Teresa A. Treat

Treatment integrity in psychotherapy research: Analysis of the studies and examination of the associated factors.

Treatment integrity refers to the degree to which an intervention is delivered as intended. Two studies evaluated the adequacy of treatment integrity procedures (including establishing, assessing, evaluating, and reporting integrity; therapist treatment adherence; and therapist competence) implemented in psychotherapy research, as well as predictors of their implementation. Randomized controlled trials of psychosocial interventions published in 6 influential psychological and psychiatric journals were reviewed and coded for treatment integrity implementation. Results indicate that investigations that systematically addressed treatment integrity procedures are virtually absent in the literature. Treatment integrity was adequately addressed for only 3.50% of the evaluated psychosocial interventions. Journal of publication and treatment approach predicted integrity implementation. Skill-building treatments (e.g., cognitive-behavioral) as compared with non-skill-building interventions (e.g., psychodynamic, nondirective counseling) were implemented with higher attention to integrity procedures. Guidelines for implementation of treatment integrity procedures need to be reevaluated.

Theories and measurement of visual attentional processing in anxiety

Most theoretical models of anxiety disorders implicate maladaptive visuo-spatial attentional processing of threat-relevant information in the onset and maintenance of symptoms. We discuss the central mechanistic hypotheses in clinical science regarding problematic attentional processing of threat in anxiety, reconcile what appear to be contradictory predictions, and integrate those hypotheses to describe comprehensively the overt and covert mechanisms of attentional processing within discrete perceptual episodes. In so doing, we examine critically the prevailing theoretical assumptions and measurement models underlying the current investigations of attention and anxiety, and we advocate for increased precision in the translation of models from vision science to the examination of the mechanisms of attentional processing in anxiety. Finally, we discuss the implications of this approach for future translational research that examines the role of attention in anxiety and its treatment.

Multidimensional Visual Statistical Learning

Recent studies of visual statistical learning (VSL) have demonstrated that statistical regularities in sequences of visual stimuli can be automatically extracted, even without intent or awareness. Despite much work on this topic, however, several fundamental questions remain about the nature of VSL. In particular, previous experiments have not explored the underlying units over which VSL operates. In a sequence of colored shapes, for example, does VSL operate over each feature dimension independently, or over multidimensional objects in which color and shape are bound together? The studies reported here demonstrate that VSL can be both object-based and feature-based, in systematic ways based on how different feature dimensions covary. For example, when each shape covaried perfectly with a particular color, VSL was object-based: Observers expressed robust VSL for colored-shape sub-sequences at test but failed when the test items consisted of monochromatic shapes or color patches. When shape and color pairs were partially decoupled during learning, however, VSL operated over features: Observers expressed robust VSL when the feature dimensions were tested separately. These results suggest that VSL is object-based, but that sensitivity to feature correlations in multidimensional sequences (possibly another form of VSL) may in turn help define what counts as an object.

Sexual coercion and the misperception of sexual intent

Misperceiving a womans platonic interest as sexual interest has been implicated in a sexual bargaining process that leads to sexual coercion. This paper provides a comprehensive review of sexual misperception, including gender differences in perception of womens sexual intent, the relationship between sexual coercion and misperception, and situational factors that increase the risk that sexual misperception will occur. Compared to women, men consistently perceive a greater degree of sexual intent in womens behavior. However, there is evidence to suggest that this gender effect may be driven largely by a sub-group of men who are particularly prone to perceive sexual intent in womens behavior, such as sexually coercive men and men who endorse sex-role stereotypes. Situational factors, such as alcohol use by the man or woman, provocative clothing, and dating behaviors (e.g., initiating the date or making eye contact), are all associated with increased estimates of womens sexual interest. We also critique the current measurement strategies and introduce a model of perception that more closely maps on to important theoretical questions in this area. A clearer understanding of sexual perception errors and the etiology of these errors may serve to guide sexual-assault prevention programs toward more effective strategies.

Effectiveness of an empirically based treatment for panic disorder delivered in a service clinic setting : 1-year follow-up

The transportability of cognitive-behavioral therapy (CBT) for panic disorder to a community mental health center (CMHC) setting at 1-year follow-up was examined by comparing CMHC treatment outcome data with results obtained in controlled efficacy studies. Participants were 81 CMHC clients with a primary diagnosis of panic disorder with or without agoraphobia who completed CBT for panic disorder. Despite differences in settings, clients, and treatment providers, both the magnitude of change from pretreatment to follow-up and the maintenance of change from posttreatment to follow-up in the CMHC sample were comparable with the parallel findings in the efficacy studies. At follow-up, 89% of the CMHC clients were panic free and a substantial proportion of the sample successfully discontinued benzodiazepine use.

Perceptual Mechanisms That Characterize Gender Differences in Decoding Women's Sexual Intent

Men and women often disagree about the meaning of womens nonverbal cues, particularly those conveying dating-relevant information. Men perceive more sexual intent in womens behavior than women perceive or report intending to convey. Although this finding has been attributed to gender differences in the threshold for labeling ambiguous cues as sexual in nature, little research has been conducted to determine etiology. Using a model that differentiates perceptual sensitivity from decisional bias, we found no evidence that men have lenient thresholds for perceiving womens nonverbal behavior as indicating sexual interest. Rather, gender differences were captured by a relative perceptual insensitivity among men. Just as in previous studies, men were more likely than women to misperceive friendliness as sexual interest, but they also were quite likely to misperceive sexual interest as friendliness. The results point to the promise of computational models of perception in increasing the understanding of clinically relevant social processes.

Modeling individual differences in perceptual and attentional processes related to bulimic symptoms.

Attentional and perceptual differences between women with high and low levels of bulimic symptoms were studied with techniques adapted from cognitive science. Stimuli were pictures of young women varying in body size and facial affect. A multidimensional scaling analysis showed that the high-symptom women were significantly more attentive to information about body size and significantly less attentive to information about affect. In prototype classification tasks, the high-symptom women used significantly more information about body size and significantly less information about affect. There were strong associations between individual differences in attention in the similarity task and decision making in the classification tasks. The study shows the potential utility of cognitive science methods for the study of cognitive factors in psychopathology.

Cognitive processes underlying women's risk judgments: associations with sexual victimization history and rape myth acceptance.

OBJECTIVE This study evaluated the effects of sexual victimization history, rape myth acceptance, implicit attention, and recent learning on the cognitive processes underlying undergraduate womens explicit risk judgments. METHOD Participants were 194 undergraduate women between 18 and 24 years of age. The sample was ethnically diverse and composed primarily of freshman, heterosexual, and single women. Stimuli were written vignettes describing social situations that varied on dimensions of sexual victimization risk and potential impact on womens popularity. Participants completed cognitive tasks assessing relative attention to victimization risk versus popularity impact, learning about either risk or popularity impact, and explicit classification of victimization risk. Participants then completed the Sexual Experiences Survey (SES) and the Rape Myth Acceptance Scale; SES responses were used to quantify the severity of victimization experiences. RESULTS More severe victimization history predicted use of higher thresholds for judging situations as risky, as well as lower sensitivity to risk and greater sensitivity to popularity impact when judging risk. Greater rape myth acceptance also predicted lower sensitivity to risk information. Higher relative attention to victimization risk predicted greater sensitivity to risk information when judging risk. Recent learning about either the risk or the popularity impact aspects of social situations modified sensitivity to risk versus popularity when making risk judgments. CONCLUSION The study emphasizes the importance of distinguishing the threshold for judging situations as risky from sensitivity to risk-relevant information in understanding individual differences in womens risk judgments. Both processes may be important to consider when developing interventions to reduce womens risk for sexual victimization.

Using cognitive science methods to assess the role of social information processing in sexually coercive behavior

Seventy-four undergraduate men completed cognitive performance tasks assessing perceptual organization, classification, and category learning, as well as self-report measures relevant to sexual coercion. The stimuli were slides of Caucasian women who varied along affect and physical exposure (i.e., sensuality) dimensions. Data were analyzed using a weighted multidimensional scaling model, signal-detection theory analyses, and a connectionist learning model (RASHNL; J. K. Kruschke & M. K. Johansen, 1999). Individual differences in performance on the classification and category-learning tasks were congruent with individual differences in perceptual organization. Additionally, participants who showed relatively more attention to exposure than to affect were less sensitive to womens negative responses to unwanted sexual advances. Overall, the study demonstrates the feasibility and utility of cognitive science methods for studying information processing in psychopathology.

Alcohol alters men's perceptual and decisional processing of women's sexual interest.

The current investigation examines the etiology of mens errors in sexual perception after moderate alcohol use. Sensitivity and bias estimates, derived from multidimensional signal detection analysis, revealed that mens alcohol-influenced performance was associated with declining sensitivity to the distinction between womens friendliness and sexual interest. However, sensitivity to the distinction between conservative and provocative clothing was unaffected. Similarly, an alcohol dose led to an increased bias to respond that womens ambiguous cues were sexual interest (rather than friendliness) but did not influence response thresholds for clothing style. Thus, there was specificity to the perceptual and decisional changes associated with alcohol use rather than a simple degradation of mens capacity to process all dating-relevant cues in the environment. Given the link between alcohol use, sexual misperception, and acquaintance-initiated sexual coercion, understanding the etiology of sexual misperception in the context of alcohol use may inform sexual coercion prevention efforts.