Promoting skill use in skill enhanced cognitive behavioral therapy: A case example.

Cognitive behavioral therapy (CBT) appears to achieve its effects at least in part by fostering the development of CBT skills. In an effort to leverage CBT skill development, our group developed and tested a skill-enhanced version of CBT (CBT-SE) in a recent trial. In this paper, we describe our work with a client who participated in a 12-week course of CBT-SE as part of that trial. Although homework is a critical aspect of CBT, the greater emphasis on skill development in CBT-SE means that homework is even more central. This client's course of treatment illustrates the potential benefits of a strong focus on skill development and the use of specific homework assignments to foster mastery and ongoing use of CBT skills. The client developed CBT skills at a rapid pace early in treatment and exhibited enduring symptom reductions. The experience of this client reinforces the value of a focus on CBT skills and highlights strategies for fostering skill development. Given the evidence in support of the therapeutic value of CBT skills and the well-established benefits of homework assignment, we encourage use of skill enhancing procedures, including in-session procedures and assignments that help clients develop and maintain ongoing skill use.

High-Temperature Intrinsic Defect Chemistry of Li8PbO6 Ceramic Breeding Material.

Understanding the intrinsic defect chemistry of tritium breeder materials proposed for use in future fusion reactors is imperative, as certain defects may act as traps leading to retention of tritium in the ceramic matrix. In this paper, we use combined density functional theory simulations with simple thermodynamics to explore the intrinsic defect chemistry of octalithium plumbate (Li8PbO6) as a function of both temperature and oxygen partial pressure. Importantly, we consider vibrational contributions to the energies of the reference states used in the calculations of the defect formation energies. Our results indicate that including these temperature effects can modify the predicted defect chemistry for materials at a high temperature. For Li8PbO6, the defect chemistry is predicted to be dominated by the VLi-1 defect, which will likely act as a trap for tritium. The charge compensating mechanism is predicted to change as a function of the conditions, with the Lii+1 interstitial defect providing compensation at low temperatures and the VO2+ vacancy defect occurring close to the Li2O saturation limit.

Vindicating pollyanna? An experimental test of cognitive restructuring and positive thinking interventions.

OBJECTIVE: Despite its considerable potential, psychotherapy research has made limited use of small-scale experimental study designs to test intervention components. This study employs such a design to test the immediate effects on emotional experience of two approaches to changing negative thoughts, cognitive restructuring and fostering positive thinking. Cognitive restructuring draws on the strategies core to cognitive behavioral therapies. Fostering positive thinking has also received attention, though less so as a psychological intervention. METHOD: We tested the benefits of these strategies over a brief interval by randomizing 230 participants to complete a worksheet introducing one of the two strategies. Participants reported their skills prior to exposure to these worksheets and affect was assessed immediately prior to and following use of worksheets. RESULTS: Participants' negative affect reduced following both strategies. Conditions did not differ significantly in affect change. Analysis of potential moderators showed that, among those with higher levels of cognitive behavioral therapy skills, the positive thinking condition produced greater gains in positive affect than the cognitive restructuring condition. CONCLUSIONS: These results indicate that both forms of brief interventions promote reductions in negative affect. Positive thinking interventions, which are not focused on the accuracy of one's thinking, appear to be particularly effective in promoting positive affect.

Thermodynamics and phase stability of Li8XO6octalithium ceramic breeder materials (X= Pb, Ce, Ge, Zr, Sn).

Octalithium ceramics with their high stoichiometric concentration of lithium offer exceptionally high tritium breeding ratios in comparison with other candidate breeder materials for tokamak fusion reactors, this is especially true with incorporation of a neutron multiplier into the crystal structures. Although, there are concerns surrounding the stability of these materials at operational temperatures. Therefore in this paper, we explore the thermodynamic properties of a selection of candidate octalithium ceramics in low and high temperature regimes (0-1200 K) using density functional perturbation theory. Enthalpies as well as Gibbs formation energies were used to distinguish candidates which may or may not be susceptible to degradation.

Accommodation of helium in PuO2±x and the role of americium.

The high alpha-activity of plutonium dioxide (PuO2) results in significant ingrowth of radiogenic helium (He) in the aged material. To safely store/dispose PuO2 or use in applications such as space exploration, the impact of He accumulation needs to be understood. In this work, defect energies obtained using a density functional theory (DFT) + U + D3 scheme are used in a point defect model constructed for PuO2 to predict the method of He incorporation within the PuO2 lattice. The simulations predict that the preferred incorporation site for He in PuO2 is a plutonium vacancy, however, the point defect model indicates that helium will be accommodated as an interstitial irrespective of He concentration and across a wide stoichiometric range. By considering the charge imbalance that arises due to incorporation of Am3+ ions it is shown that He accommodation in oxygen vacancy sites will dominate in PuO2-x as the material ages.

Using Socratic Questioning to promote cognitive change and achieve depressive symptom reduction: Evidence of cognitive change as a mediator.

Socratic questioning has long been thought to play a critical role in cognitive behavioral therapy (CBT) for depression. Though use of Socratic questioning is theorized to achieve symptom reduction by promoting cognitive change, research has yet to investigate this pathway. In a sample of 123 clients participating in CBT for depression, we tested cognitive change as a mediator of the relation between Socratic questioning and symptom change in early treatment sessions. We found evidence of a significant indirect effect, consistent with cognitive change mediating the effect of Socratic questioning on change in depressive symptoms. Further analyses showed that pre-treatment CBT skills moderated the effect of Socratic questioning on cognitive change, with this relationship being stronger for clients who started treatment with lower CBT skills. These findings provide support for the view that Socratic questioning contributes to therapeutic gains in CBT through cognitive change. This study also provides initial evidence to suggest the use of Socratic questioning is particularly important for clients who begin treatment with particularly low CBT skills.

Framing an intervention as focused on one's strength: Does framing enhance therapeutic benefit?

INTRODUCTION: A capitalization approach to enhancing client skills in cognitive behavioral interventions is focused on enhancing skills that represent relative strengths. This approach may bolster outcomes because the targeted skills are those that clients can most effectively use to recover from negative moods. Alternatively, the benefits might be due to client attitudes about these skills, such as their confidence that they can use these skills effectively. METHODS: In an unselected sample of 616 undergraduates, we randomized to one of two brief interventions (a cognitive or mindfulness intervention) and one of two framing conditions (framing the intervention as focusing on a relative strength or a weakness), resulting in four conditions. Participants were then asked to use the skill targeted in their intervention to recover from a sad mood induction. RESULTS: Framing conditions did not differ on expectations of benefit from sustained use of an intervention but did differ on mood recovery. Participants told that the intervention focused on a strength recovered more quickly following the mood induction. There was no difference between the skill interventions. DISCUSSION: Our finding suggests intervention framing positively contributes to the effects of strengths focused treatments, though perhaps not by enhancing treatment expectations.

The therapeutic alliance and dropout in cognitive behavioral therapy of depression.

Identifying predictors of dropout is an important step in improving treatment outcomes. The alliance is the most frequently studied psychotherapy process variable, but its relation to dropout in cognitive behavioral therapy (CBT) of depression is not well understood.We evaluated the alliance at session one as reported by clients and therapists as predictors of dropout among 126 clients with major depressive disorder participating in CBT for depression.Over a similar time period, those who dropped out experienced less symptom change than those who did not. Client, but not therapist reported alliance was related to reduced risk for dropout. This relation remained significant even when clients' pre-treatment predictions of the alliance were included as a covariate. Concurrent use of medication did not moderate the alliance-dropout relation.Our findings are consistent with alliance being an important contributor to risk of dropout in CBT for depression. Future research should investigate intervention strategies that might promote the alliance as a means of reducing dropout.

When Are Therapists' Efforts to Bring about Cognitive Change Effective? Considering Interpersonal Vulnerabilities as Contextual Factors.

We examined interpersonal variables as moderators of the relation between therapists' use of cognitive change (CC) strategies and CC in a sample of 125 adults who participated in cognitive behavioral therapy for depression. We measured self-reported maladaptive personality characteristics, interpersonal problems, and social skills at intake. Observers rated therapist adherence to cognitive methods for the first five sessions. Patients reported in-session CC following each session. Cognitive methods predicted greater CC. The relation between cognitive methods and CC was moderated by maladaptive personality traits; this relation was stronger for patients with greater maladaptive personality traits. We encourage future research investigating moderators of therapist interventions of putative therapeutic mechanisms.

Who Benefits From a Cognitive vs. Behavioral Approach to Treating Depression? A Pilot Study of Prescriptive Predictors.

Although experts have suggested ways that cognitive behavioral therapy (CBT) of depression might be personalized for individual clients, there has been little empirical examination of this issue. We examine cognitive behavioral skills and vulnerabilities (i.e., dysfunctional thinking, behavioral inactivation, and avoidance) as potential prescriptive predictors to cognitive vs. behavioral interventions. Forty-two adults with major depressive disorder were randomized to eight weeks of cognitive-only (n = 21) or behavioral-only (n = 21) individual psychotherapy. Clients completed pre-treatment measures of cognitive and behavioral skills and vulnerabilities. Dropout rates were comparable across treatments (21% overall). Treatment outcomes did not differ significantly between treatments (g = .13). Cognitive skills were associated with superior outcomes in the behavioral-only treatment, but additional analyses suggested general skillfulness (i.e., the tendency to have high scores across cognitive and behavioral assessments), rather than cognitive skills per se, predicted a larger response to behavioral interventions. Similarly, behavioral avoidance of social and non-social domains were associated with worse outcomes in the behavioral-only treatment, indicating that behavioral approaches yield less positive outcomes for clients high in behavioral avoidance. If replicated, the results of this pilot study suggest ways that a cognitive behavioral therapist could select intervention strategies to suit individual clients and thereby improve treatment outcomes.

Evolving Defect Chemistry of (Pu,Am)O2±x.

The ß decay of 241Pu to 241Am results in a significant ingrowth of Am during the interim storage of PuO2. Consequently, the safe storage of the large stockpiles of separated Pu requires an understanding of how this ingrowth affects the chemistry of PuO2. This work combines density functional theory (DFT) defect energies and empirical potential calculations of vibrational entropies to create a point defect model to predict how the defect chemistry of PuO2 evolves due to the incorporation of Am. The model predicts that Am occupies Pu sites in (Pu,Am)O2±x in either the +III or +IV oxidation state. High temperatures, low oxygen-to-metal (O/M) ratios, or low Am concentrations favor Am in the +III oxidation state. Am (+III) exists in (Pu,Am)O2±x as the negatively charged (AmPu 1-) defect, requiring charge compensation from holes in the valence band, thereby increasing the conductivity of the material compared to Am-free PuO2. Oxygen vacancies take over as the charge compensation mechanism at low O/M ratios. In (Pu,Am)O2±x , hypo- and (negligible) hyperstoichiometry is found to be provided by the doubly charged oxygen vacancy (VO 2+) and singly charged oxygen interstitial (Oi 1-), respectively.

Melanins as Sustainable Resources for Advanced Biotechnological Applications.

Melanins are a class of biopolymers that are widespread in nature and have diverse origins, chemical compositions, and functions. Their chemical, electrical, optical, and paramagnetic properties offer opportunities for applications in materials science, particularly for medical and technical uses. This review focuses on the application of analytical techniques to study melanins in multidisciplinary contexts with a view to their use as sustainable resources for advanced biotechnological applications, and how these may facilitate the achievement of the United Nations Sustainable Development Goals.

The defect chemistry of non-stoichiometric PuO2±x.

An increased knowledge of the chemistry of PuO2 is imperative for the design of procedures to store, dispose, or make use of PuO2. In this work, point defect concentrations in PuO2 are determined by combining density functional theory (DFT) defect energies and empirical potential calculations of vibrational entropies. The obtained defect concentrations are expressed as a function of temperature and oxygen partial pressure and used to calculate non-stoichiometry in PuO2±x. The results show that the defect chemistry of PuO2 is dominated by oxygen vacancies and interstitials. Hypo-stoichiometric PuO2-x is accommodated by both the uncharged oxygen vacancy and positively charged oxygen vacancy at small values of x, with increasingly dominant with increasing x. The negatively charged oxygen interstitial (O2-i) is found to accommodate hyper-stoichiometry (PuO2+x), but reluctance to form hyper-stoichiometric PuO2+x is observed, with oxygen interstitials present only in very low concentrations irrespective of conditions. The small degree of hyper-stoichiometry found is favoured by low temperatures.

Reevaluating the Alliance-Outcome Relationship in the Early Sessions of Cognitive Behavioral Therapy of Depression.

The therapeutic alliance has been reliably associated with outcome across psychotherapies. We investigated the alliance-outcome relationship in the early sessions of cognitive behavioral therapy of depression using a model that disaggregates within- and between-person variance while estimating the reciprocal relation between variables. We utilized this model in a combined dataset from two studies totaling 191 patients. In our primary model, we found evidence for a predictive within-patient relationship between alliance and symptoms such that symptoms predicted regressed change in alliance and alliance predicted regressed change in symptoms. In a more conservative detrended model, these relationships were not significant. Given that a) most of the variability in alliance scores is between-patient; b) the size of the alliance-outcome relationship is modest; and c) the alliance-outcome relationship is not robust to detrending, our findings suggest the alliance plays at most a small role in improving patient outcomes in cognitive behavioral therapy of depression.

Influence of Lithium Vacancy Defects on Tritium Diffusion in ß-Li2TiO3.

Lithium metatitanate, Li2TiO3, is a leading candidate for application as a tritium breeding material in a future fusion reactor. Following transmutation of lithium, the tritium must escape the crystal in order to be extracted for use in the fusion plasma. The rate-limiting step to release tritium from the Li2TiO3 pebbles is diffusion through the crystal grains. In this work, the activation barriers for tritium diffusion have been calculated using density functional theory. The results show that tritium can diffuse as an interstitial with a barrier of 0.52 eV. However, when a tritium ion becomes bound to a lithium vacancy defect, the energy required to either detrap the tritium from the vacancy or for the cluster to diffuse increases to >1 eV. Overall, these results suggest that the introduction of lithium vacancies due to Li burn-up may lead to an increase in tritium retention in the pebbles.

Driving/riding after alcohol and marijuana use among young adults: Is residing with family protective?

Objective: Driving while impaired by alcohol or drugs increases the risk of motor vehicle fatalities, the leading cause of death among young adults. The current study documented the prevalence of driving after alcohol and marijuana use in the past 2 weeks as well as the prevalence of riding with a driver who had used each substance during that time frame. We tested whether young adults who lived with family members (i.e., their parents or their children) were less likely to engage in these behaviors. Methods: Participants aged 18-25 who resided in nonmetropolitan areas in the United States (N = 1,131; 55% female, Mage = 22.6) completed an online survey. Multivariate logistic regressions examined alcohol- and marijuana-related driving and riding behaviors adjusting for demographic factors. Interactions tested whether associations varied by gender. Results: In the 2 weeks prior to the survey, 17% of participants drove after drinking alcohol and 21% had ridden with a driver who had been drinking. The prevalence of driving after marijuana use was 11%, and 16% of the sample had ridden with a driver who had been using marijuana. Participants who lived with their parents were less likely to ride with a driver who had been using alcohol or marijuana (adjusted odds ratios [AORs] = 0.71 and 0.55, respectively). Living with parents was also associated negatively with driving after both substances, but these associations were no longer significant when controlling for substance use frequency and driving frequency. Surprisingly, the odds of driving after marijuana use were over 2 times larger for young adults who lived with their children. For women, but not men, residing with children decreased the odds of driving and riding after alcohol use. Conclusions: Living with parents protects against riding after substance use among young adults. Prevention programs should target young adults who live independently or those transitioning away from the parental home. Furthermore, given the higher rates of driving after marijuana use among young adult parents, this group should be educated about the risks associated with this behavior.

Context and culture: Reasons young adults drink and drive in rural America.

Montana, a large and rural U.S. state, has a motor vehicle fatality rate almost double the national average. For young adults, the alcohol-related motor vehicle fatality rate in the state is almost three times the national average. Yet little research has explored the underlying reasons that young people in rural areas drink and drive. Drawing from the theory of triadic influence (TTI) and a series of qualitative focus group discussions, the current study examined how aspects of the landscape and culture of rural America promote and hinder drinking and driving among young people. In 2015 and 2016, 72 young adults (36 females) aged 18-25 years old (mean age = 20.2) participated in 11 semi-structured focus groups in 8 rural counties in Montana. Discussions were transcribed, and two reviewers independently coded text segments. Themes were identified and an inductive explanatory model was created. The results demonstrated that aspects of the social context (e.g., peer pressure and parental modeling), rural cultural values (e.g., independence, stoicism, and social cohesion), and the legal and physical environment (e.g., minimal police presence, sparse population, and no alternative transportation) promoted drinking and driving. The results also identified salient protective factors in each of these domains. Our findings demonstrate the importance of examining underlying distal determinants of drinking and driving. Furthermore, they suggest that future research and interventions should consider the complex ways in which cultural values and environmental factors intersect to shape the risky health behaviors of rural populations.

Dislocation loop formation by swift heavy ion irradiation of metals.

A coupled two-temperature, molecular dynamics methodology is used to simulate the structural evolution of bcc metals (Fe and W) and fcc metals (Cu and Ni) following irradiation by swift heavy ions. Electronic temperature dependent electronic specific heat capacities and electron-phonon coupling strengths are used to capture the full effects of the variation in the electronic density of states. Tungsten is found to be significantly more resistant to damage than iron, due both to the higher melting temperature and the higher thermal conductivity. Very interesting defect structures, quite different from defects formed in cascades, are found to be created by swift heavy ion irradiation in the bcc metals. Isolated vacancies form a halo around elongated interstitial dislocation loops that are oriented along the ion path. Such configurations are formed by rapid recrystallization of the molten cylindrical region that is created by the energetic ion. Vacancies are created at the recrystallization front, resulting in excess atoms at the core which form interstitial dislocation loops on completion of crystallization. These unique defect structures could, potentially, be used to create metal films with superior mechanical properties and interesting nanostructures.

The influence of the electronic specific heat on swift heavy ion irradiation simulations of silicon.

The swift heavy ion (SHI) irradiation of materials is often modelled using the two-temperature model. While the model has been successful in describing SHI damage in metals, it fails to account for the presence of a bandgap in semiconductors and insulators. Here we explore the potential to overcome this limitation by explicitly incorporating the influence of the bandgap in the parameterisation of the electronic specific heat for Si. The specific heat as a function of electronic temperature is calculated using finite temperature density functional theory with three different exchange correlation functionals, each with a characteristic bandgap. These electronic temperature dependent specific heats are employed with two-temperature molecular dynamics to model ion track creation in Si. The results obtained using a specific heat derived from density functional theory showed dramatically reduced defect creation compared to models that used the free electron gas specific heat. As a consequence, the track radii are smaller and in much better agreement with experimental observations. We also observe a correlation between the width of the band gap and the track radius, arising due to the variation in the temperature dependence of the electronic specific heat.

Thermophysical and anion diffusion properties of (U x ,Th1-x )O2.

Using molecular dynamics, the thermophysical properties of the (U x ,Th1-x )O2 system have been investigated between 300 and 3600 K. The thermal dependence of lattice parameter, linear thermal expansion coefficient, enthalpy and specific heat at constant pressure is explained in terms of defect formation and diffusivity on the oxygen sublattice. Vegard's law is approximately observed for solid solution thermal expansion below 2000 K. Different deviations from Vegard's law above this temperature occur owing to the different temperatures at which the solid solutions undergo the superionic transition (2500-3300 K). Similarly, a spike in the specific heat, associated with the superionic transition, occurs at lower temperatures in solid solutions that have a high U content. Correspondingly, oxygen diffusivity is higher in pure UO2 than in pure ThO2. Furthermore, at temperatures below the superionic transition, oxygen mobility is notably higher in solid solutions than in the end members. Enhanced diffusivity is promoted by lower oxygen-defect enthalpies in (U x ,Th1-x )O2 solid solutions. Unlike in UO2 and ThO2, there is considerable variety of oxygen vacancy and oxygen interstitial sites in solid solutions generating a wide range of property values. Trends in the defect enthalpies are discussed in terms of composition and the lattice parameter of (U x ,Th1-x )O2.