Cognitive behaviour therapy of acute stress disorder: a four-year follow-up

The aim of this study was to index the long-term benefits of early provision of cognitive behavior therapy to trauma survivors with acute stress disorder. Civilian trauma survivors (n = 80) with acute stress disorder were randomly allocated to either cognitive behavior therapy (CBT) or supportive counseling (SC) - 69 completed treatment, and 41 were assessed four years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician Administered PTSD Scale. Two CBT patients (8%) and four SC patients (25%) met PTSD criteria at four-year follow-up. Patients who received CBT reported less intense PTSD symptoms, and particularly less frequent and less avoidance symptoms, than patients who received SC. These findings suggest that early provision of CBT in the initial month after trauma has long-term benefits for people who are at risk of developing PTSD.     

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment

This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance.     

The Relation Between Coordinated Interpersonal Timing and Maternal Sensitivity in Four-Month-Old Infants

The relation between mother–infant coordinated interpersonal timing, an automated microanalytic measure of dyadic vocal coordination, and maternal sensitivity was explored. Thirty-five mothers and their developmentally normal 4-month-old infants were audio-recorded during a 20-min laboratory vocal interaction session, that was later analyzed for degree of vocal coordination. Maternal Sensitivity ratings (Ainsworth & Bell, 1969) were based on a video-taped 45-min unstructured laboratory interaction period. A significant curvilinear relation between the degree to which mother coordinated her noninterruptive co-occurring speech to that of her infant was found and revealed that mothers highest in sensitivity were characterized by moderate levels of coordination. Examining mother-infant interaction at the specific behavioral level, while incorporating tests of nonlinear trends, may provide important information about the nature of sensitive parenting.     

Psychosocial outcomes of urban African American adolescents born to teenage mothers

This is a study of psychosocial outcomes of adolescents born to teenage mothers. Adolescents' problem behaviors, psychological well-being, social support, school variables, and sexual behaviors are compared across three groups—those born to mothers 17 or younger, mothers 18–19 years old, and mothers 20 or older. Analyses from two samples of African American adolescents from Maryland (n = 205) and Michigan (n = 570) are reported. The results from both samples indicate that mother's age at birth is unrelated to adolescents' psychosocial outcomes. These two studies add to the limited number of analyses that examine adolescent outcomes for children of teen mothers. The results suggest that efforts to understand social structural determinants of healthy and problematic adolescent development may be more informative than examining the effects of mother's age. They also suggest that teen pregnancy prevention programs may be more effective if they are part of a larger prevention strategy that incorporates social structural change efforts and not only a focus on individual level change.     

Recurrent Trisomies: Chance or Inherited Predisposition?

Two patients experiencing recurring trisomic pregnancies involving a different chromosome each time are presented. Mechanisms to explain recurrent trisomies include a gene or genes predisposing to nondisjunction in general or to nondisjunction of the acrocentric chromosomes, maternal age effects, and germ-line mosaicism. Genetic counseling is complicated by the lack of a clear explanation for the recurrences, difficulty in quoting a specific recurrence risk, concern regarding the risk for uniparental disomy, and the frustration, grief and guilt reactions of the patients.     

Mothers’ attuned responses to infant affect expressivity promote earlier achievement of language milestones

To investigate infants’ affective expressivity and maternal attuned responsiveness to infant expressivity in relation to early language achievement, 77 dyads were visited in their homes at 9 and 13 months, and mothers were interviewed about their children’s language between 9 and 21 months. Maternal responses that were attuned to infant affect, by selectively matching either the gradient features or the valence of infants’ affective expressions, were more predictive of children’s language achievement than maternal nonmatching responses; and maternal matching responses at 9 months were more predictive of children’s language achievements than maternal responses at 13 months. Moreover, maternal matching responses at 9 months predicted second-year language achievements over and above infant affect expressivity at 9 and 13 months, and over and above maternal matching responses at 13 months. Infants’ affective expressivity per se was not predictive.     

Exploring Decision Making Around Therapist Self‐Disclosure in Cognitive Behavioural Therapy

Background

Therapist self‐disclosure (TSD) usage varies greatly among different psychotherapy orientations. Anecdotal evidence seems to suggest that there are reasons for its judicious use, and a small number of researchers have proposed guidelines for how TSD should be used to help therapists across psychotherapy models make decisions around disclosure. However, there is almost no literature specifically exploring how cognitive behaviour therapy (CBT) practitioners make decisions around employing TSD within the CBT framework.

Objective

This study aimed to explore how experienced CBT practitioners make decisions around TSD.

Method

In‐depth qualitative interviews were conducted with six clinical psychologists who were trained and experienced in CBT, and the interviews were analysed thematically.

Results

There were two overarching themes in terms of how they made decisions to self‐disclose: (A) the rules for TSD use, which included sub‐themes (a) it must have a clear purpose, (b) it must fit, (c) the therapist must maintain boundaries, and (d) the therapist must always reflect on his/her use of TSD; and (B) how they use TSD, which included subthemes of (a) using it as a tool for change and (b) using it to manage the therapeutic relationship.

Conclusion

Participants’ decisions on whether or not to self‐disclose were strongly influenced by the CBT model, and this process went beyond what is suggested in the transtheoretical literature. Understanding this process may lead to the development of CBT‐specific guidelines for making TSD‐related decisions.     

Do we feel the same level of guilt about the wrongdoings of close ones and distant ones? The mediating role of behavioural control

Understanding whether and why individuals' emotional responses are different to the same behaviour performed by different others is important for understanding phenomena in social interaction. Given that there is no relevant research in Eastern culture testing such issues, the present research including two studies was conducted with Chinese samples and investigated whether Easterners experience more vicarious guilt about close ones' immoral behaviours than distant ones' immoral behaviours and the underlying mechanism of the effect. Study 1 showed that people felt more guilty when recalling close ones' misdeeds than distant ones' misdeeds. Study 2 replicated the findings of Study 1 using the scenario method and demonstrated that behavioural control partially mediated the effect of relationship closeness on vicarious guilt, that is, people reported more behavioural control over close ones' immoral behaviours, which in turn resulted in more vicarious guilt. Implications for social interaction and directions for future research are discussed.     

Capturing the Structure of Distinct Types of Individual Differences in the Situation‐specific Experience of Emotions: The Case of Anger

The aim of this paper was to understand why some people experience certain emotions in a specific situation, whereas others do not. We postulate that these individual differences arise from individual differences in two underlying processes of emotion elicitation: (i) individual differences in the emotion components (appraisals and action tendencies) that situations activate in a person and (ii) individual differences in how these emotion components are related to subjective emotional experience. In this paper, we re‐analysed data from two studies on anger to capture the structure of these two types of individual differences by using clustering modelling techniques. Consistent results across the two studies demonstrated that individuals differ in anger because they (i) differ in how easy they experience anger‐relevant appraisals (Studies 1 and 2) and action tendencies (Study 2) in increasingly negative situations and (ii) differ in which of these components are necessary to experience anger. Copyright © 2011 John Wiley & Sons, Ltd.