Research Methods Seminar
Erika Hussey, NACS
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New Findings
Behavioral activation therapy helps
mildly depressed people quit smoking
Behavioral activation therapy began as a type of treatment for depression that is based on the general idea that treatment will be more effective if it includes more reinforcement for behaviors and activities that are not associated with depression and less punishment for behaviors and activities that are associated with depression. Dr. Laura MacPherson and her colleagues explored whether this type of therapy might be effective in helping mildly depressed people who want to quit smoking by comparing a group who received a Behavioral Activation Treatment for Smoking (BATS) with a group that received a therapeutic treatment that did not include BATS.
All of the participants in the study received eight weeks of therapeutic treatment. The standard group received a typical smoking-cessation treatment based on the United States Department of Health and Human Services clinical practice guidelines. One component of the treatment received by the standard group which has been shown to be ineffective in helping people quit smoking, relaxation therapy, was replaced with behavioral activation therapy in the BATS group. Both groups received an hour of therapy each week. Both groups also used a transdermal nicotine patch as part of their treatment. Participants in both groups were tested for both the severity of their depressive symptoms and their success at refraining from smoking at intervals of 1, 4, 16, and 26 weeks after the therapeutic treatment ended. Refraining from smoking was measured by each person’s report of whether or not they had smoked and was verified by biochemical drug tests that detect recent smoking.
The people in the BATS group showed both lower depressive symptoms and increased success at refraining from smoking than people in the group that received the standard form of therapy. While a number of studies have shown that behavioral activation therapies can be effective treatments for depression, the results of this study indicate that BATS shows promise of helping mildly depressed people quit smoking.
One notable aspect of the study was that 75% of the participants were ethnic minorities and 37% were classified as low-income, two groups that are typically not well studied in research concerned with quitting smoking. One the one hand, having results from these under-represented groups is an important addition to the data regarding quitting smoking. On the other hand, it is currently unknown whether or not there may be problems generalizing results about quitting smoking from these groups to the general population.
MacPherson, L., Tull, M. T., Matusiewicz, A., Rodman, S., Strong, D.R., Kahler, C.W., Hopko, D., Zvolensky, M., Brown, R.B., Lejuez, C.W. (in press). Randomized controlled trial of behavioral activation smoking cessation treatment for smokers with elevated depressive symptoms. Journal of Consulting and Clinical Psychology.
The importance of the personal relationship between the therapist and client during therapy
The complex relationship between a therapist and a client can be analyzed at a number of levels. Psychotherapists have considered several aspects of the therapist-client relationship that are thought to play a role in the success or failure of the therapeutic treatment. The “working alliance” refers to those aspects of the therapist-client interaction that both parties agree to engage in as part of the therapy. “Transference-countertransference” refers to the projection of emotions associated with a different person onto the therapist by the client (transference) or onto the client by the therapist (countertransference). The “real relationship” refers to the personal relationship between the client and the therapist independently of their working alliance or transference-countertransference patterns. In terms of important factors that affect the success of therapy, the real relationship has generally received less attention from psychotherapists than either the working alliance or transference-countertransference.
Dr. Charles Gelso presents a theory of the real relationship that attempts to realign this imbalance. According to Dr. Gelso’s theory the real relationship has two primary characteristics, realism and genuineness. Realism has to do with the extent to which both the client and the therapist experience and perceive “the other in ways that fit him or her (rather than projections based on fears and wishes related to significant others from the past), and genuineness reflects the ability to be who one truly is, as opposed to being phony or inauthentic.” The theory also takes into account the magnitude or the degree of both realism and genuineness in the therapist-client relationship and whether the evaluation of the other person within the real relationship is positive or negative (termed “valence”).In addition to summarizing the theory, Dr. Gelso reviews several empirical measures that have been designed to both measure the theoretical constructs (such as realism and genuineness) presented by the theory and to determine the degree to which these theoretical constructs are associated with both therapeutic progress and outcome. As this review makes clear, these empirical measures, while far from perfect, indicate that the real relationship is an important facet of the client-therapist interaction.
The article is accompanied by critical commentary from several scholars in the field along with Dr. Gelso’s response to the commentaries.
Diabetes-related iron deficiency during pregnancy affects children's memory
Diabetics can experience hypoxia (lack of oxygen), hyperglycemia (too much blood sugar or glucose), hypoglycemia (too little glucose) and iron deficiency. Recent research involving both humans and animals has focused on how Infants of Diabetic Mothers (IDMs) may be affected by the mother’s iron deficiency during pregnancy. A lack of iron can have a negative effect on the development of the hippocampus, a brain structure that is involved in memory, among other things, and previous research has shown that IDMs at one year of age show decreased memory abilities.
Diabetics can experience hypoxia (lack of oxygen), hyperglycemia (too much blood sugar or glucose), hypoglycemia (too little glucose) and iron deficiency. Recent research involving both humans and animals has focused on how Infants of Diabetic Mothers (IDMs) may be affected by the mother’s iron deficiency during pregnancy. A lack of iron can have a negative effect on the development of the hippocampus, a brain structure that is involved in memory, among other things, and previous research has shown that IDMs at one year of age show decreased memory abilities.
Dr. Tracy Riggins and her colleagues at The Center for Neurobehavioral Development at the University of Minnesota asked whether these early memory deficits continued later in life by comparing the memory performance of IDMs between ages 3 and 4 with controls whose mothers had not been iron deficient during pregnancy. The children were shown a sequence of events related to a theme such as “going camping”. Memory was tested in several ways that involved asking the children to recall the events in the sequence both immediately after they saw the sequence and after a delay of approximately one week. Electroencephalograph (EEG) recordings from the hippocampus were also taken as the children looked at pictures of a woman’s hand performing the events.
The difficulty of remembering the events was varied by manipulating the order in which the events in the sequence were presented to the children. Some of the events in the sequence were related in that one event naturally preceded the other. For example, in the “going camping” sequence “baiting a hook” naturally precedes “catching a fish”. Events like this are easier to remember when they are presented in their natural or logical order. Sequences were easier to remember when many of their events were presented to the children in logical order. They were harder to remember when a logical order was not present at all.
The results showed that the IDMs had poorer memory than the control children for the events in the hard-to-remember sequences. The EEG data indicated that these memory deficits involved both encoding (learning information) and retrieval of information from memory. The memory impairment was also shown to be correlated to the magnitude of the iron deficiency experienced during pregnancy.
According to the American Diabetes Association there are currently an estimated 23 million Americans (approximately 8% of the population) with diabetes. There are also indications that countries that have experienced an increase in economic livelihood coupled with a lack of emphasis on a physically active lifestyle are experiencing a greater incidence of diabetes than the United States. Given these numbers, the finding that memory impairments associated with the iron deficiencies experienced by diabetic mothers are still apparent after three to four years is not good news. However, finding out that some of the memory problems experienced by IDMs last longer than previously expected can help to emphasize the need to make sure that diabetic mothers have enough iron in their diet. In addition, finding out that the memory deficits experienced by IDMs can be overcome if the information to be remembered is presented in a logical order can help in designing situations that make it easier for everyone, including IDMs, to learn and remember.
Riggins, T., Miller, N. C., Bauer, P. J., Georgieff, M. K., & Nelson, C. A. (in press). Consequences of maternal diabetes mellitus and neonatal iron status on children's explicit memory performance. Developmental Neuropsychology.
Discrepancies in evaluations of children's behavior
It is not uncommon for people who interact with children to give different – sometimes very different – evaluations of the child’s behavior. For example, parents and teachers may give very different answers when asked to evaluate whether or not a child’s behavior is disruptive. Theses discrepancies can stem from a variety of factors: The child may behave differently with the parent than with the teacher. The parents’ and teachers’ criteria of what constitutes disruptive behavior may differ. The circumstances in which the parents or teachers were asked to give their evaluations may bias their answers.
Discrepancies in evaluations of children’s behavior pose a problem for the psychological clinician faced with the task of determining whether or not the child has a problem and, if so, identifying what that problem might be. In some cases discrepancies in characterizations of a child’s behavior are treated as coming from sources other than the child such as bias introduced by the evaluation process or different standards of evaluation held by the adults who are evaluating the child. In other cases, discrepancies in evaluations of a child’s behavior are understood as evidence that the behavior does not indicate a severe problem. This conclusion is based on the idea that the problematic behavior would occur more frequently and would be more easily seen and understood if it was being caused by a severe problem.
Dr. Andres De Los Reyes and his colleagues carried out a study that involved a child interacting with their parent in one case and a clinician the child had not met before in another. All of these interactions took place in a laboratory where the structure and the content of the interactions could be made as similar as possible. Independent coders observed these interactions and evaluated the child’s behavior within them. The evaluations of these observers were then compared with evaluations of the child’s disruptive behavior taken outside of the laboratory, from both the parent and the child’s teacher.
The results showed that the children often behaved very differently in the two laboratory situations and that the evaluations of the parents on the one hand and the teachers on the other accurately reflected differences in the child’s behavior observed in the laboratory. In particular, parent ratings appeared to reflect children’s behavior in the laboratory interactions between the parent and child and teacher ratings appeared to reflect behavior observed in interactions between the clinician and the child. These results indicate that discrepancies in evaluation of behavior may reflect real differences in the way a child behaves and cannot always be treated as being the result of factors outside the child such as bias introduced by the evaluation procedure.
Their results also indicated that differences in the child’s disruptive behavior in the two different circumstances may not be evidence of a single, but relatively weak, underlying cause. It is also possible that the circumstances themselves may have produced different kinds of similar behavior that could both be accurately labeled as “disruptive”.
Children's memory for the sequence of events
The ability to recall contextual details associated with an event begins to develop in the first year of life, yet adult levels of recall are not reached until early adolescence. In the present investigation, both behavioral and electrophysiological measures were used to assess the development of memory for a specific contextual detail, the order in which events occur in time, in early childhood. Results revealed age-related improvements in memory for temporal order. The study also suggests that children's electrical brain activity related to memory performance may have similar properties to activity that has been observed in adults.
Riggins, T., Miller, N. C., Bauer, P. J., Georgieff, M. K., & Nelson, C. A. (2009). Electrophysiological indices of memory for temporal order in early childhood: Implications for the development of recollection. Developmental Science, 12(2), 209-219
Social Relationships among Crayfish
Crayfish form social relationships in which some crayfish are dominant and others are subordinate. Graham and Herberholz exposed two juvenile crayfish that had formed a stable dominant-subordinate relationship to a larger crayfish. The large crayfish fought with the smaller ones and defeated them both. After the large crayfish was removed, the dominant-subordinate relationship between the original pair was reversed in half of the cases examined. The authors conclude that social relationships among crayfish can be destabilized by the activities of other crayfish in the social environment, and this finding may generalize to other species that live in densely organized social settings.
Graham M.E. and Herberholz J. (2009) Stability of dominance relationships in crayfish depends on social context. Animal Behaviour 77: 195-199.
Coping with Domestic Abuse
Survivors of domestic violence face an array of social and institutional factors that can either facilitate or impede their quest to attain the job-related and life-related goals they set for themselves after they escape from the abusive relationship. However, it’s not always clear how people who have suffered from domestic violence view these facilitating or impeding factors. Dr. O’Brien and her colleagues examine how these factors are viewed and understood by the people who have suffered the abuse and how understandings of facilitating and impeding factors can differ with race.
Chronister, K. M., Brown, C, O'Brien, K. M., Wettersten, K. B., Burt, M., Falkenstein, C., Shahane, A. (2009) Domestic Violence Survivors: Perceived Vocational Supports and Barriers
Journal of Career Assessment. 17: 116-131
Assessing the Diagnosis and Treatment of Depression in Children
In order to improve our ability to successfully treat people with mental health problems we need to be able to accurately diagnose the problem, prescribe an effective treatment method, and effectively monitor the whether the ongoing treatment is helping the problem. Dr. Lea Dougherty and her colleagues address these questions as they examine and evaluate a number of tools that are used to assess the diagnosis and treatment of depression in children.
Dougherty, L. R., Klein, D. N., Olino, T. M., & Laptook, R. S. (2008).
Depression in children and adolescents. In J. Hunsely, and E. Mash
(Eds.), A Guide to Assessments that Work (pp. 69-95). New York, NY:
Oxford University Press.