Providing a treatment rationale for PTSD: Does what we say matter?

Little is understood about the factors that influence a woman's preference for a particular type of treatment after an assault. Furthermore, it remains unclear the extent to which providing detailed information such as the mechanism underlying a treatment or its side effects can affect a client's treatment preference for psychotherapy or pharmacotherapy. The current study of 324 women with varying degrees of trauma exposure and posttraumatic stress symptoms experimentally manipulated the content of treatment rationales for two common PTSD treatments: sertraline (SER) and prolonged exposure (PE). Specifically, both information regarding the hypothesized mechanism of the treatment and treatment side effects were manipulated. In general, personal reactions were more positive and credibility was stronger for psychotherapy than pharmacotherapy. This preference for the psychotherapy persisted regardless of specific information presented in the treatment rationale. For those reporting heightened hyperarousal and those of minority status, there was an increased likelihood of more positive reactions to sertraline. The results highlight assessment of treatment-related beliefs and preferences early on in the therapeutic process. Ultimately, understanding the factors that shape treatment preferences may contribute to the development of personalized treatment strategies that integrate preferences and attitudes about treatment as a way of bolstering adherence and outcome.     

Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment with Children and Adolescents with Severe Emotional and Behavioral Problems

Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre- to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.     

Cognitive consequences of affirming the self: The relationship between self-affirmation and object construal

Previous research suggests that affirming one’s important values is a powerful way of protecting one’s general self integrity, allowing non-defensive processing of self-relevant information. In a series of four studies linking self-affirmation with construal level, we find that in addition to any self buffering effect, thinking about one’s values and why they are important more generally shifts cognitive processing towards superordinate and structured thinking. Self-affirmation leads participants to perceive a greater degree of structure within their selves (Study 1), to increasingly identify actions in terms of their end-states (Study 2), to more strongly distinguish between primary and secondary object features (Study 3) and to perform better on tasks requiring abstract, structured thinking than those requiring detail-oriented, concrete thinking. Together, these findings suggest that thinking about important values helps individuals to structure information and focus on the big picture.     

The pars triangularis in dyslexia and ADHD: A comprehensive approach

Limited research has been conducted on the structure of the pars triangularis (PT) in dyslexia despite functional neuroimaging research finding it may play a role in phonological processing. Furthermore, research to date has not examined PT size in ADHD even though the right inferior frontal region has been implicated in the disorder. Hence, one of the purposes of this study was to examine the structure of the PT in dyslexia and ADHD. The other purposes included examining the PT in relation to overall expressive language ability and in relation to several specific linguistic functions given language functioning often is affected in both dyslexia and ADHD. Participants included 50 children: 10 with dyslexia, 15 with comorbid dyslexia/ADHD, 15 with ADHD, and 10 controls. Using a 2 (dyslexia or not) × 2 (ADHD or not) MANCOVA, findings revealed PT length and shape were comparable between those with and without dyslexia. However, children with ADHD had smaller right PT lengths than those without ADHD, and right anterior ascending ramus length was related to attention problems in the total sample. In terms of linguistic functioning, presence of an extra sulcus in the left PT was related to poor expressive language ability. In those with adequate expressive language functioning, left PT length was related to phonological awareness, phonological short-term memory and rapid automatic naming (RAN). Right PT length was related to RAN and semantic processing. Further work on PT morphology in relation to ADHD and linguistic functioning is warranted.     

Biased processing of emotional information in sub-clinical anxiety: Evidence from Simon effects

We tested the idea that in high trait-anxiety, behavioural responses are influenced by spatial correspondence to emotional information. It is suggested that if an emotional stimulus is preferentially processed, it may act as if presented alone and yield a Simon effect: faster responses when stimulus and response spatially correspond than when not. High-trait-anxious undergraduates indeed showed a content-specific Simon effect for social-threat (not physical-threat) words that were presented together with a neutral word for 14 ms; they showed the reverse response pattern for positive words. Low-anxious undergraduates had no bias. When presentation time was lengthened to 500 ms, the response pattern for social-threat and positive words shown by high-anxious undergraduates reversed as compared to the pattern with 14 ms, but there were no significant group differences. These results can be taken to suggest that in high trait-anxiety, the processing of social-threat is specifically prioritized; social-threat and positive information may elicit an immediate response, counteracted by mood-regulation strategies. We argue that the present approach opens up interesting avenues for investigating biased information processing and response tendencies.     

Exploring the When and Why of Schadenfreude

We summarize the empirical work on schadenfreude , or pleasure felt at someone else's misfortune. Although schadenfreude is a socially undesirable emotion, research reveals at least three conditions in which it commonly arises. One condition is when observers gain from the misfortune. We discuss research showing that gains in ingroup outcomes based on the failures of rival outgroups can create schadenfreude , especially for those highly identified with their ingroups. A second condition is when another's misfortune is deserved. We focus on research showing that the misfortunes of hypocrites are perceived as highly deserved and therefore create schadenfreude in observers. A third condition is when a misfortune befalls an envied person. We summarize studies showing that the core ingredients of envy prime the envying person for schadenfreude when the envied person suffers.     

The use of pupillometry in the study of on-line verbal processing: evidence for depths of processing

The effect of context and task demand upon the perception and resolution of lexical ambiguities was investigated in three experiments using pupillary measurements. Sentence type (ambiguous, disambiguous, and control) was tested under three conditions ("recall," "define word," and "choose best meaning"). All types of ambiguous sentences had higher pupillary curves than unambiguous sentences, with a particularly sharp rise in pupil size following the homophone. In addition, differences were observed in total sentence rise among the three task demands, such that the definition task was higher than recall, while the "choice" task exhibited a continuing rise after the sentence, which both other tasks did not have. Results are discussed in relation to putative processing stages of sentences, such as lexical search and sentence integration, and the more general issue of depths of processing.     

Language deficits and the theory of syntax

A new structural account of agrammatism is proposed, which analyzes the deficit in terms of one current theory of syntax. First, the motivation for accounts of this kind is given. Then, a variety of experimental findings from sentence comprehension in agrammatism are examined and accounted for in a unified way. It is shown that a minimal change in the syntactic model (achieved by imposing a special condition on a construct called trace), results in a model which accounts for all the data at hand. A number of possible objections to this proposal is then examined, and reasons are given to dismiss these objections. Also, it is shown that this proposal is preferable to other structural accounts which have been recently proposed. Finally, the empirical consequences of this account are discussed, with a special emphasis on the implications for models of language processing.     

Cerebral blood flow in normal and abnormal sleep and dreaming

Measurements of regional or local cerebral blood flow (CBF) by the xenon-133 inhalation method and stable xenon computerized tomography CBF (CTCBF) method were made during relaxed wakefulness and different stages of REM and non-REM sleep in normal age-matched volunteers, narcoleptics, and sleep apneics. In the awake state, CBF values were reduced in both narcoleptics and sleep apneics in the brainstem and cerebellar regions. During sleep onset, whether REM or stage I-II, CBF values were paradoxically increased in narcoleptics but decreased severely in sleep apneics, while in normal volunteers they became diffusely but more moderately decreased. In REM sleep and dreaming CBF values greatly increased, particularly in right temporo-parietal regions in subjects experiencing both visual and auditory dreaming.