Cognitive-behavioral therapy of insomnia: A clinical case series study of patients with co-morbid disorders and using hypnotic medications

Cognitive-behavioral therapy for insomnia (CBTi) has demonstrated considerable efficacy within randomized clinical trials and case-series designs. This case-series study in a community sleep medicine clinic assessed the effectiveness of an eight-session CBTi protocol chronic insomnia patients who were allowed to continue their use of hypnotics (intent-to-treat n = 48), administered by a clinical psychology doctoral student receiving training and supervision in CBTi by a behavioral sleep medicine certified clinician. Outcome measures included daily sleep diaries, self-report measures on insomnia severity, dysfunctional beliefs and attitudes about sleep, daytime sleepiness, as well as medication usage. Patients showed significant improvements in sleep onset latency, wake time after sleep onset, sleep efficiency, insomnia severity, and dysfunctional sleep beliefs from pre- to post-treatment. No changes were seen in daytime sleepiness - patients were not excessively sleepy either before or after treatment. Use of sleep medication declined significantly from 87.5% pre-treatment to 54% post-treatment, despite no active efforts to encourage patients to withdraw. Results demonstrate that a CBTi conducted in a community sleep medicine clinic with patients not required to discontinue sleep-related medications can have similar effects as therapy delivered among those not on medication.     

Techniques of Structural Family Assessment: A Qualitative Analysis of How Experts Promote a Systemic Perspective

The trajectory of assessment in structural family therapy moves from a linear perspective, in which problems are located in the identified patient, to an interactional perspective, in which problems are seen as involving other members of the family. Minuchin, Nichols, & Lee (2007) developed a 4‐step model for assessing couples and families consisting of: (1) broadening the definition of the presenting complaint to include its context, (2) identifying problem‐maintaining interactions, (3) a structurally focused exploration of the past, and (4) developing a shared vision of pathways to change. To study how experts actually implement this model, judges coded video recordings of 10 initial consultations conducted by three widely recognized structural family therapists. Qualitative analyses identified 25 distinct techniques that these clinicians used to challenge linear thinking and move families toward a systemic understanding of their problems. We discuss and locate these techniques in the framework of the 4‐step model.     

Even with the Best of Intentions: Paternal Involvement and the Theory of Planned Behavior

Implicit in much of the fatherhood discourse is the assumption that if fathers want to take an active role in their children's lives, they could and would do so. While research has highlighted the factors associated with fathers' involvement, very few, if any, of these studies have been guided by a theory that accounts for both fathers' involvement intentions and their ability to follow through on those intentions. The theory of planned behavior and its emphasis on attitudes, the beliefs of significant others, and whether one has control over engaging in behavior is a conceptual fit to respond to questions related to the complex nature of paternal involvement. Using data from the Fragile Families and Child Well‐being Study, the purpose of this study was to test the utility of the theory of planned behavior in predicting fathers' involvement intentions and reports of involvement. The results revealed that the theory of planned behavior can be useful in examining paternal involvement and should be used in future research to enhance the fatherhood literature.     

Brief Sensation Seeking Scale for Chinese – Cultural adaptation and psychometric assessment

International behavioral research requires instruments that are not culturally-biased to assess sensation seeking. In this study we described a culturally adapted version of the Brief Sensation Seeking Scale for Chinese (BSSS-C) and its psychometric characteristics. The adapted scale was assessed using an adult sample (n = 238) with diverse educational and residential backgrounds. The BSSS-C (Cronbach alpha = 0.90) was correlated with the original Brief Sensation Seeking Scale (r = 0.85, p < 0.01) and fitted the four-factor model well (CFI = 0.98, SRMR = 0.03). The scale scores significantly predicted intention to and actual engagement in a number of health risk behaviors, including alcohol consumption, cigarette smoking, and sexual risk behaviors. In conclusion, the BSSS-C has adequate reliability and validity, supporting its utility in China and potential in other developing countries.     

The general factor of personality and humor styles

The present study examined the phenotypic, genetic, and environmental correlations between a general factor of personality (GFP) and four humor styles: affiliative, self-enhancing, aggressive, and self-defeating. Participants were 571 same-sex adult twin pairs. Individuals completed the Humor Styles Questionnaire (HSQ) and a short form of the NEO personality scale (from which the GFP was extracted). The GFP was found to be heritable with an estimated value of .31. At the phenotypic level, the GFP was found to correlate significantly with the HSQ scales; positively with affiliative and self-enhancing, and negatively with aggressive and self-defeating. Three of the four phenotypic correlations were found to be attributable to correlated genetic factors, suggesting that these dimensions of humor styles and the GFP may have a common genetic factor.     

INTEGRAL ECOLOGY: THE WHAT,WHO, AND HOW OF ENVIRONMENTAL PHENOMENA

Providing an overview of Integral Ecology, this article defines and explains some of the key terms and concepts that underlie an approach to the environment that is inspired by and makes use of Ken Wilber's Integral Theory. First Integral Ecology is distinguished from other environmental approaches. Then Wilber's Integral Theory is introduced, which provides a foundation for a participatory approach to ecology. Next, the ontology, epistemology, and methodology of environmental phenomena is examined in light of Wilber's framework and illustrated with multidimensional examples of recycling. Finally, an Integral Ecology platform is presented.     

Reflective measurement models,behavior domains,and common causes

Causal theories of measurement view test items as effects of a common cause. Behavior domain theories view test item responses as behaviors sampled from a common domain. A domain score is a composite score over this domain. The question arises whether latent variables can simultaneously constitute domain scores and common causes of item scores. One argument to the contrary holds that behavior domain theory offers more effective guidance for item construction than a causal theory of measurement. A second argument appeals to the apparent circularity of taking a domain score, which is defined in terms of a domain of behaviors, as a cause of those behaviors. Both arguments require qualification and behavior domain theory seems to rely on implicit causal relationships in two respects. Three strategies permit reconciliation of the two theories: One can take a causal structure as providing the basis for a homogeneous domain. One can construct a homogeneous domain and then investigate whether a causal structure explains the homogeneity. Or, one can take the domain score as linked to an existing attribute constrained by indirect measurement.     

Risk-Taking Behavior as a Mediator of the Relationship between Children's Temperament and Injury Liability

The relationship between childhood temperament, risk-taking behavior and injury liability is investigated in a sample of 209 two- to nine-year-old children using parental report. Temperament was found to be significantly related to both risk-taking behavior and the number of injuries sustained; moreover, risk-taking behavior was a significant predictor of injuries. A mediational model was tested and risk-taking behavior was found to mediate the relationship between temperament and injury liability. The implications of these findings are discussed within the context of preventive actions.     

Interference control in adolescents with Mild-to-Borderline Intellectual Disabilities and/or behavior disorders

The aim of this study was to investigate interference control in adolescents with Mild to Borderline Intellectual Disability (MBID) by addressing two key questions. First, as MBID is often associated with comorbid behavior disorders (BD), we investigated whether MBID and BD both affect interference control. Second, we studied whether interference control deficits are associated to problems in everyday executive functioning. Four groups of adolescents with and without MBID and/or BD performed the Eriksen flanker task, requiring participants to respond to a central target while ignoring interfering flanking stimuli. Their teachers rated behavior on the Behavior Rating Inventory Executive Function (BRIEF). We found pronounced effects of MBID but not BD on flanker interference control. In contrast, we observed pronounced effects of BD, but not MBID, on the BRIEF. In addition, flanker interference scores and BRIEF scores did not correlate. These results are taken to suggest that adolescents with MBID are characterized by deficits in interference control that do not become manifest in ratings of everyday executive functioning. In contrast, adolescents with BD are not characterized by deficits in interference control but do show elevated ratings of deficits in everyday executive function.