The Association between Symptom Accommodation and Emotional Coregulation in Couples with Binge Eating Disorder

Intense negative emotions and maladaptive behavioral strategies to reduce emotional distress occur not only in patients with various forms of psychopathology but also in their committed partners. One common strategy to reduce distress is for partners to accommodate to the symptoms of the disorder, which reduces distress short term but maintains symptoms long term. Accommodation is believed to be motivated by the partner reacting behaviorally to the patient's emotions, but the emotions of the partner in this context have yet to be examined. This pilot study examined how partner accommodation related to specific patterns of emotional coregulation between patients with binge eating disorder (BED) and their partners, before and after a couple‐based intervention for BED. Vocally encoded emotional arousal was measured during couples’ (n = 11) conversations about BED. As predicted, partners’ emotional reactivity to patients’ emotional arousal was associated with high accommodation before treatment. Thus, partners may use accommodation as a strategy to reduce both the patients’ and their own distress. After treatment, partners’ arousal was no longer associated with the patients’ emotional arousal; instead, partners showed greater emotional stability over time, specifically when accommodation was low. Additionally, patients were less emotionally aroused after treatment. Therefore, treatment may have decreased overall emotionality of patients and altered the association between accommodation and partners’ emotional reactivity. If replicated, this understanding of the emotional context associated with accommodation in BED can inform couple‐based treatment by targeting specific emotional precipitants of behaviors that maintain symptoms.     

Intermittent explosive disorder and other psychiatric comorbidity among court-referred and self-referred aggressive drivers

We assessed possible Axis I and Axis II disorders in two groups of aggressive drivers (n=20, court-referred; n=10, self-referred) and 30 non-aggressive driver controls, using the SCID and SCID-II. Aggressive drivers were more likely than controls to be positive for any Axis I and Axis II disorders. They were also more likely to meet the criteria for Intermittent Explosive Disorder (IED), current or past alcohol or substance abuse or dependence and Antisocial PD and Borderline PD. The self-referred aggressive drivers were more likely than court-referred aggressive drivers to meet the criteria for a current or past Anxiety Disorder. Re-analysis of aggressive driver data on the basis of presence or absence of IED revealed differences only in Axis II disorders: those with IED were more likely to meet the criteria for any Axis II disorder and Antisocial PD.     

Interventions for Family Members and Carers of Patients with Borderline Personality Disorder: A Systematic Review

Carers of patients with borderline personality disorder (BPD) experience high levels of distress. Several studies have been carried out on interventions designed to decrease their burden. However, the evidence from these studies has not been summarized. The objective of this work is to explore the clinical utility of interventions developed for family members of patients with BPD. A systematic review was conducted following the PRISMA guidelines (registration number CRD42018107318), including psychological interventions focused on relatives of patients with BPD. The following databases were used: PsycINFO, PubMed, EBSCOhost, and Web of Science. Two independent researchers reviewed the studies to determine whether the eligibility criteria were met. A total of 2,303 abstracts were identified. After duplicates had been removed, 1,746 studies were screened. Finally, 433 full‐text articles were reviewed, yielding 11 studies that satisfied the inclusion criteria. Results show that these interventions with different clinical formats and settings are effective. The quality of the included studies varies, and the empirical support for these programs is still preliminary. The results help to establish a general framework for interventions specifically developed for family members of patients with BPD, but additional efforts should be made to improve the methodological quality of this field of research and more solidly determine the utility of these interventions. Given the paucity of data so far, this information may open up new lines of research to improve the effectiveness of future programs for carers of patients with BPD and help to reduce their burden.     

Using telehealth to provide outpatient follow‐up to children with avoidant/restrictive food intake disorder

The COVID‐19 global health crisis compelled behavior analysts to consider alternatives to face‐to‐face services to treat children with feeding disorders. Research suggests telehealth is one method behavior analysts could use to initiate or continue assessment of and treatment for feeding disorders. In the current paper, we conducted pilot studies in which we analyzed chart records of patients with Avoidant/Restrictive Food Intake Disorder; who graduated from an intensive, day‐treatment program; and transitioned to an outpatient follow‐up program. In Experiment 1, we analyzed the data of participants who received follow‐up both in‐clinic and via telehealth. In Experiment 2, we analyzed goal attainment for participants who received outpatient follow‐up either in‐clinic exclusively or via telehealth exclusively. Results of both studies showed that outcomes were equivalent along most dimensions for in‐clinic and telehealth services. We provide recommendations for telehealth feeding services and discuss other considerations relevant to telehealth service delivery.     

Belief,quasi-belief,and obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) poses a puzzle about beliefs: Those with OCD experience anxiety and motivation suggesting that they believe something, even though they may profess not to believe that very thing. OCD also poses a puzzle about free will, since persons with OCD often describe their behavior as compelled, though it is unclear how it is compelled. This paper argues that at least some cases of OCD are best described as being driven by “quasi-beliefs” which have some, but not all, of the functional properties of beliefs. (A brief discussion contrasts these quasi-beliefs with the “aliefs” recently posited by Tamar Gendler.) An alternative to the quasi-belief account of OCD is the claim is that OCD can be explained in terms of ordinary beliefs that simply have irrational contents. The paper argues that the quasi-belief account of OCD fits the empirical details of the disorder better than alternative accounts.     

Beery VMI performance in autism spectrum disorder

Few studies have examined the visuomotor integration (VMI) abilities of individuals with autism spectrum disorder (ASD). An all-male sample consisting of 56 ASD participants (ages 3–23 years) and 36 typically developing (TD) participants (ages 4–26 years) completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) as part of a larger neuropsychological battery. Participants were also administered standardized measures of intellectual functioning and the Social Responsiveness Scale (SRS), which assesses autism and autism-like traits. The ASD group performed significantly lower on the Beery VMI and on all IQ measures compared to the TD group. VMI performance was significantly correlated with full scale IQ (FSIQ), performance IQ (PIQ), and verbal IQ (VIQ) in the TD group only. However, when FSIQ was taken into account, no significant Beery VMI differences between groups were observed. Only one TD participant scored 1.5 standard deviations (SDs) below the Beery VMI normative sample mean, in comparison to 21% of the ASD sample. As expected, the ASD group was rated as having significantly higher levels of social impairment on the SRS compared to the TD group across all major domains. However, level of functioning on the SRS was not associated with Berry VMI performance. These findings demonstrate that a substantial number of individuals with ASD experience difficulties compared to TD in performing VMI-related tasks, and that VMI is likely affected by general cognitive ability. The fact that lowered Beery VMI performance occurred only within a subset of individuals with ASD and did not correlate with SRS would indicate that visuomotor deficits are not a core feature of ASD, even though they present at a higher rate of impairment than observed in TD participants.     

Assessing the combined effects of resurgence and reinstatement in children diagnosed with autism spectrum disorder

Resurgence and reinstatement are laboratory models of relapse following treatments for problem behavior that arrange alternative sources of reinforcement, such as differential reinforcement of alternative behavior and noncontingent reinforcement. Resurgence models the elimination or reduction of reinforcers during treatment and reinstatement models the re‐presentation of reinforcers previously maintaining problem behavior. The present study examined individual and combined effects of resurgence and reinstatement in a translational model of treatment relapse with three children diagnosed with Autism Spectrum Disorder. We first reinforced and then extinguished an arbitrary response while providing access to a preferred toy to model a version of noncontingent reinforcement with extinction. In the following phases, we examined resurgence by removing the toy, reinstatement by presenting the training reinforcer response‐independently, and a combination of resurgence and reinstatement. Overall, relapse of target responding reliably exceeded functionally similar responses never reinforced in the experimental situation. Most importantly, relapse tended to be greater when combining resurgence and reinstatement than when assessing either alone. These findings support previous studies showing that combinations of operations can increase treatment relapse. This translational model arranging simulated problem behavior with arbitrary tasks provides a platform from which to thoroughly and systematically assess methods for understanding and improving behavioral treatments.     

Specificity of the Association between Marital Discord and Longitudinal Changes in Symptoms of Depression and Generalized Anxiety Disorder in the Irish Longitudinal Study on Ageing

This longitudinal study was conducted to evaluate actor and partner effects of marital discord on changes in symptoms of depression and generalized anxiety disorder (GAD) in a large population sample of Irish adults (N = 1,445 couples), adjusting for the potential confounds of quality of other social relationships and other psychopathology symptoms. The Actor–Partner Interdependence Model was used to examine actor and partner effects of marital discord on changes in symptoms of depression and GAD at a 2‐year follow‐up. Additional models examined these associations adjusting for family and friend discord and symptoms of the other type of psychopathology (depressive or GAD symptoms). Actor effects of marital discord on depressive and anxiety symptoms were greater for men than for women. There were significant, positive actor effects of marital discord on depressive symptoms for husbands and wives, which remained significant when adjusting for family and friend discord and GAD symptoms. There were significant, positive actor effects of marital discord on GAD symptoms for husbands, which remained significant when adjusting for family and friend discord and depressive symptoms. Results demonstrate that longitudinal associations between marital discord and depressive symptoms (for wives and husbands) and GAD symptoms (for husbands) are incremental to other rival explanations (family and friend discord and the other set of symptoms). Findings provide evidence for a potential causal association leading from marital discord to symptoms of depression and GAD.     

Sex Differences in the Pathway from Low Birth Weight to Inattention/hyperactivity

Inattention/hyperactivity is a childhood outcome of low birth weight. However, the mechanisms by which low birth weight leads to inattention/hyperactivity are unclear. This study examined arousal, activation, motor speed, and motor coordination as possible mechanisms, attending to sex differences. 823 children (400 males) from Detroit and surrounding suburbs were assessed with the Child Behavior Checklist and the Teacher Report Form and completed experimental tasks to assess vigilance and activation (Continuous Performance Test signal detection parameters) and motor output speed and control (Grooved Pegboard) at 6 years of age. The relationship between birth weight and inattention/hyperactivity was slightly, but not significantly, stronger for boys than for girls. Arousal, motor speed, and motor coordination significantly partially mediated the relationship between birth weight and inattention/hyperactivity for boys and girls. Moderated mediation was found for the pathway between motor coordination and inattention/hyperactivity such that this relationship was stronger for boys than for girls. Sex differences in the associated features of attention symptoms may reflect partially distinct etiological pathways.     

Executive and motivational inhibition: Associations with self-report measures related to inhibition

Inhibition involves the withholding or suppressing of attention or responses to irrelevant or distracting stimuli. We examined the relationship between five experimental tasks of inhibition, represented by two measures of executive, intentional control inhibition and three measures of motivational inhibition characterized by bottom-up interruption of affective and reward/punishment sensitive mechanisms. Associations between these experimental tasks with three self-report measures related to inhibition were also examined. Correlational analyses indicated a small but significant association between the measures in the executive domain (stop task and Stroop task), but a lack of associations between the measures in the motivational domain (emotional Stroop task, a card playing task involving rewards and punishments, and a gambling task). Both measures of executive and motivational inhibition entered as significant predictors on the self-report measures related to inhibition in simultaneous regression analyses, but not consistently in the expected direction. The results suggest that inhibition is not a unitary construct, and demonstrate an association between experimental measures of inhibition and self-report measures related to inhibition.