Functional communication training and noncontingent reinforcement in treatment of stereotypy

A 6‐year‐old boy with autism spectrum disorder engaged in automatically maintained stereotypy in the form of opening and closing doors. A functional analysis confirmed that he also emitted problem behavior that was maintained by access to stereotypy. We evaluated the separate and combined effects of functional communication training and arbitrary noncontingent reinforcement on both response classes. Results showed that the combination of functional communication training and noncontingent reinforcement was more effective at reducing stereotypy than either intervention on its own, although effects on problem behavior were unclear. These results suggest that combinations of interventions may be useful in the treatment of automatically maintained problem behavior.     

Virtual Reality and Cognitive-Behavioral Therapy for Driving Anxiety and Aggression in Veterans: A Pilot Study

Within the U.S. military, motor vehicle accidents (MVAs) are the leading cause of preventable morbidity and mortality. Prior combat exposure and anxiety symptoms are associated with risky and aggressive driving, which is responsible for over half of MVA fatalities. Therefore, interventions are needed to reduce driving anxiety and aggression in veterans in order to mitigate the public health impact of MVAs. Virtual reality exposure therapy (VRET) offers safe, controlled exposure to distressing stimuli. The current study piloted a novel virtual reality and cognitive behavioral intervention (VRET + CBT) for veterans that integrated both anxiety and anger management components. Virtual reality driving scenarios were delivered in a driving simulator and tailored for the military population. Six previously deployed veterans completed eight intervention sessions, as well as pre/post, one month follow-up and six to nine month follow-up assessments. Repeated measures ANOVAs demonstrated significant decline and large effect sizes for PTSD symptoms, driving phobia, hyperarousal in driving situations, anxiety/anger-related thoughts and behaviors, and risky driving. Hyperarousal in driving situations declined by 69%, aggressive driving declined by 29%, and risky driving declined by 21%. Treatment gains were maintained at follow-up. Recruitment, retention, immersion, simulator sickness scores, and qualitative feedback demonstrated feasibility of the intervention. Implications for future research and adaptation are discussed.     

“Bridge to the Literature”? Third-Party Genetic Interpretation Tools and the Views of Tool Developers

Patients and health care consumers can obtain access to their “raw,” or uninterpreted, genetic data from direct-to-consumer genetic testing companies, researchers, or providers and pursue self-directed analysis via third-party interpretation tools. Yet relatively little is known about the nature of currently available interpretation tools or the motivations of tool developers. We conducted a structured content analysis of 23 third-party interpretation tool websites and supporting information, tracking features such as types of information returned, modes of generating and presenting that information, and privacy and security measures. We additionally conducted qualitative interviews with a subset of 10 tool developers. A majority of tools (16 of 23, or 70%) offer some type of health or wellness-related information, often extracted from publicly available variant annotation databases. Half of those interviewed characterized their activities as “bridging” users to the scientific literature rather than interpretation, for which they gave a variety of scientific, ethical, and regulatory justifications. The scale, heterogeneity, and complexity of information available from third-party interpretation are unprecedented. While developers aim to enlighten and empower tool users, interpretation-free “bridging” to rapidly evolving databases may instead impose burdens on genetic counselors and other health care providers asked to provide further contextualization and explanation.     

A Two-Phase Approach to Developing SNAP: an iPhone Application to Support Appointment Scheduling and Management for Women with a <Emphasis Type="Italic">BRCA</Emphasis> Mutation

Professional organizations provide surveillance guidelines for BRCA1 and BRCA2 (BRCA) carriers with intact breasts and/or ovaries to facilitate early cancer detection. However, literature indicates adherence to surveillance guidelines is inconsistent at best. Using the Messaging Model for Health Communication Campaigns framework, we undertook a two-phase formative research approach to develop an intervention to promote adherence to surveillance guidelines. Discussion groups identified preferred intervention format and function in phase I. Findings indicated carriers desired a phone application (app) to assist with surveillance management and appointment tracking. Thus, an iPhone app for carriers to track appointments based on published surveillance guidelines was developed. In phase II, we obtained feedback from BRCA carriers via a survey during a prototype demonstration at a regional conference. Participants in phase II wanted reminder capabilities and the ability to add and modify information fields. This feedback informed intervention modifications, resulting in the Scheduling Necessary Advised Procedures (SNAP) iPhone app currently being pilot tested by BRCA carriers throughout the USA.     

In which direction to move? Facilitative and interference effects of gestures on problem solver's thinking

Recent research shows that co-speech gestures can influence gesturers’ thought. This line of research suggests that the influence of gestures is so strong, that it can wash out and reverse an effect of learning. We argue that these findings need a more robust and ecologically valid test, which we provide in this article. Our results support the claim that gestures not only reflect information in our mental representations, but can also influence gesturer's thought by adding action information to one's mental representation during problem solving (Tower of Hanoi). We show, however, that the effect of gestures on subsequent performance is not as strong as previously suggested. As opposed to what previous research indicates, gestures' facilitative effect through learning was not nullified by the potentially interfering effect on subsequent problem-solving performance of incompatible gestures. To conclude, using gestures during problem solving seems to provide more benefits than costs for task performance.     

Emotional processes in risky and multiattribute health decisions

Objective: Here, we develop an integrative account of the roles of emotion in decision-making. In Part I, we illustrate how emotional inputs into decisions may rely on physiological signals from emotions experienced while making the decision, and we review evidence suggesting that the failure to represent the emotional meaning of options can often reduce decision quality. We propose that health-related decrements in the ability to generate emotional reactions lead people to inaccurately represent emotional responses and compromise decisions, particularly about risk. Part II explores complex decisions in which choice options involve trade-offs between positive and negative attributes. We first review evidence showing that difficult trade-off decisions generate negative affect and physiological arousal. Next, we propose that medical decision-making will be linked to short- and long-term stress and health outcomes.

Conclusion: In sum, this article proposes and reviews initial evidence supporting the effective use and management of emotional inputs as important to both clinical and non-clinical populations. Our approach will contribute to the understanding of patient-centred emotional decision-making and will inform medical decision aids.     

Does Rumination Mediate the Association of Private Prayer,Stress, and Their Interaction with Depression among Christians? A Cross-Sectional Study

Mechanisms underlying significant associations between different types of prayer and depression are unknown. Based on the conceptualization of prayer as stress buffering coping style and the Response Style Theory, we proposed that rumination mediates the association of prayer types and stress with depression. This cross-sectional study (N?=?227 Christians, M_age 41.74, SD 14.82, age range 18–82 years, 76% female) used path modeling to test whether rumination mediated the associations between prayer types and prayer types by stress interactions with depression. Rumination fully mediated the associations of the colloquial and ritual prayer by stress interactions with depressive symptoms, while meditative and petitionary prayer was directly associated with depressive symptoms. Further, petitionary prayer and the ritual prayer by stress interaction were associated with more and not with less rumination and depressive symptoms, respectively. Summarized, first empirical evidence supports an integration of prayer, stress, and rumination into one model of depression. However, the exact nature of their interplay depends on the prayer type. If replicated, our findings allow the integration of prayer into cognitive-behavioral treatment of depression in religious and spiritual clients.     

Differences in Scope Assignments for Child and Adult Speakers of Mandarin

The present study used a Truth Value Judgment Task to investigate whether changes in sentence structure lead to corresponding changes in the assignment of scope relations by Mandarin-speaking children and adults. In one condition, participants were presented with ordinary negative sentences containing disjunction; this condition was designed to verify the existing claim that disjunction is a positive polarity item for adult speakers of Mandarin, but not for child speakers. In a second condition, participants were presented with negative sentences where the disjunction phrase was preposed from object position; this condition was designed to examine the extent to which changes in sentence structure can result in changes in scope assignments to negated disjunctions. The results indicate that the preposed disjunction phrase undergoes reconstruction for children, whereas reconstruction is blocked for adults. This finding also suggests that Mandarin-speaking children and adults exhibit different scope preferences for negated disjunctions, regardless of where the disjunction phrase appears in the surface syntax.     

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.