Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.     

Developing a Validity Argument Through Abductive Reasoning with an Empirical Demonstration of the Latent Class Analysis

This article proposes and demonstrates a methodology for test score validation through abductive reasoning. It describes how abductive reasoning can be utilized in support of the claims made about test score validity. This methodology is demonstrated with a real data example of the Canadian English Language Proficiency Index Program (CELPIP)-General test—a program assessing functional English language ability in the community and workplace. Abductive reasoning seeks the enabling conditions through which a claim about a person's ability makes sense. For example, it makes sense that a person has strong functional language proficiency if he or she has been regularly using English to write emails and meet with colleagues at work. A valid test score should be affected by the extent of a person's engagement with such enabling conditions. Empirical evidence that warrants such an abductively reasoned claim is illustrated through a latent class analysis within a structural equation model. Evidence is examined to investigate whether certain classes of test takers who have been differentially engaging in the enabling conditions do, in fact, predict a person's CELPIP-General performance. The steps of the methodology are summarized in the closing section.     

Psychological Predictors of Neurobehavioral Symptoms in a Polytrauma Veteran Sample

Given the high prevalence of comorbid conditions found in polytrauma settings, effective screening measures are needed. Several screening tools are commonly used in polytrauma clinics within the Department of Veterans Affairs (VA). This study examined the use of three screening measures—the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and PTSD Checklist–Civilian Version (PCL-C)—to predict scores on the Neurobehavioral Symptom Inventory (NSI). Research suggests that the presence of mental health conditions, such as PTSD, shares a significant amount of variance with postconcussive symptoms. The investigators hypothesized that the PCL-C would be the best predictor of scores on the NSI. All subjects were administered the screening measures as part of an evaluation in an outpatient Level III polytrauma clinic. Regression analysis was used to determine which instrument might serve as the best predictor of NSI total scores. Regression analysis revealed that BAI, BDI-II, and PCL-C total scores were good predictors of NSI total scores, with the BAI accounting for the majority of the variance. Mental health conditions can account for higher scores on the NSI, and screening of other mental health conditions should be taken into account when reviewing the NSI for individuals in polytrauma settings.     

社交网站使用能带来社会资本吗?

社交网站旨在维系和发展个体的人际关系网络,而社会资本是个体人际关系中潜在的、可获得的益处或资源,因此社交网站使用和社会资本存在密切关系。然而,有关一般性社交网站使用行为与社会资本关系的研究结果并不一致。针对不同类型使用行为的研究发现,特定类型的社交网站使用行为对特定类型社会资本有积极影响。社交网站中自我表露行为是获取社会资本的一种必要的途径,关系维持行为、资源动员请求行为、隐私保护行为等均是个体获取社会资本的有效行为策略。最后,就社会资本定义、线上线下社会资本存在覆盖等问题进行了探讨。     

The frequency of actions and thoughts scale: development and psychometric validation of a measure of adaptive behaviours and cognitions

This paper describes the development and preliminary psychometric evaluation of an instrument that measures the frequency of adaptive behaviours and cognitions related to therapeutic change during cognitive behavioural therapy (CBT), for symptoms of anxiety and depression. Two studies were conducted. In study one, 661 participants completed an online survey with 28 items targeting adaptive behaviours and cognitions. Exploratory factor analysis performed on part of the sample (n = 451) revealed that a four-factor solution ‘characterised’ the data. This led to the development of a 12-item instrument, the Frequency of Actions and Thoughts Scale (FATS). Confirmatory factor analysis was used to confirm the factor structure of the FATS using the remaining sample (n = 210), which revealed an acceptable model fit. In study two, 125 participants with clinically significant symptoms of anxiety, depression, or both were recruited to an Internet-delivered CBT (iCBT) treatment course. Participants completed the FATS and other measures throughout treatment, after treatment, and at three-month follow-up. Correlations and residual change scores of the FATS and its subscales with measures of anxiety, depression, behavioural activation, and CBT-related skills usage supported the construct validity of the FATS. A significant increase in FATS scores over treatment was also observed. The findings provide preliminary support for the psychometric properties of the FATS, which appears to have utility in research investigating mechanisms of change in CBT.     

多目标追踪中“线索”研究的贡献

多目标追踪范式是探讨动态情景下注意加工过程的成熟技术,其对不同阶段注意线索加工与利用的分析,对深入了解注意的动态信息加工过程具有重要意义。从注意线索的视角述评呈现阶段的内源性线索与外源性线索以及追踪阶段的目标数量动态变化和轨迹线索的研究成果及限制因素,提出多目标线索研究是客体档案理论与视觉索引理论之争的关键。虽然多目标追踪范式为内源性线索、外源性线索的提取与策略等研究提供很多便利,但目前该范式在线索的认知资源分配和加工策略上仍有研究留白,尚需进一步探索。     

A four‐disc version of the Tower of London for clinical use

Three studies are reported on the development of a four‐disc version of the Tower of London test of planning ability. The first (n = 138) involved the selection of items based on rational and empirical criteria to provide a short test of graded difficulty suitable for use with children and clinical populations. The second study (n = 480) checked the properties of the 10‐item test on a new sample and in addition examined the internal consistency and factor structure of the test. The third study (n = 61) examined the test – retest reliability of the test over a period of 1 month. The difficulty level of the test remained relatively stable from sample to sample and was sensitive to linear trend in performance from age 5 years up to 30 years. Total score did not reflect the action of a single underlying construct but rather appeared to index a number of factors. Scores were reasonably stable over the 1‐month period studied, at least for the children's sample employed. The four‐disc version is a promising method of assessing planning in children and adolescents in clinical situations.     

Delivering Intensive PTSD Treatment Virtually: The Development of a 2-Week Intensive Cognitive Processing Therapy–Based Program in Response to COVID-19

Of the many vulnerable groups affected by the spread of COVID-19, veterans have been especially impacted by the pandemic. Beginning in March 2020, nationwide shelter-in-place orders rapidly led to widespread job loss and economic upheaval; disruption and breakdown of multiple support systems; and increases in family stress, all of which may exacerbate underlying PTSD symptoms. Although telehealth has proven an effective means of delivering evidence-based psychotherapies for PTSD, little is known about the delivery of these treatments in an intensive, daily format over telehealth. There is growing need for intensive treatment options to reduce treatment-interfering barriers such as high dropout rates. In order to address this gap in the literature, this paper details several design considerations as well as patient selection procedures for a 2-week virtual intensive treatment program (vITP) for veterans with posttraumatic stress disorder (PTSD), consisting of daily individual Cognitive Processing Therapy (CPT) and other adjunctive interventions. We also describe two cases of veterans who successfully completed the vITP including their clinical outcomes, therapist reflections on the process, feedback regarding the program, as well as challenges patients encountered with the telehealth platform. Intensive evidence-based psychotherapy for PTSD delivered through a virtual format seems to show promise, but more systemic research is needed.