Showing papers in "Journal of Consulting and Clinical Psychology in 1993"
TL;DR: In this paper, the authors assessed the prevalence of crime and non-crime civilian traumatic events, lifetime posttraumatic stress disorder (PTSD), and PTSD in the past 6 months in a sample of U.S. adult women.
Abstract: Prevalence of crime and noncrime civilian traumatic events, lifetime posttraumatic stress disorder (PTSD), and PTSD in the past 6 months were assessed in a sample of U.S. adult women (N = 4,008). Random digit-dial telephone methods were used to identify study participants. Structured telephone interviews for assessment of specific crime or other traumatic event history and PTSD were conducted by trained female interviewers. Lifetime exposure to any type of traumatic event was 69%, whereas exposure to crimes that included sexual or aggravated assault or homicide of a close relative or friend occurred among 36%. Overall sample prevalence of PTSD was 12.3% lifetime and 4.6% within the past 6 months. The rate of PTSD was significantly higher among crime versus noncrime victims (25.8% vs. 9.4%). History of incidents that included direct threat to life or receipt of injury was a risk factor for PTSD. Findings are compared with data from other epidemiological studies. Results are discussed as they relate to PTSD etiology.
1,577 citations
TL;DR: In this article, the authors trace the development of the therapeutic working alliance from its psychodynamic origins to current pantheoretical formulations and review the research on the alliance under four headings: the relation between a positive alliance and success in therapy, the path of the alliance over time, the examination of variables that predispose individuals to develop a strong alliance, and the exploration of the in-therapy factors that influence the positive alliance.
Abstract: The article traces the development of the concept of the therapeutic working alliance from its psychodynamic origins to current pantheoretical formulations. Research on the alliance is reviewed under four headings: the relation between a positive alliance and success in therapy, the path of the alliance over time, the examination of variables that predispose individuals to develop a strong alliance, and the exploration of the in-therapy factors that influence the development of a positive alliance. Important areas for further research are also noted.
974 citations
TL;DR: An intervention with immediate checkup with directive-confrontational counseling resulted in a 57% reduction in drinking within 6 weeks, which was maintained at 1 year, and a single therapist behavior was predictive of 1-year outcome such that the more the therapist confronted, themore the client drank.
Abstract: To investigate the impact of counselor style, a 2-session motivational checkup was offered to 42 problem drinkers (18 women and 24 men) who were randomly assigned to 3 groups: (a) immediate checkup with directive-confrontational counseling, (b) immediate checkup with client-centered counseling, or (c) delayed checkup (waiting-list control). Overall, the intervention resulted in a 57% reduction in drinking within 6 weeks, which was maintained at 1 year. Clients receiving immediate checkup showed significant reduction in drinking relative to controls. The 2 counseling styles were discriminable on therapist behaviors coded from audiotapes. The directive-confrontational style yielded significantly more resistance from clients, which in turn predicted poorer outcomes at 1 year. Therapist styles did not differ in overall impact on drinking, but a single therapist behavior was predictive (r = .65) of 1-year outcome such that the more the therapist confronted, the more the client drank.
852 citations
TL;DR: Manipulation checks should be used in psychotherapy trials to confirm that therapists followed the treatment manuals and performed the therapy competently.
Abstract: Manipulation checks should be used in psychotherapy trials to confirm that therapists followed the treatment manuals and performed the therapy competently. This article is a review of some strategies that have been used to document treatment integrity; also, their limitations are discussed here. Recommendations for improving these checks are presented. Specific guidelines are offered regarding when and how to assess both therapist adherence to treatment protocols and competence.
777 citations
TL;DR: Support exists for further development of imagery exposure methods or cognitive therapy because of their likely role in promoting maintenance of change with this disorder, and AR and CBT contain active ingredients in the treatment of GAD.
Abstract: Nondirective (ND), applied relaxation (AR), and cognitive behavioral (CBT) therapies for generalized anxiety disorder (GAD) were compared. The latter 2 conditions were generally equivalent in outcome but superior to ND at postassessment. The 3 conditions did not differ on several process measures, and ND created the greatest depth of emotional processing. Follow-up results indicated losses in gains in ND, maintained gains in the other 2 conditions, especially CBT, and highest endstate functioning for CBT. AR and CBT thus contain active ingredients in the treatment of GAD; support exists for further development of imagery exposure methods or cognitive therapy because of their likely role in promoting maintenance of change with this disorder. Expectancy for improvement was also associated with outcome, suggesting the need for further research on this construct for understanding the nature of GAD and its amelioration.
700 citations
TL;DR: Clinical improvement in subjective well-being potentiates symptomatic improvement, and clinical reduction in symptomatic distress potentiates life-functioning improvement, which predicts that movement into a later phase of treatment depends on whether progress has been made in an earlier phase.
Abstract: A 3-phase model of psychotherapy outcome is proposed that entails progressive improvement of subjectively experienced well-being, reduction in symptomatology, and enhancement of life functioning The model also predicts that movement into a later phase of treatment depends on whether progress has been made in an earlier phase Thus, clinical improvement in subjective well-being potentiates symptomatic improvement, and clinical reduction in symptomatic distress potentiates life-functioning improvement A large sample of psychotherapy patients provided self-reports of subjective well-being, symptomatic distress, and life functioning before beginning individual psychotherapy and after Sessions 2, 4, and 17 when possible Changes in well-being, symptomatic distress, and life functioning means over this period were consistent with the 3-phase model Measures of patient status on these 3 variables were converted into dichotomous improvement-nonimprovement scores between intake and each of Sessions 2, 4, and 17 An analysis of 2 x 2 cross-classification tables generated from these dichotomous measures suggested that improvement in well-being precedes and is a probabilistically necessary condition for reduction in symptomatic distress and that symptomatic improvement precedes and is a probabilistically necessary condition for improvement in life functioning
544 citations
TL;DR: Experimental findings support a causal (mediational) interpretation of expectancy operation, and the implications for a cognitive (memory) model of expectancies and for prevention and intervention programs for problem drinking and alcoholism are discussed.
Abstract: Substantial correlational evidence supports a causal (mediational) interpretation of alcohol expectancy operation, but definitive support requires a true experimental test. Thus, moderately to heavily drinking male college students were randomly assigned to 1 of 3 conditions in a pre-post design: Expectancy challenge (designed to manipulate expectancy levels), "traditional" information, and assessment-only control. Expectancy challenge produced significant drinking decreases, compared with the other 2 groups. Decreases in measured expectancies paralleled drinking decreases in the challenge condition. Significant increases in alcohol knowledge in the traditional program were not associated with decreased drinking. These experimental findings support a causal (mediational) interpretation of expectancy operation. The implications for a cognitive (memory) model of expectancies and for prevention and intervention programs for problem drinking and alcoholism are discussed.
493 citations
TL;DR: At the 5-year follow-up, intervention, as compared with control, couples had higher levels of positive and lower levels of negative communication skills andLower levels of marital violence.
Abstract: This article reports the 4- and 5-year follow-up results of evaluating the effects of a marital distress prevention program. The program, Prevention and Relationship Enhancement Program (PREP), is a 5-session program designed to teach couples effective communication and conflict management skills. At the 5-year follow-up, intervention, as compared with control, couples had higher levels of positive and lower levels of negative communication skills and lower levels of marital violence. Data are also presented on couples who declined the program. Issues are discussed concerning selection effects, change mechanisms, and future directions for prevention research.
470 citations
TL;DR: In this paper, a typology of five groups of couples is proposed on the basis of observational data of Time 1 resolution of conflict, specific affects, and affect sequences, and a balance theory of marriage is proposed, which explores the idea that three distinct adaptations exist for having a stable marriage.
Abstract: Seventy-three couples were studied at 2 time points 4 years apart. A typology of 5 groups of couples is proposed on the basis of observational data of Time 1 resolution of conflict, specific affects, and affect sequences. Over the 4 years, the groups of couples differed significantly in serious considerations of divorce and in the frequency of divorce. There were 3 groups of stable couples: validators, volatiles, and avoiders, who could be distinguished from each other on problem-solving behavior, specific affects, and persuasion attempts. There were 2 groups of unstable couples: hostile and hostile/detached, who could be distinguished from each other on problem-solving behavior and on specific negative and positive affects. A balance theory of marriage is proposed, which explores the idea that 3 distinct adaptations exist for having a stable marriage.
451 citations
TL;DR: Wives and husbands did not differ in demand/withdraw behavior, whereas when discussing wives' issues, wives were more demanding and husbands were more withdrawing, whereas wife-demand/husband-withdraw interaction predicted a decline in wives' satisfaction 1 year later.
Abstract: Twenty-nine married couples engaged in 2 videotaped discussions: 1 in which the husband requested a change in the wife and i in which the wife requested a change in the husband. Conflict behavior was assessed by self-report and observer ratings. Neither conflict structure (who requested the change) nor gender was associated with the positivity or negativity of spouses' behavior. During discussions of husbands' issues, wives and husbands did not differ in demand/withdraw behavior, whereas when discussing wives' issues, wives were more demanding and husbands were more withdrawing. Husband-demand/wife-withdraw interaction predicted an increase in wives' satisfaction 1 year later, whereas wife-demand/husband-withdraw interaction predicted a decline in wives' satisfaction 1 year later. These results replicate and extend those of our earlier study (Christensen & Heavey, 1990). A well-developed body of literature details differences in the problem-solving behavior of distressed and nondistressed couples (see Baucom & Adams, 1987; O'Leary & Smith, 1991; Schaap, 1984; Weiss & Heyman, 1990, for reviews). This literature has examined both differences in base rates of specific behaviors and the sequences of behavior that characterize the problem solving of distressed and nondistressed couples. A pattern of marital interaction in which one spouse attempts to engage in a problem-solving discussion, often resorting to pressure and demands, while the other spouse attempts to avoid or withdraw from the discussion, has been identified as a particularly destructive style of marital interaction. Several inductively oriented studies of marital interaction have shown behaviors similar to this pattern to be typical of distressed couples (e.g., Notarius & Pellegrini, 1987; Peterson, 1979; Schaap, Buunk, & Kerkstra, 1988). There have also been several popular books addressing the causes and consequence of this type of destructive, asymmetrical marital interaction (e.g., Mornell, 1979; Rubin, 1983). Additionally, researchers have noted the tendency of spouses who engage in this pattern to grow more polarized over time, leading to the increasing deterioration, and often dissolution, of marital relationships (e.g., Gray-Little & Burks, 1983; Levenson & Gottman, 1985). Finally, Jacobson and Margolin (1979) noted that this is a core conflict for many couples and is an especially difficult pattern of marital interaction to treat in marital therapy; this assertion has received subsequent empiri
446 citations
TL;DR: V couples were more likely than the 2 nonviolent groups to engage in husband demand/wife withdraw interactions, and husbands who had less power were more physically abusive toward their wives.
Abstract: This study hypothesized that power discrepancies in the marital relationship, where the husband is subordinate, serve as risk factors for husband-to-wife violence. The construct of marital power was assessed from 3 power domains operationalized by discrepancies in economic status, decision-making power, communication patterns, and communication skill. Three groups of married couples (N = 95) were compared: domestically violent (DV), maritally distressed/nonviolent (DNV), and maritally happy/nonviolent (HNV). DV couples were more likely than the 2 nonviolent groups to engage in husband demand/wife withdraw interactions. Within the DV group, husbands who had less power were more physically abusive toward their wives. Thus, violence may be compensatory behavior to make up for husbands' lack of power in other arenas of marriage. Difficulties in assessing marital power and future direction for the study of power and violence are discussed.
TL;DR: A review of studies of cognitive-behavioral therapy (CBT) for generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia indicates that CBT is consistently more effective than waiting-list and placebo control groups as discussed by the authors.
Abstract: A review of studies of cognitive-behavioral therapy (CBT) for generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia indicates that CBT is consistently more effective than waiting-list and placebo control groups. In general, CBT has proved more beneficial than supportive therapy as well. Comparisons with active behavioral treatments provide more variable results. Converging evidence suggests that cognitive change may be a strong predictor of treatment outcome, but that such change may be produced by a number of therapeutic approaches. Pretest-posttest change with CBT is depicted in meta-analytic summary form for each disorder.
TL;DR: It is concluded that cognitive therapy has fulfilled the criteria of a system of psychotherapy by providing a coherent, testable theory of personality, psychopathology, and therapeutic change; a teachable and testable set of therapeutic principles, strategies, and techniques that articulate with the theory; and a body of clinical and empirical data that support the theory and the efficacy of the theory.
Abstract: Proponents of cognitive therapy have striven to establish this approach as a mature system of psychotherapy for over 3 decades. The theoretical formulations have been enriched by clinical extrapolations from the neopsychoanalysts and experimental findings from cognitive psychology. The therapeutic strategies and techniques have been refined as a result of interaction with behavior therapy, which also influenced the emphasis on empirical testing of the theoretical formulations and the therapeutic applications. Outcome trials have demonstrated efficacy in a number of common disorders. New emphasis on the crucial importance of specific formulations (especially dysfunctional beliefs) has provided important clues to the treatment of a large number of other disorders. I conclude that cognitive therapy has fulfilled the criteria of a system of psychotherapy by providing a coherent, testable theory of personality, psychopathology, and therapeutic change; a teachable, testable set of therapeutic principles, strategies, and techniques that articulate with the theory; and a body of clinical and empirical data that support the theory and the efficacy of the theory.
TL;DR: There was no evidence that sexual trauma is associated with hypnotizability, and MMPI and Rorschach responses suggest sexual abuse may render victims especially vulnerable to specific disturbances i involving soma and self.
Abstract: In this study, 105 abused and nonabused women were examined for patterns of adult psychopathology associated with childhood sexual abuse and to test the extent to which these patterns are independent of other pathogenic properties of the family environment. Clinical and nonclinical Ss completed the Family Environment Scale, the Minnesota Multiphasic Personality Inventory (MMPI), the Rorschach, and the Stanford Hypnotic Susceptibility Scale. Greater nonspecific impairment among abused women may be a consequence, at least in part, of pathogenic family structure rather than sexual abuse per se. However, MMPI and Rorschach responses suggest sexual abuse may render victims especially vulnerable to specific disturbances involving soma and self. Abuse was associated with greater use of dissociation, but covariance analysis revealed this effect to be accounted for by family pathology. There was no evidence that sexual trauma is associated with hypnotizability. Language: en
TL;DR: This article evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating in women with nonpurging bulimia.
Abstract: This study evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. Fifty-six women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WL). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WL condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-month and 1-year follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia.
TL;DR: The results question the assumption that greater control of the therapy variable is straightforwardly achieved with manuals and adherence scales and suggest that changing or dictating specific therapist behaviors to achieve technical adherence may alter other therapeutic variables in unexpected and even counterproductive ways.
Abstract: Sixteen therapists participated in a year-long manualized training program as part of the Vanderbilt II study of time-limited dynamic psychotherapy. Changes in therapist behavior were measured with the Vanderbilt Therapeutic Strategies Scale (an adherence measure), the Vanderbilt Psychotherapy Process Scale (VPPS), and interpersonal process codings using the Structural Analysis of Social Behavior (SASB). The training program successfully changed therapists' technical interventions in line with the manualized protocol. After training, there was increased emphasis on the expression of in-session affect, exploration of the therapeutic relationship, an improved participant-observer stance, and greater use of open-ended questions. There was also an indication of unexpected deterioration in certain interpersonal and interactional aspects of therapy as measured by the VPPS and SASB ratings. These results question the assumption that greater control of the therapy variable is straightforwardly achieved with manuals and adherence scales. Changing or dictating specific therapist behaviors to achieve technical adherence may alter other therapeutic variables in unexpected and even counterproductive ways.
TL;DR: It is the case that initial tobacco use often escalates to compulsive use accompanied by tolerance and physical dependence, this is not usually observed with nicotine replacement therapies, and further research in developing alternative nicotine delivery forms may hold substantial promise in the treatment of tobacco dependence.
Abstract: It is well established that nicotine meets all criteria of a highly addictive drug. However, as recognized by the U.S. surgeon general, the nicotine delivery system itself is an important determinant of the toxic and addictive effects engendered by nicotine use. Therefore, altering the form of nicotine dosing may allow for selective therapeutic action in efforts to develop safer and less addictive nicotine replacement therapies. While it is the case that initial tobacco use often escalates to compulsive use accompanied by tolerance and physical dependence, this is not usually observed with nicotine replacement therapies. These observations are consistent with laboratory data indicating that (a) nicotine polacrilex and transdermal systems deliver nicotine more slowly and at lower dose levels than tobacco-based forms, and (b) human data suggesting that the abuse liability of these systems is substantially lower than that of the tobacco-based nicotine delivery systems. Because the drug dosage form can be systematically manipulated and evaluated, further research in developing alternative nicotine delivery forms may hold substantial promise in the treatment of tobacco dependence. Psychological research methods can play an important part in their evaluation.
TL;DR: In this article, the authors used the Inventory of Interpersonal Problems (IIP) to identify dysfunctional patterns in interpersonal interactions and found that problems in the "exploitable" octant improve most frequently, whereas problems in "dominating," "vindictive," and "cold" octants do not improve as readily.
Abstract: The Inventory of Interpersonal Problems (IIP) has been used to identify dysfunctional patterns in interpersonal interactions. Interpersonal problems can be organized in two dimensions, and the two-dimensional space can be divided into eight equal sectors (octants). Subscales of the IIP describe each of these octants. The instrument has been used to identify (a) interpersonal problems that are discussed most often in a brief dynamic psychotherapy and (b) problems that are treated most easily. The results show that problems in the "exploitable" octant improve most frequently, whereas problems in the "dominating," "vindictive," and "cold" octants do not improve as readily. Attachment styles in adulthood were examined (following a model proposed by Bowlby), and different attachment styles were found to correspond to different types of interpersonal problems. Finally, these variables were related to the ability to describe other people clearly. The article also discusses implications for brief dynamic psychotherapy.
TL;DR: None of the mental health and personality tests used in this study was significantly associated with recidivism, and Incest offenders were reconvicted at a slower rate than were offenders who selected only boys, with offenders against girls showing a rate intermediate between these two groups.
Abstract: We examined the long-term recidivism rates of 197 child molesters released from prison between 1958 and 1974. Overall, 42% of the total sample were reconvicted for sexual crimes, violent crimes, or both, with 10% of the total sample reconvicted 10-31 years after being released. Incest offenders were reconvicted at a slower rate than were offenders who selected only boys, with offenders against girls showing a rate intermediate between these two groups. Other factors associated with increased recidivism were (a) never being married and (b) previous sexual offenses. None of the mental health and personality tests used in this study (e.g., the Eysenck Personality Inventory and the Minnesota Multiphasic Personality Inventory) was significantly associated with recidivism. Language: en
TL;DR: This meta-analysis of 163 randomized trials examines a number of questions not studied in previous syntheses, including differences in outcome associated with different theoretical orientations, differences between marital and family therapies versus individual therapies, and the effects of various substantive and methodological moderators of therapy outcome.
Abstract: This meta-analysis of 163 randomized trials (including 59 dissertations) examines a number of questions not studied in previous syntheses. These include differences in outcome associated with different theoretical orientations, differences between marital and family therapies versus individual therapies, the clinical significance of therapy outcome, differences between marital versus family therapies in both outcomes and problems treated, and the effects of various substantive and methodological moderators of therapy outcome. The review concludes with some observations about the methodological status of this literature.
TL;DR: At posttreatment, both the PST and the RT conditions produced significant reductions in depressive symptoms, compared with the WLC group, and PST participants experienced significantly less depression than RT subjects.
Abstract: Compared the effects of 2 psychotherapies based on divergent conceptualizations of depression in later life. Seventy-five older adults diagnosed with major depressive disorder were assigned randomly to problem-solving therapy (PST), reminiscence therapy (RT), or a waiting-list control (WLC) condition. Participants in PST and RT were provided with 12 weekly sessions of group treatment. Dependent measures, taken at baseline, posttreatment, and 3-month follow-up, included self-report and observer-based assessments of depressive symptomatology. At posttreatment, both the PST and the RT conditions produced significant reductions in depressive symptoms, compared with the WLC group, and PST participants experienced significantly less depression than RT subjects. Moreover, a significantly greater proportion of participants in PST versus RT demonstrated sufficient positive change to warrant classification of their depression as improved or in remission at the posttreatment and follow-up evaluations.
TL;DR: It is concluded that the provision of food to weight-loss patients is a promising methodology that deserves further exploration.
Abstract: Behavioral treatments for obesity seek to modify eating and exercise behaviors by a change in their antecedents and consequences. More direct modification of antecedents and consequences by (a) the provision of food to patients and (b) the provision of financial rewards for weight loss was hypothesized to improve treatment outcomes. Two hundred two men and women were randomly assigned to no treatment, standard behavioral treatment (SBT), SBT plus food provision, SBT plus incentives, or SBT plus food provision and incentives. The major finding was that food provision significantly enhanced weight loss. Weight losses with SBT averaged 7.7, 4.5, and 4.1 kg at 6, 12, and 18 months, respectively, compared with 10.1, 9.1, and 6.4 kg, respectively, at the same intervals with the addition of food. Food provision also enhanced attendance, completion of food records, quality of diet, and nutrition knowledge. We conclude that the provision of food to weight-loss patients is a promising methodology that deserves further exploration.
TL;DR: Comparisons of the therapy process in brief psychodynamic and cognitive-behavioral therapies demonstrated that although some features were common to both treatments, there were important differences.
Abstract: Archival records were used to compare the therapy process in 30 brief psychodynamic and 32 cognitive-behavioral therapies. Verbatim transcripts of 186 treatment sessions were rated with the Psychotherapy Process Q-set, designed to provide a standard language for the description of process. Results demonstrated that although some features were common to both treatments, there were important differences. Cognitive-behavioral therapy promoted control of negative affect through the use of intellect and rationality combined with vigorous encouragement, support, and reassurance from therapists. In psychodynamic psychotherapies, there was an emphasis on the evocation of affect, on bringing troublesome feelings into awareness, and on integrating current difficulties with previous life experience, using the therapist-patient relationship as a change agent. The clinical theoretical precepts underlying psychodynamic treatments received considerable support. In cognitive-behavioral therapies, there was evidence for the importance of developmental, as opposed to rationalist, intervention strategies for treatment outcome.
TL;DR: In this article, a discrete-time survival analysis is used to address questions about onset, cessation, relapse, and recovery of suicide ideation and depression. But the authors focus on the early stages of suicidal ideation.
Abstract: In this article, we show how discrete-time survival analysis can address questions about onset, cessation, relapse, and recovery. Using data on the onset of suicide ideation and depression and relapse into cocaine use, we introduce key concepts underpinning the method, describe the action of the discrete-time hazard model, and discuss several types of main effects and interactions that can be included as predictors. We also comment on practical issues of data analysis and strategies for interpretation and presentation.
TL;DR: In this paper, the potential efficacy of antidepressant therapy, cognitive-behavioral therapy, and nicotine replacement therapy for smokers with depressive disorders or traits is discussed, and clinical implications and the role of patient treatment matching are also discussed.
Abstract: Depression, whether conceptualized as a trait, symptom, or as a diagnosable disorder, is overrepresented among smokers. Depressed smokers appear to experience more withdrawal symptoms on quitting, are less likely to be successful at quitting, and are more likely to relapse. This article documents these relationships and explores several potential links between smoking and depression. The potential efficacy of antidepressant therapy, cognitive-behavioral therapy, and nicotine replacement therapy for smokers with depressive disorders or traits is discussed. Clinical implications and the role of patient treatment matching are also discussed.
TL;DR: It was discovered that witnessing violence had a negative effect on depression, although somewhat unexpected, and may be the result of some youths possessing a set of extraordinary coping mechanisms that help to insulate them from negative environmental experiences.
Abstract: Distributional properties and correlates of the Children's Depression Inventory (CDI) were presented for a sample (n = 221) of low-income, African-American youths between 7 and 18 years of age. The results showed that younger children and those living in a household without their mother reported more depressive symptoms. Regression analyses revealed that victims of violence reported more depressive symptoms. However, chronic exposure to violence, in the form of witnessing violent acts, was not significantly related to depression. On further inspection, it was discovered that witnessing violence had a negative effect on depression. This finding, although somewhat unexpected, may be the result of some youths possessing a set of extraordinary coping mechanisms that help to insulate them from negative environmental experiences.
TL;DR: The guiding theory behind cognitive-behavioral interventions with youth, such as a therapeutic posture, an important cognitive distinction, and a specific treatment goal, is described, as well as a review of the literature.
Abstract: This article begins with a brief description of the guiding theory behind cognitive-behavioral interventions with youth, such as a therapeutic posture, an important cognitive distinction, and a specific treatment goal. Next, on the basis of a review of the literature, the nature of cognitive functioning, the treatments, and the outcome of treatment studies are described and examined for (a) aggression, (b) anxiety, (c) depression, and (d) attention-deficit hyperactivity. Conclusions and emerging developments are provided.
TL;DR: Factor analyses carried out at three ages showed that, over time, both the changes in form and the addition of new problems are quantifiable and thus represent orderly change.
Abstract: Children's traits, such as antisocial behavior, are embedded in a matrix that is changing over time. Although the trait score is stable, there are changes in the form of antisocial acts. There can also be subgroups of boys who show systematic increases in mean level of antisocial behavior. Latent growth models were used to demonstrate both changes in form and systematic changes in mean level for a subgroup of boys. The analyses included measures of covariates that were thought necessary to cause these changes. There are also qualitative changes brought about by the presence of the antisocial trait itself (e.g., academic failure, peer rejection, and depressed mood). Factor analyses carried out at three ages showed that, over time, both the changes in form and the addition of new problems are quantifiable and thus represent orderly change. Language: en
TL;DR: Examination of the psychological adjustment of 159 homeless children in comparison with a sample of 62 low-income children living at home suggests that homeless children share many of the risks and problems of other American children being reared in poverty.
Abstract: This study examined the psychological adjustment of 159 homeless children in comparison with a sample of 62 low-income children living at home. In each group, ages ranged from 8 to 17 years. As expected, homeless children were found to have greater recent stress exposure than housed poor children, as well as more disrupted schooling and friendships. Child behavior problems were above normative levels for homeless children, particularly for antisocial behavior. Across the 2 samples, however, behavior problems were more related to parental distress, cumulative risk status, and recent adversity than to housing status or income. Results suggest that homeless children share many of the risks and problems of other American children being reared in poverty. In the past decade, there has been an alarming increase in the number of homeless families with children and, concomitantly, a growing concern about the welfare of children living under such precarious and marginal conditions (Institute of Medicine, 1988). In a status report from the U.S. Conference of Mayors (1989), it was estimated that 36% of all the nation's homeless were families, and well over half of those family members were children. Nationwide, it has been estimated that 100,000 children may be homeless with their parents on any
TL;DR: Comparisons of individual responsiveness showed that boys who responded to one treatment also responded to the other, and group effects reflected those obtained in analyses of individual differences.
Abstract: This study evaluated the separate and combined effects of behavior modification and 2 doses of methylphenidate (MPH; 0.3 and 0.6 mg/kg) compared with baseline (no behavior modification and a placebo) on the classroom behavior and academic performance of 31 ADHD (attention deficit-hyperactivity disorder) boys attending a summer treatment program. Results revealed significant effects of both interventions, with the mean effect size of medication being more than twice as great as that of behavior modification. Relatively small incremental value was gained by the higher dose of medication or the addition of behavior modification, compared with the effects of the low dose of MPH. In contrast, the addition of either dose of MPH resulted in improvement beyond the effects of behavior modification alone. These group effects reflected those obtained in analyses of individual differences. Furthermore, comparisons of individual responsiveness showed that boys who responded to one treatment also responded to the other.