Treating PTSD in active duty service members using cognitive processing therapy or prolonged exposure therapy: Examining everyday practice at a military outpatient clinic

The Institute of Medicine has stressed the need for evaluations of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) among active duty service members (AD) using a variety of evaluation approaches (Institute of Medicine, 2012). The current study examined the clinical files of 134 service members who completed treatment for PTSD using either prolonged exposure (PE) or cognitive processing therapy at an outpatient clinic. At the completion of each session, therapists made a clinical rating as to whether or not the session was protocol adherent. The total number of treatment sessions and the proportion of sessions rated as being protocol adherent were calculated. Multi-level models estimated the change in patient PTSD and other psychological symptoms over time as a function of clinician-rated protocol adherence and total number of sessions. Approximately 65% of clinic encounters were rated by therapists as being protocol adherent. Significant reductions in PTSD and psychological symptoms were associated with protocol adherence, and this was particularly true for patients who began treatment above clinical thresholds for both PTSD and other psychological symptoms. However, as the number of sessions increased, the impact of protocol adherence was attenuated. Patient characteristics, including gender, ethnicity, and co-morbidity for other psychiatric disorders were not related to symptom change trajectories over time. These findings suggest that protocol adherence and efficiency in delivery of EBTs for the treatment of PTSD with AD is critical.     

Utilitarian epistemology

Standard epistemology takes it for granted that there is a special kind of value: epistemic value. This claim does not seem to sit well with act utilitarianism, however, since it holds that only welfare is of real value. I first develop a particularly utilitarian sense of “epistemic value”, according to which it is closely analogous to the nature of financial value. I then demonstrate the promise this approach has for two current puzzles in the intersection of epistemology and value theory: first, the problem of why knowledge is better than mere true belief, and second, the relation between epistemic justification and responsibility.     

Fundamentalism and Political Violence: The Case of Paisley and Ulster Evangelicals

One of the dangers of using the term ‘fundamentalism’ for a wide variety of religiously inspired political movements is that it disguises vital differences. This article examines in great detail the involvement of the evangelical Protestant religious and political leader Reverend Ian Paisley in the political violence of Northern Ireland. It concludes that, despite the context apparently encouraging a Protestant jihad, or holy war, Ulster evangelicals are peaceful and law-abiding. Parallels with American fundamentalism are used to raise the question of contrasts to Islamic fundamentalism. It is argued that fundamentalisms differ in their attitudes towards political violence and that the differences are unlikely to be just a matter of circumstance.     

Working memory deficits in developmental dyscalculia: The importance of serial order

Although a number of studies suggests a link between working memory (WM) storage capacity of short-term memory and calculation abilities, the nature of verbal WM deficits in children with developmental dyscalculia (DD) remains poorly understood. We explored verbal WM capacity in DD by focusing on the distinction between memory for item information (the items to be retained) and memory for order information (the order of the items within a list). We hypothesized that WM for order could be specifically related to impaired numerical abilities given that recent studies suggest close interactions between the representation of order information in WM and ordinal numerical processing. We investigated item and order WM abilities as well as basic numerical processing abilities in 16 children with DD (age: 8–11 years) and 16 typically developing children matched on age, IQ, and reading abilities. The DD group performed significantly poorer than controls in the order WM condition but not in the item WM condition. In addition, the DD group performed significantly slower than the control group on a numerical order judgment task. The present results show significantly reduced serial order WM abilities in DD coupled with less efficient numerical ordinal processing abilities, reflecting more general difficulties in explicit processing of ordinal information.     

The Spontaneous Generation of the Human in the “Heng Xian”

This essay argues that the “Heng Xian” bridges between two distinct discourses that were both prevalent in the late fourth century. One discourse focused on the origination of the natural world through a spontaneous process of differentiation, a position familiar from the Daodejing and “Tai yi sheng shui.” The other focused on the specific ways in which different kinds of things live, a position known primarily from Ru discussions centering on the concept of xing 性, the nature or spontaneous reactions of a particular kind of thing. The “Heng Xian” attempts to account for the specificity of human life—including language and social organization—while remaining within a naturalistic view grounded in spontaneity. The essay concludes by reflecting on what the “Heng Xian” tells us about the status of human institutions.     

Role salience and support as moderators of demand/conflict relationships in China

This study examined the effects of role demand on both work–family conflict and family–work conflict, and the moderating effects of role salience and support on these relationships. Based on 391 dual-career (managerial and blue-collar employees) couples from a Taiwanese company in China, the results of this survey study showed clear gender differences in the patterns of relationships observed. For men, the most important demands that negatively impacted on work–family conflict were frequency of overtime and frequency of socializing for work purposes (yingchou), and supervisory support buffered the negative impact of frequent overtime. For women however, strong supervisory support and low work role salience were more important for reducing work–family conflict, and there was no significant main effect found for any of the role demand factors. Furthermore, women with high work role salience were more likely to feel the impact of yingchou on work–family conflict. In the family domain, the most influential demand for men was hours spent on household tasks, but for women, it was the frequency of family-related leave. Interestingly, males reported higher family role salience than females and spouse support intensified rather than buffered the positive impact of hours spent on household tasks on family–work conflict for males.     

Delusion,Dissociation and Identity

Abstract

Envy and resentment are generally thought to be unpleasant and unethical emotions which ought to be condemned. I argue that both envy and resentment, in some important forms, are moral emotions connected with concern for justice, understood in terms of desert and entitlement. They enable us to recognise injustice, work as a spur to acting against it and connect us to others. Thus, we should accept these emotions as part of the ethical life.     

Gender,the Perception of Aggression,and the Overestimation of Gender Bias

The purpose of this study was to investigate how the gender of aggressor, target, and observer influences the perception and evaluation of aggression. One hundred seventy-one university students (predominantly White) read 1 of 8 vignettes that described an aggressive act. The aggressor–target gender combinations and the aggressive act were varied. Data did not support the hypothesis that, because of the impact of gender stereotypes, participants would perceive more aggressiveness in men's aggression than in women's aggression. Participants rated women's aggression as more acceptable than men's aggression, and male participants considered the aggression more acceptable, apparently because they saw the act as less aggressive. In addition, participants estimated how most men/women would perceive and evaluate the aggression. Results suggest that people overestimate how biased others are toward members of their own gender.     

Treatment approaches for sleep difficulties in college students

College students face many challenges and live experiences that may lead to sleep difficulties, including: varied and changing schedules, repeated deadlines, increased freedom and self-responsibility, and group living arrangements, to name but a few. A high frequency of sleep difficulties is commonly reported among college student and others who encounter similar life experiences. The prevalence of sleep difficulties is explored and a rationale provided for treatment. It is suggested that interventionists need to consider the impact of sleep difficulties on their clients' immediate and long-term functioning. To help psychologists, counsellors, and therapists better ameliorate sleep problems a number of proven techniques are reviewed which are applicable to individuals in both clinical and non-clinical settings.