Showing papers in "American Psychologist in 2017"

What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice.

Abstract: Across 5 decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit and hyperactivity disorder) disorders and problems. Since the last broad-based youth meta-analysis in 1995, the number of trials has almost tripled and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects using multilevel modeling to address ES dependency that is common, but typically not modeled, in meta-analyses. Mean posttreatment ES was 0.46; the probability that a youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators, including the problem targeted in treatment: Mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and nonsignificant for multiproblem treatment (0.15). ESs differed across control conditions, with "usual care" emerging as a potent comparison condition, and across informants, highlighting the need to obtain and integrate multiple perspectives on outcome. Effects of therapy type varied by informant; only youth-focused behavioral therapies (including cognitive-behavioral therapy) showed similar and robust effects across youth, parent, and teacher reports. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention science. (PsycINFO Database Record

Advancing Social Connection as a Public Health Priority in the United States

Abstract: A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one's life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to that of many leading health determinants (that receive significant public health resources), government agencies, health care providers and associations, and public or private health care funders have been slow to recognize human social relationships as either a health determinant or health risk marker in a manner that is comparable to that of other public health priorities. This article evaluates current evidence (on social relationships and health) according to criteria commonly used in determining public health priorities. The article discusses challenges for reducing risk in this area and outlines an agenda for integrating social relationships into current public health priorities. (PsycINFO Database Record

Interpersonal mechanisms linking close relationships to health.

Abstract: Close relationships play a vital role in human health, but much remains to be learned about specific mechanisms of action and potential avenues for intervention. This article provides an evaluation of research on close relationships processes relevant to health, drawing on themes from major relationship science theories to present a broad conceptual framework for understanding the interpersonal processes and intrapersonal pathways linking relationships to health and disease outcomes. The analysis reveals that both social connection and social disconnection broadly shape biological responses and behaviors that are consequential for health. Furthermore, emerging work offers insights into the types of social dynamics that are most consequential for health, and the potential pathways through which they operate. Following from this analysis, the authors suggest several research priorities to facilitate the translation of discoveries from relationship science into relationship-based interventions and public health initiatives. These priorities include developing finer grained theoretical models to guide research, the systematic investigation of potential mediating pathways such as dyadic influences on health behavior and physiological coregulation, and taking into account individual differences and contextual factors such as attachment style, gender, socioeconomic status, and culture. In addition, a pressing need exists for laboratory and field research to determine which types of interventions are both practical and effective. (PsycINFO Database Record

Understanding Political Radicalization: The Two-Pyramids Model

Abstract: This article reviews some of the milestones of thinking about political radicalization, as scholars and security officials struggled after 9/11 to discern the precursors of terrorist violence. Recent criticism of the concept of radicalization has been recognized, leading to a 2-pyramids model that responds to the criticism by separating radicalization of opinion from radicalization of action. Security and research implications of the 2-pyramids model are briefly described, ending with a call for more attention to emotional experience in understanding both radicalization of opinion and radicalization of action. (PsycINFO Database Record

Is the alliance really therapeutic? Revisiting this question in light of recent methodological advances.

Abstract: The therapeutic value of alliance is a contested supposition. Although many theorists and researchers believe that alliance is therapeutic in itself, others see it as a byproduct of effective treatment or as a common nonspecific factor enabling the truly effective ingredients of treatment to work. For many years, the debate was confined mainly to the domain of theory, and no studies were available to confirm which of these approaches is correct. The only empirical evidence that existed was studies showing a correlation between alliance and outcome, and advocates of the above conflicting opinions used the same correlation to prove the validity of their position. Over the last few years, however, a revolution has taken place in alliance research, which brings this theoretical debate into the realm of the empirical. Several recent alliance studies have applied advanced methodologies to achieve this aim. Based on an integration of these studies, the present article proposes a new model for understanding the potential therapeutic role of alliance as sufficient to induce change by itself. The model stresses the importance of differentiating between patients' general tendencies to form satisfying relationships with others, which affect also the relationship with the therapist ("trait-like" component of alliance), and the process of the development of changes in such tendencies through interaction with the therapist ("state-like" component of alliance). The former enables treatment to be effective; the latter makes alliance therapeutic. Based on the literature, this article attempts to determine which of these components is the predictor of treatment outcome. (PsycINFO Database Record

Attitude roots and Jiu Jitsu persuasion: Understanding and overcoming the motivated rejection of science.

Abstract: There is a worryingly large chasm between scientific consensus and popular opinion. Roughly one third of Americans are skeptical that humans are primarily responsible for climate change; rates of some infectious diseases are climbing in the face of anti-immunization beliefs; and significant numbers of the population worldwide are antievolution creationists. It is easy to assume that resistance to an evidence-based message is a result of ignorance or failure to grasp evidence (the "deficit model" of science communication). But increasingly, theorists understand there are limits to this approach, and that if people are motivated to reject science, then repeating evidence will have little impact. In an effort to create a transtheoretical language for describing these underlying motivations, we introduce the notion of "attitude roots." Attitude roots are the underlying fears, ideologies, worldviews, and identity needs that sustain and motivate specific "surface" attitudes like climate skepticism and creationism. It is the antiscience attitude that people hear and see, but it is the attitude root-what lies under the surface-that allows the surface attitudes to survive even when they are challenged by evidence. We group these attitude roots within 6 themes-worldviews, conspiratorial ideation, vested interests, personal identity expression, social identity needs, and fears and phobias-and review literature relevant to them. We then use these insights to develop a "jiu jitsu" model of persuasion that places emphasis on creating change by aligning with (rather than competing with) these attitude roots. (PsycINFO Database Record

Beyond happiness: Building a science of discrete positive emotions.

Abstract: While trait positive emotionality and state positive-valence affect have long been the subject of intense study, the importance of differentiating among several "discrete" positive emotions has only recently begun to receive serious attention. In this article, we synthesize existing literature on positive emotion differentiation, proposing that the positive emotions are best described as branches of a "family tree" emerging from a common ancestor mediating adaptive management of fitness-critical resources (e.g., food). Examples are presented of research indicating the importance of differentiating several positive emotion constructs. We then offer a new theoretical framework, built upon a foundation of phylogenetic, neuroscience, and behavioral evidence, that accounts for core features as well as mechanisms for differentiation. We propose several directions for future research suggested by this framework and develop implications for the application of positive emotion research to translational issues in clinical psychology and the science of behavior change. (PsycINFO Database Record

Close relationships and the management of chronic illness: Associations and interventions.

Abstract: Self-management of a chronic illness involves not only monitoring symptoms, adhering to medication regimens, and keeping medical appointments but also making and maintaining difficult lifestyle changes. This article highlights correlational and intervention research suggesting family members are influential in children's and adults' illness management. The argument is made that a dyadic approach to chronic illness management that targets the influence of close relationships may yield more sustainable effects on patient behavior than has been achieved in the past. In particular, dyadic approaches aimed at helping patients and family members to find ways to collaborate in goal setting for these behaviors is recommended. Such dyadic interventions may also benefit family members who are ill or are at risk because of poor health behaviors. (PsycINFO Database Record

Incorporating the cultural diversity of family and close relationships into the study of health.

Abstract: Relationships are at the center of the human social environment, and their quality and longevity are now recognized to have particular relevance for health. The goal of this article is to bring attention to the role of culture in how relationships, particularly close relationships and family relationships, influence health. To this end, 2 contexts that are characterized by 2 distinct forms of cultural collectivism (East Asian and Latino) are spotlighted to highlight the unique patterns that underlie broader cultural categories (e.g., collectivism). In addition, related research on other understudied cultures and nonethnic or nonnational forms of culture (e.g., social class, religion) is also discussed. The review centers on social support, a key pathway through which relationships shape psychological and physical health, as the psychological process that has received the most empirical attention in this area. Overall, it is clear that new and more systematic approaches are needed to generate a more comprehensive, novel, and inclusive understanding of the role of culture in relationship processes that shape health. Three recommendations are offered for researchers and professionals to generate and incorporate knowledge of culture-specific relationship processes into their understanding of health. (PsycINFO Database Record

The implicit revolution: Reconceiving the relation between conscious and unconscious.

Abstract: In the 1970s, memory researchers converged on interesting phenomena observed in Korsakoff-syndrome amnesic patients. These patients' performances on difficult tasks were reliably improved by practice sessions from which they could recall nothing. Related findings of indirect memory effects in college students triggered wide attention to phenomena that, in 1985, were first identified as implicit memory. Within a decade, the indirect measurement methods of implicit memory research had spread to social psychologists' studies of attitudes and stereotypes. After another two decades, the methods and findings of this developing revolution have revised understanding of how past learning, operating in ways that bypass conscious awareness, nevertheless shapes conscious judgment and perception. This revolution in psychological thinking is on the cusp of reconceiving the relation between unconscious and conscious mental process. Further, it demands researchers' careful attention to justification for many self-report measures that are now routinely treated as face-valid. (PsycINFO Database Record

Close social ties and health in later life: Strengths and vulnerabilities.

Abstract: The world is aging at an unprecedented rate, with older adults representing the fastest-growing segment of the population in most economically developed and developing countries. This demographic shift leaves much uncharted territory for researchers who study social relationships and health. Social relationships exert powerful influences on physical health in later adulthood, a critical consideration given age-related increases in the prevalence of chronic health conditions and physical disability. A large body of research indicates that older adults report greater satisfaction with their social networks than do younger adults, and that they often take measures to minimize their exposure to negative social encounters. These emotionally satisfying and generally positive social ties afford some health protection against a backdrop of mounting physical limitations and play an important role when juxtaposed with the potentially health-damaging frictions that sometimes emerge in older adults' social relationships. Although most older adults report that they are satisfied with their social ties, some older adults experience frequent conflicts or ambivalent exchanges with members of their social networks, and these experiences detract from their health. In addition, many older adults will experience the loss of one or more close relationships during the course of their lives, with ramifications for their health and, often, for the reorganization of their social lives over time. Understanding how both the strengths and vulnerabilities of close social relationships affect health and well-being in later life is an important goal, particularly in view of the accelerating rate of population aging worldwide. (PsycINFO Database Record

The American Psychological Association Task Force assessment of violent video games: Science in the service of public interest.

Abstract: A task force of experts was convened by the American Psychological Association (APA) to update the knowledge and policy about the impact of violent video game use on potential adverse outcomes. This APA Task Force on Media Violence examined the existing literature, including the meta-analyses in the field, since the last APA report on media violence in 2005. Because the most recent meta-analyses were published in 2010 and reflected work through 2009, the task force conducted a search of the published studies from 2009-2013. These recently published articles were scored and assessed by a systematic evidentiary review, followed by a meta-analysis of the high utility studies, as documented in the evidentiary review. Consistent with the literature that we reviewed, we found that violent video game exposure was associated with: an increased composite aggression score; increased aggressive behavior; increased aggressive cognitions; increased aggressive affect, increased desensitization, and decreased empathy; and increased physiological arousal. The size of the effects was similar to that in prior meta-analyses, suggesting a stable result. Our task force concluded that violent video game use is a risk factor for adverse outcomes, but found insufficient studies to examine any potential link between violent video game use and delinquency or criminal behavior. Our technical report is the basis of this article. (PsycINFO Database Record

Building community resilience to violent extremism through genuine partnerships

Abstract: What is community resilience in relation to violent extremism, and how can we build it? This article explores strategies to harness community assets that may contribute to preventing youth from embracing violent extremism, drawing from models of community resilience as defined in relation to disaster preparedness. Research suggests that social connection is at the heart of resilient communities and any strategy to increase community resilience must both harness and enhance existing social connections, and endeavor to not damage or diminish them. First, the role of social connection within and between communities is explored. Specifically, the ways in which social bonding and social bridging can diminish risk for violence, including violent extremism, is examined. Second, research on the role of social connection between communities and institutions or governing bodies (termed social linking) is described. This research is discussed in terms of how the process of government partnering with community members can both provide systems for early intervention for violent extremism, as well as strengthen bonding and bridging social networks and in this way contribute broadly to building community resilience. Finally, community-based participatory research, a model of community engagement and partnership in research, is presented as a road map for building true partnerships and community engagement. (PsycINFO Database Record

APA efforts in promoting human rights and social justice.

Abstract: This article reviews the American Psychological Association's (APA) efforts in promoting human rights and social justice. Beginning with a historical review of the conceptualizations of human rights and social justice, the social challenges that have faced the United States over time are discussed in relation to the APA's evolving mission and strategic initiatives enacted through its boards, committees, and directorates. From early efforts on the Board for Social and Ethical Responsibility in Psychology and the Board of Ethnic Minority Affairs to the establishment of the Public Interest Directorate, the APA's efforts to address these human rights and social justice challenges through its task force reports, guidelines, and policies are described. Specifically, issues related to diversity and underrepresentation of minority group members and perspective within the APA, as well as women's issues (prochoice, violence against women, sexualization of young girls, human trafficking) were central to these efforts. These minority groups included racial and ethnic minority groups; immigrants and refugees; lesbian, gay, bisexual, transgendered, and queer individuals; and those with disabilities. Later attention shifted to broader social justice challenges within a public health perspective, such as AIDS, obesity, and violence. Also included is a brief discussion of the Hoffman Report. The article ends with a discussion of future directions for the APA's efforts related to human rights and social justice related to health disparities, violent extremism, social inequality, migration, cultural and racial diversity, and an evidence-based approach to programming. (PsycINFO Database Record

Evolutionary psychology: A how-to guide.

Abstract: Researchers in the social and behavioral sciences are increasingly using evolutionary insights to test novel hypotheses about human psychology. Because evolutionary perspectives are relatively new to psychology and most researchers do not receive formal training in this endeavor, there remains ambiguity about "best practices" for implementing evolutionary principles. This article provides researchers with a practical guide for using evolutionary perspectives in their research programs and for avoiding common pitfalls in doing so. We outline essential elements of an evolutionarily informed research program at 3 central phases: (a) generating testable hypotheses, (b) testing empirical predictions, and (c) interpreting results. We elaborate key conceptual tools, including task analysis, psychological mechanisms, design features, universality, and cost-benefit analysis. Researchers can use these tools to generate hypotheses about universal psychological mechanisms, social and cultural inputs that amplify or attenuate the activation of these mechanisms, and cross-culturally variable behavior that these mechanisms can produce. We hope that this guide inspires theoretically and methodologically rigorous research that more cogently integrates knowledge from the psychological and life sciences. (PsycINFO Database Record

The power and the pain of adolescents’ digital communication: Cyber victimization and the perils of lurking.

Abstract: Many adolescents are heavily engaged with social media and text messaging (George & Odgers, 2015; Lenhart, 2015), yet few psychologists have studied what digital communication means for adolescents' relationships and adjustment. This article proposes that psychologists should embrace the careful study of adolescents' digital communication. We discuss theoretical frameworks for understanding adolescents' involvement with social media, present less widely recognized perils of intense involvement with social media, and highlight positive features of digital communication. Coconstruction theory suggests that adolescents help to create the content of digital communication that shapes their lives, and that there may be strong continuity between adolescents' offline and online lives (Subrahmanyam, Smahel, & Greenfield, 2006). However, psychological theories and research methods could further illuminate the power and the pain of adolescents' digital communication. Psychologists need to understand more about subtle but potentially serious risks that adolescents might face: The agony of victimization by even a single episode of cyberbullying and the pain of social exclusion and comparison resulting from vast amounts of time reading large social media feeds and seeing friends doing things without you and comparing your inner emotional experience to everyone else's highly groomed depictions of their seemingly marvelous lives. If we seek to understand developmental psychopathology and to help youth at risk, psychologists need to embrace careful study of the content of adolescents' online communication, parents need to talk with their children about their own online experiences and become familiar with social media themselves, and clinicians need to address adolescents' online social lives in prevention and treatment programs. (PsycINFO Database Record

Childhood close family relationships and health.

Abstract: Emerging data suggest that during childhood, close family relationships can ameliorate the impact that adversity has on life span physical health. To explain this phenomenon, a developmental stress buffering model is proposed in which characteristics of family relationships including support, conflict, obligation, and parenting behaviors evolve and change from childhood to adolescence. Together, these characteristics govern whether childhood family relationships are on balance positive enough to fill a moderating role in which they mitigate the effects that childhood adversities have on physical health. The benefits of some family relationship characteristics are hypothesized to stay the same across childhood and adolescence (e.g., the importance of comfort and warmth from family relationships) whereas the benefits of other characteristics are hypothesized to change from childhood to adolescence (e.g., from a need for physical proximity to parents in early childhood to a need for parental availability in adolescence). In turn, close, positive family relationships in childhood operate via a variety of pathways, such as by reducing the impact that childhood stressors have on biological processes (e.g., inflammation) and on health behaviors that in turn can shape physical health over a lifetime. (PsycINFO Database Record

Voice-only communication enhances empathic accuracy

Abstract: This research tests the prediction that voice-only communication increases empathic accuracy over communication across senses. We theorized that people often intentionally communicate their feelings and internal states through the voice, and as such, voice-only communication allows perceivers to focus their attention on the channel of communication most active and accurate in conveying emotions to others. We used 5 experiments to test this hypothesis (N = 1,772), finding that voice-only communication elicits higher rates of empathic accuracy relative to vision-only and multisense communication both while engaging in interactions and perceiving emotions in recorded interactions of strangers. Experiments 4 and 5 reveal that voice-only communication is particularly likely to enhance empathic accuracy through increasing focused attention on the linguistic and paralinguistic vocal cues that accompany speech. Overall, the studies question the primary role of the face in communication of emotion, and offer new insights for improving emotion recognition accuracy in social interactions. (PsycINFO Database Record

There and back again: The study of mental disorder and terrorist involvement.

Abstract: For the past forty years, researchers studied the relationship between mental disorder and terrorist involvement. The literature developed in four paradigms, each of which differs in terms of their empirical evidence, the specific mental disorders studied, and their conceptualizations of terrorist involvement. These paradigms have not, however, witnessed linear and incremental improvements upon one another. Although one paradigm has generally tended to dominate a temporal period, many false assumptions and incorrect interpretations of earlier work permeate into today’s discourse. This paper provides a history of the study of mental disorders and the terrorist. First, we briefly outline the core fundamental principles of the first two paradigms, The paper then outlines the core arguments produced by the seminal reviews conducted in paradigm three. We highlight how these findings were consistently misinterpreted in subsequent citations. We then highlight recent innovations in the study of terrorism and mental disorder since the various influential literature reviews of 1997-2005. We conclude by outlining how future research in this area may improve in the coming years by broadening our understanding of both terrorist involvement and psychopathology away from simple dichotomous thinking.

The Pediatric Patient-Centered Medical Home: Innovative models for improving behavioral health.

Abstract: This article examines the concept of the Patient-Centered Medical Home (PCMH) as it applies to children and adolescents, emphasizing care for behavioral health conditions, the role of psychology and psychological science, and next steps for developing evidence-informed models for the Pediatric-PCMH. The PCMH concept for pediatric populations offers unique opportunities for psychological science to inform and enhance the transformation of the United States health care system and improve health in our nation. Available evidence on the outcomes of PCMH implementation for pediatric populations is limited, underscoring the need for additional research evaluating Pediatric-PCMH models and concepts. While behavioral health has only recently been emphasized as a formal part of the PCMH, accumulating evidence supports the effectiveness of some approaches for providing behavioral health care through pediatric primary care. These approaches suggest that a comprehensive Pediatric-PCMH model that includes behavioral health care has the potential to optimize the availability, quality, benefits, and cost-effectiveness of behavioral health services. This could ultimately enhance youth health and behavioral health, with effects potentially extending through the adult years. Rigorous research and demonstration projects are needed to guide further development of optimal strategies for improving health and behavioral health in pediatric populations and advancing the public health impact of behavioral health care services. (PsycINFO Database Record

To the fringe and back: Violent extremism and the psychology of deviance.

Abstract: We outline a general psychological theory of extremism and apply it to the special case of violent extremism (VE). Extremism is defined as motivated deviance from general behavioral norms and is assumed to stem from a shift from a balanced satisfaction of basic human needs afforded by moderation to a motivational imbalance wherein a given need dominates the others. Because motivational imbalance is difficult to sustain, only few individuals do, rendering extreme behavior relatively rare, hence deviant. Thus, individual dynamics translate into social patterns wherein majorities of individuals practice moderation, whereas extremism is the province of the few. Both extremism and moderation require the ability to successfully carry out the activities that these demand. Ability is partially determined by the activities' difficulty, controllable in part by external agents who promote or oppose extremism. Application of this general framework to VE identifies the specific need that animates it and offers broad guidelines for addressing this pernicious phenomenon. (PsycINFO Database Record

Risk assessment and the prevention of radicalization from nonviolence into terrorism.

Abstract: This article considers the challenges associated with completing risk assessments in countering violent extremism. In particular, it is concerned with risk assessment of those who come to the attention of government and nongovernment organizations as being potentially on a trajectory toward terrorism and where there is an obligation to consider the potential future risk that they may pose. Risk assessment in this context is fraught with difficulty, primarily due to the variable nature of terrorism, the low base-rate problem, and the dearth of strong evidence on relevant risk and resilience factors. Statistically, this will lead to poor predictive value. Ethically, it can lead to the labeling of an individual who is not on a trajectory toward violence as being "at risk" of engaging in terrorism and the imposing of unnecessary risk management actions. The article argues that actuarial approaches to risk assessment in this context cannot work. However, it further argues that approaches that help assessors to process and synthesize information in a structured way are of value and are in line with good practice in the broader field of violence risk assessment. (PsycINFO Database Record

The psychology of neurofeedback: Clinical intervention even if applied placebo.

Abstract: Advocates of neurofeedback make bold claims concerning brain regulation, treatment of disorders, and mental health. Decades of research and thousands of peer-reviewed publications support neurofeedback using electroencephalography (EEG-nf); yet, few experiments isolate the act of receiving feedback from a specific brain signal as a necessary precursor to obtain the purported benefits. Moreover, while psychosocial parameters including participant motivation and expectation, rather than neurobiological substrates, seem to fuel clinical improvement across a wide range of disorders, for-profit clinics continue to sprout across North America and Europe. Here, we highlight the tenuous evidence supporting EEG-nf and sketch out the weaknesses of this approach. We challenge classic arguments often articulated by proponents of EEG-nf and underscore how psychologists and mental health professionals stand to benefit from studying the ubiquitous placebo influences that likely drive these treatment outcomes. (PsycINFO Database Record

Payment reform in the patient-centered medical home: Enabling and sustaining integrated behavioral health care.

Abstract: The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet. However, challenges to implementing the PCMH framework are compounded for real-world practitioners because payment reform rarely happens concurrently. Nowhere is this more evident than in attempts to integrate behavioral health clinicians into primary care. As behavioral health clinicians find opportunities to work in integrated settings, a comprehensive understanding of payment models is integral to the dialogue. This article describes alternatives to the traditional fee for service (FFS) model, including modified FFS, pay for performance, bundled payments, and global payments (i.e., capitation). We suggest that global payment structures provide the best fit to enable and sustain integrated behavioral health clinicians in ways that align with the Triple Aim. Finally, we present recommendations that offer specific, actionable steps to achieve payment reform, complement PCMH, and support integration efforts through policy. (PsycINFO Database Record

Victim voice in reenvisioning responses to sexual and physical violence nationally and internationally.

Abstract: Internationally and in the United States many victims of sexual assault and domestic violence are unserved, underserved, or ill-served, especially those from the most vulnerable populations. Programs developed in the United States are routinely exported to developing countries but often without success. Notably, the failures seen internationally resemble those in the United States and are related to structural and attitudinal-cultural factors. Many victims do not disclose, and if they do seek services, they often report that available options mismatch their objectives, present accessibility challenges, disempower their pursuit of justice, and fail to augment needed resources. A deeper understanding of obstacles to effective service provision is needed if the United States is to continue to be an international partner in victim response and violence prevention. This article builds on what is known about service delivery challenges in U.S. programs to envision a path forward that concomitantly accommodates anticipation of shrinking resources, by (a) reviewing illustrative services and feedback from victims about utilizing them; (b) examining structural inequalities and the intersections of personal and contextual features that both increase vulnerability to victimization and decrease accessibility and acceptability of services; (c) advocating for reintroduction of direct victim voice into response planning to enhance reach and relevance; and (d) reorienting delivery systems, community partnerships, and Coordinated Community Response teams. The authors suggest as the way forward pairing direct victim voice with open-minded listening to expressed priorities, especially in vulnerable populations, and designing services accordingly. Through a process that prioritizes adaptation to diverse needs and cultures, U.S models can increase desirability, equity, and thrift at home as well as enhance international relevance. (PsycINFO Database Record

"Let's get in formation": On becoming a psychologist-activist in the 21st century.

Abstract: Throughout the history of the United States, there have been many social movements that have resulted in an array of historic societal outcomes-ranging from the end of racial segregation to women's voting rights to the legalization of same-sex marriages. Despite the positive outcomes derived from political activism, many psychologists have struggled with how to advocate for social justice while maintaining their professional responsibilities and ethical boundaries. The current article reviews the historical ways that psychologists have participated in political movements-from the use of psychological research in landmark U.S. Supreme Court cases to psychologist-led pushes for policy changes in psychology, medicine, and other mental health related fields. Next, a critical review provides some of the major controversies or dilemmas regarding psychology, social justice, and political participation-including (a) ethical concerns and professional boundaries, (b) the utility of political neutrality in psychology, (c) psychologists' balance and self-care, (d) psychologists' lack of advocacy training, and (e) beliefs concerning the role of social justice advocacy in psychology. Finally, the article concludes with a discussion of the concept "psychologist-activist"-highlighting the many ways that psychologists across various subfields and institutions can combat oppression on individual, interpersonal, group, and institutional levels. (PsycINFO Database Record

The microbiome as a novel paradigm in studying stress and mental health.

Abstract: At the intersection between neuroscience, microbiology, and psychiatry, the enteric microbiome has potential to become a novel paradigm for studying the psychobiological underpinnings of mental illness. Several studies provide support for the view that the enteric microbiome influences behavior through the microbiota-gut-brain axis. Moreover, recent findings are suggestive of the possibility that dysregulation of the enteric microbiota (i.e., dysbiosis) and associated bacterial translocation across the intestinal epithelium may be involved in the pathophysiology of stress-related psychiatric disorders, particularly depression. The current article reviews preliminary evidence linking the enteric microbiota and its metabolites to psychiatric illness, along with separate lines of empirical inquiry on the potential involvement of psychosocial stressors, proinflammatory cytokines and neuroinflammation, the hypothalamic-pituitary-adrenal axis, and vagal nerve activation, respectively, in this relationship. Finally, and drawing on these independent lines of research, an integrative conceptual model is proposed in which stress-induced enteric dysbiosis and intestinal permeability confer risk for negative mental health outcomes through immunoregulatory, endocrinal, and neural pathways. (PsycINFO Database Record

Neurocognitive deficits in children with chronic health conditions.

Abstract: Over 4 million children in the United States suffer from chronic health conditions, including cancer, sickle cell disease, and diabetes. Because of major advances in the early identification and treatment of these conditions, survival rates for these children continue to rise, and the majority now lives into adulthood. However, increases in survival have come with costs related to long-term effects of disease processes and treatments. Foremost among these consequences is impairment in brain development and neurocognitive function that may affect a substantial portion of children with chronic health conditions and follow many into adulthood. Impaired cognitive function may contribute to impairment in educational and occupational attainment, mental health, and quality of life for children with chronic conditions. Despite the significance and scope of this problem, advances in the identification and understanding of neurocognitive problems and the delivery of effective clinical care have been hindered in part because research has been "siloed"-conducted on each chronic condition in isolation. This review examines, for the first time, neurocognitive problems in a selected set of 6 chronic pediatric health conditions-leukemia, brain tumors, sickle cell disease, congenital heart disease, Type 1 diabetes, and traumatic brain injury-to define the magnitude of the problem and identify directions for future research and clinical care. Psychologists from many areas of specialization, including pediatric psychology, educational and school psychology, neuropsychology, behavioral medicine, and adult primary care, are uniquely positioned to contribute to every phase of this work, including research, identification, and intervention. (PsycINFO Database Record

Ethical and legal considerations in psychobiography.

Abstract: Despite psychobiography's long-standing history in the field of psychology, there has been relatively little discussion of ethical issues and guidelines in psychobiographical research. The Ethics Code of the American Psychological Association (APA) does not address psychobiography. The present article highlights the value of psychobiography to psychology, reviews the history and current status of psychobiography in the field, examines the relevance of existing APA General Principles and Ethical Standards to psychobiographical research, and introduces a best practice ethical decision-making model to assist psychologists working in psychobiography. Given the potential impact of psychologists' evaluative judgments on other professionals and the lay public, it is emphasized that psychologists and other mental health professionals have a high standard of ethical vigilance in conducting and reporting psychobiography. (PsycINFO Database Record

Psychologists in patient-centered medical homes (PCMHs): Roles, evidence, opportunities, and challenges.

Abstract: The patient-centered medical home (PCMH) is an increasingly common model of health care delivery with many exciting opportunities for psychologists. The PCMH reflects a philosophy and model of care that is highly consistent with psychological science and practice. It strives to provide patient-centered, comprehensive, team-based, coordinated, accessible, and quality and safety-oriented health care delivery to individuals and families. Moreoever, in keeping with changes in the health care system more broadly, the PCMH model prioritizes the integration of behavioral and physical health care, and this emphasis lays the foundation for active and full engagement of psychologists in this context. This article provides an overview of the PCMH and the evidence and roles for psychologists across a range of pediatric, adult, and geriatric health care populations and settings. Current challenges to the necessary expansion of psychology in the PCMH are discussed, with particular attention to the needs for training and advocacy to support the contributions of behavioral health care in the PCMH. Psychology must embrace its rightful place as a health profession and appreciate and highlight the ways in which psychologists can play unique and critical roles in transforming present and future health care delivery models. (PsycINFO Database Record