Effectiveness of Cognitive Behavioral Therapy for Anxiety and Depression Among Orthodox Jews

Several clinical papers have provided clinical recommendations for how to provide cognitive behavioral therapy (CBT) for obsessive-compulsive symptoms among Orthodox Jewish individuals. However, no published studies have described culturally adapted CBT for anxiety or depression in this population or quantified the effectiveness of such approaches. We evaluated the effectiveness of CBT for symptoms of generalized anxiety and depression in a sample of Orthodox Jews (n = 65) and a comparison sample (n = 42) presenting to the Center for Anxiety, a private outpatient clinic with three offices in the New York area (www.centerforanxiety.org). A chart review revealed that all patients received CBT-based interventions with appropriate religious-cultural adaptations of treatment, which we present in two case studies. We observed statistically and clinically significant treatment gains from pretreatment to midtreatment (anxiety: t = 8.56, p < .001; depression: t = 8.01, p < .001), and again from midtreatment through termination (anxiety: t = 3.68, p < .001; depression: t = 3.62, p < .001). No significant differences in anxiety or depression were observed between Orthodox Jewish patients and controls at any time point or for treatment effects (anxiety: Wilks’ Lambda = .950, F = 2.65, p = .076, η_p² = .050; depression: Wilks’ Lambda = .99, F = 2.00,p = .49, η_p² = .014). This paper offers clinical insight into delivery of CBT to Orthodox Jewish patients, as well as preliminary support for the effectiveness of CBT in treating symptoms of generalized anxiety and depression within this population.     

The Boston Naming Test: Norm data and cue utilization in a sample of normal 6- and 7-year-old children

The object-naming abilities of 83 normal children were examined using the Boston Naming Test developed by E. Kaplan, H. Goodglass, and S. Weintraub (1976, The Boston Naming Test (experimental edition), unpublished test, Veterans Hospital, Boston, Massachusetts). There is currently a lack of available norms for this instrument, especially for populations of younger children. Cue utilization in this sample is explored and attention is focused upon possible gender differences in naming performance and cue strategies. Seven summary scores derived from the test are presented in this report. Results indicate that the Boston Naming Test can discriminate within a normal population sample of young children and provides a relatively normal distribution for six of seven derived scores. Boys were found to have a significantly greater number of items correctly named but no gender differences in cue utilization were evident. A major proportion of the children in this sample of 6- and 7-year-olds used phonological cues almost exclusively, rather than semantic cues also provided. Cue use was not related to age or spontaneously given responses, and none of the children were found to be highly proficient at using both types of cues.     

The biological function of Pavlovian conditioning: Learned inhibition of aggressive behavior in territorial fish

Following Pavlovian discrimination training, stimuli predicting the appearance of a territory intruder (an excitatory conditional stimulus, CS+) or the absence of that event (an inhibitory conditional stimulus, CS−) were presented to pairs of territorial male fish immediately before their first aggressive interaction. Pairmates that both received excitatory stimuli prior to the confrontation were significantly more aggressive than a control group which received the same training but which received neither a CS+ nor a CS− in the test. Pairmates in which both received a CS− were significantly less aggressive than the control group. In these three groups, no differences in aggression were observed between the individual members of a single pair. Two additional groups were composed of pairs whose members received different stimuli prior to the test. Although no differences were found between pairmates in the group in which one member received a pretest CS− while the other member received no stimulus presentation, large differences in aggressive behavior were obtained when one fish received a CS+ and its pairmate received a CS−. We discuss the behavioral ecology of terriorial behavior in fish and attempt to show the potential importance of these results in this naturalistic context. In addition, we discuss the implications of an ecological approach for causal analyses of inhibitory learning.     

Examination of personality-ability relationships in the elderly: The role of the contextual (interface) assessment mode

Personality-ability relationships in old age were examined in 71 elderly persons. Two modes of assessment were used. One consisted of measuring intellectual abilities (17 tests) and personality (6 dimensions) by means of established instruments. Intellectual abilities covered were drawn from Horn and Cattell's model of psychometric intelligence. Personality dimensions included three measures of locus of control and one measure each for achievement motivation, anxiety, and morale. The second mode of assessment was aimed directly at the interface between cognitive abilities and personality. Six such interface (context-specific) scales, involving self-assessment and attributions dealing with intellectual functioning in the context of aging, were developed using the six traditional (transcontextual) personality scales as conceptual criteria. These newly developed interface scales exhibit satisfactory convergent and discriminant validity with their transcontextual parent scales of personality. The six parent personality measures and the six personality-ability interface scales were correlated, separately, with performance scores of psychometric intelligence. Relationships between the two domains (personality, ability) were substantial and of greater magnitude when personality was assessed in the context of the personality-ability interface. Because of the conjoint anchoring of the interface scales to both personality and ability, the findings provide a basis for beginning to clarify the nature of personality-ability relationships in old age. In addition, the results support the continuation of a measurement approach to the study of interdomain relationships that includes the use of direct assessments of the domain interface, in addition to traditionally distinct measures of different domains.     

Self-consciousness and aspects of identity

This study investigated the relationship between public and private self-consciousness and social and personal aspects of identity. As predicted by self-consciousness theory, public self-consciousness correlated significantly more strongly with social than with personal aspects of identity, and private self-consciousness correlated significantly more strongly with personal than with social aspects of identity. Implications for the psychology of identity are discussed.     

Cerebral lateralization in bilinguals: Methodological issues

The literature on lateralization for language in bilinguals manifests two apparent contradictions. Some papers demonstrate differences in lateralization between bilinguals and monolinguals; others demonstrate none. In studies with exclusively bilingual subjects, some papers demonstrate differences between the lateralization for the two languages, while others demonstrate none. This paper discusses the range of methodological parameters which must be borne in mind when conducting or evaluating studies of lateralization for language in bilinguals. These include issues of subject selection, language and stimulus selection, testing procedures, data analysis, and interpretation of results.     

Language skills in developmentally disabled children

Language measures of receptive and expressive vocabulary, story telling, and immediate verbal memory, as well as two perceptual tests, were administered to a group of developmentally disabled children, and three groups of normal children, one matched for chronological age, one for mean length of utterance, and one for performance on one of the perceptual tests. When diagnostic subgroups of “autism,” “childhood schizophrenia,” and “other severe disturbance” were formed using standard diagnostic tools, no language differences were found between diagnostic subgroups. When compared with the normal control groups, many of the language skills of the entire group of disabled children, and of the autistic children alone, were rather evenly delayed, showing only a relative sparing of the naming function, and a relative deficit on immediate verbal memory. Furthermore, a high correlation was found in a small subsample between the difficulty levels of morphemes in the disabled children and those reported for young normal children. Experienced special-education and early-childhood teachers could not discriminate the stories of the disabled children from those of young normal children. Analysis of the disabled children's error strategies, however, revealed features of their language not found in normal children's language: (1) extreme perseveration in test answers and stories, (2) attention to minor features of test stimuli, and (3) failure to adopt alternate, flexible communicative strategies. We conclude that the language acquisition of the developmentally disabled children is delayed but not deviant in its semantic and syntactic competence, and that current diagnostic practice does not differentiate linguistically distinct subgroups. We further argue that where developmentally disabled children do exhibit aberrant features of language, such deviance parallels similar features in other cognitive skills, and is not unique to language.     

Reversal operations after brain damage

The ability to perform reversals—that is, the appreciation of the relationship between original and transformed states of knowledge—is critical to human thought processes. In order to assess whether a number of “special-purpose processors” are responsible for reversal operations, depending on the particular context in which the reversal is couched, or whether a single “core processing mechanism” subserves a critical aspect of reversal operations regardless of the specific context, patients with localized brain damage were asked to solve eight reversal problems. Visual and auditory reversals mediated by linguistic and non-linguistic symbol systems were presented. The findings demonstrate that patients with insult to the anterior portion of the right hemisphere encounter more difficulty performing reversals than patients with right posterior insult, Broca's aphasics, and fluent aphasics. This is regardless of the symbol system mediating the reversal, regardless of the modality of presentation, and regardless of the amount of available processing time. Subjects with insult to the posterior region of the left hemisphere or the right hemisphere also exhibit some difficulty solving reversal problems, although their difficulties appear modality specific. These data lend support to the claim that a core processing mechanism may play a critical role in the performance of reversal operations.