Does internet-based prevention reduce the risk of relapse for anorexia nervosa?

Technological advancements allow new approaches to psychotherapy via electronic media. The eating disorder literature currently contains no studies on internet intervention in anorexia nervosa (AN). This study presents a RCT on an internet-based relapse prevention program (RP) over nine months after inpatient treatment for AN. The sample comprised 258 women, randomized to the RP or treatment as usual (TAU). Expert- and self-ratings were evaluated by intent-to-treat analyses. Concerning age, age at onset and comorbidity, both groups were comparable at randomization. During the RP, the intervention group gained weight while the TAU group had minimal weight loss. RP completers gained significantly more body weight than patients in the TAU condition. Group-by-time comparisons for eating-related cognitions and behaviors and general psychopathology showed a significantly more favorable course in the RP program for "sexual anxieties" and "bulimic symptoms" (interview), and "maturity fears" and "social insecurity" (EDI-2). General psychopathology showed no significant group-by-time interaction. Important factors for successful relapse prevention were adherence to the intervention protocol and increased spontaneity. Considering the unfavorable course and chronicity of anorexia nervosa (AN), internet-based relapse prevention in AN following inpatient treatment appears a promising approach. Future internet-based programs may be further improved and enhanced.     

Genomic Counseling: Next Generation Counseling

Personalized medicine continues to expand with the development and increasing use of genome-based testing. While these advances present new opportunities for diagnosis and risk assessment, they also present challenges to clinical delivery. Genetic counselors will play an important role in ushering in this new era of testing; however, it will warrant a shift from traditional genetic counseling to “genomic counseling.” This shift will be marked by a move from reactive genetic testing for diagnosis of primarily single-gene diseases to proactive genome-based testing for multiple complex diseases for the purpose of disease prevention. It will also require discussion of risk information for a number of diseases, some of which may have low relative risks or weak associations, and thus, may not substantially impact clinical care. Additionally, genomic counselors will expand their roles, particularly in the area of health promotion to reduce disease risk. This additional role will require a style of counseling that is more directive than traditional counseling and require greater knowledge about risk reducing behaviors and disease screening.     

Evaluation of the Latin American version of the Life Orientation Test-Revised

The Life Orientation Test (LOT-R) is the most intensively used instrument for the assessment of optimism, but empirical evidence of its psychometric quality in Latin America is lacking. The aim of this study was to test psychometric properties of this questionnaire based on a representative sample of the general population of Colombia (N = 1,500). Confirmatory factor analyses confirmed the bi-dimensionality of the questionnaire with two factors, namely Optimism and Pessimism. The sum scores of the optimism and pessimism subscale correlated with r = ?.12. Convergent validity aspects were studied by correlating LOT-R values with anxiety, depression, quality of life, fatigue, mental health, hopelessness, and self-efficacy. Optimism was more strongly correlated with these variables than pessimism. Normative data and mean values for both genders and different age groups are given. Generally, there were only small age and gender effects. Compared to the German norm data, the Colombian participants scored on average one scale point higher in the dimension of optimism. In summary, the LOT-R in its Spanish version is an appropriate and practical tool for screening purposes in individual diagnostics and epidemiological research in Latin American samples.     

The locus of the emotional Stroop effect: A study with the PRP paradigm

Stimuli that are clearly positive or negative (hence valence-laden stimuli) have the potential to interrupt unrelated task processing. A typical example is the emotional Stroop effect (ESE) in which responding to a certain task feature (e.g., color) is delayed by the presentation of task-irrelevant valent stimuli (e.g., negative pictures) compared to valence-neutral stimuli. Here we scrutinize which processes are slowed down by irrelevant but valent stimulation. In Experiment 1, participants performed in a Psychological Refractory Period (PRP) experiment with tone discrimination as Task 1 and color discrimination as Task 2. Importantly, colors in Task 2 were accompanied by valent or neutral pictures. Valent pictures delayed responding in Task 2 (thus an ESE) and this delay was additive to the time interval between tasks. In Experiment 2, task order was reversed and the ESE in Task 1 fully propagated to the Task 2 tone discrimination. These results imply that irrelevant valence-laden stimulation delays capacity-limited processes, and we suggest that this is a late perceptual process acting on stimulus categorization.     

Determining inhibition: Individual differences in the 'lexicon context' trade-off during lexical ambiguity resolution in working memory

The current experiment assessed the relation between inhibitory mechanisms underlying language processing in working memory (WM) and the influence of a postulated internal cognitive trade-off between lexicon and context factors driving inhibition in sentence processing. Participants with high and low WM span (Daneman & Carpenter, 1980) were presented with sentences that began with an ambiguous noun (being both homographic and homophonic). A cue towards the relevant meaning of the ambiguous word was presented three words later by another noun. Immediately after the cue, a verb was presented that finally disambiguated the ambiguous noun. In half of the cases, the final disambiguation was congruent with the disambiguation cue. In the other half, subjects had to realize that it was not the cued but the other meaning, which turned out to be relevant in the actual sentence. This experimental paradigm was identical to the one used in Gunter et al. (2003). In contrast to the original experiment, the filler items in the present study were unambiguous. Both groups showed a smaller N400 component for the cue related to the dominant as compared to the subordinate meaning, suggesting that the dominant meaning was more active in WM than the subordinate one. In the original experiment, only the high-span subjects manifested this effect. Thus, a change in the global experimental setting changed the use of WM-related inhibitory processes. Data also suggest that, as a default strategy, the lexicon-context trade-off of high-span subjects relies more on lexicon information than does that of low-span subjects.     

The Obsessive-Compulsive Inventory: development and validation of a short version

This article reports on the development of a revised version of the Obsessive-Compulsive Inventory (OCI; E. B. Foa, M. J. Kozak, P. Salkovskis, M. E. Coles, & N. Amir, 1998), a psychometrically sound, theoretically driven, self-report measure. The revised OCI (OCI-R) improves on the parent version in 3 ways: It eliminates the redundant frequency scale, simplifies the scoring of the subscales, and reduces overlap across subscales. The reliability and validity of the OCI-R were examined in 215 patients with obsessive-compulsive disorder (OCD), 243 patients with other anxiety disorders, and 677 nonanxious individuals. The OCI-R, which contains 18 items and 6 subscales, has retained excellent psychometric properties. The OCI-R and its subscales differentiated well between individuals with and without OCD. Receiver operating characteristic (ROC) analyses demonstrated the usefulness of the OCI-R as a diagnostic tool for screening patients with OCD, utilizing empirically derived cutscores.     

Gaze behavior in analytical and holistic face processing

We conducted two experiments examining children's and adults' gaze behavior when processing faces analytically (focusing on a single feature) or holistically (comparing the overall similarity of the faces). Children 6-8 and 9-10 years of age and adults were instructed to assign schematically drawn faces in Experiment 1 and photos of real faces in Experiment 2 to two categories. The categories were constructed so as to allow either an analytical or holistic categorization of the faces. During all trials, gaze behavior was recorded from stimulus onset until reaction. The location and duration of the fixations used were analyzed. Whereas the holistic processors fixated the whole area of the eyes and nose most and longest independently of age, analytical processors showed a more feature-specific gaze behavior, focusing their fixations upon the particular feature used for subsequent processing. Thus, differences in analytical and holistic face processing can be detected early in gaze behavior-that is, at the visual encoding stage.