Psychological effects of sustained shipboard operations on U.S. Navy personnel

This study investigated the psychological and physical health status of 265 crew members on two U.S. Navy ships (a guided missile cruiser and a frigate on convoy escort duty for tankers under U.S. flag) during the Persian Gulf conflict at four time periods during combat-ready operations on a single day. Findings suggest that adaptation occurs to extreme stressors associated with sustained operations. Suggestions are made relative to measures that may minimize psychological and physical conditions that adversely affect performance under conditions of heavy stress. Report No. 89-18, supported by the Naval Medical Research and Development Command, Bethesda MD, Department of the Navy, under research Work Unit No. 63206N.M0096. The opinions expressed in this paper are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, nor the U.S. Government.     

Putting families in the center: family perspectives on decision making and ADHD and implications for ADHD care

Objective: To examine components of family-centered care in families' stories about treatment decision making for their child with ADHD. Method: Twenty-eight families participated in qualitative interviews that addressed families' perspectives on (a) the treatment decision-making process, (b) the cause and impact of their child's symptoms, and (c) treatment goals and preferences. Results: The majority of families preferred to be primary or shared decision makers regarding treatment decisions. Families' perspectives on the cause of the child's symptoms varied and often were not consistent with a biomedical framework. Families described multiple areas of impairment on child, family relationships, and family functioning. Perspectives toward evidence-based treatments were mixed, with families also expressing interest in and pursuing interventions not delineated in current treatment guidelines. Conclusion: These findings reinforce the importance of eliciting families' perspectives and involving these important stakeholders in shared decision making as critical components of family-centered care for children with ADHD.     

A Systematic Scoping Review of the Choice Architecture Movement: Toward Understanding When and Why Nudges Work

In this paper, we provide a domain‐general scoping review of the nudge movement by reviewing 422 choice architecture interventions in 156 empirical studies. We report the distribution of the studies across countries, years, domains, subdomains of applicability, intervention types, and the moderators associated with each intervention category to review the current state of the nudge movement. Furthermore, we highlight certain characteristics of the studies and experimental and reporting practices that can hinder the accumulation of evidence in the field. Specifically, we found that 74% of the studies were mainly motivated to assess the effectiveness of the interventions in one specific setting, while only 24% of the studies focused on the exploration of moderators or underlying processes. We also observed that only 7% of the studies applied power analysis, 2% used guidelines aiming to improve the quality of reporting, no study in our database was preregistered, and the used intervention nomenclatures were non‐exhaustive and often have overlapping categories. Building on our current observations and proposed solutions from other fields, we provide directly applicable recommendations for future research to support the evidence accumulation on why and when nudges work. Copyright © 2017 John Wiley & Sons, Ltd.     

THE SECOND SPHERE AND THE STORY OF NO STORY

The author discusses Roy Schafer's ideas of the second self and second reality, as well as his consistent theme of storyteller and story. The latter theme is also explored in the context of more recent psychoanalytic influences, such as Bionian thought, trauma theory, the French approach, and the interpersonal perspective. To illustrate the idea of the nonstory in today's clinical encounters, the author presents two clinical vignettes.     

Counselor Competency in the Courtroom

This article outlines general courtroom procedures and offers systematic practical advice for the counselor testifying as an expert witness. Major topics include the counselor role in court, preparing for testimony, answering questions, and dealing with the cross-examination.     

Implementation in a Changing Landscape: Provider Experiences During Rapid Scaling of Use of Evidence-Based Treatments

This study examined 133 service providers’ perspectives on a rapid shift to mandated evidence-based treatment delivery, utilizing an inductive coding process to capture themes present in their qualitative feedback. The majority of provider comments were negatively valenced, but attitudes varied considerably across response categories: comments regarding practice context and support were nearly uniformly negative, while comments regarding treatment fit and therapeutic consequences were more balanced. Treatment fit was the most commonly cited category; the fit to therapist (e.g., ease of use) subcategory was predominantly positive in contrast with the fit to client (e.g., flexibility) subcategory, which was predominantly negative. Results illustrate the intended and unintended consequences of large-scale implementation efforts on community providers, and may aid implementation researchers and system decision makers optimize the conditions under which community providers are asked to implement evidence-based treatment.     

Influence of seasonally adjusted exposure to cold and darkness on cognitive performance in circumpolar residents

The effects of seasonally adjusted 24-h exposure to cold and darkness on cognitive performance in urban circumpolar residents was assessed in 15 male subjects who spent three 24-h periods in a climatic chamber at 65° latitude during the winter (January–March) and/or summer (August–September). Each subject was exposed to three different environmental conditions in random order: (1) 22 °C temperature and 500 lx lighting; (2) 10 °C temperature and 500 lx lighting; and (3) 10 °C temperature and 0.5–l lx lighting. Accuracy on an addition-subtraction task was significantly greater in the summer than in the winter ( p = 0.038), while accuracy on a repeated acquisition task was significantly greater in the winter than in the summer ( p < 0.001). Independent of season, exposure to cold and darkness was significantly associated with a decline in response time on five cognitive tests, an improvement in accuracy on three tests measuring complex cognitive tasks, and a decline in accuracy on two tests measuring simple tasks. Increased performance on complex tasks may result from increased arousal in response to the combination of cold temperatures and dim light characteristic of the winter in urban circumpolar settings.     

The role of sincere amends and perceived partner responsiveness in forgiveness

In a sample of 188 people currently in a romantic relationship, the authors examined the extent to which perceiving a partner as responsive and sincere in making amends relates to participants' forgiveness of a partner after a real‐life hurtful event. Specifically, it was predicted that sincere amends would be associated with greater forgiveness because it conveys that one's partner has understood and validated one's experience of the hurtful event. Results supported this mediational model. Further, exploratory analyses suggested that this meditational model is moderated by event severity and relationship satisfaction. Discussion focuses on understanding how this work might help to inform the dynamic process of forgiveness in couples.