Issues in diagnosing anxiety disorders

Research progress in the anxiety disorders is predicated on a useful classification system. In this paper, we review the reliability and validity data for theDiagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III) anxiety disorders and discuss the salient issues associated with both the conceptualization of anxiety disorders and the diagnostic criteria offered in the DSM-III. It is concluded that the diagnostic reliability for these disorders is, overall, satisfactory. A dearth of validity data, however, hinders progress in both the diagnosis and the treatment of the anxiety disorders. Nevertheless, the DSM-III work group has proposed several changes in the diagnostic criteria for the anxiety disorders. We find some of these proposed changes helpful in that they clarify current diagnostic criteria; changes in diagnostic criteria that alter the basic classification schema, however, seem to be premature.Preparation of this paper was supported in part by MIMH Research Grant 1368.On sabbatical leave from Indiana State University.     

Variables related to reported learning in brief experiential groups held at professional meetings

Reports of learning from 119 participants of 18 general psychodynamic groups from the 1981 and 1982 annual meetings of the Canadian Group Psychotherapy Association were investigated. Two main learning factors emerged from a factor analysis of participant ratings, learning about oneself in a small group (factor one) and learning how to be an effective leader with professional skills (factor two). Participants reported moderate to considerable learning for both factors even though the stated task of the groups did not emphasize the learning of professional skills. Relationships between several classes of variables (group, leader, demographic) and reported learning were studied. Results that were consistent with several previous investigations were found. The discovery of a participant, sex-difference finding, i.e., greater reported learning by the women, generated a number of questions that may be addressed in future investigations.This article was derived from a paper presented at the Fourth Annual Meeting of the Canadian Group Psychotherapy Association, October 27, 1983, Banff, Canada.     

Presidential threats and the secret service in a free society

In September 1981, a symposium of distinguished mental health practitioners from various clinical, administrative, research, and legal disciplines was conducted on the topic of “Behavioral Science and the Secret Service,” under the sponsorship of the National Academy of Sciences, Institute of Medicine. The article combines a study of the symposium's written conference summary, the author's experience as legal counsel to a state security hospital, and research into federal cases that have interpreted the so-called “Presidential Threat Statute” (18 USC 871) in order to discuss the role of the Secret Service in protecting elected federal officials from physical harm. The potential for increasing practical cooperation between the Service and state mental health systems is also discussed.     

Follow-up of a full-scale network assembly

The authors conducted two full-scale network assemblies for the family network of a suicidal adolescent. Findings from the clinical follow-up and telephone interviews with 21 of 65 participants revealed benefits for the index family and the network members who participated in the meetings. A ripple effect in which the participants' own personal networks improved was also demonstrated. Benefits included resolution of a suicidal crisis, better understanding of depression and family stress, more adaptive responses to depression and suicidal risk, and improved personal relationships. No casualties from this intervention were discovered. This report is intended to stimulate future, more systematic outcome studies.     

The influence of flavor preexposure and test interval on conditioned taste aversions in the rat

The effects of flavor preexposure and test interval on conditioned taste aversions were examined in four experiments. In the first three experiments, prior experience with a flavor different from that used as a conditioned-stimulus (CS) produced attenuated aversions when testing occurred after a 1-day interval but not after a 21-day interval. Preexposure to the same stimulus used as a CS produced attenuated aversions at both 1- and 21-day intervals. In Experiment 4, a delay interval between flavor preexposure and conditioning eliminated the attenuating effect of preexposure, but only when different stimuli were used for preexposure and conditioning. These data could not be easily accounted for by contemporary interpretations of preexposure as an event that interferes with subsequent acquisition of a conditioned aversion. An alternative retrieval interference hypothesis was outlined.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Death by 1000 ‘true fans’: Do marketing laws apply to music listening?

The advice to musicians and marketers is to focus on what they love: a truism for practitioners is to find 1000 ‘true fans’ and make $100 from each of them (Kelly, 2008. 1000 True fans. The Technium). If this advice is correct, we should see musicians with loyal user bases engaging more with their favourite artists and less with other music, suggesting a narrow targeting strategy would suffice. On the other hand, the established marketing laws indicate that the listeners of very different genres should overlap more than conventional wisdom would suggest, supporting the need for a much broader approach to targeting potential audiences. Given these conflicting views, musicians need to know if they should market to their existing listeners, the listeners of music similar to theirs (i.e., the same genre), or if they should try to reach a much wider audience. We turn to established choice patterns from the marketing literature to address these questions in the music context. This study examines 84,000,000 observations of music listening from 27,000 unique global users between 2013 and 2014 and survey data from 2019 containing music listening from over 1000 representative respondents in the United States. The results show that listening follows the Duplication of Purchase law for genres, artists, albums, and songs, at an annual, 6-months, 3-months, 1-month, and 1-week period, with no indication of partitioned music listening. The implication is that musicians should try to reach all potential listeners, regardless of what they already listen to. These findings contribute to the theoretical knowledge about duplication analyses of various durations, extend the contexts of choice behaviour that exhibit this pattern, and managerially, to knowledge about the extent of potential audiences and ‘share of ear’ competition.     

Implicit and explicit COVID-19-vaccine harmfulness/helpfulness associations predict vaccine beliefs,intentions, and behaviors

We investigated the role of implicit and explicit associations between harm and COVID-19 vaccines using a large sample (N = 4668) of online volunteers. The participants completed a brief implicit association test and explicit measures to evaluate the extent to which they associated COVID-19 vaccines with concepts of harmfulness or helpfulness. We examined the relationship between these harmfulness/helpfulness COVID-19 vaccine associations and vaccination status, intentions, beliefs, and behavior. We found that stronger implicit and explicit associations that COVID-19 vaccines are helpful relate to vaccination status and beliefs about the COVID-19 vaccine. That is, stronger pro-helpful COVID-19 vaccine associations, both implicitly and explicitly, related to greater intentions to be vaccinated, more positive beliefs about the vaccine, and greater vaccine uptake.     

Differences in the importance of romantic structures among transgender and cisgender adults during the COVID-19 pandemic

The stressors of the global COVID-19 pandemic have led to an increased need for support. For adults, romantic relationships often represent an environment of emotional support and stability; as such, attitudes toward—and particularly the importance of—romantic relationships may have shifted as a result of the pandemic. The present cross-sectional study explores how U.S. transgender (n = 99) and cisgender people (n = 1886) report whether they have perceived a change in their feelings about the importance of long-term romantic structures (i.e., committed relationships, monogamy, cohabiting with a romantic partner, and marriage) as a result of the COVID-19 pandemic. Results found that transgender people reported a more positive perceived change in importance placed on all four romantic items relative to cisgender people. Different forms of stress (e.g., social, financial, health) associated with the COVID-19 pandemic may have contributed to an increased need, and subsequent desire, for social connection and support in the form of romantic relationships among transgender individuals to a greater extent than cisgender individuals, perhaps in part due to the additional layers of stress transgender people must navigate. Results are discussed through the lens of the minority stress framework.