Showing papers in "Journal of Consulting and Clinical Psychology in 1987"

Behavioral treatment and normal educational and intellectual functioning in young autistic children.

Abstract: Autism is a serious psychological disorder with onset in early childhood. Autistic children show minimal emotional attachment, absent or abnormal speech, retarded IQ, ritualistic behaviors, aggression, and self-injury. The prognosis is very poor, and medical therapies have not proven effective. This article reports the results of behavior modification treatment for two groups of similarly constituted, young autistic children. Follow-up data from an intensive, long-term experimental treatment group (n = 19) showed that 47% achieved normal intellectual and educational functioning, with normal-range IQ scores and successful first grade performance in public schools. Another 40% were mildly retarded and assigned to special classes for the language delayed, and only 10% were profoundly retarded and assigned to classes for the autistic/retarded. In contrast, only 2% of the controlgroup children (n = 40) achieved normal educational and intellectual functioning; 45% were mildly retarded and placed in language-delayed classes, and 53% were severely retarded and placed in autistic/retarded classes. Kanner (1943) defined autistic children as children who exhibit (a) serious failure to develop relationships with other people before 30 months of age, (b) problems in development of normal language, (c) ritualistic and obsessional behaviors ("insistence on sameness"), and (d) potential for normal intelligence. A more complete behavioral definition has been provided elsewhere (Lovaas, Koegel, Simmons, & Long, 1973). The etiology of autism is not known, and the outcome is very poor. In a follow-up study on young autistic children, Rutter (1970) reported that only 1.5% of his group (n = 63) had achieved normat functioning. About 35% showed fair or good adjustment, usually required some degree of supervision, experienced some diffaculties with people, had no personal friends, and showed minor oddities of behavior. The majority (more than 60%) remained severely handicapped and were living in hospitals for mentally retarded or psychotic individuals or in other protective settings. Initial IQ scores appeared stable over time. Other studies (Brown, 1969; DeMyer et al., 1973; Eisenberg, 1956; Free

The Scope of Rape: Incidence and Prevalence of Sexual Aggression and Victimization in a National Sample of Higher Education Students.

Abstract: Because of inadequacies in the methods used to measure sexual assault, national crime statistics, criminal victimization studies, convictions, or incarceration rates fail to reflect the true scope of rape Studies that have avoided the limitations of these methods have revealed very high rates of overt rape and lesser degrees of sexual aggression The goal of the present study was to extend previous work to a national basis The Sexual Experiences Survey was administered to a national sample of 6,159 women and men enrolled in 32 institutions representative of the diversity of higher education settings across the United States Women's reports of experiencing and men's reports of perpetrating rape, attempted rape, sexual coercion, and sexual contact were obtained, including both the rates of prevalence since age 14 and of incidence during the previous year The findings support published assertions of high rates of rape and other forms of sexual aggression among large normal populations Although the results are limited in generalizabil ity to postsecondary students, this group represents 26% of all persons aged 18-24 in the United States The Federal Bureau of Investigation (FBI) defines rape as "carnal knowledge of a female forcibly and against her consent" and reports that 87,340 such offenses occurred in 1985 (FBI, 1986) However, these figures greatly underestimate the true scope of rape because they are based only on instances reported to police Government estimates suggest that for every rape reported, 3-10 rapes are committed but not reported (Law Enforcement Assistance Administration [LEAA], 1975) Likewise, it is difficult to obtain realistic estimates of the number of men who perpetrate rape because only a fraction of reported rapes eventually result in conviction (Clark & Lewis, 1977) Victimization studies, such as the annual National Crime Survey (NCS), are the major avenue through which the full extent of the crime is estimated (eg, Bureau of Justice Statistics [BJS], 1984) In these studies, the residents of a standard sampling area are asked to indicate those crimes of which they or anyone else in their household have been victims during the previous 6 months These rates are then compared with official crime statistics for the area and the rate of unreported crime is esti

Effectiveness of psychotherapy with children and adolescents: a meta-analysis for clinicians

Abstract: How effective is psychotherapy with children and adolescents? The question was addressed by metaanalysis of 108 well-designed outcome studies with 4-18-year-old participants. Across various outcome measures, the average treated youngster was better adjusted after treatment than 79% of those not treated. Therapy proved rnore effective for children than for adolescents, particularly when the therapists were paraprofessionals (e.g., parents, teachers) or graduate students. Professionals (with doctor's or master's degrees) were especially effective in treating overcontrolled problems (e.g., phobias, shyness) but were not more effective than other therapists in treating undercontrolled problems (e.g., aggression, impulsivity). Behavioral treatments proved more effective than nonbehavioral treatments regardless of client age, therapist experience, or treated problem. Overall, the findings revealed significant, durable effects of treatment that differed somewhat with client age and treatment method but were reliably greater than zero for most groups, most problems, and most methods.

Living with a depressed person.

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Causal attribution, perceived benefits, and morbidity after a heart attack: An 8-year study.

Abstract: Etude d'un echantillon de victimes d'une crise cardiaque (N=287) sur une periode de huit ans: mise en evidence des relations entre l'attribution de la causalite, les benefices percus, et la morbidite post-crise

Assessment of major and daily stressful events during adolescence: The Adolescent Perceived Events Scale.

Abstract: Four studies were conducted to develop a measure of major and daily stressful events during adolescence, the Adolescent Perceived Events Scale (APES) Study I identified an item pool of events that were drawn from the open-ended reports of adolescents In Study 2, multidimensional scaling analysis was used to identify the salient features of stressful events that were cognitively appraised by adolescents Study 3 examined the test-retest reliability of the APES, and Study 4 examined the concurrent validity of the measure among older adolescents Subsequent research is summarized that has shown the APES to be significantly related to behavior problems and psychological symptomatology in a wide age range of adolescents, and directions for future research are outlined The stressful life events encountered by individuals consti

Diagnosis and treatment of normal eating.

Abstract: The shift in societal preference toward a thin physique has led to an increasing prevalence of dieting such that "normal" eating for North American women is now characterized by dieting. In this article, we explore similarities between such normal dieters and individuals with an eating disorder and question whether a continuity exists between normal and abnormal eating behavior. The regulation of intake among normal dieter and patient populations is compared and is explained by the boundary model of consumption, which leads to the conclusion that in neither group is eating technically disordered, although it does depart from appropriate physiological norms. We conclude that many normal eaters (i.e., dieters or restrained eaters) display characteristics of eating-disorder pathologies and should be treated accordingly. Such treatment involves changing both the patient and the environment, especially societal attitudes toward body weight and shape. The current societal preference for a thin physique has spawned a corresponding societal preoccupation with dieting and weight loss. The extent of this preoccupation is such that it may now be accurate to regard dieting and its attendant diet mentality as normative, both descriptively and prescriptively. In short, it is now "normal" for individuals in our society to express concern about their weight and to engage in fitful attempts to change it. A normal lifestyle now requires periodic exercise; normal eating now requires periodic dieting. Why is a thin physique prized, especially among women? Answers to this question typically refer to historical variation in the sort of physique that is most highly valued. In former times, endomorphy was preferred, as is evidenced by the inevitably referenced Rubenesque nude. Nowadays, women are induced to strive toward a condition of ruddy-cheeked emaciation. Describing this historical shift does not account for it, of course, and the explanations usually tendered are both easy to produce and difficult to prove. Their validity aside, these explanations tend to fall into three classes: The first class focuses on the aesthetics of physique, with thin women seen as more beautiful and, consequently, of greater sexual allure; the second class emphasizes the implicit personality correlates of various physiques, with thinness connoting power, health, and other contemporary values; and the third class infers behaviors from the physique itself, with thinness reflecting the sort of self-control that is presumably required to achieve and maintain slender

Psychopathology in the offspring of anxiety disorders patients

Abstract: Recherche des caracteristiques des enfants dont les parents souffrent d'anxiete pathologique: par rapport aux groupes-controle, ils sont plus anxieux et craintifs, ont plus de difficultes scolaires, expriment davantage de soucis personnels ou familiaux et de plaintes somatiques et enfin, ils sont plus souvent occupes a des activites solitaires

Familial contributions to the etiology and course of anorexia nervosa and bulimia.

Abstract: In this article, we summarize the current knowledge of familial influences in anorexia nervosa and bulimia. Three lines of evidence are reviewed: descriptions of family interaction, familial correlates of the course and phenomenology of symptoms, and studies of familial transmission. We conclude that although certain familial patterns are associated with eating disorders, there is no single mechanism or pathway of influence. Rather, it seems likely that certain personality factors, which may be genetically determined, predispose the individual to greater sensitivity and vulnerability to powerful familial and social experiences that impinge adversely on self-esteem and self-efficacy. Although the role played by familial factors in the etiology of eating disorders currently excites a great deal of theoretical interest, empirical data are fragmentary, and most ideas about the nature and extent of this role are highly speculative (Kog & Vandereycken, 1985; Yager & Strober, 1985). In this article, we review evidence on the familial factors that have been linked to the development and course of anorexia nervosa and bulimia. We do not imply that these factors are the most influential determinants of vulnerability to the eating disorders; rather, we believe that a detailed account of the potential advances and the methodological problems that hamper ongoing efforts in this area is timely.

Marital discord and treatment outcome in behavioral treatment of child conduct disorders.

Abstract: Research assessing the role of marital variables in the treatment of childhood conduct disorders is scarce. The aim of this study was (a) to assess the role of marital discord in the overall outcome of a program training parents in behavioral techniques (behavioral parent training) and (b) to assess the effects of an adjunctive treatment (partner support training [PST]) on outcome. The latter treatment focused on marital conflict, communication, and problem solving. Twenty-four families with a child diagnosed as oppositional or conduct disordered were assigned to either a marital-discord group (n = 12) or a no-marital-discord group (n = 12). Families within each group were then randomly assigned to either child management training (CMT) alone or CMT with PST. Measures of child deviance, parenting behavior, and marital satisfaction were collected at pre- and posttraining and at a 6-month follow-up. Results indicated a significant interaction between marital discord and treatment type on most measures at follow-up but not at posttraining. Although PST added little to the maintenance of change for the nondiscordant group, it produced significant gains over those who received CMT only for the discordant group. Further results highlighting the interaction of marital and treatment variables are discussed.

Running versus weight lifting in the treatment of depression.

Abstract: We compared the effectiveness of an aerobic and nonaerobic exercise in the treatment of clinical depression in women. A total of 40 women, screened on the Research Diagnostic Criteria for major or minor depressive disorder, were randomly assigned to an 8-week running (aerobic), weight-lifting (nonaerobic), or wait-list control condition. Subjects were reassessed at mid- and posttreatment, and at 1-, 7-, and 12-month follow-ups. Depression was monitored by the Beck Depression Inventory, Lubin's Depression Adjective Check List, and the Hamilton Rating Scale for Depression; fitness level was assessed using submaximal treadmill testing. Results were remarkably consistent across measures, with both exercise conditions significantly reducing depression compared with the waitlist control condition, and generally appearing indistinguishable from each other. No significant between-group fitness changes were noted. These findings indicate that both types of exercise conditions significantly reduce depression and that these results are not dependent on achieving an aerobic effect.

Comparison of multisystemic therapy and parent training in the brief treatment of child abuse and neglect.

Abstract: This study evaluated the relative efficacy of two promising treatments of child abuse and child ne-glect: parent training and multisystemic therapy. Subjects included 18 abusive families and 15 ne-glectful families who were randomly assigned to the treatment conditions. Self-report and observa-tional measures were used to evaluate the effects of treatment at three levels that have been associatedwith child maltreatment: individual functioning, family relations, and stress/social support. Statisti-cal analyses revealed that families who received either treatment showed decreased parental psychiat-ric symptomology, reduced overall stress, and a reduction in the severity of identified problems.Analyses of sequential observational measures revealed that multisystemic therapy was more effec-tive than parent training at restructuring parent-child relations. Parent training was more effectivethan multisystemic therapy at reducing identified social problems. The differentia] inOuences of thetwo treatments were probably associated with differences in their respective treatment contexts andepistemologies.

Cultural factors in the clinical assessment of Asian Americans.

Abstract: In view of the growing interest in the influence of cultural factors in psychological assessment, this article critically evaluates assessment issues with Asian American populations. Examined are issues in (a) the extent and symptoms of psychopathology, (b) personality assessment, and (c) face-to-face clinical assessment. It is argued that, without understanding cultural factors, researchers and practitioners may draw inappropriate and invalid conclusions. Cultural factors are important not only in providing a context for interpreting assessment outcomes but also in suggesting appropriate conceptual and methodological strategies. Suggestions are made for improving assessment strategies and for testing the limitations and generality of constructs.

Social competence and parental support as mediators of the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus.

Abstract: This study investigated whether the link between stress and metabolic control in adolescents with insulin-dependent diabetes mellitus (IDDM) is direct or indirect and whether this association is mediated by either social competence or parental support. Subjects included 104 adolescents with IDDM and their mothers. Measures of adherence, life stress, social competence, and parental support were obtained during the assessment session, and metabolic control was determined by averaging the adolescent's glycosylated hemoglobin levels during the previous year. Multiple regression analysis revealed that stress was directly associated with metabolic control, independent of the link between adherence and metabolic control. Multiple regression analysis also showed that social competence buffered the negative association between stress and metabolic control. Moreover, parental support was directly linked with adherence, and adolescent age was indirectly linked with adherence through its association with parental support. These findings are consistent with the developmental transitions that accompany adolescence.