Argues that research on change processes is needed to help explain how psychotherapy produces change. To explain processes of change, it will be important to measure 3 types of outcomes—immediate, intermediate, and final—and 3 levels of process—speech act, episode, and relationship. Emphasis will need to be placed on specifying different types of in-session change episodes and the intermediate outcomes they produce. The assumption that all processes have the same meaning (regardless of context) needs to be dropped, and a context-sensitive process research needs to be developed. Speech acts need to be viewed in the context of the types of episodes in which they occur, and episodes need to be viewed in their relationship context. This approach would result in the use of a battery of process instruments to measure process patterns in context and to relate these to outcome. (52 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
66 undergraduates listed all the events that they thought would happen to them or that they would engage in (a) over the next weekend, (b) over the next summer, (c) 5 yrs from now, or (d) 20 yrs from now and whether each event would be personally or externally controlled. Data indicate that internals and externals differ not only in the degree of control they perceive their actions exerting over the corresponding reinforcement but also in the degree of control over the behavior itself. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Compared a dropout group and a nondropout group of high school boys on several psychometric and demographic variables. The data both predated and postdated (by about 10 yr.) the time of dropout. The group were subdivided by intelligence, additional training, and early vs. late dropouts for the dropout group. The later lives of dropouts were characterized in general by relatively low socioeconomic status (SES), a downward social mobility, a higher incidence of criminal activity, and bigger families. 9th grade MMPI tests showed some personality differences between dropouts and nondropouts. When dropout and nondropout groups were matched by intelligence, most of the differences persisted. Training after dropout is of some help in future SES. Few differences were found between early and late dropouts. (16 ref.)
The psychiatric comorbidity, health, and functioning of primary care patients with alcohol abuse and dependence (AAD) were investigated in a sample of 1,000 patients. Psychiatric symptomatology was assessed with the Primary Care Evaluation of Mental Disorders (PRIME-MD) diagnostic system. Health and functional status was assessed with the Medical Outcomes Study Short Form General Health Survey (SF-20). Results indicated that use of the PRIME-MD system brought about a 71% increase in physician recognition of AAD. AAD patients were diagnosed with substantial psychiatric comorbidity, and they reported poorer health and functioning than did patients without any psychiatric disorders. However, they reported less impairment and psychiatric comorbidity than did patients with other psychiatric disorders. Results also indicated that AAD patients' health and functioning were associated with the presence or absence of psychiatric comorbidity.
A randomized clinical trial evaluated the therapeutic efficacy of group cognitive-behavioral therapy (GCBT) versus a wait-list control (WLC) condition to treat anxiety disorders in children. Results indicated that GCBT, with concurrent parent sessions, was highly efficacious in producing and maintaining treatment gains. Children in GCBT showed substantial improvement on all the main outcome measures, and these gains were maintained at 3-, 6-, and 12-month follow-ups. Children in the WLC condition did not show improvements from the pre- to the postwait assessment point. These findings are discussed in terms of the need to continue to advance the development of practical, as well as conceptual, knowledge of efficacious treatment for anxiety disorders in children.
The issue of whether mild head injuries (HIs) in children cause behavior problems and poor scholastic performance is controversial. This study included 119 children (range = 8-16 years old) with HI, 114 with other injuries, and 106 with no injury (NI). Behavioral functioning was assessed with the Child Behavior Checklist; academic functioning, with school grades and standardized testing. Higher T scores were found for both injury groups versus NI participants on preinjury behavioral status. All 3 groups' behavioral scores decreased relative to baseline at 1 year. HI and NI groups did not differ in school grades or achievement testing either pre- or postinjury. These results are consistent with the conclusion that head injury of the mildest type does not increase the probability of new overt behavioral or academic problems.
The role of 2 parenting variables, monitoring and communication, in adolescent deviant behavior was examined within 4 samples; Black Americans living in Montgomery, Alabama, and the Bronx, New York, and Hispanics living in the Bronx, New York, and San Juan, Puerto Rico. The participants comprised 907 14- to 16-year-old adolescents and their mothers recruited through high schools in 3 communities. The results indicated that higher levels of parental monitoring, but not parent--adolescent communication, predicted lower levels of adolescent deviance in each of the samples. The replication of these findings in samples that vary by ethnicity and location provides strong support for the generalizability of the association between parental monitoring and low levels of adolescent deviant behavior.
Concerns about dysfunctional alcohol use among lesbians and gay men are longstanding. The authors examined alcohol use patterns and treatment utilization among adults interviewed in the 1996 National Household Survey on Drug Abuse. Sexually active respondents were classified into 2 groups: those with at least 1 same-gender sexual partner (n = 194) in the year prior to interview and those with only opposite-gender sexual partners (n = 9,714). The authors compared these 2 groups separately by gender. For men, normative alcohol use patterns or morbidity did not differ significantly between the 2 groups. However, homosexually active women reported using alcohol more frequently and in greater amounts and experienced greater alcohol-related morbidity than exclusively heterosexually active women. Findings suggest higher risk for alcohol-related problems among lesbians as compared with other women, perhaps because of a more common pattern of moderate alcohol consumption.
This study examined outcomes at a 2-year follow-up assessment for child psychotherapy as it typically is delivered in outpatient settings. The treatment condition (53 children, mean age = 10.5 years) and control condition (53 children, mean age = 10.0 years) were compared with regard to rates of linear and curvilinear change for psychopathology, adaptive functioning, and consumer satisfaction. Although both conditions showed curvilinear as well as linear improvement in behavioral and emotional problems, relatively little support was found for the effectiveness of traditional child psychotherapy or for the presence of a psychotherapy "sleeper effect."
Current widespread use of the same youth assessment measures and scales across different nations assumes that youth psychopathology syndromes do not differ meaningfully across nations. By contrast, the authors' syndromal sensitivity model posits 3 processes through which cultural differences can lead to cross-national differences in psychopathology syndromes. The authors tested this model in a comparison of Child Behavior Checklist syndromes for adolescents in Thailand and the United States. In support of the model, about half of the Thai-U.S. syndrome comparisons showed poor agreement (kappa = .40), and distinctive Thai syndromes emerged reflecting 3 prominent themes in Thai research literature: delayed maturation, indirect aggression and/or delinquency, and sex problems in boys. Such syndromal dissimilarity carries significant implications for assessment, diagnosis, epidemiology, and intervention across national boundaries.
Collective traumas can negatively affect large numbers of people who ostensibly did not experience events directly, making it particularly important to identify which people are most vulnerable to developing mental and physical health problems as a result of such events. It is commonly believed that successful coping with a traumatic event requires expressing one's thoughts and feelings about the experience, suggesting that people who choose not to do so would be at high risk for poor adjustment. To test this idea in the context of collective trauma, 2,138 members of a nationally representative Web-enabled survey panel were given the opportunity to express their reactions to the terrorist attacks of September 11, 2001, on that day and those following. Follow-up surveys assessing mental and physical health outcomes were completed over the next 2 years. Contrary to common belief, participants who chose not to express any initial reaction reported better outcomes over time than did those who expressed an initial reaction. Among those who chose to express their immediate reactions, longer responses predicted worse outcomes over time. Implications for myths of coping, posttrauma interventions, and psychology in the media are discussed.
Attempted to develop a descriptive classification system that could be used to group children for research and clinical purposes, to reflect adaptive competencies as well as behavior problems, and to facilitate quantitative assessment of behavioral change. The system is embodied in a series of Child Behavior Profiles that are standardized separately for children of each sex at ages 4–5, 6–21, and 12–26 yrs. The profiles are scored from the Child Behavior Checklist (CBCL), which was designed to obtain parents' reports of their children's competencies and problems in standardized format. The present article reports standardization of the profile for boys aged 6–11 yrs. Factor analysis of the CBCLs of 450 disturbed boys yielded 9 behavior problem scales labeled Schizoid, Depressed, Uncommunicative, Obsessive–Compulsive, Somatic Complaints, Social Withdrawal, Hyperactive, Aggressive, and Delinquent. The 1st 5 problem scales loaded on a 2nd-order factor labeled Internalizing, and the last 3 loaded on a factor labeled Externalizing. Three social competence scales entitled Activities, Social, and School were also constructed from the CBCL. Norms are based on a normal sample of 300. Comparison of disturbed and normal boys showed significant differences on all behavior problem and social competence scores. Eight-day test–retest correlations averaged .89, whereas interparent correlations averaged .74. Computerized and hand-scored versions of the profile can be used to display item and scale scores for individual boys.
This study examined long-term sequelae of severe adolescent psychopathology from the perspective of adult attachment theory. The study compared 66 upper-middle-class adolescents who were psychiatrically hospitalized at age 14 for problems other than thought or organic disorders, to 76 sociodemographically similar high school students. When reinterviewed at age 25, virtually all of the previously hospitalized adolescents displayed insecure attachment organizations, in contrast to a more typical mixture of security and insecurity in the former high school sample. Lack of resolution of previous trauma with attachment figures accounted for much of this insecurity. Insecurity in adult attachment organization at age 25 was also linked to self-reported criminal behavior and use of hard drugs in young adulthood. These findings are discussed as reflecting a substantial and enduring connection between attachment organization and severe adolescent psychopathology and a possible role of attachment organization in mediating some of the long-term sequelae of such psychopathology.
This article reports the construction of editions of the Child Behavior Profile for boys aged 12-16 and girls aged 6-11 and 12-16 years. Scored from the Child Behavior Checklist, the profile consists of three a priori social competence scales plus behavior problem scales that were derived through factor analysis of the checklists filled out by parents of 450 children of each sex and age group referred for mental health services. The behavior problem scales were labeled as follows: boys 12-16 - Somatic Complaints, Schizoid, Uncommunicative, Immature, Obsessive-Compulsive, Hostile Withdrawal, Delinquent, Aggressive, and Hyperactive; girls 6-11 - Somatic Complaints, Schizoid-Obsessive, Depressed, Social Withdrawal, Sex Problems, Cruel, Delinquent, Aggressive, and Hyperactive; girls 12-16 - Somatic Complaints, Schizoid, Depressed Withdrawal, Anxious-Obsessive, Immature-Hyperactive, Cruel, Aggressive, and Delinquent. Second-order factor analyses showed that the behavior problem scales for each sample could be divided into broadband groupings called internalizing and externalizing. Normalized T scores for the social competence scales, behavior problem scales, internalizing, and externalizing were derived from nonclinical samples. Comparison of clinical and nonclinical samples showed differences (p < .001) on all social competence and behavior problem scores. One-week test-retest correlations averaged .87, and interparent correlations averaged .67. Comparison with findings for boys aged 6-11 years are reported. Computerized and hand-scored versions of the profile can be used to display item and scale scores for individual children.
Mental health data were gathered at ages 11, 13, 15, 18, and 21 in an epidemiological sample using standardized diagnostic assessments. Prevalence of Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised; American Psychiatric Association, 1987) mental disorders increased longitudinally from late childhood (18%) through mid-(22%) to late-adolescence (41%) and young adulthood (40%). Nearly half of age-21 cases had comorbid diagnoses; and comorbidity was associated with severity of impairment. The incidence of cases with adult onset was only 10.6%: 73.8% of adults diagnosed at age 21 had a developmental history of mental disorder. Relative to new cases, those with developmental histories were more severely impaired and more likely to have comorbid diagnoses. The high prevalence rate and significant impairment associated with a diagnosis of mental disorder suggests that treatment resources need to target the young adult sector of the population. The low new-case incidence in young adulthood, however, suggests that primary prevention and etiological research efforts need to target children and adolescents.
Risk and promotive effects were investigated as predictors of persistent serious delinquency in male participants of the Pittsburgh Youth Study (R. Loeber, D. P. Farrington, M. Stouthamer-Loeber, & W. B. van Kammen, 1998), living in different neighborhoods. Participants were studied over ages 13-19 years for the oldest sample and 7-13 years for the youngest sample. Risk and promotive effects were studied in 6 domains: child behavior, child attitudes, school and leisure activities, peer behaviors, family functioning, and demographics. Regression models improved when promotive effects were included with risk effects in predicting persistent serious delinquency. Disadvantaged neighborhoods, compared with better neighborhoods, had a higher prevalence of risk effects and a lower prevalence of promotive effects. However, predictive relations between risk and promotive effects and persistent serious delinquency were linear and similar across neighborhood socioeconomic status.
Interventions in health psychology and behavioral medicine represent an integral area of research for the development of psychological therapies to enhance health behaviors, manage symptoms and sequelae of disease, treat psychological symptoms and disorders, prolong survival in the face of a life-threatening illness, and improve quality of life. A sampling of interventions in health psychology and behavioral medicine is offered that meet the criteria for empirically supported treatments for smoking cessation, chronic pain, cancer, and bulimia nervosa. Evidence for empirically supported treatments is identified, along with promising interventions that do not yet meet the criteria as outlined by D. L. Chambless and S. D. Hollon (1998). Evidence for the effectiveness and clinical significance of these interventions is reviewed, and issues in this area of research are outlined.
Proponents of the sociocultural model of eating disorders have suggested that ethnic differences in body dissatisfaction may be diminishing as the thin ideal of beauty becomes more widely disseminated among minority women. In a meta-analysis, the authors examined temporal trends in Black-White differences and also examined whether these differences generalize across various age groups and measures. Results confirmed more favorable body image evaluations among Black than White females, with the greatest differences at the age period of the early 20s. Although results confirmed that ethnic differences have diminished, this trend was limited to weight-focused measures. On more global body image measures, ethnic differences actually increased. These results suggest that the relationship between Black-White ethnicity and body image is more complex than previously suggested.
"Real-life" interpersonal and emotional problem solving was measured in 40 narcotics abusers in ambulatory treatment, 20 in "good" standing and 20 in "poor" standing. A modified means–ends problem-solving procedure was used that required narrative responses containing relevant means (RMs) for solving 7 problems. Good Ss had more total RMs, used more introspective and emotional RMs, were better at RM recognition, but did not have more sufficient narratives than the poor Ss. Results are consistent with those of previous studies of problem-solving thinking. (3 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving, emotional expression, and emotional regulation), Secondary Control Engagement Coping (positive thinking, cognitive restructuring, acceptance, and distraction), and Disengagement Coping (denial, avoidance, and wishful thinking). Structural equation modeling using latent variables revealed that secondary control engagement coping predicted lower levels of anxiety/depression symptoms and somatic complaints, and disengagement coping was related to higher levels of anxiety/depression and somatic complaints. Implications for understanding child and adolescent coping with pain are highlighted.
In this study, 126 clients (87 men, 39 women) entering outpatient alcoholism treatment were assigned randomly to 1 of 3 preparatory conditions: a role induction (RI) session, a motivational interview (MI) session, or a no-preparatory session control group (CG). Clients assigned to the MI preparatory condition attended more treatment sessions and had fewer heavy drinking days during and 12 months after treatment relative to CG clients. Clients assigned to MI, relative to CG clients, also had more abstinent days during treatment and during the first 3 months posttreatment, although this difference was not maintained through the remainder of the 12-month follow-up period. Clients assigned to the RI condition showed no significant advantage over those in the CG condition.
This randomized trial is a first evaluation of a brief psychotherapeutic intervention for primary care patients. Sixty-two participants were randomly assigned to the intervention or to treatment as usual. As compared with treatment as usual, the intervention led to significant reductions in symptoms of anxiety and depression. The reduction was maintained for 3 months after the end of treatment, but some return of symptoms occurred by 6 months after treatment. The treatment was well accepted by patients. This study provides good preliminary evidence for the effectiveness of this intervention.
This commentary on the special section on clinical adolescent psychology (G. Holmbeck & P. Kendall. 2002) reviews and critiques the conceptual and empirical articles that this compilation comprises. As articulated in the conceptual contributions to this collection, two fundamental principles should guide research on the etiology, prevention, and treatment of psychological disorder and dysfunction during adolescence: First, drawing on the fiel of developmental psychopathology, the study of clinical adolescent psychology should focus on the trajectories of disorder that precede, characterize, and follow adolescence. Second, drawing on the literature on normative adolescent development, the study of clinical adolescent psychology must proceed with an explicit recognition of the unique biological, cognitive, psychosocial, and contextual features that define adolescence as a developmental period. The empirical contributions to this compilation are evaluated with respect to the extent to which they reflect these tenets. Although the study of clinical adolescent psychology, as evidenced by this collection of articles, is appropriately grounded in the broader enterprise of developmental psychopathology, less progress has been made with respect to the integration of the study of clinical phenomena in adolescence with the study of normative adolescent development.
This article reviews the empirical literature on psychosocial, psychopharmacological, and adjunctive treatments for children between the ages of 6 and 12 with internalizing disorders. The aim of this review was to identify interventions that have potential to prevent substance use disorders in adolescence by treating internalizing disorders in childhood. Results suggest that a variety of behavioral, cognitive-behavioral, and pharmacological interventions are effective in reducing symptoms of childhood depression, phobias, and anxiety disorders. None of the studies reviewed included substance abuse outcomes. Thus, little can be said about the relationship between early treatment and the prevention of later substance use. The importance of evaluating the generalizability of research-supported interventions to community settings is highlighted and recommendations for future research are offered.
To advance the theoretical modeling of the development of alcohol expectancies as a parallel processing memory network, this study assessed expectancies and alcohol consumption of 2,324 children in Grades 3, 6, 9, and 12 from a large suburban-rural school district. Individual-differences scaling (INDSCAL), a variant of multidimensional scaling, mapped expectancies into a hypothetical memory network format, and preference mapping (PREFMAP) modeled hypothetical paths of association within this network. Throughout this age range, older and higher drinking youth appeared to associate positive and arousing effects with alcohol cues, in contrast to lower drinking children, who appeared to mainly associate undesirable effects. These drinking-related differences in the organization of expectancy information are discernible well before onset of regular drinking habits and may influence the development of drinking in adolescence.
This randomized controlled trial examines the relative efficacy of a disorder-specific treatment program (TrennungsAngstprogramm Für Familien [TAFF]; English: Separation Anxiety Family Therapy) for children suffering from separation anxiety disorder (SAD) in comparison with a general anxiety program.
Sixty-four children aged 8-13 with SAD and their parents were assigned either to a 16-session disorder-specific SAD treatment program, including parent training and classical cognitive-behavioral therapy (CBT) components (TAFF), or to a general child-focused 16-week comparison group (Coping Cat [CC]) without any parent training. Diagnoses and parent cognitions were assessed at baseline and at follow-ups. Global success ratings were collected at end of treatment and at follow-up. Ratings for anxiety, impairment/distress, and life quality were collected at Baseline 1, again after a 4-week waiting period, repeatedly throughout treatment, at 4 weeks, and at 1-year follow-up.
The response rate (no SAD diagnosis) at 4-week follow-up among the 52 treatment completers was 87.5% vs. 82.1% (TAFF vs. CC; intent-to-treat: 67.7% vs. 69.7%). At 1-year follow-up, the response was 83.3% versus 75% (TAFF vs. CC; intent to treat: 64.5% vs. 63.6%). Differences were nonsignificant. Results from rating scales indicated improvement for both groups across time points and assessment areas, with few between-group differences, and some small effects favoring the TAFF program. Both treatment programs yielded a reduction in parental dysfunctional beliefs.
Results indicate a slight advantage of the TAFF program over a general child-based treatment for SAD. However, these differences were less strong than hypothesized, indicating that the inclusion of parent training does not add large effects to classical child-based CBT in school-age children with SAD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
The present study examined the differential validity of teacher ratings of Inattention/Overactivity and Aggression among a sample of 48 clinic-referred boys. These ratings were correlated with observations undertaken in three different classroom settings: large group work; small group work; and independent seat work. Results indicated that the teachers were able to differentiate significantly between these externalizing behaviors in the classroom settings. The results of previous studies suggesting common correlates of both hyperactivity and conduct problems factors might have been limited by both sample characteristics and the rating scale factors employed.
Risk factors affecting the course of posttraumatic stress disorder (PTSD) are poorly understood. As part of a larger study on characterizing exposure to herbicides in Vietnam, the authors investigated this issue in a random sample of 1,377 American Legionnaires who had served in Southeast Asia during the Vietnam War and were followed over a 14-year period. High combat exposure, perceived negative community attitudes at homecoming, minority race, depression symptoms at Time 1, and more anger at Time 1 predicted a more chronic course. Community involvement at Time 1 was protective and associated with decreased risk at Time 2. Discomfort in disclosing Vietnam experiences was associated with an increased risk for developing PTSD but did not predict its course. Combat exposure predicted PTSD course more strongly than any other risk factor. Findings suggest recovery from PTSD is significantly influenced by perceived social support.
We tested parent-reported family variables, problems, competencies, and stress as predictors of (a) academic problems, (b) school behavior problems, (c) receipt of mental health services, (d) child's need for additional help, (e) suicidal behavior, (f) police contacts, and (g) the sum of these 6 outcomes. Included in the study were 995 cases manifesting at least 1 sign of disturbance (from Outcomes a-f) and 995 matched controls from a national sample of 2,479 children assessed twice over a 3-year interval. Path analyses identified predictors that were significant across age and sex plus those specific to particular groups. The predictive models accounted for medium to large effects in Time 2 signs of disturbance. Time 2 Child Behavior Checklist scores were significantly associated with all Time 2 disturbance scores. The multiple significant risk factors associated with signs of disturbance indicated variations in pathways leading to particular signs of disturbance.
Administered the MMPI and the 16 PF to 21 homosexual and 72 heterosexual prison inmates. J. Panton's Hsx scale and the 16 PF I (tough- vs. tender-minded) scale did not differentiate between the sexual groups. The Mf scale, M. Manosevitz's abridged forms of the Mf scale, and the 16 PF C scale (affected by feelings vs. emotionally stable) did differentiate the groups. Misclassification rates were 35 and 39% for the Manosevitz scales, 39% for the Mf scale, and 40% for the 16 PF C scale. Age significantly correlated with the Hsx scale (p < .01). Suggestions that age and education affect the Mf scale were not supported. It is proposed that the Mf scale be subjected to further cross-validation and refinement.
ADMINISTERED THE 16 PF, THE MPI, AND THE MMPI TO 267 AIRMEN. A FACTOR ANALYSIS WAS CARRIED OUT ON THE 16 PF SCALES, AND ESTIMATED CORRELATIONS OF MPI AND MMPI SCALES WITH THE 16 PF FACTORS WERE OBTAINED. IT IS CONCLUDED THAT THE 16 PF EXTRAVERSION FACTOR AND THE MPI EXTRAVERSION SCALE WERE IDENTICAL FOR MOST PURPOSES, BUT THAT THE 16 PF ANXIETY FACTOR AND THE MPI NEUROTICISM SCALE SHOWED CONSIDERABLE DIFFERENCES. FINDINGS CONCERNING THE MMPI CLINICAL SCALES, THE 16 PF FACTORS, AND THE MPI SCALES ARE DISCUSSED. (17 REF.)
The WAIS-R was factor analyzed across the 9 age groups in the standardization sample (1,880 Ss). When 3- and 4-factor analyses were performed, the familiar 3-factor structure (Verbal Comprehension, Perceptual Organization, and Freedom From Distractibility) was clearly visible. Findings indicate that the individual subtests seem to play equivalent roles in the WAIS and WAIS-R, with the possible exception of Picture Arrangement, which no longer loads highly on factors other than General Intelligence. (8 ref)
A set of mutually exclusive, exhaustive parcels of MMPI items and the 16 personality factor scales from the Cattell 16 PF were factored together on 217 normal and 40 abnormal adult Air Force men. The analysis of the resulting 64 variables (45 MMPI parcels and 19 16 PF scales) yielded 21 factors, of which 13 are clearly identifiable as factors in the 16 PF and 4 are clearly MMPI factors. MMPI data were scored also for the traditional 14 clinical scales, and their predictability from 16 PF source trials examined in terms of the squared multiple correlations. The 7-factor space typically represented by the MMPI clinical scales was found to lie within the dimensionality of the Cattell 16 PF. The total prediction of the set of MMPI clinical scales from a single form (A) of the 16 PF, uncorrected for attenuation, is represented by the canonical correlation of .8. (47 ref.)
A 16 yr old male, who presented an 11 yr history of severe temper outbursts, was apparently successfully treated by a self control treatment program. The treatment procedure is described in detail. The case is noteworthy because it demonstrates that self control training is a useful treatment approach when environmental control is very limited. The case also illustrates the relevance of Bandura's reciprocal model of behavior as a rationale for the conduct of self control training.
Presents a replication and extension of J. Harris and J. Baxter..s (see record 1965-10119-001) study of MMPI ambiguity. Ss were asked to answer and then immediately rate the ambiguity in meaning of each item on the MMPI and/or 16 PF. Overall ambiguity value was significantly higher for the 16 PF. Ss who rated a higher proportion of items as ambiguous had higher guilt and tension and lower outgoing scores on the 16 PF. Results generally support Harris and Baxter..s findings. (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Describes the 166-item Faschingbauer Abbreviated Minnesota Multiphasic Personality Inventory (FAM) which was developed using cluster analysis and compared to the MMPI and other short forms. Median reliabilities of .88 for 146 Ss (1 day apart) and .77 for 50 Ss (1 wk apart) as well as median validities of .91 for 399 Ss (in context) and .76 for 119 Ss (1 day apart) were found. All Ss were either normal undergraduates or psychiatric inpatients. On code-type correspondence, configural classifications, profile validities, and scale elevations, the FAM compared favorably to a retest MMPI. Differences in context, obvious, and true items were minimal. The FAM retains the usual 13 scales and 47% of the critical items and showed itself superior to the other short forms in most respects. (37 ref)
In a controlled clinical trial, 57 Ss meeting DSM-III-R criteria for generalized anxiety disorder, and fulfilling an additional severity criterion, were randomly allocated to cognitive behavior therapy (CBT), behavior therapy (BT), or a waiting-list control group. Individual treatment lasted 4-12 sessions; independent assessments were made before treatment, after treatment, and 6 months later, and additional follow-up data were collected after an interval of approximately 18 months. Results show a clear advantage for CBT over BT. A consistent pattern of change favoring CBT was evident in measures of anxiety, depression, and cognition. Ss were lost from the BT group, but there was no attrition from the CBT group. Treatment integrity was double-checked in England and in Holland, and special efforts were made to reduce error variance. Possible explanations for the superiority of CBT are discussed.
Some critical comments are offered with regard to the use of the designation psychotherapy dropout in the article by Weisz, Weiss, and Langmeyer (1987). It is proposed that individuals who do not begin a course of psychotherapy should not be viewed as dropouts. Reference is also made to problems of generalization.
Separate analyses of five-, six- and seven-factor solutions for the first 168 Minnesota Multiphasic Personality Inventory item responses from a large unselected sample of public mental health patients revealed close correspondence with the six factors derived by Overall, Hunter, and Butcher. The seven-factor solution, however, did provide some help in clarifying the psychological significance and differentiation of the factors involved.
Administered the 1st 168 items of the MMPI to 505 psychiatric patients. Factor analysis of the resulting data identified factors of Somatization, Depression, Psychotic Distortion, Low Morale, and Acting Out, plus a separate Masculinity-Femininity factor. Results compare favorably with those from the technically best of the item-level analyses of the complete MMPI that have been reported by others. Factor scoring keys that can be used with an abbreviated short-form administration are presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
An 11-yr-old female Gilles de la Tourette patient was taught to gradually substitute nonobscene phrases whenever she felt the urge to vocalize an obscenity. The rate of coprolalia quickly diminished and nearly disappeared. S was taught relaxation and positive imagery as self-control techniques. Self-monitoring and positive reinforcement for control of her tics were effective only for short periods. Follow-up at 4 and 18 mo indicated maintenance of therapeutic gains. (9 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Patients were randomly assigned to 1 of 3 treatments: brief broad-spectrum (BBS), extended relationship enhancement (ERE), or extended cognitive-behavioral (ECB). A hierarchical latent growth model was used to analyze the data of 188 patients (82%) followed for 18 months. ERE treatment was significantly more effective in increasing abstinence of patients entering treatment with a network unsupportive of abstinence or with a low level of investment in their network, whereas BBS treatment was more effective for patients with either (a) both a social network unsupportive of abstinence and a low level of network investment or (b) high investment in a network supportive of abstinence. ECB outcomes were neither as good as those matched nor as bad as those mismatched to the different exposures of relationship enhancement. This suggests that dose of relationship enhancement should be determined after assessing patient relationships.
In a long-term follow-up of a randomized controlled trial (Compas et al., 2009) to examine the effects at 18- and 24-month follow-ups of a family group cognitive-behavioral (FGCB) preventive intervention for mental health outcomes for children and parents from families (N = 111) of parents with a history of major depressive disorder (MDD).
Parents with a history of MDD and their 9- to 15-year-old children were randomly assigned to a FGCB intervention or a written information comparison condition. Children's internalizing, externalizing, anxiety/depression, and depressive symptoms; episodes of MDD and other psychiatric diagnoses; and parents' depressive symptoms and episodes of MDD were assessed at 18 and 24 months after randomization.
Children in the FGCB condition were significantly lower in self-reports of anxiety/depression and internalizing symptoms at 18 months and were significantly lower in self-reports of externalizing symptoms at 18 and 24 months. Rates of MDD were significantly lower for children in the FGCB intervention over the 24-month follow-up (odds ratio = 2.91). Marginal effects were found for parents' symptoms of depression at 18 and 24 months but not for episodes of MDD.
Support was found for a FGCB preventive intervention for children of parents with a history of MDD significantly reducing children's episodes of MDD over a period of 2 years. Significant effects for the FGCB intervention were also found on internalizing and externalizing symptoms, with stronger effects at 18- than at 24-month follow-up.
Following a suicide attempt by female adolescents, the impact of a specialized emergency room (ER) care intervention was evaluated over the subsequent 18 months. Using a quasi-experimental design, this study assigned 140 female adolescent suicide attempters (SA), ages 12-18 years, and their mothers (88% Hispanic) to receive during their ER visit either: (a) specialized ER care aimed at enhancing adherence to outpatient therapy by providing a soap opera video regarding suicidality, a family therapy session, and staff training; or (b) standard ER care. The adjustment of the SA and their mothers was evaluated over 18 months (follow-up, 92%) using linear mixed model regression analyses. SA's adjustment improved over time on most mental health indices. Rates of suicide reattempts (12.4%) and suicidal reideation (29.8%) were lower than anticipated and similar across ER conditions. The specialized ER care condition was associated with significantly lower depression scores by the SA and lower maternal ratings on family cohesion. Significant interactions of intervention condition with the SA's initial level of psychiatric symptomatology indicated that the intervention's impact was greatest on maternal emotional distress and family cohesion among SA who were highly symptomatic. SA's attendance at therapy sessions following the ER visit was significantly associated with only one outcome--family adaptability. Specialized ER interventions may have substantial and sustained impact over time, particularly for the parents of youth with high psychiatric symptomatology.
Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after treatment. Across the 3 treatments, drinkers who provided follow-up data maintained abstinence on almost 80% of days during follow-up, with no differences in drinking or marital happiness outcomes between groups. AA/ABCT participants attended AA meetings more often than ABCT or RP/ABCT participants, and their drinking outcomes were more strongly related to concurrent AA attendance. For the entire sample, AA attendance was positively related to abstinence during follow-up in both concurrent and time-lagged analyses. In the RP/ABCT treatment, attendance at posttreatment booster sessions was related to posttreatment abstinence. Across treatment conditions, marital happiness was related positively to abstinence in concurrent but not time-lagged analyses.
In this study, the authors examined perceived benefits and costs of the outbreak of severe acute respiratory syndrome (SARS). Mixed accounts of benefits and costs, rather than exclusive accounts of only benefits or costs, were proposed to be characterized by nondefensiveness and enduring changes in psychosocial resources. Participants were 70 SARS recoverers, 59 family members of SARS recoverers, and 172 healthy adults residing in Hong Kong--a SARS-affected region. Results show that participants giving an exclusive account of benefits had higher levels of defensiveness than those giving a mixed account and those giving an exclusive account of costs. Only the perceived impact of benefits given in mixed accounts were related to future accruements in personal and social resources over an 18-month period.
Administered a structured questionnaire to a cross-sectional sample of 1,034 mothers and a welfare sample of 1,000 mothers of 6-18 yr olds in New York City. One or more psychiatrists rated each of the children on a 5-point scale of total psychiatric impairment. Factor analysis of the questionnaire items of child behavior yielded 18 factors. The 7 factors with the highest correlations with total psychiatric impairment were selected for the inventory, each represented by 5 items. The correlation of the total 35-item score and total psychiatric impairment was .82. The screening inventory significantly and substantially improved over chance in assigning children to impairment statuses in the cross-sectional sample and the sample used for cross-validation, the welfare sample. Correlations of the total score with child's treatment status and a direct clinical examination rating were expectedly low. In its present form, the instrument is recommended only for comparisons of different child and adolescent groups. (25 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study examined 2 process variables, emotional engagement and habituation, and outcome of exposure therapy for posttraumatic stress disorder. Thirty-seven female assault victims received treatment that involved repeated imaginal reliving of their trauma, and rated their distress at 10-min intervals. The average distress levels during each of 6 exposure sessions were submitted to a cluster analysis. Three distinct groups of clients with different patterns of distress were found: high initial engagement and gradual habituation between sessions, high initial engagement without habituation, and moderate initial engagement without habituation. Clients with the 1st distress pattern improved more in treatment than the other clients. The results are discussed within the framework of emotional processing theory, emphasizing the crucial role of emotional engagement and habituation in exposure therapy.
This study evaluated follow-up outcomes associated with cognitive behavioral therapy (CBT) for childhood anxiety by comparing successfully and unsuccessfully treated participants 6.72 to 19.17 years after treatment.
Participants were a sample of 66 youths (ages 7-14 years at time of treatment, ages 18-32 years at present follow-up) who had been diagnosed with an anxiety disorder and randomized to treatment in a randomized clinical trial on average 16.24 (SD = 3.56, range = 6.72-19.17) years prior. The present follow-up included self-report measures and a diagnostic interview to assess anxiety, depression, and substance misuse.
Compared with those who responded successfully to CBT for an anxiety disorder in childhood, those who were less responsive had higher rates of panic disorder, alcohol dependence, and drug abuse in adulthood. Relative to a normative comparison group, those who were less responsive to CBT in childhood had higher rates of several anxiety disorders and substance misuse problems in adulthood. Participants remained at particularly increased risk, relative to the normative group, for generalized anxiety disorder and nicotine dependence regardless of initial treatment outcome.
The present study is the first to assess the long-term follow-up effects of CBT treatment for an anxiety disorder in youth on anxiety, depression, and substance abuse through the period of young adulthood when these disorders are often seen. Results support the presence of important long-term benefits of successful early CBT for anxiety.
THE RAVEN STANDARD PROGRESSIVE MATRICES WAS ADMINISTERED TO 356 5TH AND 6TH GRADE SS TO DETERMINE THE EFFECTS OF PAST EXPERIENCES RELATED TO RACE, SOCIAL CLASS, AND SEX. ALL SOCIAL CLASS DIFFERENCES WERE SIGNIFICANT, WHILE A RACIAL DIFFERENCE WAS FOUND ONLY IN THE LOWER CLASS. NO SEX DIFFERENCES WERE SIGNIFICANT. RELATIONSHIPS BETWEEN THE MATRICES AND OTHER MEASURES (BOTH STANDARD TESTS AND FAMILY EXPERIENCES) VARIED AMONG THE DIFFERENT RACE, CLASS, AND SEX GROUPS. FUTURE RESEARCH MUST CONSIDER RACE, CLASS, AND SEX IN ITS INVESTIGATION OF THE USEFULNESS OF THE MATRICES, AND, MORE GENERALLY, EXPERIMENTIAL INFLUENCES ON INTELLIGENCE AND SCHOOL ACHIEVEMENT. (19 REF.)