A pragmatic approach to measuring adherence in treatment delivery in psychotherapy

ABSTRACT

Measuring therapists’ adherence to treatment manuals is recommended for evaluating treatment integrity, yet ways to do this are poorly defined, time consuming, and costly. The aims of the study were to develop a Therapy Component Checklist (TCC) to measure adherence to manualised CBT; to test its application in research and clinical practice; to determine its validity; and consider its cost benefits. We conducted a randomised trial in 230 people with cancer evaluating effectiveness of CBT for depression. In this, therapists delivered manualised treatment. Experts agreed on key components of therapy and therapists were asked to record these after therapy sessions by ticking a TCC. Inter-rater reliability was tested using an independent rater. Therapists delivered 543 CBT sessions. TCCs were completed in 293, of which 39 were assessed by the independent rater. Self-reported TCC data suggested close adherence to the manual. Prevalence-adjusted and bias-adjusted kappa scores suggested substantial agreement, (>0.60) in 38 out of 46 items. Self-rating of adherence saved around £96 per rating. In conclusion the TCC provides a quick and cost effective way of evaluating the components of therapy delivered. This approach could be applied to other psychological treatments and may help with linking therapeutic interventions with outcome.     

Individual differences in reading aloud: A mega-study,item effects,and some models

Normal individual differences are rarely considered in the modelling of visual word recognition – with item response time effects and neuropsychological disorders being given more emphasis – but such individual differences can inform and test accounts of the processes of reading. We thus had 100 participants read aloud words selected to assess theoretically important item response time effects on an individual basis. Using two major models of reading aloud – DRC and CDP+ – we estimated numerical parameters to best model each individual’s response times to see if this would allow the models to capture the effects, individual differences in them and the correlations among these individual differences. It did not. We therefore created an alternative model, the DRC-FC, which successfully captured more of the correlations among individual differences, by modifying the locus of the frequency effect. Overall, our analyses indicate that (i) even after accounting for individual differences in general speed, several other individual difference in reading remain significant; and (ii) these individual differences provide critical tests of models of reading aloud. The database thus offers a set of important constraints for future modelling of visual word recognition, and is a step towards integrating such models with other knowledge about individual differences in reading.     

Modeling dating decisions in a mock swiping paradigm: An examination of participant and target characteristics

New online dating platforms, such as Tinder, are dramatically changing the context in which people seek romantic relationships. In these platforms, users select partners they are willing to start a conversation with by “swiping” on them. These platforms provide exciting possibilities for applying new methods to test how user (e.g., demographic, personality) and target/partner (e.g., attractiveness, race) factors predict attraction. Across four laboratory studies (total N = 2,679), target physical attractiveness and target race were the largest predictors of decisions in this hypothetical dating context, whereas user individual difference traits were poor predictors. The current studies provide substantive information about the factors that predict romantic attraction in the context of mobile-based dating applications.     

Natural Leaders: Some Interlocutors Elicit Greater Convergence Across Conversations and Across Characteristics

Are there individual tendencies in convergence, such that some speakers consistently converge more than others? Similarly, are there natural “leaders,” speakers with whom others converge more? Are such tendencies consistent across different linguistic characteristics? We use the Switchboard Corpus to perform a large-scale convergence study of speakers in multiple conversations with different interlocutors, across six linguistic characteristics. Because each speaker participated in several conversations, it is possible to look for individual differences in speakers' likelihood of converging and interlocutors' likelihood of eliciting convergence. We only find evidence for individual differences by interlocutor, not by speaker: There are natural leaders of convergence, who elicit more convergence than others across characteristics and across conversations. The lack of similar evidence for speakers who converge more than others suggests that social factors have a stronger effect in mediating convergence than putative individual tendencies in producing convergence, or that such tendencies are characteristic-specific.     

Inter-individual differences in sport refereeing: A review of theory and practice

Most studies on sport officials ignore the variance of the data in terms of individual differences. Here we highlight the need to focus on these differences in refereeing as the main point and goal of the current review. We argue that the study of individual differences is important for referee selection, development and performance evaluation. We present the available research on differences related to referee communication styles, types of interactions, and game management. We regard expertise and experience level as a key contributor to individual differences. Given the gap in research around the in-group variance, we discuss new directions for research and further recommendations for the field. We suggest that the areas in which more research and practice will inform our selection, training, and evaluation processes are communication and personal communication style, while having more flexibility in applying different refereeing styles to facilitate performance in different contexts.     

Extrafoveal Processing in Categorical Search for Geometric Shapes: General Tendencies and Individual Variations

The paper addresses the capabilities and limitations of extrafoveal processing during a categorical visual search. Previous research has established that a target could be identified from the very first or without any saccade, suggesting that extrafoveal perception is necessarily involved. However, the limits in complexity defining the processed information are still not clear. We performed four experiments with a gradual increase of stimuli complexity to determine the role of extrafoveal processing in searching for the categorically defined geometric shape. The series of experiments demonstrated a significant role of extrafoveal processing while searching for simple two-dimensional shapes and its gradual decrease in a condition with more complicated three-dimensional shapes. The factors of objects’ spatial orientation and distractor homogeneity significantly influenced both reaction time and the number of saccades required to identify a categorically defined target. An analysis of the individual p-value distributions revealed pronounced individual differences in using extrafoveal analysis and allowed examination of the performance of each particular participant. The condition with the forced prohibition of eye movements enabled us to investigate the efficacy of covert attention in the condition with complicated shapes. Our results indicate that both foveal and extrafoveal processing are simultaneously involved during a categorical search, and the specificity of their interaction is determined by the spatial orientation of objects, type of distractors, the prohibition to use overt attention, and individual characteristics of the participants.     

单克隆抗体的治病与“致病”

对单克隆抗体在病毒性疾病治疗和引起病毒感染增强两方面的作用进行了综述，分析了各自涉及的机理。指出于者是矛盾的统一体，辨证地看待是前提，深入研究是关键，合理和才是目标。     

Designing a brief measure of social anxiety: Psychometric support for a three-item version of the Interaction Anxiousness Scale (IAS-3)

Although social situations are enjoyable for most people, they cause extreme anxiety in others. To better understand individual differences in social anxiety, researchers have designed scales, such as the 15-item Interaction Anxiousness Scale (IAS; Leary, 1983), to measure people’s anxiousness in social situations. Despite the importance of measuring social anxiety, many research settings that require time or space constraints (e.g., field, longitudinal, daily diary studies) cannot always accommodate a 15-item scale. To address this problem, the current research aimed to create and validate a three-item version of the IAS. Studies examined the psychometric properties of a three-item measure of social anxiety (IAS-3). After choosing the best three items using item response theory methods (Study 1), we examined the IAS-3’s (a) concurrent validity with the 15-item IAS in a student sample (Studies 1 and 2), (b) test–retest reliability across 4 months (Study 2), and (c) construct validity in a diverse international sample (Studies 3 and 4). Across all studies, the IAS-3 showed good reliability and validity, supporting its use in future research.