Alliance Expectations and Alliance as Predictor of Therapy Engagement and Outcome

Clients begin psychotherapy with expectations that may or may not be met during treatment. Discrepancies between pretherapy expectations and the therapy experience may influence client response to treatment. This naturalistic observational pilot study investigated whether the discrepancy between initial expectations of the working alliance and the experience of the alliance predicts early client engagement and outcome. Participants were adult therapy clients at a university training clinic. Each participant completed the Expected-Working Alliance Inventory before their first session and a shortened version of the Working Alliance Inventory after. We hypothesized that the difference between expected alliance scores and actual alliance scores would predict level of client engagement and outcome. We found that participants in this study engaged at a higher rate than generally seen among therapy clients, with 82% remaining in treatment after four weeks. Even with this unusually high engagement rate, the results showed that the expected-actual alliance discrepancy predicted client engagement. Most notably, exceeding alliance expectations was associated with greater early therapy engagement. The expected-actual alliance discrepancy did not predict client outcomes. The results showed a pattern of better outcomes when the alliance exceeded expectations, but this finding was not significant, which may be due in part to a small sample size. Overall, this pilot study suggests that while initial client expectations about the therapy relationship are complex, efforts to surpass alliance expectations may lead to greater early therapy engagement. In addition, recommendations for further research and other clinical implications are discussed

Alliance Expectations and Alliance as Predictor of Therapy Engagement and Outcome

Clients begin psychotherapy with expectations that may or may not be met during treatment. Discrepancies between pretherapy expectations and the therapy experience may influence client response to treatment. This naturalistic observational pilot study investigated whether the discrepancy between initial expectations of the working alliance and the experience of the alliance predicts early client engagement and outcome. Participants were adult therapy clients at a university training clinic. Each participant completed the Expected-Working Alliance Inventory before their first session and a shortened version of the Working Alliance Inventory after. We hypothesized that the difference between expected alliance scores and actual alliance scores would predict level of client engagement and outcome. We found that participants in this study engaged at a higher rate than generally seen among therapy clients, with 82% remaining in treatment after four weeks. Even with this unusually high engagement rate, the results showed that the expected-actual alliance discrepancy predicted client engagement. Most notably, exceeding alliance expectations was associated with greater early therapy engagement. The expected-actual alliance discrepancy did not predict client outcomes. The results showed a pattern of better outcomes when the alliance exceeded expectations, but this finding was not significant, which may be due in part to a small sample size. Overall, this pilot study suggests that while initial client expectations about the therapy relationship are complex, efforts to surpass alliance expectations may lead to greater early therapy engagement. In addition, recommendations for further research and other clinical implications are discussed

The Early Evolution of Primordial Pair-Instability Supernovae

The observational signatures of the first cosmic explosions and their chemical imprint on second-generation stars both crucially depend on how heavy elements mix within the star at the earliest stages of the blast. We present numerical simulations of the early evolution of Population III pair-instability supernovae with the new adaptive mesh refinement code CASTRO. In stark contrast to 15 - 40 Msun core-collapse primordial supernovae, we find no mixing in most 150 - 250 Msun pair-instability supernovae out to times well after breakout from the surface of the star. This may be the key to determining the mass of the progenitor of a primeval supernova, because vigorous mixing will cause emission lines from heavy metals such as Fe and Ni to appear much sooner in the light curves of core-collapse supernovae than in those of pair-instability explosions. Our results also imply that unlike low-mass Pop III supernovae, whose collective metal yields can be directly compared to the chemical abundances of extremely metal-poor stars, further detailed numerical simulations will be required to determine the nucleosynthetic imprint of very massive Pop III stars on their direct descendants.Comment: submitted to ApJ, comments welcom

Versatile transporter apparatus for experiments with optically trapped Bose-Einstein condensates

We describe a versatile and simple scheme for producing magnetically and optically-trapped Rb-87 Bose-Einstein condensates, based on a moving-coil transporter apparatus. The apparatus features a TOP trap that incorporates the movable quadrupole coils used for magneto-optical trapping and long-distance magnetic transport of atomic clouds. As a stand-alone device, this trap allows for the stable production of condensates containing up to one million atoms. In combination with an optical dipole trap, the TOP trap acts as a funnel for efficient loading, after which the quadrupole coils can be retracted, thereby maximizing optical access. The robustness of this scheme is illustrated by realizing the superfluid-to-Mott insulator transition in a three-dimensional optical lattice

The Nucleosynthetic Imprint of 15-40 Solar Mass Primordial Supernovae on Metal-Poor Stars

The inclusion of rotationally-induced mixing in stellar evolution can alter the structure and composition of presupernova stars. We survey the effects of progenitor rotation on nucleosynthetic yields in Population III and II supernovae using the new adaptive mesh refinement (AMR) code CASTRO. We examine spherical explosions in 15, 25 and 40 solar mass stars at Z = 0 and 10^-4 solar metallicity with three explosion energies and two rotation rates. Rotation in the Z = 0 models resulted in primary nitrogen production and a stronger hydrogen burning shell which led all models to die as red supergiants. On the other hand, the Z=10^-4 solar metallicity models that included rotation ended their lives as compact blue stars. Because of their extended structure, the hydrodynamics favors more mixing and less fallback in the metal free stars than the Z = 10^-4 models. As expected, higher energy explosions produce more enrichment and less fallback than do lower energy explosions, and less massive stars produce more enrichment and leave behind smaller remnants than do more massive stars. We compare our nucleosynthetic yields to the chemical abundances in the three most iron-poor stars yet found and reproduce the abundance pattern of one, HE 0557-4840, with a zero metallicity 15 solar mass, 2.4 x 10^51 erg supernova. A Salpeter IMF averaged integration of our yields for Z=0 models with explosion energies of 2.4x10^51 ergs or less is in good agreement with the abundances observed in larger samples of extremely metal-poor stars, provided 15 solar mass stars are included. Since the abundance patterns of extremely metal-poor stars likely arise from a representative sample of progenitors, our yields suggest that low-mass supernovae contributed the bulk of the metals to the early universe.Comment: 16 pages, 11 figures; submitted to Ap

The first spectral line surveys searching for signals from the Dark Ages

Our aim is to observationally investigate the cosmic Dark Ages in order to constrain star and structure formation models, as well as the chemical evolution in the early Universe. Spectral lines from atoms and molecules in primordial perturbations at high redshifts can give information about the conditions in the early universe before and during the formation of the first stars in addition to the epoch of reionisation. The lines may arise from moving primordial perturbations before the formation of the first stars (resonant scattering lines), or could be thermal absorption or emission lines at lower redshifts. The difficulties in these searches are that the source redshift and evolutionary state, as well as molecular species and transition are unknown, which implies that an observed line can fall within a wide range of frequencies. The lines are also expected to be very weak. Observations from space have the advantages of stability and the lack of atmospheric features which is important in such observations. We have therefore, as a first step in our searches, used the Odin satellite to perform two sets of spectral line surveys towards several positions. The first survey covered the band 547-578 GHz towards two positions, and the second one covered the bands 542.0-547.5 GHz and 486.5-492.0 GHz towards six positions selected to test different sizes of the primordial clouds. Two deep searches centred at 543.250 and 543.100 GHz with 1 GHz bandwidth were also performed towards one position. The two lowest rotational transitions of H2 will be redshifted to these frequencies from z~20-30, which is the predicted epoch of the first star formation. No lines are detected at an rms level of 14-90 and 5-35 mK for the two surveys, respectively, and 2-7 mK in the deep searches with a channel spacing of 1-16 MHz. The broad bandwidth covered allows a wide range of redshifts to be explored for a number of atomic and molecular species and transitions. From the theoretical side, our sensitivity analysis show that the largest possible amplitudes of the resonant lines are about 1 mK at frequencies <200 GHz, and a few micro K around 500-600 GHz, assuming optically thick lines and no beam-dilution. However, if existing, thermal absorption lines have the potential to be orders of magnitude stronger than the resonant lines. We make a simple estimation of the sizes and masses of the primordial perturbations at their turn-around epochs, which previously has been identified as the most favourable epoch for a detection. This work may be considered as an important pilot study for our forthcoming observations with the Herschel Space Observatory.Comment: 15 pages, 9 figures, 3 on-line pages. Accepted for publication in Astronomy & Astrophysics 8 March 2010

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

OBJECTIVE: The objective of this study is to assess the contribution of mental comorbidity to role impairment among college students. METHODS: Web-based self-report surveys from 14,348 first-year college students (Response Rate [RR] = 45.5%): 19 universities, eight countries of the World Mental Health International College Student Initiative. We assessed impairment (Sheehan Disability Scales and number of days out of role [DOR] in the past 30 days) and seven 12-month DSM-IV disorders. We defined six multivariate mental disorder classes using latent class analysis (LCA). We simulated population attributable risk proportions (PARPs) of impairment. RESULTS: Highest prevalence of role impairment was highest among the 1.9% of students in the LCA class with very high comorbidity and bipolar disorder (C1): 78.3% of them had severe role impairment (vs. 20.8%, total sample). Impairment was lower in two other comorbid classes (C2 and C3) and successively lower in the rest. A similar monotonic pattern was found for DOR. Both LCA classes and some mental disorders (major depression and panic, in particular) were significant predictors of role impairment. PARP analyses suggest that eliminating all mental disorders might reduce severe role impairment by 64.6% and DOR by 44.3%. CONCLUSIONS: Comorbid mental disorders account for a substantial part of role impairment in college students. © 2018 John Wiley & Sons, Ltd