Behavioral case formulation: An experimental assessment study of transient tic disorder

A nine-year-old male, who met DSM III-R criteria for transient tic disorder, participated in an experimental assessment strategy to generate support for a case formulation. In addition to presenting motor disturbance, assessment procedures revealed six problem areas. All problems were formulated as manifestations of a hypersensitivity to evaluation, etiologically related to the boy's relationship with an insecure and critical father. It was hypothesized that the patient's tic disorder was a consequence of his hypersensitivity to father's excessive criticism, which then generalized to other evaluative situations. Using a controlled single-subject design, predictions derived from the formulation were tested by exposing the child to a planned combination of evaluative observers (e.g., father, mother, therapist, etc.) who watched him as he worked on a series of puzzles. The dependent measures included (1) behavioral recordings of tic frequency and (2) frontalis EMG responses. The results indicated significant differences in tic rate and EMG as a function of the type of observer. Consistent with the formulation, the patient displayed the highest levels of tic behavior and EMG response when his father was the observer and lowest in the presence of the mother. Predictions regarding other stimulus conditions were also confirmed. These results provided support for the case formulation that was used to design an effective treatment intervention. Findings suggest that the case formulation model offers a method whereby novel case hypotheses can be generated for poorly understood psychopathology and tested later in the experimental situation.     

Aging drivers and post delineated express lanes: Threading the needle at 70 miles per hour

Post-delineated express lanes represent a combination of driving complexities that are particularly difficult for older drivers to navigate. The narrow geometry and high speeds that are common to this treatment reflect a critical test for drivers whose depth perception, contrast sensitivity, and visual processing speed are reduced. The present study was designed to empirically examine the effects of age and color of express lane delineators on driver behavior. Three groups of participants (aged 18–39, 40–64, and 65 + years old) were required to complete a series of simulated driving scenarios consisting of combinations of single and dual lane configurations, with speed and lane position measured at the beginning and midpoint of each express lane. All drivers were pre-screened on various visual functioning abilities. Drivers in the 65 and older group show significant age-related declines in depth perception, contrast sensitivity, and phoria which were subsequently correlated with a wide range of driving measures including deceleration rate, brake time, jerk, speed, and lane position. Age related perceptual declines were statistically correlated with slower driving speed and wider lane deviations, including a statistically significant increase in the number of excursions beyond the typical 12-foot lane width. Based on these findings, the behavior of senior drivers was identified as a distinct design condition that should govern the design of high-speed, narrow geometric conditions. This age group requires wider lane widths, particularly at the beginning of single-lane post delimited sections, wider buffer areas around the post markers, and dual lane configurations wherever possible.     

The Strengths and Limitations of Case Record Reviews in Examining Family Preservation Outcome Formulation and Treatment Planning

Much debate has centered on what are reasonable outcomes of the short-term intensive family preservation services (IFPS). However, little attention has been given to how therapists actually formulate outcomes in their practices. The files of 98 families who used IFPS were reviewed to determine how therapists formulated outcomes and whether formulated outcomes varied by service sector (child welfare or mental health) and child age. It was found that formulated outcomes in mental health were more likely than those in child welfare to have a child focus and an interpersonal locus. Variation in outcome formulation in child welfare by child age was found, with outcomes of younger children more likely to be parent-focused than were outcomes of older children. The issues pointed out by these findings are discussed. Since case records are a potential data source for researchers, the paper concludes with a discussion of the strengths and limitations of case record reviews for research purposes.     

Color charts, esthetics, and subjective randomness

Color charts, or grids of evenly spaced multicolored dots or squares, appear in the work of modern artists and designers. Often the artist/designer distributes the many colors in a way that could be described as "random," that is, without an obvious pattern. We conduct a statistical analysis of 125 "random-looking" art and design color charts and show that they differ significantly from truly random color charts in the average distance between adjacent colors. We argue that this attribute generalizes results in subjective randomness in a black/white setting and gives further evidence supporting a connection between subjective randomness and what is esthetically pleasing.     

Color-object interference: Further tests of an executive control account

Young children are slower in naming the color of a meaningful picture than in naming the color of an abstract form (Stroop-like color-object interference). The current experiments tested an executive control account of this phenomenon. First, color-object interference was observed in 6- and 8-year-olds but not in 12- and 16-year-olds (Experiment 1). Second, meaningful pictures did not interfere in 5- to 7-year-olds’ manual sorting of objects on the basis of color (Experiment 2) or in their naming the number of colored objects in the display, that is, subitizing (Experiment 3). These findings provide support for the view that color-object interference results from the children’s immature inhibition of the prepotent but irrelevant task of object naming.     

The impact of uniform color on judging tackles in association football

ObjectivesThe aim of the study was to question whether uniform color had any impact on judging tackles in football.DesignFifty-two videos showing the tackles of an achromatic and a chromatic team were individually presented in random order. The chromatic team's uniform color was changed to blue, green, red and yellow.MethodsFootball referees and participants with a high and minor level of understanding of the rules of football judged the roughness of each tackle.ResultsBy analyzing all four colors, results did not reveal any impact of uniform color. Restricting analysis to blue and red showed that referees and participants with a high level of understanding of the rules judged tackles from behind more harshly for players wearing red.ConclusionsThe study found some empirical support for associating red with aggression and emphasized a differential impact of blue versus red uniforms for tackles committed from behind.     

CBT/DBT-Informed Intensive Outpatient Treatment for Anxiety and Depression: A Naturalistic Treatment Outcomes Study

Anxiety and depression are highly prevalent and disabling mental health disorders, with comorbidity often posing as a barrier to successful treatment outcomes, thus creating a need for more intensive treatment options. Outpatient clinicians are more likely to refer patients with severe symptoms of anxiety and depression to inpatient hospitalizations rather than partial hospital programs (PHPs) or intensive outpatient programs (IOPs), despite evidence that inpatient hospitalization is associated with high costs and other risks following discharge. The present study reviews two case studies of patients who received cognitive-behavioral therapy/dialectical behavior therapy (CBT/DBT)-based IOP treatment in a private New York clinic. We evaluated treatment outcomes for 73 adult patients (50.7% female) with a mean age of 29.10 years (SD = 10.30). At intake, patients averaged 2.15 diagnoses (SD = 0.94, range = 4) and the majority (80.8%) were prescribed psychotropic medication. Treatment was structured and individually tailored, with patients receiving an average of 21.77 hours (SD = 15.06) of psychotherapy over 12.63 treatment sessions (SD = 9.76), across 12.21 days (SD = 9.61). We observed a clinically and statistically significant change in symptoms of anxiety (t = 6.24, p < .001), depression (t = 5.55, p < .001), and suicidality (t = 2.32, p < .05) over the course of the IOP. After completing treatment, 68.1% of participants tapered down to once-weekly treatment. The present study highlights the clinical utility of an IOP and suggests that this approach can be effective for adult patients presenting with severe symptoms of anxiety and/or depression.     

Naturalistic outcome of case formulation-driven cognitive-behavior therapy for anxious depressed outpatients

This article describes a case formulation-driven approach to the treatment of anxious depressed outpatients and presents naturalistic outcome data evaluating its effectiveness. Fifty-eight patients who received case formulation-driven cognitive-behavior therapy (CBT) in a private practice setting were studied. All received individual CBT guided by a case formulation and weekly outcome monitoring; in addition, 40 patients received adjunct therapies, including pharmacotherapy, which were added as indicated by the case formulation and the results of weekly outcome monitoring. Patients treated with case formulation-driven CBT showed statistically and clinically significant changes in anxiety and depression that were generally comparable to those reported in published randomized controlled trials of empirically supported therapies (ESTs) for single mood and anxiety disorders. Findings support the proposal that anxious depressed patients who have multiple comorbidities and require multiple therapies can benefit from empirically supported treatments guided by a case formulation and weekly outcome monitoring.     

The relation between children's conceptual functioning with color and color term acquisition

Young children experience considerable difficulty in learning their first few color terms. One explanation for this difficulty is that initially they lack a conceptual representation of color sufficiently abstract to support word meaning. This hypothesis, that prior to learning color terms children do not represent color as an abstraction, was tested in two experiments using samples of 25- to 39-month-olds and 20- to 32-month-olds. Children's ability to conceptually represent color and their knowledge of color terms were assessed, and a strong association was found between the ability to make inferences based on color and the comprehension of color words. Children who did not comprehend color terms were unsuccessful at a conceptual task that required them to represent color as a property independent of the particular objects that displayed it. The results suggest that the initial absence of an abstract representation of color contributes to the difficulty that young children encounter when first learning color words.