A Comparison of Interactions Among Children,Parents, and Therapists in Cognitive Behavior Therapy for Anxiety Disorders in Australia and Japan

Despite growing attention to the efficacy of culturally adapted cognitive-behavioral treatment (CBT) programs for children and adolescents, there is still little empirical and practical information available to therapists who adapt original treatment protocols to suit clients of a specific culture. The current study aimed to compare therapeutic interactions across CBT treatment delivered with two different cultural groups. We developed an observational coding system to examine behaviors exhibited by child, parent, and therapist during CBT sessions conducted in Australia and Japan for children with anxiety disorders. Our results demonstrated significant differences between the two countries with respect to the treatment readiness of children, the proportion of talking during the sessions by parents and children, therapists’ laughter, length of silence during the first session, and parent indices of accommodation. In terms of transitions over time (i.e., first to last CBT session), parents in both countries tended to talk more during the last CBT session, whereas only Australian therapists talked less over time. The proportion of silence decreased over time during the Japanese sessions, and the amount of interruptions by parents increased over time for Australian sessions. Finally, our exploratory analyses demonstrated that a number of behavioral observations were correlated with anxiety treatment outcome at posttreatment. This study suggests that interactions between a child, parent, and therapist during CBT sessions may be affected by the culture in which the CBT session occurs, which could have implications for culturally adapted CBT programs.     

Feasibility and Acceptability of Group-Facilitated Prolonged Exposure Therapy for PTSD in VA Residential Rehabilitation Treatment Programs

Prolonged Exposure therapy (PE) is a first-line treatment for posttraumatic stress disorder (PTSD); however, few VA patients receive this treatment. One of the barriers to PE receipt is that it is only available in an individual (one-on-one) format, whereas many VA mental health clinics provide the majority of their psychotherapy services in group format. In particular, PTSD residential rehabilitation treatment programs (RRTPs) offer most programming in group format. Consequently, strategies are needed to improve the scalability of PE by adapting it to fit the delivery setting. The current study was designed to pilot test a group-facilitated format of PE in RRTPs. Thirty-nine Veterans who were engaged in care in the PTSD RRTP at a Midwestern VA were recruited to participate in a Group-facilitated PE protocol. Participants engaged in twelve 90-minute sessions of Group PE over the course of 6 weeks, plus six 60-minute individual sessions for imaginal exposure. Group treatment followed the PE model and consisted of psychoeducation, treatment rationale, and in vivo exposure to reduce trauma-related avoidance and thereby improve PTSD symptoms. PTSD symptoms were measured via the PTSD Checklist for DSM-5 (PCL-5) and depression symptoms were measured via the Patient Health Questionnaire (PHQ-9) at baseline, endpoint (6 weeks), and at 2-month follow-up. Thirty-nine individuals initiated Group-facilitated PE and 34 completed treatment. The average number of group sessions attended was 11 out of 12. Acceptability ratings were high. Mean change (improvement) in the intent-to-treat sample at 2-month follow-up was 20.0 points on the PCL-5 (CI 18.1, 21.9; Cohen’s d = 1.1) and 4.8 points on the PHQ-9 (CI 4.1, 5.5, d = .8). These results suggest that adapted evidence-based interventions for PTSD can improve treatment access and efficiency for the RRTP setting. A group-based approach has the potential to improve the scalability of PTSD treatment by reducing required resources. A fully powered trial is now needed to test the effectiveness of Group-facilitated PE in the RRTP setting.     

A Randomized Test of Interpretation Bias Modification for Perfectionism Versus Guided Visualization Relaxation Among High Perfectionistic Undergraduate Students

Clinical perfectionism contributes to the onset and maintenance of multiple psychological concerns. We conducted a randomized, longitudinal test of the efficacy of a web-based intervention for perfectionism (specifically, cognitive bias modification, interpretation retraining; CBM-I), compared to an active treatment comparison condition (specifically, guided visualization relaxation training) for reducing perfectionism and related psychopathology. College students (N = 167) with elevated perfectionism were randomized to one of the two study conditions and were asked to complete their assigned intervention twice weekly for 4 weeks. Participants completed measures of perfectionism and psychological symptoms at baseline, 2 weeks (midway through the intervention period), 4 weeks (at the conclusion of the intervention period), and 8 weeks (1 month follow-up). CBM-I was rated as acceptable overall, though relaxation training was rated slightly more favorably. CBM-I outperformed relaxation training on improving perfectionism-relevant interpretation biases (i.e., increasing nonperfectionistic interpretations and decreasing perfectionistic interpretations), though with small effect sizes and inconsistency across study timepoints. Self-reported perfectionism showed small decreases across time in both intervention conditions. Support was found for a key hypothesized mechanism of CBM-I, such that randomization to CBM-I had a longitudinal, indirect effect on decreasing psychopathology symptom scores through improving perfectionism-relevant interpretation biases. However, in light of small effect sizes, the present study failed to provide compelling evidence that CBM-I for perfectionism contributes meaningfully to the treatment of perfectionism.     

Need for Cognitive Closure and Conservative Political Beliefs: Differential Mediation by Personal Worldviews

The paper investigates the relationships between motivated social cognition (need for cognitive closure), personal worldviews (traditional, modern, or postmodern), and conservative political beliefs. The relationships were analyzed in a sample of 189 Polish adults. High need for closure was associated with support for both traditional and modern worldviews. Although different in content (i.e., endorsing different values and assumptions about the methods and limits of cognition), the worldviews share similar formal characteristics: Both assume the absolute nature of values and the existence of definite truths. However, acceptance of the traditional worldview was related to political conservatism (i.e., support for nationalist and isolationist opinions and a stronger role for traditional, religious values in public life), whereas acceptance of the modern worldview was associated with a rejection of conservative political beliefs. Moreover, personal worldviews mediated the relationship between need for closure and political beliefs: Support for social conservatism was mediated by acceptance of the traditional worldview, whereas acceptance of the modern worldview predicted rejection of conservative values.     

Predicting the Early Developmental Course of Symptoms of Attention Deficit Hyperactivity Disorder

Data from the National Institute of Child Health and Human Development Study of Early Child Care were examined to test whether: attention deficit/hyperactivity disorder (ADHD) symptoms remain stable from 54 months through early elementary school; behavioral inhibition and attention deficits assessed at 54 months predict ADHD symptoms in elementary school, even after controlling for their temporal stability; and early behavioral inhibition and attention deficits moderate the longitudinal stability in ADHD symptoms. Data were examined using continuous and categorical measures of symptoms. Modest stability in ADHD symptoms from 54 months to third grade was found. Measures of inhibition and inattention predicted later teacher ratings uniquely, but no evidence was found for moderation. Measures of preschool behavioral inhibition also predicted “persistently at risk status” defined by elevated teacher ratings over time. Results are discussed in terms of executive and motivational facets of inhibition that may be related to early signs of ADHD.     

轻度认知功能障碍患者工作记忆中 脑电能量及皮质联络功能的变化特征

探讨轻度认知功能障碍患者（MCI）工作记忆状态下脑电能量及皮质联络功能的变化特征。被试为从社区选取的35名轻度认知功能障碍患者和34名健康志愿者。采用简单计算回忆方法,结果发现工作记忆加工过程中会引起4.0~18.0Hz范围内功率值的改变,且MCI组高于正常对照组;MCI患者在中央、顶、颞叶的半球间相干系数均显著高于正常对照组。研究结果提示MCI患者可能存在中央、顶、颞叶皮层的功能减退,工作记忆状态下通过代偿机制仍能维持加工的有效性     

Peer Victimization in Youth with Tourette’s Syndrome and Chronic Tic Disorder: Relations with Tic Severity and Internalizing Symptoms

The present study analyzed rates of peer victimization in children with a chronic tic disorder as compared to children with type 1 diabetes and healthy controls. The associations among peer victimization, tic symptom severity, and psychological symptoms, as well as the potential mediating relationship between peer victimization, tic severity, and child internalizing symptoms, were also explored. Children with tics displayed higher rates of peer victimization than control groups, and peer victimization in children with tics was positively correlated with tic symptom severity, loneliness, anxiety symptoms, and parent report of child internalizing symptoms. Results also supported the hypothesis that peer victimization mediates the relationship between tic symptom severity and loneliness. Findings highlight the importance of the assessment and treatment of psychosocial variables in children with chronic tic disorders, including social functioning and peer relationships.     

Choosing between hearts and minds: Children's understanding of moral advisors

Moral development research has often focused on the development of moral reasoning without considering children's understanding of moral advisors. We investigated how children construe sources of moral advice by examining the characteristics that children deem necessary for reasoning about moral or scientific problems. In two experiments, children in grades K, 2, and 4 were presented with dilemmas of a moral nature or scientific nature and chose between two advisors. Second and fourth graders chose advisors differentially based on their expertise, while kindergartners did not discriminate between advisors. In a third experiment, older children indicated that only certain characteristics are needed to solve moral or scientific problems, and they endorsed these characteristics differentially based on the problem to be solved. Thus, by middle childhood, children construe moral knowledge as distinct from scientific knowledge and select advisors in each area accordingly.     

“This way!”, “No! That way!”—3-year olds know that two people can have mutually incompatible desires

In theory of mind research, there is a long standing dispute about whether children come to understand the subjectivity of both desires and beliefs at the same time (around age 4), or whether there is an asymmetry such that desires are understood earlier. To address this issue, 3-year olds’ understanding of situations in which two persons have mutually incompatible desires was tested in two studies. Results revealed that (i) children were quite proficient at ascribing incompatible desires to two persons, and in simpler scenarios even incompatible desire-dependent emotions; (ii) children showed this proficiency even though they mostly failed the false belief task. Overall, these results suggest that there is an asymmetry such that young children come to understand the subjective nature of desires before they understand the corresponding subjectivity of beliefs. Possible explanations for this asymmetry are discussed in light of conceptual change and information-processing accounts of theory of mind development.