children with more category knowledge showed broader generalization when presented with multiple subordinate exemplars, compared to less knowledgeable children and adults. This implies a U‐shaped developmental trend. The Bayesian model was not able to account for these data, even with inputs that reflected the similarity judgments of children. We discuss implications for the Bayesian model, including a combined Bayesian/morphological knowledge account that could explain the demonstrated U‐shaped trend.     

The experiences of short-term humanitarian aid workers in Haiti

A small group of humanitarian aid workers travelled to Port-au-Prince, Haiti six months after the 2010 earthquake to assist in recovery efforts at an orphanage. This study explores the experiences of these workers and how they coped with the challenges in Port-au-Prince. Participants kept a journal to record their daily experiences. A phenomenological methodology was used to analyse the data in this study. Themes included relationships and connections, faith/perspective, care of self and others, purpose, and perspective. Researchers concluded relief workers need more preparation and support during and after humanitarian trips as experiences significantly impact workers perspective of themselves and others.     

Heterogeneity in verbal memory: a marker of preclinical Alzheimer's disease?

Demonstrations of memory changes in those at risk for Alzheimer's disease by the presence of the APOE e4 allele have been inconsistent to date. The present study went beyond traditional analyses of central tendency (i.e., group differences on mean test scores) and also conducted distribution analyses to search for subtle cognitive differences in subgroups of normal-functioning elderly persons with the APOE e4 genotype. The results of the study revealed that (a) the e4 and non-e4 groups failed to differ in terms of their mean scores on tests of memory and verbal skills; and (b) relative to the non-e4 group, the e4 subjects had significantly greater heterogeneity of variance on the memory measures but not on fundamental verbal skills. Logistic regression analyses indicated that the discrepancy in scores on the memory measures was a significant predictor of genotype group membership (82% correct classification rate). Implications of these findings for the detection of a preclinical phase of AD are discussed.     

Connectivity among semantic associates: an fMRI study of semantic priming

Semantic priming refers to a reduction in the reaction time to identify or make a judgment about a stimulus that has been immediately preceded by a semantically related word or picture and is thought to result from a partial overlap in the semantic associates of the two words. A semantic priming lexical decision task using spoken words was presented in event-related fMRI and behavioral paradigms. Word pairs varied in terms of semantic relatedness and the connectivity between associates. Thirteen right-handed subjects underwent fMRI imaging and 10 additional subjects were tested in a behavioral version of the semantic priming task. It was hypothesized priming would be greatest, reaction time fastest, and cortical activation reduced the most for related word pairs of high connectivity, followed by related word pairs of low connectivity, and then by unrelated word pairs. Behavioral and fMRI results confirmed these predictions. fMRI activity located primarily in bilateral posterior superior and middle temporal regions showed modulation by connectivity and relatedness. The results suggest that these regions are involved in semantic processing.     

First graders' literacy and self-regulation gains: The effect of individualizing student instruction

We examined the effect of individualizing student instruction (ISI; N = 445 students, 46 classrooms) on first graders' self-regulation gains compared to a business-as-usual control group. Self-regulation, conceptualized as a constellation of executive skills, was positively associated with academic development. We hypothesized that the ISI intervention's emphasis on teacher planning and organization, classroom management, and the opportunity for students to work independently and in small groups would promote students' self-regulation. We found no main effect of ISI on self-regulation gains. However, for students with weaker initial self-regulation, ISI was associated with greater self-regulation gains compared to peers in control classrooms. The ISI effect on self-regulation was greater when the intervention was more fully implemented.