Evaluation of a Video Prompting and Fading Procedure for Teaching Dish Washing Skills to Adults with Developmental Disabilities

We evaluated a video prompting and fading procedure for teaching three adults with developmental disabilities to wash dishes. Video prompting involved showing video clips depicting each step of the task. All three adults reached 90–100% correct when video prompting was implemented. Following acquisition, video prompting was withdrawn, but performance deteriorated. Subsequently, a 3-step fading procedure was implemented in which the separate video clips were merged to form larger, multi-step segments of video. Performance reached 80–100% correct as the video prompts were re-applied and then faded. Performance decreased at the 3-month follow-up when prompting was removed, but stabilized at 80–90% correct when the third step in the fading sequence was reinstated. These data suggest a promising approach for fading video prompts.     

Brief Imaginal Exposure for PTSD: Trajectories of Change in Distress

Preliminary evidence shows that brief, condensed imaginal exposure only interventions can be effective in the treatment of PTSD, but we need to understand its mechanisms of action. Consistent with extinction learning and retrieval processes, the present study examined whether a pattern of between-session distress reduction observed during standard prolonged exposure (PE) therapy would be observed and predict outcome. Sixty-three patients with PTSD were enrolled in two clinical trials using our treatment protocol consisting of six daily 50-min sessions focusing on imaginal exposure and processing only. Individual patient trajectories of distress reduction were examined over the course of the five imaginal exposure sessions (Sessions 2-6). Overall, significant linear distress reduction was observed for anticipatory (d = 1.18), peak (d = 1.83), and ending imaginal exposure distress (d = 1.21). Consistent with extinction learning, the steeper slope of peak distress (d = 1.03) and end distress (d = 0.68) across imaginal exposure sessions strongly predicted decreases in PTSD symptoms. Distress reduction across sessions was predicted by higher baseline avoidance and hyperarousal but not reexperiencing symptoms. This condensed format of daily 50-min sessions without in vivo exposure may be operating via similar extinction learning processes as longer protocols. Our clinical observations suggest that the brief daily format may offer the advantage of allowing each session to build on the previous one to promote meaningful shifts in the retrieval of the trauma memory. Brief imaginal exposure and processing may be a viable option for PTSD patients in settings where brief interventions are needed. Understanding potential change processes and baseline predictors of change brings us closer toward precision medicine in treating PTSD.     

Partners' internal stress and well-being: The role of dyadic coping and problem resolution

Couples' experiences of daily stress can be detrimental for partners' individual and relational well-being, specifically their identity as a couple, their relational satisfaction, and their life satisfaction. Grounded in the Systemic Transactional Model, this study aimed at analyzing factors that may safeguard partners and their relationship from detrimental effects of internal stress (i.e., stress that originates inside the relationship). We examined the buffering effect of partners' positive dyadic coping and internal problem resolution. Daily diary data were collected across 7 days from 82 heterosexual couples. Multilevel dyadic analyses showed that internal stress was negatively associated with partners' individual and relational well-being. Positive dyadic coping moderated the association between partners' internal stress and couple satisfaction for both partners, but not life satisfaction and couple identity. Moreover, for partners who reported a resolution to the internal problem, the negative associations of internal stress with life satisfaction, couple satisfaction, and couple identity were significantly lower than for those who did not resolve the internal problem. This study confirms the negative role of internal stress on well-being, shows the associations between internal stress and couple identity, and highlights the protective role of dyadic coping and internal problem resolution in couples' daily lives.     

Exploring Daily Religious/Spiritual Activities Among Older Couples: Religious/Spiritual Influence Moderating the Effects of Health Symptoms on Marital Interactions

Using data from 191 later-life couples across 14 days, patterns of husband and wife religious/spiritual activities were explored, as well as how those activities predicted daily marital processes and how they moderated the links between daily physical symptoms and marital interactions. Husband and wife reports of religious/spiritual influence were linked with their own positive and negative marital interactions (“actor” effects). However, only husband religious/spiritual influence was linked with wife marital interactions (“partner” effects). Religious/spiritual influence moderated the link between symptoms and marital interactions for wives. Findings suggest a buffering effect of religious/spiritual activities on daily symptoms for older married wives.     

Stress and worry: examining intolerance of uncertainty's moderating effect

Intolerance of uncertainty (IU), or the way an individual perceives, interprets, and reacts to uncertainty in life, has been frequently investigated in relation to anxiety and worry. While a substantial body of research suggests that individual differences in IU foster stress and anxiety, IU's involvement as a potential moderator in the relation between stressful events and worry has only recently been investigated. Therefore, the present study examined the moderating effect of IU on the relation between daily hassles and worry as well as major life events and worry in a sample of 1092 young adults. Results revealed that IU showed a significant moderation effect in the relation between daily stress and worry. More specifically, when the two factors were examined individually only inhibitory IU served as a moderator between daily stress and worry. While major life events significantly predicted worry, no moderation effect was found for this relation. These findings highlight the need to better understand the mechanisms through which IU impacts worry and contributes to anxiety.     

The factors associated with geriatric depression in rural China: stratified by household structure

Depressive symptoms and empty nest phenomenon of rural elderly people are both important public health issues, which should not be ignored. We aimed to estimate the prevalence of depressive symptoms and related factors of the empty nest elderly in rural China. We recruited 3182 eligible subjects and gathered data by face-to-face interview. Multivariate logistic regression models were used to explore the related factors of depressive symptoms. The present study showed that the prevalence of depressive symptoms significantly differed between empty nest old adults and non-empty nesters (24.1% vs. 19.0%). The elderly living alone had highest OR of depressive symptoms. Depressive symptoms of empty nest elderly was associated with sleep quality, economic status, pain, social support and ADL. While it was associated with gender, economic status, pain and PSMS in non-empty nest group. Number of chronic disease showed significant associations with depressive symptoms in the elderly living alone. Subjective support, support utilization and pain were positively associated with depressive symptoms in the elderly living with spouse. Sleep quality, economic status and ADL were common factors. Depressive symptoms obviously prevail among empty nest elderly than non-empty nesters. It reminded us that complementary social support from family and society is essential.     

Sensitive performance-based assessment of everyday action in older and younger adults

Everyday function is compromised by mild cognitive changes in aging. These changes predict risk for future decline and dementia but remain poorly characterized, largely due to a scarcity of sensitive, objective measures.Twenty-seven younger adults and 25 non-demented older adults completed the Naturalistic Action Test (NAT), a performance-based measure of everyday action involving simple and complex tasks. Performance was coded for overt errors and subtle inefficiencies. Participants also completed self-report functional measures and cognitive tests. Mixed ANOVAs revealed that older adults made more subtle NAT errors with high task demands; groups did not differ in overt errors. Correlations did not reveal significant relations between self-report and NAT errors, but NAT performance was correlated with learning and recall.The NAT provides a promising tool for detecting subtle age-related changes and examining decline across levels of impairment. Self-report may lack sensitivity to subtle changes, and episodic memory changes underlie early functional disruption.     

Effects of stress management and relaxation training on the relationship between diabetes symptoms and affect among Latinos

Objective: Stress management and relaxation (SMR) interventions can reduce symptoms of chronic disease and associated distress. However, there is little evidence that such interventions disrupt associations between symptoms and affect. This study examined whether SMR dampened the link between symptoms of hyperglycemia and proximal levels of affect. We predicted that during periods of increased hyperglycemia, individuals receiving SMR training, relative to controls, would demonstrate smaller increases in negative affect.

Design: Fifty-five adult Latinos with type 2 diabetes were randomised to either one group session of diabetes education (DE-only; N = 23) or diabetes education plus eight group sessions of SMR (DE + SMR; N = 32). After treatment, participants reported five diabetes symptoms and four affective states twice daily for seven days using a bilingual telephonic system.

Results: Mean age = 57.8 years, mean A1c = 8.4%, and ¾ was female with less than a high school education. Individuals receiving DE + SMR, compared to DE-only, showed a weaker positive within-person association between daily diabetes symptoms and nervous affect. Groups also differed on the association between symptoms and enthusiasm. Age moderated these associations in most models with older individuals showing less affect reactivity to symptoms.

Conclusions: Findings provide partial support for theorised mechanisms of SMR.     

Activated or deactivated? Understanding how cognitive appraisals can drive emotional activation in the aftermath of daily work events

Introduction

Past research has highlighted the relevance of cognitive appraisals in the link events-emotions (e.g., appraisal of an event's importance and its pleasant or unpleasant valence). We hypothesized a 3-way interaction between affective events (hassles and uplifts), cognitive appraisals of importance and intrinsic pleasantness on emotional activation.