Risk and Trust in Public Health: A Cautionary Tale

The leading ethical position on placebo-controlled clinical trials is that whenever proven effective treatment exists for a given condition, it is unethical to test a new treatment for that condition against placebo. Invoking the principle of clinical equipoise, opponents of placebo-controlled trials in the face of proven effective treatment argue that they (1) violate the therapeutic obligation of physicians to offer optimal medical care and (2) lack both scientific and clinical merit. We contend that both of these arguments are mistaken. Clinical equipoise provides erroneous ethical guidance in the case of placebo-controlled trials, because it ignores the ethically relevant distinction between clinical trials and treatment in the context of clinical medicine and the methodological limitations of active-controlled trials. Placebo controls are ethically justifiable when they are supported by sound methodological considerations and their use does not expose research participants to excessive risks of harm.     

Body checking and avoidance in ethnically diverse female college students

Although body checking and avoidance behaviors are common in women with eating disorders, minimal research has examined the nature or correlates of these behaviors in ethnically diverse female college students without eating disorders. Self-identified European American (n = 268), Asian American (n = 163), Latina (n = 146), and African American (n = 73) women completed self-report measures of body checking and avoidance, thin-ideal internalization, eating pathology, and clinical impairment. Results indicated that European and Asian American women reported significantly more body checking and avoidance than African American and Latina women. Generally, correlates of body checking and avoidance were consistent across ethnic groups: Regression analyses indicated that type of ethnicity predicted body checking and avoidance; and ethnicity, body checking, and body avoidance predicted eating pathology and clinical impairment. These associations suggest that body checking and avoidance are not benign behaviors in diverse nonclinical women.     

Improved intertask coordination after extensive dual-task practice

This study examines whether an improved intertask coordination skill is acquired during extensive dual-task training and whether it can be transferred to a new dual-task situation. Participants practised a visual–manual task and an auditory–vocal task. These tasks were trained in two groups matched in dual-task performance measures before practice: a single-task practice group and a hybrid practice group (including single-task and dual-task practice). After practice, the single-task practice group was transferred to the same dual-task situation as that for the hybrid practice group (Experiment 1), both groups were transferred to a dual-task situation with a new visual task (Experiment 2), and both groups were transferred to a dual-task situation with a new auditory task matched in task difficulty (Experiment 3). The results show a dual-task performance advantage in the hybrid practice group over the single-task practice group in the practised dual-task situation (Experiment 1), the manipulated visual-task situation (Experiment 2), and the manipulated auditory-task situation (Experiment 3). In all experiments, the dual-task performance advantage was consistently found for the auditory task only. These findings suggest that extended dual-task practice improves the skill to coordinate two tasks, which may be defined as an accelerated switching operation between both tasks. This skill is relatively robust against changes of the component visual and auditory tasks. We discuss how the finding of task coordination could be integrated in present models of dual-task research.     

Personality Disorder Attributes as Supplemental Goals for Change in Interpersonal Psychotherapy

Interpersonal Psychotherapy (IPT) is a manualized, short-term (usually 12–16 sessions) based on the assumption that psychological disorders often emerge secondary to social and interpersonal problems that require active intervention to achieve symptom remission. The time-limited nature of IPT compels therapists to establish the goal of diminishing, on a weekly basis, a small number of focused interpersonal problems with a decided emphasis on proximal rather than historic conflicts and associated patterns of behavior. This strategy discourages the adoption of diffuse therapy goals and directions that have more opportunity to emerge in long-term, unstructured treatment modalities. The role of traditional personality testing in short-term therapy, when it occurs, is to identify and quantify symptom clusters that warrant attention as dependent measures in the treatment process. The role of personality factors in the genesis or maintenance of psychological disturbance is rarely addressed. The present article explores theoretical and pragmatic objections to the use of personality testing in IPT. A method is proposed for the limited but systematic incorporation of personality testing in the IPT treatment process using the Millon Clinical Multiaxial Inventory (MCMI-III). While unreasonable to expect personality transformation through short-term therapy, the partial attenuation of maladaptive behavioral, attitudinal, and emotional reactions to stressors could prove exceedingly helpful to short-term treatments such as IPT.     

Action and language: Contextual action theory in counselling

Contextual action theory is presented as a conceptual framework useful for grounding the recent work in counselling and career development called Life Design. Based on the premise of the goal-directed nature of human action, this approach has links to language in theories of naive action and attribution, and theory of mind. Contextual action theory has an associated research method that has been used to generate a range of research studies that have described actions and projects in the career development and counselling domains. The link that contextual action theory provides between research and practice allows the identification of five tasks for the counselling practitioner informed by this approach.     

Cultivating Community Psychology for Future Generations: Symbiosis,Synergy, and Separation

As we near the fiftieth anniversary of the founding of a community psychology division of the American Psychological Association, there are reasons to be concerned about the sustainability of the field. This commentary proposes a need for deliberate, systematic efforts to cultivate settings that can sustain the field. A framework for outreach to build symbiotic relationships and synergistic collaborations with persons who do not identify as community psychologists is proposed. Simultaneously, a strategy of separation from other disciplines may be needed in some circumstances to conserve settings that sustain the field. Finding a balance in these strategies is necessary to cultivate community psychology for future generations.     

Are demographic Variables Associated with Performance on the Examination for Professional Practice in Psychology (EPPP)?

The Examination for Professional Practice in Psychology (EPPP) is a universal requirement for psychology licensure in the United States and much of Canada. However, in the 53?years of its use, many fundamental questions about this “high stakes” exam remain. Specifically, the EPPP relies exclusively upon content validity evidence, and it is unknown if scores are associated with relevant performance criteria. Limited evidence suggests that failure rates vary according to applicant demographics. To further assess the latter, a Freedom of Information Act request was submitted to a populous US state (N of applicants?=?4892). Significant differences in first-time failure rates were found according to ethnicity (i.e., Blacks?=?38.50%; Hispanics?=?35.60%; Asians?=?24.00%; Whites?=?14.07%). Men (18.85%) failed more often than women (15.82%) and PsyDs (20.07%) failed more often than PhDs (15.02%), but the magnitude of difference in these two analyses was relatively small. Meaningful interactions between ethnicity, gender, and degree type were not found, but given the ethnic performance discrepancies and limited validity evidence, additional psychometric investigation of the EPPP appears warranted (e.g., in terms of criterion and predictive validity testing). Further, it is recommended that the EPPP Step-2 should undergo similar assessments prior to implementation.     

Oculomotor behavior and the level of repetition in motor practice: Effects on pupil dilation,eyeblinks and visual scanning

The benefits of less repetitive practice in motor learning have been explained by the increased demand for memory processes during the execution of motor skills. Recently, a new perspective associating increased demand for perception with less repetitive practice has also been proposed. Augmented information gathering and visual scanning characterize this higher perceptual demand. To extend our knowledge about mental effort and perceptual differences in practice organization, the association between oculomotor behavior and type of practice was investigated. We required participants to press four keys with different absolute and relative timing goals during the acquisition phase. An eye-tracker captured visual scanning of the skill’s absolute and relative information displayed on the screen. Participants were tested 24 h after acquisition by a retention and transfer test. A higher level of both pupil dilation and amount of eyeblinks indicated an increased mental effort in less repetitive practice compared to more repetitive practice. Visual scanning of the skill’s relative and absolute information was specific to the type of practice. The findings indicate many differences in oculomotor behavior associated with the practice schedule.