Therapeutic response to Cognitive Processing Therapy in White and Black female veterans with military sexual trauma-related PTSD

Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD. Reductions in PTSD symptom severity, number of sessions attended, and early termination rates were compared between Black (n = 20) and White (n = 16) female veterans. A hierarchical linear modeling approach was used, with PTSD symptom severity over the course of treatment and follow-up entered as a level-1 variable and race (Black or White) entered as a level-2 predictor. Piecewise growth curves analyses revealed that both Black and White female veterans experienced significant reductions in PTSD symptom severity over the course of treatment and gains were maintained up to 6 months post-treatment. Race was not found to be a significant predictor of change in the slope of PTSD symptom severity over the course of CPT treatment. Additionally, number of sessions attended and rates of early termination did not significantly differ based on race. Results suggest that CPT was a well-tolerated and effective psychotherapeutic treatment for this sample regardless of racial self-identification.     

哲学视野下脑卒中后心理障碍的辩证康复

脑卒中后的心理障碍不但影响患者的心理健康,还严重阻碍整个康复治疗的进程。心理疗法作为一种重要的心理障碍康复手段,其有效性已得到相关临床研究的证实。但如何根据临床具体情况选择适宜的心理疗法加速患者功能的康复,提高其生活质量和日常生活活动能力,最终帮助患者重返家庭和社会一直是临床关注的热点。为了更好地提高对卒中患者心理障碍的认识和干预,本文试从哲学的角度出发,结合各期心理障碍的特点,对脑卒中后心理障碍的康复作一论述。     

The impact of a rural or urban context in eating awareness and self‐regulation strategies in children and adolescents from eight European countries

Complex relationships exist between eating behaviour and personal and environmental factors. Rural and urban geographic contexts seem to play a role in eating behaviour, and therefore deserve a deeper study. A healthy eating behaviour and the conditions that promote it are a major issue in the promotion of adolescent health. The study aims to investigate the associations between the area of residence (urban vs. rural), self‐regulation strategies (TESQ‐E) and eating behaviours among children and adolescents. A total of 11,820 adolescents (50.6% girls) participated in the study, with a mean age of 13.30 years (SD= 2.13). Nine countries (The Netherlands, United Kingdom, Poland, Portugal, Denmark, Romania, Germany, Finland and Belgium) completed a questionnaire in the school context, asking about the use of self‐regulation strategies, eating behaviour awareness/care and sociodemographic questions such as age, gender and residential area. Both areas of residence (urban vs. rural) are associated with eating awareness/care in Romania and Portugal, controlling for age, gender and self‐regulation strategies. In some European countries at least, and most probably around the world, health promotion should focus on an ecological approach that includes the understanding of the effect of both environmental factors and personal skills on eating behaviour/awareness.     

Cognitive behavior therapy in treatment-naive children and adolescents with obsessive-compulsive disorder: an open trial

This work aims is to evaluate the therapeutic efficacy of cognitive behavior therapy (CBT) in pediatric patients with obsessive-compulsive disorder (OCD) who had not previously been treated with either pharmacotherapy or psychotherapy and who remained medication-free during CBT. Sixteen OCD outpatients, 8-17 years of age, were treated in a 12-week open trial with manualized CBT. Target symptoms were rated at two-week intervals with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the National Institute of Mental Health Global Obsessive-Compulsive Scale (NIMH Global), the Clinical Global Impression Scale (CGI), and the Hamilton Anxiety Rating Scale (Ham-A). Statistical analyses showed a significant benefit for treatment. Ten patients experienced at least a 50% reduction in symptoms on the CY-BOCS; seven were asymptomatic on the NIMH Global. These results build on previous reports that CBT may be effective in the acute treatment of pediatric OCD. Further, the results of this study suggest that CBT can be efficacious in alleviating OCD symptoms in the absence of pharmacotherapy. These results must be considered preliminary, given the small sample size and open administration of treatment.     

Racial/ethnic differences moderate associations of coping strategies and posttraumatic stress disorder symptom clusters among women experiencing partner violence: a multigroup path analysis

Background: Past research underscores the key role of coping strategies in the development, maintenance, and exacerbation of posttraumatic stress disorder (PTSD) symptoms. The goal of the current study was to extend existing literature by examining whether race/ethnicity moderates the relations among coping strategies (social support, problem-solving, avoidance) and PTSD symptom clusters (intrusion, avoidance, numbing, arousal).

Methods: Participants were 369 community women (134 African Americans, 131 Latinas, 104 Whites) who reported bidirectional aggression with a current male partner. Multigroup path analysis was utilized to test the moderating role of race/ethnicity in a model linking coping strategies to PTSD symptom clusters.

Results: The strength and direction of relations among coping strategies and PTSD symptom clusters varied as a function of race/ethnicity. Greater social support coping was related to more arousal symptoms for Latinas and Whites. Greater problem-solving coping was related to fewer arousal symptoms for Latinas. Greater avoidance coping was related to more symptoms across many of the PTSD clusters for African Americans, Latinas, and Whites, however, these relations were strongest for African Americans.

Conclusion: Results provide support for the moderating role of race/ethnicity in the relations among coping strategies and PTSD symptom clusters, and highlight potential targets for culturally informed PTSD treatments.     

心理学视角下的极端膜拜伤害问题

对极端膜拜团体造成身心伤害现象的科学研究, 集中在对极端膜拜伤害的界定、测量和机制三个方面。本文的目的, 是梳理这三个主题上的研究脉络, 明晰其中的争议之处和取得的成绩。文本分析表明, 对极端膜拜伤害的界定从“洗脑”转向了“心理虐待”, 对这类伤害的经验观察由个体症状转向了群体行为和经历的描述, 测量方法由传统心理测试工具变成了新型团体心理虐待量表, 膜拜伤害的心理机制研究在综合环境和个人精神特质两种因素的基础上建立了二者交互的病理模型, 表观遗传学和人际神经生物学用于极端膜拜伤害的生理机制研究已见端倪。但是, 迄今对于极端膜拜伤害的学术研究尚未形成范式。     

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.     

Predicting cognitive development and early symptoms of autism spectrum disorder in preterm children: The value of temperament and sensory processing

This study was the first to longitudinally explore the extent to which early temperament and sensory processing were of predictive value for cognitive development and Autism Spectrum Disorder (ASD) symptomatology in a sample of preterm children (N = 50, 22 girls, mean gestational age 27 weeks). At the corrected ages of 10, 18, and 24 months, sensory processing and temperament were assessed, as were cognitive development and ASD symptoms at 36 months. Better cognitive development was predicted by fewer hospitalisation days at birth and by lower Activity Level at 18 months. Temperamental subscales of Negative Affect showed associations with both parent-reported and observational measures of ASD symptomatology, whereas sensory processing only had predictive value for parent-reported symptoms of ASD. The usefulness of temperament and sensory processing for prediction of ASD symptom severity and cognitive outcomes became clear in the second year of life. The results indicate that this area of research is worth additional investigation in the extreme and very preterm population, to explore in further detail whether these two concepts might be able to provide information about which preterms are more likely to develop ASD or cognitive impairments.     

父母心理控制与对立违抗障碍儿童抑郁和攻击行为的关系:父子依恋和母子依恋的中介效应

采用父母心理控制、亲子依恋、抑郁量表对从北京市、山东省和云南省14所小学筛选出来的246名对立违抗障碍(Oppositional Defiant Disorder,ODD)儿童进行施测,并由被试的班主任填写儿童攻击行为量表,考察父、母心理控制对ODD儿童抑郁和攻击行为的影响,以及父子依恋和母子依恋在其中的中介作用。结果发现:(1)ODD儿童中男生人数更多,且男孩的抑郁和攻击行为更严重;(2)父亲对男孩的心理控制更强,而母亲在对男孩和女孩的心理控制上没有显著差异;(3)父、母心理控制与ODD儿童的父子依恋、母子依恋和抑郁均呈显著相关,但只有父亲心理控制与ODD儿童的攻击行为显著相关;(4)父子依恋在父母心理控制和ODD儿童抑郁之间没有起到显著的中介作用,母子依恋在母亲心理控制和ODD儿童抑郁之间有显著的中介作用。父子依恋和母子依恋在父、母心理控制和ODD儿童攻击行为之间均没有起到显著的中介作用。     

Autonomic and subjective responsivity to emotional images in people with dissociative seizures

People with dissociative seizures (DS) report a range of difficulties in emotional functioning and exhibit altered responding to emotional facial expressions in experimental tasks. We extended this research by investigating subjective and autonomic reactivity (ratings of emotional valence, arousal and skin conductance responses [SCRs]) to general emotional images in 39 people with DS relative to 42 healthy control participants, whilst controlling for anxiety, depression, cognitive functioning and, where relevant, medication use. It was predicted that greater subjective negativity and arousal and increased SCRs in response to the affective pictures would be observed in the DS group. The DS group as a whole did not differ from controls in their subjective responses of valence and arousal. However, SCR amplitudes were greater in ‘autonomic responders’ with DS relative to ‘autonomic responders’ in the control group. A positive correlation was also observed between SCRs for highly arousing negative pictures and self‐reported ictal autonomic arousal, in DS ‘autonomic responders’. In the DS subgroup of autonomic ‘non‐responders’, differences in subjective responses were observed for some conditions, compared to control ‘non‐responders’. The findings indicate unaffected subjective responses to emotional images in people with DS overall. However, within the group of people with DS, there may be subgroups characterized by differences in emotional responding. One subgroup (i.e., ‘autonomic responders’) exhibit heightened autonomic responses but intact subjective emotional experience, whilst another subgroup (i.e., ‘autonomic non‐responders’) seem to experience greater subjective negativity and arousal for some emotional stimuli, despite less frequent autonomic reactions. The current results suggest that therapeutic interventions targeting awareness and regulation of physiological arousal and subjective emotional experience could be of value in some people with this disorder.