Faculty Bibliography

Cognitive behavioral therapy (CBT) is an empirically supported and well-established treatment for youth anxiety disorders. CBT therapists often involve parents and school staff in treatment to promote the generalization of therapeutic gains across settings. To facilitate therapist communication with those who provide collateral support, we discuss both general guidelines and specific examples of how parents and teachers can best support anxious youth by acting as coping models, labeling and validating anxious feelings, rewarding brave behavior, and reducing accommodations. We provide answers to questions commonly asked by parents (e.g., "How should I respond

Stokes and Osnes (1989) outlined three principles to facilitate the generalization and maintenance of therapeutic gains. Use of functional contingencies, training diversely, and incorporating functional mediators were recommended. Our review, with most illustrations from studies of youth, updates Stokes and Osnes's original paper with a focus on evidence-based strategies to increase generalization of therapeutic gains across settings, stimuli, and time. Research since 1989 indicates that training for generalization by increasing the frequency of naturally occurring reinforcers for positive behaviors, and altering maladaptive contingencies that inadvertently reinforce problem behaviors, are associated with favorable treatment outcomes. Training diversely by practicing therapy skills across contexts and in response to varying stimuli is also implicated in clinical outcomes for internalizing, externalizing, and neurodevelopmental disorders. Preliminary research recommends the use of internal (e.g., emotion identification) and external (e.g., coping cards) functional mediators to prompt effective coping in session and at home. Strategies for increasing generalization, including the use of technology, are examined and future research directions are identified.

BACKGROUND: Poor sleep health is a major health disparity and public health concern. The primary goal of this study was to accurately obtain the rates of self-reported sleep disorders, sleep dysfunction, and daytime sleepiness in a true community sample of black adults. METHODS: We used a community-based participatory research design to identify a health priority to design a study that could (a) provide an accurate assessment of the problem, (b) help to better understand the barriers to treatment, and (c) provide the community with access to care. Subsequently, 470 black adults, approached at salons, barber shops, and churches throughout Brooklyn participated. They underwent anthropometric measurement and completed a self-reported sleep assessment. RESULTS: Sleep disorders (insomnia, obstructive sleep apnea) were found in 34% of the sample, and 75% of the population that had a sleep disorder was unaware of it. Fourteen percent of the sample self-identified as having obstructive sleep apnea, 38.0% reported having Insomnia, and 38% reported having excessive daytime somnolence. People with a sleep disorder described less satisfaction with their sleep quality and poorer health than did those without a sleep disorder. CONCLUSION: The variability in the reported rates of sleep disorders in black samples suggests that the true rates of these conditions are not well-known. However, the large number of black individuals who have sleep disturbances warrants increased scientific and public health attention. In addition, with increased community involvement in research, there can be increased buy-in and greater accuracy in the assessments and reduced barriers to treatment.

Emotions are a fundamental part of our living experience, yet our grasp on what they are and how to study them is still tenuous. Cell editor Mirna Kvajo talked with Joe LeDoux, Cristina Alberini, and Liz Phelps about the challenges in researching emotions and whether studies in animals can teach us about them. An excerpt of the conversation appears below, and the full conversation is available with the article online.

Adults primarily walk to reach a new location, but why do infants walk? Do infants, like adults, walk to travel to a distant goal? We observed 30 13-month-old and 30 19-month-old infants during natural walking in a laboratory playroom. We characterized the bout structure of walking-when infants start and stop walking-to examine why infants start and stop walking. Locomotor activity was composed largely of brief spurts of walking. Half of 13-month-olds' bouts and 41% of 19-month-olds' bouts consisted of three or fewer steps-too few to carry infants to a distant goal. Most bouts ended in the middle of the floor, not at a recognizable goal. Survival analyses of the distribution of steps per bout indicated that the probability of continuing to walk was independent of the length of the ongoing bout; infants were just as likely to stop walking after five steps as after 50 steps and they showed no bias toward bouts long enough to carry them across the room to a goal. However, 13-month-olds showed an increased probability of stopping after 1-3 steps, and they did not initiate walking more frequently to compensate for their surfeit of short bouts. We propose that infants' natural walking is not intentionally directed at distant goals; rather, it is a stochastic process that serves exploratory functions. Relations between the bout structure of walking and other measures of walking suggest that locomotor exploration is constrained by walking skill in younger infants, but not in older infants.