Tailoring Cognitive Behavioral Therapy for Individuals Diagnosed with Bulimia Nervosa

There is a wealth of data indicating the effectiveness of cognitive behavioral therapy in the treatment of bulimia nervosa. However, the best evidence indicates a treatment success rate of 50%. The purpose of this paper is to briefly describe cognitive behavioral treatment of bulimia nervosa and to offer suggestions on how this therapy approach may be tailored to best serve the needs of individual clients. Such tailoring should ultimately lead to even greater treatment success.     

Parenting, achievement strategies and satisfaction in ice hockey

The aim of this study is to understand adolescent players' satisfaction as a function of parenting styles, players' achievement strategies, and their norm breaking behavior. Finnish 14- and 16-year-old ice-hockey players (n=1018) completed a questionnaire measuring their achievement strategies (SAQ; Nurmi, Salmela--Aro & Haavisto, 1995 b), as well as scales of norm breaking and satisfaction, prepared for the present study. The parents (n=979) filled in scales measuring their parenting styles (CRPR; Pulkkinen, 1996) and attitudes towards norm breaking. Results revealed that players from authoritative families who showed a high level of mastery-orientation expressed high satisfaction in playing ice hockey. Results also showed negative associations between authoritative parenting and both task irrelevant and norm breaking behavior. Parents with parental stress and those with authoritarian parenting styles showed positive attitudes to norm breaking behavior, and players from authoritarian and parental stress homes showed norm breaking behavior in ice hockey. There was no association between norm breaking behavior and player satisfaction. Our results contribute to the planning of a coaching system that serves more educational and developmental purposes, and that encourages the desire to play ice hockey as a hobby.     

Emotion Socialization in Families of Children With an Anxiety Disorder

Compared emotion socialization in 26 children with anxiety disorders ages 8–12 years and their mothers to 26 nonclinical counterparts without psychopathology. Children and their mothers participated in an emotion interaction task in which they discussed occasions when the child felt worry, sadness, and anger. Responses were coded for length of discussion, proportion of words spoken by child vs. mother, frequency of positive and negative emotion words, explanatory discussion of emotion, and maternal facilitation of emotion discussion. Children and their mothers also completed the Expressiveness and Control scales of the Family Environment Scale. Results indicated that mothers of children with an anxiety disorder spoke less frequently than their child, used significantly fewer positive emotion words, and discouraged their childrens emotion discussions more than did mothers of nonclinical children. Nonclinical children and their mothers indicated significantly more emotional expressiveness in their families than did children with an anxiety disorder and their mothers. These results highlight the potential role of truncated family emotional expressivity in the emotional development and functioning of children with an anxiety disorder.     

执行功能中认知灵活性发展的研究进展

近十多年以来,执行功能已成为研究的热点和前沿。认知灵活性是执行功能的主要成分,它对个体能力发展和对环境适应的方面起着重要作用。该文从认知灵活性的本质、发展、研究方法及其与教育的关系进行探讨。     

Processing coordinated structures: incrementality and connectedness

We recorded participants' eye movements while they read sentences containing verb-phrase coordination. Results showed evidence of immediate processing disruption when a reflexive pronoun embedded in the conjoined verb phrase mismatched the sentence subject. We argue that this result is incompatible with models of human parsing that employ only bottom-up parsing procedures, even when flexible constituency is employed. Models need to incorporate a mechanism similar to the adjoining operation in Tree-Adjoining Grammar, in which one structure is inserted into another.     

Psychometric Properties of the Grief Cognitions Questionnaire (GCQ)

Cognitive behavioral conceptualizations of complicated grief propose that negative cognitions play a core role in the development and persistence of emotional problems after bereavement, because they generate negative emotions and cause mourners to engage in counterproductive attempts to avoid the implications and the pain of the loss. To facilitate the assessment of potentially problematic cognitions after bereavement, the Grief Cognitions Questionnaire (GCQ) has been developed—a 38-item questionnaire representing 9 categories of cognitions. Building on a previous study that supported the reliability and validity of the GCQ, the current study further examined its psychometric properties, with data of 531 bereaved individuals who completed research questionnaires online through the Internet. Confirmatory factor analyses supported the nine-factor structure with 9 interrelated factors. The reliability and convergent and discriminative validity were found to be adequate. Altogether the GCQ seems to be a useful tool for the assessment of negative thinking after bereavement in research and clinical practice.     

A Meta-Analysis of Cognitive Deficits in Adults with a Diagnosis of Schizophrenia

This review identified 1275 studies examining cognitive deficits in people with schizophrenia, published between 1990 and 2003. Data from 113 studies (4365 patients and 3429 controls) were combined in a meta-analysis carried out on the five cognitive domains of IQ, memory, language, executive function, and attention. Studies were excluded where they lacked a suitable control group or failed to present complete information. In all five cognitive domains, analysis indicated a consistent trend for patients to perform more poorly than healthy controls, with significant heterogeneity across studies. Sources of heterogeneity were analyzed and a need to ensure more appropriate composition of patient and control groups and to adopt a more refined and methodologically correct, hypothesis-driven approach was identified.     

A call to restructure the drug development process: Government over-regulation and non-innovative late stage (Phase III) clinical trials are major obstacles to advances in health care

The history of drug/vaccine development has included major advances guided primarily by risk/benefit analyses concerning the innovative agent, not by evidence-based clinical trials (Phase I–IV). Because the approval for new drugs is hindered under the present process, the system requires restructuring. The Phase I/II study period should be more flexible, using the “environment of knowledge” about the new agent, plus risk/benefit assessments. Phase III, as presently constructed, does not add new adverse events data, it provides a narrower profile of drug efficacy than properly done Phase II studies, and placebo-controlled trials continue to raise unresolved ethical and social issues. Phase III studies should be abandoned for most drugs, and substituted with properly powered Phase II doseranging studies plus careful post-marketing surveillance. Phase III should be a penalty for poor drug development, not a regulatory requirement. To accomplish efficient drug development, greater cooperation between pharmaceutical companies and governments in developing clinical trials is needed rather than over-regulation. These changes will synchronize the drug development and regulatory process with the current rapid drug discovery process, reduce drug development time and cost, and improve patient care. The author is Adjunct Professor of Medicine, Weill Medical College of Cornell University, New York, New York, USA.     

Negative Affect in Victimized Children: The Roles of Social Withdrawal, Peer Rejection, and Attitudes Toward Bullying

This study evaluated the validity of mediating pathways in predicting self-assessed negative affect from shyness/social withdrawal, peer rejection, victimization by peers (overt and relational), and the attitude that aggression is legitimate and warranted. Participants were 296 3rd through 5th graders (156 girls, 140 boys) from 10 elementary schools. Self-report measures of victimization, attitudes, and negative affect, and a teacher-report measure of shyness/social withdrawal and peer rejection were completed during the spring semesters of 2 consecutive years. Hierarchical regression analyses supported the mediational model in predicting negative affect at Time 2. However, an increase in negative affect over the 12-month study period was best accounted for by direct effects of increased victimization and changes in attitudes/attributions regarding aggression. Implications for the planning of school interventions designed to interrupt these victimization-maladjustment pathways are discussed.