Therapist competence in cognitive therapy for depression: Predicting subsequent symptom change.

Objective: The efficacy of cognitive therapy (CT) for depression has been well established. Measures of the adequacy of therapists' delivery of treatment are critical to facilitating therapist training and treatment dissemination. While some studies have shown an association between CT competence and outcome, researchers have yet to address whether competence ratings predict subsequent outcomes. Method: In a sample of 60 moderately to severely depressed outpatients from a clinical trial, we examined competence ratings (using the Cognitive Therapy Scale) as a predictor of subsequent symptom change. Results: Competence ratings predicted session-to-session symptom change early in treatment. In analyses focused on prediction of symptom change following 4 early sessions through the end of 16 weeks of treatment, competence was shown to be a significant predictor of evaluator-rated end-of-treatment depressive symptom severity and was predictive of self-reported symptom severity at the level of a nonsignificant trend. To investigate whether competence is more important to clients with specific complicating features, we examined 4 patient characteristics as potential moderators of the competence-outcome relation. Competence was more highly related to subsequent outcome for patients with higher anxiety, an earlier age of onset, and (at a trend level) patients with a chronic form of depression (chronic depression or dysthymia) than for those patients without these characteristics. Competence ratings were not more predictive of subsequent outcomes among patients who met (vs. those who did not meet) criteria for a personality disorder (i.e., among personality disorders represented in the clinical trial). Conclusions: These findings provide support for the potential utility of CT competence ratings in applied settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training and dissemination of cognitive behavior therapy for depression in adults: A preliminary examination of therapist competence and client outcomes.

Objective: In this study, the authors examined the feasibility and effectiveness of training community therapists to deliver cognitive behavior therapy (CBT) for depression. Method: Participants were therapists (n = 12) and clients (n = 116; mean age = 41 years, 63% women) presenting for treatment of depression at a not-for-profit and designated community mental health center for St. Joseph County, Indiana. The training model included a 2-day workshop followed by 1 year of phone consultations. CBT competence ratings from the Cognitive Therapy Scale were obtained prior to training and at 6 and 12 months posttraining. Two different groups of clients, a treatment-as-usual (TAU) group (n = 74) and a CBT group (n = 42), were compared with respect to decrease in symptoms of depression (assessed with the Beck Depression Inventory) and anxiety (assessed with the Beck Anxiety Inventory). Results: Therapists showed significant increases in total scores from pretraining to 6 months posttraining, increases that were maintained at 12 months. The increase in the total score reflected gains on items that specifically measure CBT skills and structure. Although both TAU and CBT resulted in a significant decrease in depressive symptoms, the CBT clients showed significantly greater change than the TAU clients, F(2, 113) = 53.40, p     

Exploring developmental differences in visual short-term memory and working memory.

Although visuospatial short-term memory tasks have been found to engage more executive resources than do their phonological counterparts, it remains unclear whether this is due to intrinsic differences between the tasks or differences in participants’ experience with them. The authors found 11-year-olds’ performances on both visual short-term and working memory tasks to be more greatly impaired by an executive suppression task (random number generation) than were those of 8-year-olds. Similar findings with adults (e.g., Kane & Engle, 2000) suggest that the imposition of a suppression task may have overloaded the older children’s executive resources, which would otherwise be used for deploying strategies for performing the primary tasks. Conversely, the younger children, who probably never had the capacity or know-how to engage these facilitative strategies in the first place, performed more poorly in the single task condition but were less affected in the dual task condition. These findings suggest that differences in the children’s ability to deploy task-relevant strategy are likely to account for at least part of the executive resource requirements of visual memory tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Locomotor expertise predicts infants’ perseverative errors.

This research examined the development of inhibition in a locomotor context. In a within-subjects design, infants received high- and low-demand locomotor A-not-B tasks. In Experiment 1, walking 13-month-old infants followed an indirect path to a goal. In a control condition, infants took a direct route. In Experiment 2, crawling and walking 13-month-old infants crawled through a tunnel to reach a goal at the other end and received the same control condition as in Experiment 1. In both experiments, perseverative errors occurred more often in the high-demand condition than in the low-demand condition. Moreover, in Experiment 2, walkers perseverated more than crawlers, and extent of perseveration was related to infants’ locomotor experience. In Experiment 3, the authors addressed a possible confound in Experiment 2 between locomotor expertise and locomotor posture. Novice crawlers perseverated in the difficult tunnels condition, behaving more like novice walkers than expert crawlers. As predicted by a cognitive capacity account of infant perseveration, overtaxed attentional resources resulted in a cognition–action trade-off. Experts who found the task less motorically effortful than novices had more cognitive resources available for problem solving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder.

Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related to the trajectory of change in a variety of panic-relevant outcomes. Method: Participants had a primary diagnosis of panic disorder (N = 43; 70% female; mean age = 40.14 years). Race or ethnicity was reported as 91% Caucasian, 5% African American, 2.3% biracial, and 2.3% “other.” Change in catastrophic misinterpretations (assessed with the Brief Body Sensations Interpretation Questionnaire; Clark et al., 1997) was used to predict a variety of treatment outcomes, including overall panic symptom severity (assessed with the Panic Disorder Severity Scale [PDSS]; Shear et al., 1997), panic attack frequency (assessed with the relevant PDSS item), panic-related distress/apprehension (assessed by a latent factor, including peak anxiety in response to a panic-relevant stressor—a straw breathing task), and avoidance (assessed by a latent factor, which included the Fear Questionnaire–Agoraphobic Avoidance subscale; Marks & Mathews, 1979). Results: Bivariate latent difference score modeling indicated that, as expected, change in catastrophic misinterpretations predicted subsequent reductions in overall symptom severity, panic attack frequency, distress/apprehension, and avoidance behavior. However, change in the various symptom domains was not typically a significant predictor of later interpretation change (except for the distress/apprehension factor). Conclusions: These results provide considerable support for the cognitive model of panic and speak to the temporal sequence of change processes during therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of cognitive skills and gains in academic school readiness for children from low-income families.

This study examined developmental associations between growth in domain-general cognitive processes (working memory and attention control) and growth in domain-specific skills (emergent literacy and numeracy) across the prekindergarten year and their relative contributions to kindergarten reading and math achievement. One hundred sixty-four Head Start children (44% African American or Latino; 57% female) were followed longitudinally. Path analyses revealed that working memory and attention control predicted growth in emergent literacy and numeracy skills during the prekindergarten year and that growth in these domain-general cognitive skills made unique contributions to the prediction of kindergarten math and reading achievement, controlling for growth in domain-specific skills. These findings extend research highlighting the importance of working memory and attention control for academic learning, demonstrating the effects in early childhood, prior to school entry. Implications of these findings for prekindergarten programs are discussed, particularly those designed to reduce the school readiness gaps associated with socioeconomic disadvantage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of embodied emotive states on cognitive categorization.

Research has uncovered that positive affect broadens cognitive categorization. The motivational dimensional model, however, posits that positive affect is not a unitary construct with only one cognitive consequence. Instead, this model puts forth that there are different positive affects varying in approach motivational intensity. According to this model, only positive affects lower in motivational intensity should broaden cognitive processes, whereas positive affects higher in motivational intensity should narrow cognitive processes. Consistent with these predictions, high approach positive affect has been shown to narrow attention, whereas low approach positive affect has been shown to broaden it (Gable & Harmon-Jones, 2008). High approach positive affect, therefore, might narrow categorization. Two experiments investigated this possibility by having participants respond to cognitive categorization tasks in 3 body postures designed to elicit different levels of approach motivation: reclining backward, which should evoke low approach motivation; sitting upright, which should evoke moderate approach motivation; and leaning forward, which should evoke high approach motivation. Participants smiled while in each posture in order to experience positive affect. Experiment 1 provided initial support for the idea that high approach positive affect narrows categorization and low approach positive affect broadens categorization. Experiment 2 replicated these findings with improved smiling instructions. These results extend previous work by showing that the motivational model's predictions hold for basic attentional processes as well as higher level cognitive processes such as categorization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of different positive emotions on persuasion processing: A functional evolutionary approach.

Much research has found that positive affect facilitates increased reliance on heuristics in cognition. However, theories proposing distinct evolutionary fitness-enhancing functions for specific positive emotions also predict important differences among the consequences of different positive emotion states. Two experiments investigated how six positive emotions influenced the processing of persuasive messages. Using different methods to induce emotions and assess processing, we showed that the positive emotions of anticipatory enthusiasm, amusement, and attachment love tended to facilitate greater acceptance of weak persuasive messages (consistent with previous research), whereas the positive emotions of awe and nurturant love reduced persuasion by weak messages. In addition, a series of mediation analyses suggested that the effects distinguishing different positive emotions from a neutral control condition were best accounted for by different mediators rather than by one common mediator. These findings build upon approaches that link affective valence to certain types of processing, documenting emotion-specific effects on cognition that are consistent with functional evolutionary accounts of discrete positive emotions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional retraining procedures: Manipulating early or late components of attentional bias?

According to cognitive models of anxiety disorders, attentional bias for threatening information is a vulnerability factor to the etiology and maintenance of anxiety. A recently developed methodology to reduce attentional bias has been found to reduce emotional reactivity and anxiety. The present study aimed at identifying the effects of this attentional bias reduction on early and later stages of threat processing. Undergraduates were allocated to an attentional bias reduction (n = 23) versus control condition (n = 25). It was found that attentional bias reduction influenced late but not early stages of threat processing. This finding is of theoretical importance in relation to studies on the causal role of attentional bias and emotional reactivity. Moreover, the present findings also bear relevance to the clinical application of attentional retraining procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion regulation and decision making under risk and uncertainty.

It is well established that emotion plays a key role in human social and economic decision making. The recent literature on emotion regulation (ER), however, highlights that humans typically make efforts to control emotion experiences. This leaves open the possibility that decision effects previously attributed to acute emotion may be a consequence of acute ER strategies such as cognitive reappraisal and expressive suppression. In Study 1, we manipulated ER of laboratory-induced fear and disgust, and found that the cognitive reappraisal of these negative emotions promotes risky decisions (reduces risk aversion) in the Balloon Analogue Risk Task and is associated with increased performance in the prehunch/hunch period of the Iowa Gambling Task. In Study 2, we found that naturally occurring negative emotions also increase risk aversion in Balloon Analogue Risk Task, but the incidental use of cognitive reappraisal of emotions impedes this effect. We offer evidence that the increased effectiveness of cognitive reappraisal in reducing the experience of emotions underlies its beneficial effects on decision making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)