Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

     

Cognitive Behavioral Training Using a Mobile Application Reduces Body Image-Related Symptoms in High-Risk Female University Students: A Randomized Controlled Study

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.     

Promoting an Empathic Dialectic for Therapeutic Change: An Integrative Review

This integrative review is focused on a formulation of therapeutic empathy. We describe the “empathic dialectic” as therapists’ capacity to emotionally resonate with patients’ internal states, such as during ruptures, and to coregulate their own and the patients’ states through mentalization. The first aim was to provide a theoretical framework for the empathic dialectic, by summarizing background literature on the empathic process, intersubjectivity, rupture repair, relational psychoanalysis, and attachment. The second aim was to conduct an integrative review of peer-reviewed articles published between the years of 2016 and 2021. After conducting a review of 28 articles, we sought to identify (1) research that supports the existence of an empathic dialectic, (2) evidence that therapists’ attachment influences the empathic dialectic, and (3) implications of the empathic dialectic for training and supervision. Results pointed to the central role of therapists’ attachment security in the empathic dialectic, and the negative repercussions of therapists’ insecurity when mentalization is underdeveloped. Results also highlighted the role of supervision as a means of enhancing trainees’ self-awareness of their attachment, and its impact on the alliance. As the American Psychological Association embraces a clinical competencies model in its accreditation of clinical psychology doctoral programs, the importance of attaining an integrative understanding of therapeutic empathy has become increasingly imperative. To this end, we conclude by promoting the empathic dialectic as a key clinical competency, and providing further recommendations for training and supervision.

     

The development of regret

In two experiments, 4- to 9-year-olds played a game in which they selected one of two boxes to win a prize. On regret trials the unchosen box contained a better prize than the prize children actually won, and on baseline trials the other box contained a prize of the same value. Children rated their feelings about their prize before and after seeing what they could have won if they had chosen the other box and were asked to provide an explanation if their feelings had changed. Patterns of responding suggested that regret was experienced by 6 or 7 years of age; children of this age could also explain why they felt worse in regret trials by referring to the counterfactual situation in which the prize was better. No evidence of regret was found in 4- and 5-year-olds. Additional findings suggested that by 6 or 7 years, children's emotions were determined by a consideration of two different counterfactual scenarios.     

Additivity pretraining and cue competition effects: developmental evidence for a reasoning-based account of causal learning

The effect of additivity pretraining on blocking has been taken as evidence for a reasoning account of human and animal causal learning. If inferential reasoning underpins this effect, then developmental differences in the magnitude of this effect in children would be expected. Experiment 1 examined cue competition effects in children's (4- to 5-year-olds and 6- to 7-year-olds) causal learning using a new paradigm analogous to the food allergy task used in studies of human adult causal learning. Blocking was stronger in the older than the younger children, and additivity pretraining only affected blocking in the older group. Unovershadowing was not affected by age or by pretraining. In experiment 2, levels of blocking were found to be correlated with the ability to answer questions that required children to reason about additivity. Our results support an inferential reasoning explanation of cue competition effects.     

Observational learning in mice can be prevented by medial prefrontal cortex stimulation and enhanced by nucleus accumbens stimulation

The neural structures involved in ongoing appetitive and/or observational learning behaviors remain largely unknown. Operant conditioning and observational learning were evoked and recorded in a modified Skinner box provided with an on-line video recording system. Mice improved their acquisition of a simple operant conditioning task by observational learning. Electrical stimulation of the observer's medial prefrontal cortex (mPFC) at a key moment of the demonstration (when the demonstrator presses a lever in order to obtain a reward) cancels out the benefits of observation. In contrast, electrical stimulation of the observer's nucleus accumbens (NAc) enhances observational learning. Ongoing cognitive processes in the demonstrator could also be driven by electrical stimulation of these two structures, preventing the proper execution of the ongoing instrumental task (mPFC) or stopping pellet intake (NAc). Long-term potentiation (LTP) evoked in these two cortical structures did not prevent the acquisition or retrieval process--namely, mPFC and/or NAc stimulation only prevented, or modified, the ongoing behavioral process. The dorsal hippocampus was not involved in either of these two behavioral processes. Thus, both ongoing observational learning and performance of an instrumental task require the active contribution of the mPFC and/or the NAc.     

Female Self-Sexualization in MySpace.com Personal Profile Photographs

This article reports the results of a content analysis of female self-sexualization in personal profile pictures on MySpace.com (N = 24,000). Photographs were analyzed according to three measures: ritualization of subordination, body display, and objectification. Trained evaluators coded the photographs for each measure by race/ethnicity, body type, sexual orientation, and education level. Findings reveal that rates of ritualization of subordination were significantly higher for Hispanics, average body types, and bisexuals. Body display and objectification were both significantly higher for Blacks and Hispanics, bisexuals, and women with higher education levels. Body display and objectification rates were significantly lower for larger body types while body display alone was significantly lower for lesbians. Overall self-sexualizing behavior in this study sample is low based upon study measures. Images presented on MySpace.com do reveal, however, an acceptance of constrained and stereotypical notions regarding both gender and sex roles.