Persuasion criteria in research and practice: Gathering more meaningful psychotherapy data

Psychotherapy research should ultimately benefit the psychotherapy client. Unfortunately, traditional psychotherapy research continues to have little influence on practicing clinicians and, therefore, does not benefit psychotherapy clients. As behavior analysts begin to show interest in this area of research, they may be in a position to improve its quality. We argue that traditional psychotherapy researchers have become prematurely wedded to a methodology that does not address the concerns of clinical audiences. Furthermore, we make a case for defining and evaluating psychotherapy data in terms of its capacity to influence both researchers and clinicians. We also suggest several alternative methods for gathering psychotherapy data based on the case formulation approach. We argue that this approach may be one of the most promising methods for gathering useful psychotherapy data.     

Do Parent–Adolescent Discrepancies in Family Functioning Increase the Risk of Hispanic Adolescent HIV Risk Behaviors?

In the family‐based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent–adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent–adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent–adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent–adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90‐day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family‐based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families.     

Addressing Relationship Health Needs in Primary Care: Adapting the Marriage Checkup for Use in Medical Settings with Military Couples

The overall objective of this study was to pilot the Marriage Checkup (MC), a brief intervention for enhancing marital resiliency tailored to a military population, for use by internal behavioral health consultants (IBHCs) working in an integrated primary care clinic. The MC was revised to fit into the fast-paced environment of primary care (e.g., streamlined to fit within three 30-min appointments), and military-relevant material was added to the content. IBHCs working in primary care were then trained to offer the intervention. Thirty participants were enrolled in the study and completed a relationship checkup and one-month follow-up questionnaires. Analysis of post-test and one-month follow-up data showed statistically significant improvements in participants’ marital health compared to pre-treatment. The MC intervention appeared to be well received by both couples and IBHCs.     

Breast Cancer as Trauma: Posttraumatic Stress and Posttraumatic Growth

Diagnosis and treatment of cancer has been associated with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG). This cross-sectional study sought to assess the frequency, common predictors, and interrelationships of PTSD symptoms and PTG in breast cancer survivors (n = 65). In this sample, symptoms of PTSD and reports of PTG were common and were not significantly related to one another. Greater social constraints on talking about breast cancer and perception of cancer as a traumatic stressor were associated with greater PTSD symptomatology. Younger age and perception of cancer as a traumatic stressor were associated with greater PTG. Findings suggest the central role of subjective appraisal in adjustment to cancer. Psychosocial interventions should be sensitive to the potential for PTG, both in treatment design and in assessment of outcomes.     

Acceptance in behavior therapy: Understanding the process of change

Acceptance is integral to several cutting-edge behavior therapies. However, several questions about acceptance remain to be clearly answered. First, what does acceptance look like, and can it be observed and measured? Second, what are the behavioral principles involved in the promotion of acceptance? Third, when is acceptance indicated or contraindicated as a therapeutic goal? The current paper attempts to clarify answers to these questions. The goal is to provide a conceptualization of the what, how, and when of acceptance that is accessible to behavior analysts, both to promote our understanding of acceptance as a behavioral phenomenon and to facilitate its empirical study and therapeutic utility.     

Examining the effects of postural constraints on estimating reach

The tendency to overestimate has consistently been reported in studies of reachability estimation. According to one of the more prominent explanations, the postural stability hypothesis, the perceived reaching limit depends on the individual's perceived postural constraints. To test that proposition, the authors compared estimates of reachability of 38 adults (a) in the seated posture (P1) and (b) in the more demanding posture of standing on one foot and leaning forward (P2). Although there was no difference between conditions for total error, results for the distribution and direction of error indicated that participants overestimated in the P1 condition and underestimated in the P2 condition. It therefore appears that perceived postural constraints could be a factor in judgments of reachability. When participants in the present study perceived greater postural demands, they may have elected to program a more conservative strategy that resulted in underestimation.     

Three-dimensional joint kinematics of ACL-deficient and ACL-reconstructed knees during stair ascent and descent

Mechanical environmental changes in the knee are induced by altered joint kinematics under cyclic loading during activities of daily living after anterior cruciate ligament (ACL) injury. This is considered a risk factor in progressive cartilage degeneration and the early onset of osteoarthritis following ACL injury and even after reconstructive surgery. The purpose of this study was to examine 3D joint kinematics of ACL-deficient and ACL-reconstructed knees to health controls during stair ascent and descent. A 3D optical video motion capture system was used to record coordinate data from reflective markers positioned on subjects as they ascended and descended a custom-built staircase. Spatiotemporal gait and knee joint kinematic variables were calculated and further analyzed. The ACL-deficient knees exhibited a significant extension deficit compared to the ACL-intact controls. A more varus and internally rotated tibial position was also identified in the ACL-deficient knees during both stair ascent and descent. The ACL-reconstructed knees exhibited less abnormality in both spatiotemporal gait parameters and joint kinematics, but these variables were not fully restored to a normal level. The kinematic profiles of the ACL-reconstructed knees were more similar to those of the ACL-deficient knees when compared to the ACL-intact knees. This suggests that the ACL-reconstructed knees had been "under-corrected" rather than "over-corrected" by the reconstructive surgery procedure. Findings from this study may provide more insight with respect to improving ACL reconstruction surgical techniques, which may aid the early progression of cartilage degeneration in ACL-reconstructed knees.     

Emotional Skillfulness as a Key Mediator of Aggression

Psychological research has documented several predictors of aggression, including adherence to hegemonic masculinity, trauma symptoms, and insecure attachment. However, at present, little is known about why these variables predict aggression. This study used acceptance theory to introduce the concept of emotional skillfulness as a counterpoint to emotion dysregulation. In an effort to better understand the pathways through which these variables predict aggression, this study used a clinical sample to test three mediational models which hold that emotional skillfulness functions as a common link between the aforementioned predictors and aggression in both men and women. Results indicated that emotional skillfulness is a mediator of aggression for both men and women, but that the predictors of aggression differed by gender.     

A desire to be taught: Instructional consequences of intrinsic motivation

This paper summarizes the results from a series of studies designed to test the hypothesis that making learning more fun will produce corresponding increases both in learning and retention and in subsequent interest in the subject matter itself. Each study examined the effects of two or more versions of an educational activity, each designed to involve identical instructional content, but to differ in motivational appeal. The data from the studies presented provide good general support for the hypothesized cognitive and motivational benefits of appropriately designed motivational embellishments of educational activities. Exceptions to this rule, however, and a more general theoretical analysis of the conditions under which such positive effects are (and are not) expected to occur, are also discussed.This research was supported, in part, by research grant HD-17371 from the National Institute of Child Health and Human Development to Mark R. Lepper.