Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N = 20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter.Educational objectives: The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach.     

Assessing Interpersonal Aspects of Schizoid Personality Disorder: Preliminary Validation Studies

In 2 studies, we examined the reliability and validity of an interpersonal measure of schizoid personality disorder (SZPD) based on nonverbal behaviors and interpersonal interactions occurring during interviews. A total of 556 male jail inmates in the United States participated in Study 1; 175 mentally disordered offenders in maximum security hospitals in the United Kingdom participated in Study 2. Across both samples, scores on the Interpersonal Measure of Schizoid Personality Disorder (IM–SZ) exhibited adequate reliability and patterns of correlations with other measures consistent with expectations. The scale displayed patterns of relatively specific correlations with interview and self-report measures of SZPD. In addition, the IM–SZ correlated in an expected manner with features of psychopathy and antisocial personality and with independent ratings of interpersonal behavior. We address implications for assessment of personality disorder.     

Assessing interpersonal aspects of schizoid personality disorder: preliminary validation studies

In 2 studies, we examined the reliability and validity of an interpersonal measure of schizoid personality disorder (SZPD) based on nonverbal behaviors and interpersonal interactions occurring during interviews. A total of 556 male jail inmates in the United States participated in Study 1; 175 mentally disordered offenders in maximum security hospitals in the United Kingdom participated in Study 2. Across both samples, scores on the Interpersonal Measure of Schizoid Personality Disorder (IM-SZ) exhibited adequate reliability and patterns of correlations with other measures consistent with expectations. The scale displayed patterns of relatively specific correlations with interview and self-report measures of SZPD. In addition, the IM-SZ correlated in an expected manner with features of psychopathy and antisocial personality and with independent ratings of interpersonal behavior. We address implications for assessment of personality disorder.     

The Effect of a Prejudice-Reduction Simulation on Attitude Change1

The effectiveness of a well-known prejudice-reduction simulation, “Blue Eyes-Brown Eyes,” was assessed as a tool for changing the attitudes of nonblack teacher education students toward blacks. The three outcomes were (a) virtually all of the subjects reported that the experience was meaningful for them; (b) the statistical evidence supporting the effectiveness of the activity for prejudice reduction was moderate; and (c) virtually all of the participants, as well as the simulation facilitator, reported stress from the simulation.     

Development of syntax in a retarded girl using procedures of imitation, reinforcement, and modelling

Three experiments demonstrated the development and generalized use of a singular and plural declarative sentence in a child initially lacking sentence form responses. In each experiment, an adult(s) served as a language model(s), and consequences (sweets) were provided for imitation of the model. During training trials, an item(s) was displayed first to the model(s) then to the subject; these displays were accompanied by requests to label the item(s). Generalization was assessed by a number of probe trials that were periodically interspersed among training trials. During these trials, the subject was requested to label the displayed item(s) without any preceding labelling response from the model. Using these procedures, generalized use of a singular sentence ("That is one-") resulted in Experiment I, and generalized use of a plural sentence ("These are two-") resulted in Experiment II. In Experiment III, two models (a singular and a plural sentence model) were made available to the subject but imitation of only one model was reinforced during any one condition. Results indicated the subject labelled probe (generalization) items with the same sentence form that was modelled and reinforced during training trials.     

Change technology and the implementation of automation in mental health care settings

The problem of clinician resistance to automated systems in mental health care delivery settings is discussed. It is argued that this resistance is a natural part of the change process, an indicator of an inadequate change strategy. The theory of change is briefly reviewed. Previous efforts to install automated systems in mental health care delivery settings are discussed in terms of change theory. Suggestions for incorporating the technology of change into the implementation process are proposed.     

Temporal aspects of passive movement-related corticomotor inhibition

We have previously shown that during rhythmic passive movement of the index finger, the amplitude of the motor evoke potential (MEP) of the first dorsal interosseous muscle (FDI) as the index finger moved through mid-range adduction, is significantly reduced compared to rest [Edwards, D. J., Thickbroom, G. W., Byrnes, M. L., Ghosh, S., & Mastaglia, F. L. (2002). Reduced corticomotor excitability with passive movement: A study using Transcranial Magnetic Stimulation. Human Movement Science 21, 533-540]. In the present study we have investigated the time-course of this phenomenon. We found that MEP amplitude was significantly reduced at the mid-range position in the first cycle of movement (50+/-6% of resting baseline values), and did not vary across subsequent cycles (10 cycles in 50 s), but that MEP amplitude returned to baseline values within 1s of cessation of movement. The results suggest that the pattern of afferent discharge set up by the kinematics of the movement acting at spinal or supraspinal levels underlies the inhibition observed, rather than an effect of central origin or a cumulative effect of ongoing cyclic movement.     

Reductions in criminality subsequent to group, individual, and family therapy in adolescent residential and day treatment settings.

The complete population of adolescents in a residential and day-treatment program over a 4-year period, 532 youths, served in two studies. Along with residential and day-treatment settings, predictive variables of interest were the number of hours spent in group, individual, and family therapy. A total of 227 adolescents qualified for Study 1 which found a reduction of rates of criminal charges from pre- to posttreatment. Study 1 also found that hours in group therapy explained the most variance in the reduction in rates of criminal charges, followed closely by hours in individual therapy. Hours in family therapy was not a significant predictor. A total of 430 adolescents qualified for Study 2, which found that residential treatment was associated with greater reductions in adult correctional commitments than day treatment. Implications stress the need for further research examining the relationships between therapeutic components of residential treatment and behavioral outcomes.     

Reduced corticomotor excitability with cyclic passive movement: a study using transcranial magnetic stimulation

Human voluntary movement involves the integration of kinaesthetic information with efferent motor activity during the planning and execution stages of movement. While much is known of the inhibitory and excitatory effects resulting from activation of specific kinaesthetic sensory receptors, in the present study we employed cyclic passive movement of the index finger in order to activate a range of kinaesthetic receptors in a manner that was intended to correspond to how these receptors might be active during a comparable voluntary movement. We intended to identify how this passive movement protocol might affect the excitability of the corticomotor pathway. During 1 Hz cyclic passive movement of the index finger there was an approximately 60% reduction in the amplitude of the motor evoked response from the first dorsal interosseous muscle. The results of the present study demonstrate that passive movement can have a profound effect on the excitability of the corticomotor pathway.