SOCIAL SHARING IN ANTICIPATION OF CARDIAC SURGERY: WHO TALKS MORE AND WHY

This study presents the stress and sharing model, which was developed in order to predict the extent to which patients anticipating cardiac surgery, share their emotions. The model hypothesizes that preoperative sharing of emotions mediated by need, is positively related to surgery-related stress measured independently, and in comparison to the roommates. The model was tested for surgery-related and surgery-unrelated feelings. One hundred and fifty-seven Greek patients participated in the study. The variables included in the model were measured daily, using self-reports. Results show a good fit of the model only for surgery-related feelings (χ²=4.688, p=0.321). The study shows that patients anticipating surgery share their emotions in the same way as patients recovering from stressful or traumatic events. Stressed patients experience the need to focus on the threat (verbally) and not to be ‘distracted’ by talking about irrelevant topics. These findings have important implications for the design of preparatory interventions for surgical patients.     

Memories of Childhood Threat,Fear of Disclosure and Paranoid Ideation: A Mediation Analysis Using a Nonclinical Sample

This study investigated whether associations between childhood memories of threat and adult paranoia could be partially mediated by factors associated with impeded interpersonal communication (concealment and fear of disclosure of personal and distressing information). University undergraduates (N = 179) completed a battery of psychometric scales. Mediation analysis identified a direct effect between early memories of threat and paranoid ideation (B = 0.11, 95% CI = [0.07, 0.14], p = .00). A mediated effect between these variables was also significant (B = .05, 95% CI = [0.02, 0.07], p = .01). However, although significant associations were identified between memories of threat and each of the mediating variables (self-concealment, fear of self-disclosure, anxiety, depression) only fear of self-disclosure displayed a significant association with paranoid ideation (B = .05, 95% CI = [0.02, 0.07], p = .01).     

Cortico-limbic-striatal circuits subserving different forms of cost-benefit decision making

Research on the neural basis that underlies decision making in humans has revealed that these processes are mediated by distributed neural networks that incorporate different regions of the frontal lobes, the amygdala, the ventral striatum, and the dopamine system. In the present article, we review recent studies in rodents investigating the contribution of these systems to different forms of cost-benefit decision making and focus on evaluations related to delays, effort, or risks associated with certain rewards. Anatomically distinct regions of the medial and orbital prefrontal cortex make dissociable contributions to different forms of decision making, although lesions of these regions can induce variable effects, depending on the type of tasks used to assess these functions. The basolateral amygdala and the nucleus accumbens play a more fundamental role in these evaluations, helping an organism overcome different costs to obtain better rewards. Dopamine activity biases behavior toward more costly yet larger rewards, although abnormal increases in dopamine transmission can exert opposing actions on different types of decision making. The fact that similar neural circuits are recruited to solve these types of problems in both humans and animals suggests that animal models of decision making will prove useful in elucidating the mechanisms mediating these processes.     

Decision-making under uncertainty: biases and Bayesians

Animals (including humans) often face circumstances in which the best choice of action is not certain. Environmental cues may be ambiguous, and choices may be risky. This paper reviews the theoretical side of decision-making under uncertainty, particularly with regard to unknown risk (ambiguity). We use simple models to show that, irrespective of pay-offs, whether it is optimal to bias probability estimates depends upon how those estimates have been generated. In particular, if estimates have been calculated in a Bayesian framework with a sensible prior, it is best to use unbiased estimates. We review the extent of evidence for and against viewing animals (including humans) as Bayesian decision-makers. We pay particular attention to the Ellsberg Paradox, a classic result from experimental economics, in which human subjects appear to deviate from optimal decision-making by demonstrating an apparent aversion to ambiguity in a choice between two options with equal expected rewards. The paradox initially seems to be an example where decision-making estimates are biased relative to the Bayesian optimum. We discuss the extent to which the Bayesian paradigm might be applied to the evolution of decision-makers and how the Ellsberg Paradox may, with a deeper understanding, be resolved.     

Usefulness of Self-Report Instruments in Assessing Men Accused of Domestic Violence

The Psychological Record - Clinical assessment of domestic violence has traditionally relied on self-report methods of data collection, using structured interviews and lengthy questionnaires such...     

Using a Learning Collaborative Model to Disseminate Cognitive Processing Therapy to Community-Based Agencies

Although effective treatments for posttraumatic stress disorder exist, their use in community settings is disappointingly low. Training alone does not necessarily lead to adoption. To address this problem, we trained community clinicians in cognitive processing therapy, an evidence-based treatment for posttraumatic stress disorder, using a Learning Collaborative, an intensive training methodology focused on both clinical training and developing sustainability. Sixty clinicians within 18 agencies began the year-long, team-based Learning Collaborative. Clinicians attended three in-person Learning Sessions, received weekly consultation, and submitted audio-recorded sessions to be rated for fidelity. Clinicians were rostered as approved treatment providers if they completed all training requirements. Additionally, we engaged leadership from each agency to build a sustainable practice. Clinicians trained through the Learning Collaborative demonstrated a high degree of fidelity to the treatment (average competence ratings “satisfactory” to “good”), and most (68%) were rostered as approved treatment providers. Patients treated by clinician trainees exhibited significant symptom reductions (d = 1.68 and 1.28 for posttraumatic stress and depression symptoms, respectively, among treatment completers). At a 6-month follow-up, 95% of rostered clinicians and 100% of agencies with rostered clinicians were still providing the treatment. These results suggest that the Learning Collaborative model is a promising approach for the dissemination and implementation of evidence-based treatments for adult posttraumatic stress disorder.