Adding motivational interviewing to exposure and ritual prevention for obsessive-compulsive disorder: an open pilot trial

Exposure and ritual prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD), but high dropout rates and variable treatment adherence limit its effectiveness. Motivational interviewing (MI) has shown promise as an adjunct to symptom-focused treatments for improving treatment adherence and outcomes. The authors developed a manual integrating MI with EX/RP, consisting of three information-gathering/motivational enhancement sessions and 15 EX/RP sessions with an optional MI module to be used as needed. Six patients with moderate to severe OCD symptoms (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score> or =16) underwent treatment. Five showed a decrease in their baseline Y-BOCS scores and an increase in their quality of life, with three achieving an excellent response (i.e. Y-BOCS< or =12 at Session 18). The authors briefly describe the motivational strategies used in the six cases and suggest that integrating MI with standard EX/RP is a promising method to increase and sustain patient engagement with EX/RP. Challenges in combining these treatments and maintaining the integrity of each as well as limitations of the study are discussed.     

Ethnic Differences in Parental Perceptions of Genetic Testing for Deaf Infants

As genetic testing becomes an integral part of the evaluation of deaf infants and children, it is important to understand parental views on genetic testing. The purpose of this study is to examine parental reasons for, and beliefs about, genetic testing for deafness in early-identified infants, and to determine if they differ as a function of ethnicity. We present baseline data collected from 56 Caucasian, 59 Hispanic, and 24 Asian parents of deaf children participating in a longitudinal, prospective study on genetic testing for connexin-related deafness. The overall finding is that reasons for, and beliefs about, genetic testing for deafness varied as a function of ethnicity. Virtually all parents sought genetic testing to understand why their child is deaf. However, Asian and/or Hispanic parents were more likely than Caucasian parents to view family planning, helping with their child's medical care, and helping the family as other important reasons for testing, and were more likely than Caucasian parents to perceive genetic testing to be useful for these purposes. Asian and Hispanic parents were more likely than Caucasian parents to perceive genetic testing in harmful terms. Genetic testing fulfills a cognitive need for parents to understand why their child is deaf, yet differences in responses suggest that Asian and Hispanic parents may seek testing for other purposes. Understanding different perspectives on genetic testing for deafness will enhance genetic counselors' cultural competence and facilitate the pre-test genetic counseling session.     

The subgenual anterior cingulate cortex in mood disorders

The anterior cingulate cortex (ACC) ventral to the genu of the corpus callosum has been implicated in the modulation of emotional behavior on the basis of neuroimaging studies in humans and lesion analyses in experimental animals. In a combined positron emission tomography/magnetic resonance imaging study of mood disorders, we demonstrated that the mean gray matter volume of this "subgenual" ACC (sgACC) cortex is abnormally reduced in subjects with major depressive disorder (MDD) and bipolar disorder, irrespective of mood state. Neuropathological assessments of sgACC tissue acquired postmortem from subjects with MDD or bipolar disorder confirmed the decrement in gray matter volume, and revealed that this abnormality was associated with a reduction in glia, with no equivalent loss of neurons. In positron emission tomography studies, the metabolic activity was elevated in this region in the depressed relative to the remitted phases of the same MDD subjects, and effective antidepressant treatment was associated with a reduction in sgACC activity. Other laboratories replicated and extended these findings, and the clinical importance of this treatment effect was underscored by a study showing that deep brain stimulation of the sgACC ameliorates depressive symptoms in treatment-resistant MDD. This article discusses the functional significance of these findings within the context of the preclinical literature that implicates the putative homologue of this region in the regulation of emotional behavior and stress response. In experimental animals, this region participates in an extended "visceromotor network" of structures that modulates autonomic/neuroendocrine responses and neurotransmitter transmission during the neural processing of reward, fear, and stress. These data thus hold important implications for the development of neural models of depression that can account for the abnormal motivational, neuroendocrine, autonomic, and emotional manifestations evident in human mood disorders.     

General pretrial publicity in sexual assault trials

An experiment was designed to explore effects of general pretrial publicity in sexual assault trials. Four pretrial publicity conditions (no publicity, neutral news media, prodefendant, and antidefendant) in the form of simulated newspaper articles were presented to 356 participants. Participants subsequently read a mock rape trial summary and reported verdicts. In the absence of pretrial publicity related to sexual assault, women were more likely than men to convict the defendant, but the presence of sexual assault pretrial publicity in any form eliminated sex differences in conviction rates.     

Why epistemologists are so down on their luck

It is nearly universally acknowledged among epistemologists that a belief, even if true, cannot count as knowledge if it is somehow largely a matter of luck that the person so arrived at the truth. A striking feature of this literature, however, is that while many epistemologists are busy arguing about which particular technical condition most effectively rules out the offensive presence of luck in true believing, almost no one is asking why it matters so much that knowledge be immune from luck in the first place. I argue that the best explanation for the consensus that luck undermines knowledge is that knowledge is, complications aside, credit-worthy true believing. To make this case, I develop both the notions of luck and credit, and sketch a theory of knowledge in those terms. Furthermore, this account also holds promise for being able to solve the “value problem” for knowledge, and it explains why both internal and external conditions are necessary to turn true belief into knowledge. The arguments and ideas in this paper have been in development for a while, and I would like to thank a number of people for their contribution to that development. For many helpful discussions on these topics, In d’like to thank Steve Ellis, Linda Zagzebski and the students in my graduate epistemology seminar—Mary Gwin, Ben Hagy, Matthew Hodge, Robert Johnson and Shyam Patwardhan. And thanks to Karen Antell for her comments on an earlier draft     

Hartshorne’s Dipolar Theism and the Mystery of God

Anselm said that God is that than which nothing greater can be conceived, but he believed that it followed that God is greater than can be conceived. The second formula—essential to sound theology—points to the mystery of God. The usual way of preserving divine mystery is the via negativa, as one finds in Aquinas. I formalize Hartshorne’s central argument against negative theology in the simplest modal system T. I end with a defense of Hartshorne’s way of preserving the mystery of God, which he locates in the actuality of God rather than in the divine existence or essence. This paper was delivered during the APA Pacific 2007 Mini-Conference on Models of God.     

Reputation as a moderator of political behavior-work outcomes relationships: a two-study investigation with convergent results

Personal reputation has been acknowledged to have an important influence on work outcomes. However, substantive research has been relatively scarce to date. The 2-study research plan reported here supports reputation's role as a moderator of the relationships between political behavior and the work outcomes of uncertainty, emotional exhaustion, and job performance ratings (i.e., self- and supervisor report). The 1st investigation contained both a pilot study, which was undertaken to demonstrate the consistency of self- and others' perceptions of reputation, and a test of the substantive relationships. The 2nd study served as a constructive replication of the hypothesized relationships. Supporting prior research, Study 1 demonstrated that self-reports of personal reputation were significantly related to peer report. In each study, political behavior was associated with decreased uncertainty and emotional exhaustion and increased job performance ratings for individuals with a favorable reputation. Conversely, political behavior predicted increased uncertainty and emotional exhaustion and decreased job performance ratings for individuals with an unfavorable reputation. Implications of these results, strengths and limitations, and directions for future research are discussed.     

Cocktail party listening in a dynamic multitalker environment

A priori information about the location of the target talker plays a critical'role in cocktailparty listening tasks, but little is known about the influence of imperfect spatial information in situations in which the listener has some knowledge about the location of the target speech but does not know its exact location prior to hearing the stimulus. In this study, spatial uncertainty was varied by adjusting the probability that the target talker in a multitalker stimulus would change locations at the end of each trial. The results show that listeners can adapt their strategies according to the statistical properties of a dynamic acoustic environment but that this adaptation is a relatively slow process that may require dozens of trials to complete.     

How Do Children Stigmatize People With Mental Illness?

A way to promote eliminating stigma surrounding mental illnesses is targeting the phenomenon in children. This study's purpose is to validate models of mental illness stigma on children in Grades 6–8. Children completed the revised Attribution Questionnaire in a pretest of a larger study on a mental health education program. Data from this study permitted testing of roles of demographics in these social cognitive models. Subsequent analyses using manifest model structural equations were mixed, but mostly showed adequate fit for multiple versions of the models. These results suggest that models of blame and dangerousness are relevant to the way 10 to 13-year-olds stigmatize mental illness. Demographics were not found to fit these models satisfactorily. Implications of these findings for stigma-change agenda are discussed.     

Embedding an identity-matching task within a prompting hierarchy to facilitate acquisition of conditional discriminations in children with autism

Least-to-most prompting hierarchies (e.g., progressing from verbal to modeled to physical prompts until the target response occurs) may be ineffective when the prompts do not cue the individual to attend to the relevant stimulus dimensions. In such cases, emission of the target response persistently requires one or more of the higher level prompts, a condition called prompt dependence (Clark & Green, 2004). Reinforcement of differential observing responses (DORs) has sometimes been used to ensure that participants attend to the relevant stimulus dimensions in matching-to-sample (MTS) tasks (e.g., Dube & McIlvane, 1999). For 2 participants with autism, we embedded an identity-matching task within a prompting hierarchy as a DOR to increase the likelihood that the participants attended to and discriminated the relevant features of the comparison stimuli in an MTS task. This procedure was compared with a traditional least-to-most prompting hierarchy and a no-reinforcement control condition in a multielement design. Results for both participants indicated that mastery-level acquisition of spoken-word-to-picture relations occurred only under the identity-matching condition. Findings are discussed relative to the use of DORs to facilitate acquisition of conditional discriminations in persons with autism or other conditions who do not attend to the comparison stimuli.