Maintenance of weight loss after obesity treatment: is continuous support necessary?

OBJECTIVE: This study examined outcome differences of 109 obese subjects, who participated in a 10-week cognitive-behavioral inpatient treatment followed by either a weight maintenance program or a follow-up period without professional support. METHODS: Self-rated weight loss, eating behaviors, and general psychopathology were assessed several months before treatment, when subjects were admitted, at discharge, and at the 6-, 12-, and 18-month follow-ups. Structured interviews for mental disorders and eating pathology were conducted additionally. RESULTS: The mean weight of the sample at baseline was 127 kg. Weight loss of the total sample amounted to 8.0 kg (6.3%) and was completely maintained during the follow-up period. Significant reductions of eating and general psychopathology were observed at the 18-month follow-up. The outcome in the maintenance condition did not significantly differ from the outcome in the control condition. CONCLUSIONS: Weight regain after obesity treatment is not inevitable, but continuous patient-therapist contacts do not distinctly improve treatment effects.     

The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

The Shift from Monologue to Dialogue in a Couple Therapy Session: Dialogical Investigation of Change from the Therapists’ Point of View

As part of a larger research project on couple therapy for depression, this qualitative case study examines the nature of dialogue. Drawing on Bakhtinian concepts, the investigation shows how the conversation shifts from a monologue to dialogue. Among the findings are: first, the process of listening is integral to the transforming experience. That is, the careful listening of the therapist can evoke new voices, just as the experience of one of the partners’ “listening in” to the conversation between the other partner and the therapist can create movement and new trajectories. The latter is a qualitative difference between dialogic therapy with a couple and that with an individual. Second, the therapist not only acts as creative listener, but as the dialogue unfolds, actively contributes to meaning‐making. Third, the study upholds having a team of researchers as a polyphonic forum and the usefulness of Bakhtinian concepts in clinical research on dialogue in multi‐actor sessions.     

Testing orofacial abilities of children who stutter: the Movement, Articulation, Mandibular and Sensory awareness (MAMS) assessment procedure

Objective

The purpose of this article is to introduce a new assessment designed to measure the orofacial abilities of children who stutter (CWS), the Movement, Articulation, Mandibular and Sensory Awareness (MAMS) Orofacial Assessment. The new instrument was developed and validated to measure orofacial abilities in a comprehensive manner.

Design

A group of 43 CWS (mean age 13.10 years, S.D. 2.10 years) and a control group of 32 fluent children (mean age 13.4 years, S.D. 2.6 years) were tested with the new tool. It was hypothesized, that (a) the MAMS is a reliable and valid instrument to measure orofacial abilities in CWS, (b) fluent children have better orofacial abilities than CWS and (c) that the therapy outcome of CWS depend on their orofacial abilities.

Results

The MAMS Orofacial Assessment proved to be a valid and reliable instrument to assess orofacial abilities. Compared with their fluent peers, CWS had significantly worse orofacial abilities. CWS with better orofacial abilities had a better prognosis for therapy outcome.

Conclusions

The new instrument is a reliable and valid tool to measure orofacial abilities and MAMS distinguishes CWS and controls. Orofacial abilities are one set of factors that influence therapy outcome for CWS.Educational objectives: The reader will get an overview over of the literature on orofacial abilities in people who stutter and will learn about and be able to (1) describe different characteristics of orofacial abilities, (2) use the MAMS Orofacial Assessment in the diagnostic process for CWS and for research purposes, and (3) interpret the results of the MAMS to use them for therapy planning.     

心理资本对大学生就业成功率的影响

心理资本近年已成为研究大学生就业状况相关问题的热点之一.研究采用问卷调查法探讨了性别、生源地、专业、实习经验等因素对大学生心理资本的影响,以及两者对大学生就业成功率的影响.具体采用列联表分析、￡检验、方差分析以及二元logistic回归分析分析了心理资本各维度与各因素对大学生就业成功率的影响,发现专业和实习经历对心理资本有显著影响,心理资本中的乐观维度对大学生就业成功率有显著影响;建议为了提高大学生就业成功率,学校应努力为大学生提供更多的实践机会,重视大学生的人文教育,营造乐观的文化氛围.     

Does Exposure to Stereotype‐Disconfirming Politicians Reduce the Effect of Stereotypes on Voting? Evidence From Seven Plagiarism Scandals in Germany

We examine whether exposure to several salient counterexamples reduces the effect of stereotypes on voting. By taking advantage of a series of seven plagiarism scandals in Germany—a country with high regard for academic credentials where academic titles (Dr. and Prof.) get printed on ballot papers—we test whether the tendency to vote for candidates with a doctor's title decreased in the wake of the scandals. Using cross‐sectional and longitudinal estimators and controlling for a large range of potential confounders, we find that the electoral advantage of candidates with a doctor's title shrinks from a good half of a percentage point before the scandals down to a third after the scandals. In line with a subtyping hypothesis, the reduction is stronger for candidates from traditional middle‐class parties (i.e., the parties of the politicians who were implicated in the scandals). Neither of these effects turns out to be strong enough to reach statistical significance, however. We conclude that seven negative examples in one legislative term had no noticeable effect on the tendency to select candidates based on academic titles. Our study provides a rare opportunity to test the effect of stereotype‐disconfirming information on electoral behavior. Our results contribute to a literature demonstrating the resilience of stereotypes to disconfirming information. They also suggest that plagiarism affairs are unlikely to reduce electoral incentives for politicians to obtain a fake doctorate.     

Fostering networking behavior,career planning and optimism,and subjective career success: An intervention study

The present study evaluated personal resource-oriented interventions supporting the career development of young academics, working at German universities within the STEM fields. The study sought to foster subjective career success by improving networking behavior, career planning, and career optimism. The study involved a quasi-experimental pre-post intervention with two intervention and two control groups (N = 81 research associates). Participants of the first intervention group received networking training; participants of the second intervention group received the same networking training plus individual career coaching. Participants of both intervention groups were female. Participants of the control groups (i.e., male vs. female group) did not participate in any intervention. As expected, path analyses, based on mean differences from pre-test to post-test, revealed an increase in career planning and career optimism within the networking plus career coaching intervention group, that was indirectly positively related to changes in subjective career success. Contrary to our expectations, the networking group training alone and in combination with the career coaching showed no effectiveness in fostering networking behavior. Results are discussed in the context of career counseling and intervention effectiveness studies.     

A Video Recall Study of In‐session Changes in Sentiment Override

This study examines in‐session changes in sentiment override over the first three sessions of couple therapy. Couples viewed a video recording of therapy sessions immediately after each of the first three sessions and continuously rated their level of sentiment override. Ninety‐eight changes were randomly chosen for analysis. Three talk turns prior to each change was coded using the Family Relational Communication Control Coding System. Results show that changes in sentiment override occur frequently. Repeated incidents of communication control were related to negative change in sentiment override for females. Repeated incidents of being left out of the conversation were related to negative changes in sentiment override for females and positive changes for males.