Cognitive therapy outcome: the effects of hopelessness in a naturalistic outcome study

This study prospectively examined the effect of hopelessness on outcome in cognitive therapy. Hopelessness has a central role in cognitive theories of depression, and consistently predicts suicide attempts and suicide completion. Furthermore, there is indirect evidence that hopelessness predicts cognitive therapy outcome, in terms of early termination of therapy, perhaps in part because theories of therapy change suggest that "remoralization" is a critical first phase of change. It was hypothesized that hopelessness non-responsiveness early in therapy would be predictive of eventual outcome, over and above hopelessness severity at intake. In a naturalistic study of 122 patients diagnosed with unipolar depression, it was found that non-responsive hopelessness predicted outcome in cognitive therapy, and this effect is over and above any effect of initial severity of hopelessness or depression. These findings suggest that patients whose level of hope is responsive to early interventions make more rapid and pronounced improvements during "real world" cognitive therapy.     

Locally dependent latent trait model for polytomous responses with application to inventory of hostility

Psychological tests often involve item clusters that are designed to solicit responses to behavioral stimuli. The dependency between individual responses within clusters beyond that which can be explained by the underlying trait sometimes reveals structures that are of substantive interest. The paper describes two general classes of models for this type of locally dependent responses. Specifically, the models include a generalized log-linear representation and a hybrid parameterization model for polytomous data. A compact matrix notation designed to succinctly represent the system of complex multivariate polytomous responses is presented. The matrix representation creates the necessary formulation for the locally dependent kernel for polytomous item responses. Using polytomous data from an inventory of hostility, we provide illustrations as to how the locally dependent models can be used in psychological measurement.     

The Impact of Neuropsychological Deficits on Functional Stroke Outcomes

This review examines the available literature on neuropsychological outcomes of stroke and the literature on the ability of specific areas of neuropsychological deficit to predict functional stroke outcome. The literature reviewed indicates that post-stroke deficits in executive function, memory, language, and speed of processing are common, with those identified as having progressive ‘post-stroke dementia’ presenting with a similar, though more impaired profile, with increased impairments particularly noted in the area of memory. It is clear that some aspects of neuropsychological functioning (e.g., presence of neglect, aphasia, anosognosia; and verbal memory and attention deficits) show promise as a means of predicting post-stroke functional outcomes. Examining the available literature, it becomes evident that there is a need for long-term, large scale (i.e., population based) follow-up studies, evaluating likely long-term neuropsychological outcomes of stroke and their prognostic utility.     

The interpretation of negative social events in social phobia: changes during treatment and relationship to outcome

Catastrophic interpretations of negative social events are considered to be an important factor underlying social phobia. This study investigated the extent to which these interpretative biases change during cognitive-behavioural treatment for social phobia, and examined whether within-treatment changes in different types of interpretations predict longer-term treatment outcome. Results showed that treatment was associated with decreases in various types of maladaptive interpretations of negative social events, but that social phobia symptoms 3 months after treatment were independently predicted only by within-treatment reductions in the degree to which individuals personally believed that negative social events were indicative of unfavourable self-characteristics. These findings are discussed in relation to cognitive models of the maintenance of social anxiety, and implications for treatment are considered.     

Effects of cocaine on fixed-interval responding reinforced by the opportunity to run

Rate-dependent drug effects have been observed for operant responding maintained by food, water, heat, light onset, electrical brain stimulation, shock-stimulus termination, and shock presentation. The present study sought to determine if the effects of cocaine on lever pressing maintained by the opportunity to run could also be described as rate dependent. Seven male Wistar rats were trained to respond on levers for the opportunity to run in a wheel. The schedule of reinforcement was fixed-interval 60 s, and the reinforcing consequence was the opportunity to run for 60 s. On this schedule, overall rates of responding were low, usually below six presses per minute, and pauses frequently exceeded the 60-s interval. Despite these differences, an overall scalloped pattern of lever pressing was evident for each rat. Doses of 1, 2, 4, 8, and 16 mg/kg cocaine were administered 10 min prior to a session. Only at the 16 mg/kg dose did the responding of the majority of rats change in a manner suggestive of a rate-dependent drug effect. Specifically, lower response rates at the beginning of the intervals increased and higher rates at the end of the intervals decreased, as indicated by the fact that slopes from the regression of drug rates on control rates decreased. These data provide tentative support for the generalization of rate-dependent effects to operant responding maintained by wheel running. Differences in the baseline performance maintained by wheel running compared to those for food and water point to the need for further experimentation before this effect can be firmly established.     

Accomplishing Structural Change: Identifying Intermediate Indicators of Success

Coalitions are routinely employed across the United States as a method of mobilizing communities to improve local conditions that impact on citizens’ well-being. Success in achieving specific objectives for environmental or structural community change may not quickly translate into improved population outcomes in the community, posing a dilemma for coalitions that pursue changes that focus on altering community conditions. Considerable effort by communities to plan for and pursue structural change objectives, without evidence of logical and appropriate intermediate markers of success could lead to wasted effort. Yet, the current literature provides little guidance on how coalitions might select intermediate indicators of achievement to judge their progress and the utility of their effort. The current paper explores the strengths and weaknesses of various indicators of intermediate success in creating structural changes among a sample of 13 coalitions organized to prevent exposure to HIV among high-risk adolescents in their local communities.