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.     

Studying entrepreneurial occupations in the Terman women

To achieve a better understanding of entrepreneurship development in women, longitudinal data on 672 individuals collected from 1922 to 1959 were analysed in a secondary investigation of the Terman Longitudinal Study. Women's reports on their occupations during 10 different years were assigned to one of two categories: work for pay (0/1), and work allowing for self‐employment (0/1) in the respective year. Structural equation modelling supported earlier results concerning male entrepreneurial activity. Personality and aspects of the parenting context the women had experienced by the average age of 12 predicted early entrepreneurial competencies (inventions, leadership) and occupational interests by age 13, which related to an entrepreneurship‐related career goal in 1936, when the participants were about 27 years of age on average. Such a career goal in turn predicted a higher number of occasions of entrepreneurship‐prone work. Surprisingly, we also found a relationship to divorce. Women who had experienced the failure of a marriage were in occupations with a potential for entrepreneurship more often. Reasons are discussed against a backdrop of historical timing and current findings to identify general aspects of entrepreneurship development.     

Job-content Perceptions, Performance–reward Expectancies, and Absenteeism among Low-wage Public-sector Clerical Employees

This study explored relations of job-content perceptions (i.e., skill variety and task significance), and performance–reward expectancies, with absenteeism among 134 low-wage public-sector clerical employees. Results indicated that those employees who perceived limited performance–reward expectancies (i.e., lower instrumentality), and who considered their jobs to be either higher on skill variety or task significance, were likely to be absent more often. Moreover, the link between skill variety and absenteeism was moderated by instrumentality in a manner suggesting that respondents may have utilized absenteeism as a means of compensating for perceived workplace contributions not extrinsically rewarded. These findings further suggest that employees in occupational settings for which performance-related extrinsic rewards are less available may not respond to favorable job-content perceptions in the positive manner generally predicted by job characteristics theory.     

Genetic Counseling and Screening of Consanguineous Couples and Their Offspring: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic counseling and screening for consanguineous couples (related as second cousins or closer) and their offspring with the goals of1. providing preconception reproductive options2. improving pregnancy outcome and identifying reproductive choices3. reducing morbidity and mortality in the 1st years of life, and4. respecting psychosocial and multicultural issues.The recommendations are the opinions of a multicenter working group (the Consanguinity Working Group (CWG)) with expertise in genetic counseling, medical genetics, biochemical genetics, genetic epidemiology, pediatrics, perinatology, and public health genetics, which was convened by the National Society of Genetic Counselors (NSGC). The consensus of the CWG and NSGC reviewers is that beyond a thorough medical family history with follow-up of significant findings, no additional preconception screening is recommended for consanguineous couples. Consanguineous couples should be offered similar genetic screening as suggested for any couple of their ethnic group. During pregnancy, consanguineous couples should be offered maternal–fetal serum marker screening and high-resolution fetal ultrasonography. Newborns should be screened for impaired hearing and detection of treatable inborn errors of metabolism. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

How young and older adults differ in their responses to perceived age discrimination

The authors examined the consequences of perceived age discrimination for well-being and group identification. The rejection-identification model suggests that perceived discrimination harms psychological well-being in low status groups but that group identification partially alleviates this effect. The authors hypothesized that this process model would be confirmed among older adults because their low status group membership is permanent but not confirmed among young adults whose low status is temporary. Using structural equation modeling, the authors found support for the hypothesized direct negative link between perceived age discrimination and well-being among older adults, with increased age group identification partially attenuating this effect. For young adults, these relationships were absent. Differences in responses to discrimination appear to be based on opportunities for leaving a low status group.     

Interindividual differences in intraindividual changes in proactivity during organizational entry: a latent growth modeling approach to understanding newcomer adaptation

Intraindividual change over time is the essence of the change phenomenon hypothesized to occur in the individual newcomer adaptation process. Many important adaptation questions cannot be answered without an adequate conceptualization and assessment of intraindividual change. Using a latent growth modeling approach to data collected from 146 doctoral program newcomers over 4 repeated measurements spaced at 1-month intervals, the authors explicitly modeled interindividual differences in intraindividual changes in newcomer proactivities (information seeking, relationship building) and proximal adaptation outcomes (task mastery, role clarity, social integration) during organizational entry. Results indicated that changes in proactivity may be related to newcomer characteristics and adaptation outcomes in interesting ways that have not been previously examined.     

Effects of competitive reward distribution on auditing and competitive responding

This study allowed subjects to audit each other's responding during a series of competitive contests. Six pairs of female college students competed in 3-min contests in which the competitive response was a knob pull. A sum of money was divided using a proportional distribution or a 100%/0% reward distribution. In the proportional distribution, a subject's proportion of the sum was her proportion of the total number of responses. Also, in every contest either subject could make a response that would end the contest prematurely and give both subjects the same amount: a sum equal to 33% of the competitive total. Each subject could press either or both of two audit buttons that displayed her own and the other's response total for 10 s. Results replicated earlier findings in showing the superiority of the proportional distribution in total number of competitive responses made. No subject audited continuously, and only 1 audited most of the time. Most audits were interpersonal, including both own and other's scores. Auditing typically was more frequent in 100%/0% contests in which subjects were more likely to stop the contest when they were far behind. Winners were more likely to audit than were losers. Competitive response rates increased when the differences revealed by audits were small and decreased when they were large. Overall audit patterns were consistent with the view that feedback as "news" is more often sought when it can lead to improved outcomes.     

Adaptive motor behavior of cerebellar patients during exposure to unfamiliar external forces

The authors investigated adaptation of goal-directed forearm movements to an unknown external viscous force assisting forearm flexion in 6 patients with cerebellar dysfunction and in 6 control participants. Motor performance was generally degraded in cerebellar patients and was markedly reduced under the force condition in both groups. However, patients and controls were able to adapt to the novel force within 8 trials. Only the healthy controls were able to improve motor performance when readapting to a null-force condition. The results indicate that cerebellar patients' motor control system has imprecise estimations of actual limb dynamics at its disposal. Force adaptation may have been preserved because single-joint movements were performed, whereas the negative viscous force alone and no interaction forces had to be compensated.     

Delayed rule following

Although the elements of a fully stated rule (discriminative stimulus [S(D)], some behavior, and a consequence) can occur nearly contemporaneously with the statement of the rule, there is often a delay between the rule statement and the S(D). The effects of this delay on rule following have not been studied in behavior analysis, but they have been investigated in rule-like settings in the areas of prospective memory (remembering to do something in the future) and goal pursuit. Discriminative events for some behavior can be event based (a specific setting stimulus) or time based. The latter are more demanding with respect to intention following and show age-related deficits. Studies suggest that the specificity with which the components of a rule (termed intention) are stated has a substantial effect on intention following, with more detailed specifications increasing following. Reminders of an intention, too, are most effective when they refer specifically to both the behavior and its occasion. Covert review and written notes are two effective strategies for remembering everyday intentions, but people who use notes appear not to be able to switch quickly to covert review. By focusing on aspects of the setting and rule structure, research on prospective memory and goal pursuit expands the agenda for a more complete explanation of rule effects.