A Model for Adapting Evidence-Based Interventions to Be LGBQ-Affirmative: Putting Minority Stress Principles and Case Conceptualization Into Clinical Research and Practice

The mental health field now possesses clinical trials attesting to the efficacy of affirmative practice with sexual minority individuals. With the goal of efficiently moving the results of these clinical trials into real-world clinical practice, this paper offers a model for adapting existing evidence-based practices originally developed for the general population to be lesbian, gay, bisexual, and queer (LGBQ)-affirmative. The adaptation model presented here guides clinicians to incorporate six LGBQ-affirmative transtheoretical principles of change into practice. These principles facilitate raising awareness of the impact of minority stress on sexual minority clients’ mental health and on client self-evaluation while drawing upon sexual minority resilience and intersectional experiences to build empowering coping skills and validating relationships. The adaptation model also provides a transtheoretical approach to case conceptualization that directs clinicians to consider the role of early and ongoing minority stress on sexual minority clients’ cognitive, affective, motivational, behavioral, and self-evaluative experiences that maintain current distress. This case conceptualization approach highlights common associations among these experiences, suggesting clear routes of interventions for many sexual minority client presentations. Case examples from recent clinical trials of LGBQ-affirmative cognitive-behavioral therapy illustrate how these principles and this case conceptualization can be effectively utilized in practice. While the principles and case conceptualization are meant to be transtheoretical and therefore applicable across therapeutic techniques, to date they have been tested only in clinical trials for cognitive-behavioral treatments. Therefore, this paper concludes with a call for future research to determine the effectiveness of implementing this adaptation model across diverse therapeutic modalities and client presentations.     

Post-Admission Cognitive Therapy for a Transgender Service Member With a Recent Suicidal Crisis: A Case Study of Gender-Affirming Care

While elevated suicide risk in the American military and veteran population has led to the development of targeted interventions, the increased risk of suicidal ideation and behavior among transgender and gender diverse (TGD) Service members requires that interventions address suicide risk within the context of minority stressors and gender-affirming care. This case study presents Jordan (an alias), a transgender Service member who received inpatient psychiatric treatment following a suicide attempt precipitated by distress relating to gender dysphoria, minority status, and associated stressors. Jordan completed Post-Admission Cognitive Therapy (PACT; Ghahramanlou-Holloway, Cox, & Greene, 2012), a cognitive-behavioral intervention targeting suicide risk among military personnel and dependents psychiatrically hospitalized following a suicidal crisis. Within the context of PACT, Jordan’s treatment included identifying and addressing distress related to minority stressors (externalized stigma, internalized transphobia, anticipated rejection, gender concealment) using gender-affirming best practices. Marked changes in Jordan's self-report measures from baseline to follow-up, as well as qualitative changes reported by Jordan, demonstrate that she felt comfortable, safe, and ready to be discharged from the inpatient unit after completing PACT treatment and gaining exposure to the skills necessary to help prevent and/or manage future suicidal crises. Treatment implications and recommendations for addressing suicide risk within the context of gender-affirming care and prevalent minority stressors are discussed.     

A review on equivalence-based procedures to teach food-portion estimation skills

This review involved a systematic analysis of equivalence-based instruction (EBI) that aimed to improve food-size interventions in diverse populations. Systematic searches identified seven studies published since 2010 that met inclusion criteria. These studies were analyzed according to their participants, design, setting, content taught, training structures, training protocol, testing format, treatment integrity, and outcomes. Results showed EBI procedures for teaching food estimation skills have been mostly implemented with adults. The type of content taught in the identified studies included carbohydrate ranges, portion size with food and non-food items, measuring cups and nutritional content of calories. Majority of included studies used one-to-many training structure and simultaneous protocols for teaching stimulus relations. Five studies completed a generalization probe and three studies reported treatment integrity data. Overall, all participants demonstrated skill acquisition of novel relations between food and portion measurement aides. Recommendations for future research and clinical applications of EBI in teaching food portion estimation are presented.     

On the longevity of behavioral interventions for challenging behavior

The capacity for a treatment to maintain its effects over time may be the most critical component of behavioral interventions for challenging behavior as treatments that fail to persist are likely to be of little value to society. We reviewed the quality and quantity of different types of post-intervention data for the treatment of challenging behavior in studies published over the last 7 years. We found that for the majority of participants at least one measure of maintenance, fading, or follow-up was reported but with limited information regarding the quality of those measures. Reports of secondary variables related to post-intervention data (e.g., latency to measurement) were also uncommon. We discuss possible explanations for the paucity of post-intervention data, barriers to obtaining post-intervention data, strategies for obtaining these data, and implications for the external validity of behavioral interventions for challenging behavior. We provide recommendations for increasing the probability that post-intervention data are included in applied research on challenging behavior.     

Correspondence between resident- and staff-report on the QABF: Do justice-involved youth agree with residential staff?

Residents in juvenile residential treatment facilities (JRTFs) often display various emotional, behavioral, and educational needs. Researchers have recently developed behavioral interventions to increase residents' appropriate behavior such as cooperation with facility staff instructions, accepting feedback from facility staff, and tolerating unpleasant events. However, there is not a generally accepted tool for assessing the operant function of residents' problem behavior in JRTFs. For various logistical reasons, indirect functional assessments may be more appropriate in a JRTF than manipulating either antecedent or consequent events. This study obtained scores on the Questions About Behavior Function (QABF) assessment for 17 residents from two dormitory staff members for each resident. To increase the number of respondents, each resident completed a QABF for their own behavior. Results revealed moderate to high correspondence (i.e., agreement) for highest and lowest potential operant function of problem behavior between combinations of JRTF staff and residents. These preliminary findings suggest additional research with the QABF in JRTFs is warranted.     

自闭症和智力障碍儿童行为问题与父母焦虑的关系:育儿压力的中介作用与领悟社会支持的调节作用

为探讨自闭症和智力障碍儿童行为问题与其父母焦虑的关系及其内在作用机制,研究采用问卷法对1023名自闭症和智力障碍儿童父母进行调查。结果表明：(1)自闭症和智力障碍儿童行为问题对父母焦虑具有正向预测作用;(2)育儿压力在儿童行为问题和父母焦虑间起中介作用;(3)儿童行为问题与育儿压力的关系受到领悟社会支持水平的调节,调节作用只在智力障碍儿童父母群体中显著。研究结果有助于揭示自闭症和智力障碍儿童行为问题对父母焦虑的影响及作用机制,对改善自闭症和智力障碍儿童父母育儿压力与焦虑具有一定指导意义。     

Taking stock of the longitudinal study of romantic couple relationships: The last 20 years

Longitudinal dyadic research provides significant benefits for our understanding of romantic couple relationships. In this systematic review, we begin by providing a broad overview of topical trends and approaches in longitudinal couple relationships research from 2002 through 2021. Then, we narrow our review to dyadic relationship quality articles, highlighting key themes as well as noting important gaps in the research. Using an intersectional perspective that acknowledges multiple ways that disadvantage, power, and oppression may be seen in both research and in couples' lived experience, we note prominent paradigms used in examining couple relationships, what types of questions have been most valued, and what groups and approaches are underrepresented in the literature. Most longitudinal couple relationships research is quantitative, relies on self-report approaches from American couples in the early-to-middle years of their relationships, concentrates more on negative aspects of relationships than positives, and takes a communication-satisfaction paradigm in studying couples. We see a clear need to increase the use of methodologies beyond self-report measures, conduct more studies with within-group minority, older adult, culturally-diverse, and context-specific samples to explore the diversity of relationships, and fully consider both strengths and positive processes in relationships as well as the challenges couples experience.     

Affection deprivation is more aversive than excessive affection: A test of affection exchange theory

Affection exchange theory predicts that both excessive affection and affection deprivation are associated with poorer health, compared with receiving the level of affectionate communication that one desires. A similar yet-untested prediction is that affection deprivation is more aversive than excessive affection. This preregistered study tested both hypotheses on a battery of mental and physical health outcomes, including depression, loneliness, stress, physical pain, frequency of nightmares, and sleep quality, using a Census-matched sample of U.S. American adults (N = 827). As hypothesized, receiving the right amount of affection was associated with more health-supportive scores on all outcomes than either excessive or deficient affection. Similarly, excessive affection was associated with lower depression, loneliness, stress, and pain, and higher sleep quality, than affection deprivation.     

Quand le syndrome de l’imposteur influence la recherche de feedback : étude des relations entre le syndrome de l’imposteur et les stratégies de recherche utilisées chez les employés

IntroductionThe impostor syndrome is a frequent phenomenon that can have deleterious consequences for the individual from a psychological point of view. It is a vicious circle in which the individual perceives feedback as a threat. This syndrome seems to impact the individual's feedback seeking strategies.ObjectivesThe aim of our study is to show that impostor syndrome will have an effect on the type of feedback seeking used by employees with their supervisor.MethodThrough an online questionnaire with 370 French-speaking employees, we assessed the impostor syndrome, the level of perceived experience, and the types of strategies used in seeking feedback from the superior.ResultsOur results show, after controlling for perceived experience and gender, that individuals with a strong imposter syndrome tend to seek feedback more often and in a less direct way (i.e., indirect, or observational).ConclusionThese results confirm the hypothesis of a link between the impostor syndrome and feedback seeking. The latter would be an element to be considered in the understanding of the impostor syndrome and its consequences.     

Does authenticity always breed mental health? A cross-cultural comparison between the United States and China

Numerous studies on Western cultures have suggested a strong linkage between authenticity and mental health. However, little is known about whether such an association can be generalized to Eastern cultures. This study aimed to conduct a cross-cultural comparison on the association between three dimensions of authenticity (authentic living, self-alienation, and accepting external influence) and two factors of mental health (negative and positive) across Western and Eastern cultures. Measurement invariance tests were carried out and multigroup structural regression models developed on two college samples from the US (n = 392) and China (n = 281). Results suggested that the associations between authenticity and the negative factor of mental health were consistent across cultures, where both self-alienation and accepting external influence were positively associated with anxiety. However, the associations between authenticity and the positive factor of mental health were different in the US and Chinese samples. Specifically, both authentic living and accepting external influence were significantly associated with life satisfaction in the US sample but not in the Chinese sample. Findings stress that having a nondistorted perception of the true self is critically related to lower levels of anxiety across cultures and highlighted the need to identify culture-specific promotive factors for life satisfaction.