Changes in Anxiety Control Beliefs Following a Brief CBT Treatment and Their Association With Anxiety Symptom Reduction

Anxiety control beliefs (i.e., beliefs regarding one’s ability to cope with external, fear-inducing threats and internal reactions to those perceived threats) have been found to negatively predict anxiety symptoms in children and adults and to be modifiable by cognitive-behavioral therapy for anxiety disorders. The current study examines whether changes in anxiety control beliefs were seen following a brief, intensive treatment for specific phobias, and whether those changes were associated with improvements in the targeted phobia and comorbid anxiety disorder symptoms. Participants were 135 children and adolescents (M age = 9.01 years, 49% male) who received one-session treatment (OST) with or without parental involvement for their primary specific phobia. Results indicated that self-reported anxiety control beliefs significantly increased following treatment and that these increases significantly predicted reductions in specific phobia severity and symptoms of comorbid anxiety disorders 6 months and 1 year following treatment. Findings illustrate that involvement in a single 3-hour OST was associated with changes in anxiety control beliefs and demonstrate the potential importance of targeting control beliefs in pediatric anxiety treatment.     

Psychosis,symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo’s Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung’s conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.     

Parent-child interactions during joint engagement with touchscreen technology: A comparison of younger versus older toddlers

With a plethora of touchscreen apps aimed at young children, parents are receiving mixed messages about the appropriateness of such technology for their toddlers. The American Academy of Pediatrics (2016) advises limited engagement with digital media for this age group and encourages parents to co-engage with children when they are using screens. However, very little is known about parent-child interaction in the context of joint engagement with digital screen media in the toddler years. This study observed 56 toddlers (M = 32.5 months old; 53 % female) and a parent (52 mothers; 4 fathers) performing a 3-minute drawing task on a touchscreen tablet (digital condition), and on an Etch-A-Sketch (non-digital condition) using a repeated measures design. Observations were analysed using global ratings of dyadic interaction, comparing warmth, cooperation and conflict between digital and non-digital conditions. A mixed MANCOVA analysis, controlling for levels of daily usage of touchscreens, revealed lower levels of parent-child cooperation and warmth in the digital condition compared to the non-digital condition. In addition, there was a main effect of age with younger dyads displaying less cooperation overall, particularly in the digital condition where interactions were also less warm. Results suggest that co-engaging with digital technology can be a challenging and potentially emotionally charged context for both parents and young children. Younger toddlers, especially, may be more likely to experience less cooperative interactions when co-engaging with digital technology with a parent. Results are discussed in relation to developmental differences between 2- and 3-year olds, and the need for more nuanced guidance for parents supporting young children’s interaction with digital media.     

Temporal coordination between maternal looming and infant gaze in depressed and nondepressed dyads: A bootstrapping approach

In this study, we examine the convergent validity of a measure of maternal looming derived using a motion capture system, and the temporal coordination between maternal loom and infant gaze using an event-based bootstrapping procedure. The sample comprised 26 mothers diagnosed with postpartum depression, 43 nondepressed mothers, and their 4-month-old infants. Mother-infant interactions were recorded during a standard face-to-face setting using video cameras and a motion capture system. First, results showed that maternal looming was correlated with a globally coded measure of maternal overriding. Maternal overriding is an intrusive behavior occurring when the mother re-directs the infant’s attention to parent-led activities. Thus, this result confirms that maternal looming can be considered a spatial intrusion in early interactions. Second, results showed that compared to nondepressed dyads, depressed dyads were more likely to coordinate maternal loom and infant gaze in a Loom-in-Gaze-pattern. We discuss the use of automated measurement for analyzing mother-infant interactions, and how the Loom-in-Gaze pattern can be interpreted as a disturbance in infant self-regulation.     

The Lived Experiences of Addiction Counselors After Marijuana Legalization

This qualitative study examines the perceptions of counselors who work with populations with addictions in states where marijuana has been legalized. Findings include themes related to client experiences, counselor experiences, specific interventions, and lack of understanding.     

Brief Cognitive-Behavioral Therapy for Suicidal Inpatients

Suicide risk is elevated in psychiatric patients following discharge from inpatient care. Despite this vulnerability, there has been limited research investigating suicide prevention protocols that take into account the unique system characteristics of this setting (e.g., short lengths of stay, crisis stabilization treatment model, multidisciplinary team coordination). Cognitive-behavioral therapy (CBT) has demonstrated efficacy for improving suicide risk in outpatients, but has not been validated with inpatients. The current study was a treatment development and pilot feasibility open trial that modified brief cognitive-behavioral therapy (BCBT) for an inpatient setting (BCBT-I). Key treatment modifications included administering up to 10 sessions (depending on patient length of stay), daily, and in a standardized order, with core crisis management skills introduced during the first three sessions. In addition, coordination with the inpatient treatment team was included in BCBT-I implementation. Six adult inpatients with a recent suicide attempt enrolled and completed an average of 4.67 BCBT-I sessions (SD = 1.36). The treatment was highly acceptable (Client Satisfaction Questionnaire total score M = 3.49, SD = 0.73). Pre- to posttreatment effect sizes demonstrated improvements in suicidal ideation (d = 0.97), depression (d = 1.33), and suicidal implicit associations (d = 1.28). All but one of the participants (83%) completed follow-up assessments 1-, 2-, and 3-months postdischarge. Over follow-up, two participants reported suicidal ideation (both without intent), and none reported suicide attempts, preparatory acts or behaviors, or nonsuicidal self-injury. This study provided preliminary evidence supporting the feasibility of CBT to treat suicidal inpatients. Future research is needed to validate BCBT-I in a larger, randomized controlled trial to determine whether BCBT-I reduces suicide risk beyond that afforded by inpatient treatment alone.     

Using the teaching interaction procedure to train interventionists to implement the Cool versus Not CoolTM procedure

The teaching interaction procedure is a behavior analytic procedure that has been used to target the development of social skills. The teaching interaction procedure consists of labeling the target skill, providing a meaningful rationale, describing the steps of the target skill, modeling the skill, role‐play, and providing feedback throughout the interaction. Although the teaching interaction procedure has been used to teach a variety of social skills for individuals diagnosed with autism spectrum disorder (ASD), it has only been used to train staff in two studies. The purpose of this study was to evaluate the use of the teaching interaction procedure to teach three interventionists to implement the Cool versus Not Cool? procedure to target the development of social skills for children diagnosed with ASD. The results of a multiple baseline design demonstrated that the teaching interaction procedure was effective for all three interventionists. Results of the child participants' skill acquisition are also provided.     

Comparing computer‐based training and lecture formats to teach visual analysis of baseline‐treatment graphs

Accurate analysis of data is vital to the validation of interventions. As such, there has been a recent increase in studies evaluating visual analysis training procedures. However, past investigations have not evaluated direct and indirect visual analysis training methods with matched instructional content that was systematically designed. Furthermore, training has rarely included assessment of generalization and maintenance of visual analysis skills. The purpose of the current dissertation study was to compare the effectiveness and efficiency of (a) computer‐based training, (b) lecture formats with and (c) without the opportunity to pause, and (d) a no‐training group to teach visual analysis of AB graphs to university students. To make these formats directly comparable, the instructional content was equated by ensuring information and examples were identical across the three training procedures. Eighty‐three students were randomly assigned to one of the four groups. Results showed that all three training formats produced increases in accurate responding compared to the no‐training group. Visual analysis skills generalized to novel graphs and maintained approximately 2 weeks following all trainings. These results suggest that structured approaches that are carefully designed to train visual analysis are effective and lead to gains that generalize and maintain in the absence of training.     

Driver conflict response during supervised automation: Do hands on wheel matter?

Securing appropriate driver responses to conflicts is essential in automation that is not perfect (because the driver is needed as a fall-back for system limitations and failures). However, this is recognized as a major challenge in the human factors literature. Moreover, in-depth knowledge is lacking regarding mechanisms affecting the driver response process. The first aim of this study was to investigate how driver conflict response while using highly reliable (but not perfect) supervised automation differ for drivers that (a) crash or avoid a conflict object and (b) report high trust or low trust in automation to avoid the conflict object. The second aim was to understand the influence on the driver conflict response of two specific factors: a hands-on-wheel requirement (with vs. without), and the conflict object type (garbage bag vs. stationary vehicle). Seventy-six participants drove with highly reliable but supervised automation for 30 min on a test track. Thereafter they needed to avoid a static object that was revealed by a lead-vehicle cut-out. The driver conflict response was assessed through the response process: timepoints for driver surprise reaction, hands-on-wheel, driver steering, and driver braking. Crashers generally responded later in all actions of the response process compared to non-crashers. In fact, some crashers collided with the conflict object without even putting their hands on the wheel. Driver conflict response was independent of the hands-on-wheel requirement. High-trust drivers generally responded later than the low-trust drivers or not at all, and only high trust drivers crashed. The larger stationary vehicle triggered an earlier surprise reaction compared to the garbage bag, while hands-on-wheel and steering response were similar for the two conflict object types. To conclude, crashing is associated with a delay in all actions of the response process. In addition, driver conflict response does not change with a hands-on-wheel requirement but changes with trust-level and conflict object type. Simply holding the hands on the wheel is not sufficient to prevent collisions or elicit earlier responses. High trust in automation is associated with late response and crashing, whereas low trust is associated with appropriate driver response. A larger conflict object trigger earlier surprise reactions.     

Urgent and non-urgent takeovers during conditional automated driving on public roads: The impact of different training programmes

Supplying training to drivers that teaches them about automated driving and requests to intervene may help them to build and maintain a mental representation of how automation works and thereby improve takeover performance. We aimed to investigate the effect of different types of training programmes about the functioning of automated driving on drivers’ takeover performance during real driving. Fifty-two participants were split into three groups for training sessions: paper (short notice), video (3-minute tutorial) and practice (short drive). After the training, participants experienced automated driving and both urgent and non-urgent requests to intervene in a Wizard-of-Oz vehicle on public roads. Participants’ takeover time, visual behaviour, mental workload, and flow levels during the requests to intervene were assessed. Our results indicated that in urgent circumstances, participants’ takeover response times were faster in the practice training condition compared to the other training conditions. Nevertheless, the practice training session did not present any other positive effect on drivers’ visual behaviour. This could indicate that prior training, particularly when reinforcing drivers' motor skills, improved their takeover response time at the latest motor stages rather than in the early sensory states. In addition, the analysis of in-vehicle videos revealed that participants’ attention was captured in the first place by the in-vehicle human-machine interface during the urgent request to intervene. This highlights the importance for designers to display information on the HMI in an appropriate way to optimise drivers’ situation awareness in critical situations.