Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

Do chimpanzees (Pan troglodytes) understand single invisible displacement?

Previous research suggests that chimpanzees understand single invisible displacement. However, this Piagetian task may be solvable through the use of simple search strategies rather than through mentally representing the past trajectory of an object. Four control conditions were thus administered to two chimpanzees in order to separate associative search strategies from performance based on mental representation. Strategies involving experimenter cue-use, search at the last or first box visited by the displacement device, and search at boxes adjacent to the displacement device were systematically controlled for. Chimpanzees showed no indications of utilizing these simple strategies, suggesting that their capacity to mentally represent single invisible displacements is comparable to that of 18-24-month-old children.     

The heart of the matter: a proposal for placing the self of the therapist at the center of family therapy research and training

As it faces the transition marked by the death or retirement of most of its first-generation founders, the field of family therapy finds itself still unable to answer the critical question of what it is that makes family therapy work. The two dominant approaches to answering this question, the common-factors perspective and the model-specific factors perspective, remain divided at this juncture by a fundamental difference of emphasis between the two. This article proposes a way of integrating the two perspectives via the hypothesis that therapists achieve maximum effectiveness by committing themselves to a family therapy model of proven efficacy whose underlying worldview closely matches their own personal worldview. The implications of this hypothesis for the training of family therapists are examined.     

Learning of letter names and sounds and their contribution to word recognition

This study investigated knowledge of letter names and letter sounds, their learning, and their contributions to word recognition. Of 123 preschoolers examined on letter knowledge, 65 underwent training on both letter names and letter sounds in a counterbalanced order. Prior to training, children were more advanced in associating letters with their names than with their sounds and could provide the sound of a letter only if they could name it. However, children learned more easily to associate letters with sounds than with names. Training just on names improved performance on sounds, but the sounds produced were extended (CV) rather than phonemic. Learning sounds facilitated later learning of the same letters' names, but not vice versa. Training either on names or on sounds improved word recognition and explanation of printed words. Results are discussed with reference to cognitive and societal factors affecting letter knowledge acquisition, features of the Hebrew alphabet and orthography, and educational implications.     

Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles

Increased understanding of the nature and role of intrusive imagery has contributed to the development of effective treatment protocols for some anxiety disorders. However, intrusive imagery in severe health anxiety (hypochondriasis) has been comparatively neglected. Hence, the current study investigates the prevalence, nature and content of intrusive imagery in 55 patients who met DSM-IV-TR (APA, 2000) criteria for the diagnosis of hypochondriasis. A semi-structured interview was used to assess the prevalence, nature and possible role of intrusive imagery in this disorder. Over 78% of participants reported experiencing recurrent, distressing intrusive images, the majority (72%) of which either were a memory of an earlier event or were strongly associated with a memory. The images tended to be future orientated, and were reliably categorised into four themes: i) being told ‘the bad news’ that you have a serious/life threatening-illness (6.9%), ii) suffering from a serious or life-threatening illness (34.5%), iii) death and dying due to illness (22.4%) and iv) impact of own death or serious illness on loved ones (36.2%). Participants reported responding to experiencing intrusive images by engaging in avoidance, checking, reassurance seeking, distraction and rumination. Potential treatment implications and links to maintenance cycles are considered.     

Aversive racism and medical interactions with Black patients: A field study

Medical interactions between Black patients and nonBlack physicians are usually less positive and productive than same-race interactions. We investigated the role that physician explicit and implicit biases play in shaping physician and patient reactions in racially discordant medical interactions. We hypothesized that whereas physicians’ explicit bias would predict their own reactions, physicians’ implicit bias, in combination with physician explicit (self-reported) bias, would predict patients’ reactions. Specifically, we predicted that patients would react most negatively when their physician fit the profile of an aversive racist (i.e., low explicit-high implicit bias). The hypothesis about the effects of explicit bias on physicians’ reactions was partially supported. The aversive racism hypothesis received support. Black patients had less positive reactions to medical interactions with physicians relatively low in explicit but relatively high in implicit bias than to interactions with physicians who were either: (a) low in both explicit and implicit bias, or (b) high in both explicit and implicit bias.     

Expanding the study of U.S. religion: Reflections on the state of a subfield

The study of U.S. religion, which dates from the 19th century, expanded its sources, methods, and scope during the last quarter of the 20th century, as specialists offered more inclusive historical narratives. That methodological expansion never went far enough, however, and the impulse toward narrative inclusiveness has been restrained in recent years. The subfield, I argue, now faces a number of challenges that also confront other specializations in the study of religion—contraction, overspecialization, fragmentation, and parochialism. After a focused overview of the subfield’s history, I discuss those challenges. Proposing a tentative response, I suggest that specialists celebrate methodological diversity and theoretical sophistication, encourage comparative and translocative studies, and increase collaboration across disciplinary boundaries and national borders. Finally, I suggest that we expand the subfield’s temporal span and geographical scope and reframe the study of U.S. religion in terms of the Atlantic World, the Pacific World, and the Western Hemisphere.     

Effects of instruction on learners’ ability to generate an effective pathway in the method of loci

One of the most effective mnemonic techniques is the well-known method of loci. Learning and retention, especially of sequentially ordered information, is facilitated by this technique which involves mentally combining salient loci on a well-known path with the material to be learned. There are several variants of this technique that differ in the kind of path that is suggested to the user and it is implicitly assumed that these variants are comparable in effectiveness. The experiments reported in this study were designed to test this assumption. The data of two experiments show that participants who are instructed to generate and apply loci on a route to their work recall significantly more items in a memory test than participants who are instructed to generate and apply loci on a route in their house. These results have practical implications for the instruction and application of the method of loci.     

The influence of forward and backward associative strength on false memories for encoding context

Two experiments examined the effects of forward associative strength (FAS) and backward associative strength (BAS) on false recollection of unstudied lure items. Themes were constructed such that four associates were strongly related to a lure item in terms of FAS or BAS and four associates were weakly related to a lure item in terms of FAS or BAS. Further, when FAS was manipulated, BAS was controlled across strong and weak associates, while FAS was controlled across strong and weak associates when BAS was manipulated. Strong associates were presented in one font while weak associates were presented in a second font. At test, lure items were disproportionately attributed to the source used to present lures' strong associates compared to lures' weak associates, both when BAS was manipulated and when FAS was manipulated. This outcome demonstrates that both BAS and FAS influence lure item false recollection, which favours global-matching models' explanation of false recollection over the explanation offered by spreading activation theories.     

Racial healthcare disparities: A social psychological analysis

Around the world, members of racial/ethnic minority groups typically experience poorer health than members of racial/ethnic majority groups. The core premise of this chapter is that thoughts, feelings, and behaviours related to race and ethnicity play a critical role in healthcare disparities. Social psychological theories of the origins and consequences of these thoughts, feelings, and behaviours offer critical insights into the processes responsible for these disparities and suggest interventions to address them. We present a multilevel model that explains how societal, intrapersonal, and interpersonal factors can influence ethnic/racial health disparities. We focus our literature review, including our own research, and conceptual analysis at the intrapersonal (the race-related thoughts and feelings of minority patients and non-minority physicians) and interpersonal levels (intergroup processes that affect medical interactions between minority patients and non-minority physicians). At both levels of analysis, we use theories of social categorisation, social identity, contemporary forms of racial bias, stereotype activation, stigma, and other social psychological processes to identify and understand potential causes and processes of health and healthcare disparities. In the final section, we identify theory-based interventions that might reduce ethnic/racial disparities in health and healthcare.