Showing papers in "Journal of Consulting and Clinical Psychology in 1998"
TL;DR: It is suggested that, in evaluating the benefits of a given treatment, the greatest weight should be given to efficacy trials but that these trials should be followed by research on effectiveness in clinical settings and with various populations and by cost-effectiveness research.
Abstract: A scheme is proposed for determining when a psychological treatment for a specific problem or disorder may be considered to be established in efficacy or to be possibly efficacious. The importance of independent replication before a treatment is established in efficacy is emphasized, and a number of factors are elaborated that should be weighed in evaluating whether studies supporting a treatment's efficacy are sound. It is suggested that, in evaluating the benefits of a given treatment, the greatest weight should be given to efficacy trials but that these trials should be followed by research on effectiveness in clinical settings and with various populations and by cost-effectiveness research.
2,728Â citations
TL;DR: The results suggest that applied risk assessments of sexual offenders should consider separately the offender's risk for sexual and nonsexual recidivism.
Abstract: reoffending than those who completed treatment. The predictors of nonsexual violent recidivism and general (any) recidivism were similar to those predictors found among nonsexual criminals (e.g., prior violent offenses, age, juvenile deliquency). Our results suggest that applied risk assessments of sexual offenders should consider separately the offender's risk for sexual and nonsexual recidivism. Assessing chronicity is crucial for clients whose sexual behaviors have brought them into conflict with the law. Many exceptional criminal justice policies, such as postsentence detention (e.g., Anderson & Masters, 1992), lifetime community supervision, and community notification, target those sexual offenders likely to reoffend. Clinicians need to judge whether the client's behaviors are truly atypical of the individual (as the client would like us to believe) or whether the client merits a virtually permanent label as a sexual offender.
2,253Â citations
TL;DR: This writing task was found to lead to significantly improved health outcomes in healthy participants and was enhanced in 4 outcome types--reported physical health, psychological well-being, physiological functioning, and general functioning--but health behaviors were not influenced.
Abstract: A research synthesis was conducted to examine the relationship between a written emotional expression task and subsequent health. This writing task was found to lead to significantly improved health outcomes in healthy participants. Health was enhanced in 4 outcome types--reported physical health, psychological well-being, physiological functioning, and general functioning--but health behaviors were not influenced. Writing also increased immediate (pre- to postwriting) distress, which was unrelated to health outcomes. The relation between written emotional expression and health was moderated by a number of variables, including the use of college students as participants, gender, duration of the manipulation, publication status of the study, and specific writing content instructions.
1,045Â citations
TL;DR: This research addressed 2 limitations of past research on peer victimization: the tendency to study boys only and the tendencyto focus on forms of peer maltreatment that are common in boys'peer groups but occur much less frequently in girls' peer groups.
Abstract: This research addressed 2 limitations of past research on peer victimization: the tendency to study boys only and the tendency to focus on forms of peer maltreatment that are common in boys' peer groups (victimization through overt aggression) but occur much less frequently in girls' peer groups Peer- and self-report instruments were used to assess a relational form of victimization in addition to the overt form that has been the focus of past research Results showed that girls were more relationally victimized, whereas boys were more overtly victimized Both forms of victimization were shown to predict concurrent sociopsychological adjustment problems significantly (eg, peer rejection, loneliness) beyond aggression Victims identified through a combination of self- and peer-reports were particularly maladjusted
961Â citations
TL;DR: Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period, most showed a decline in problems over time, suggesting a developmental maturational effect.
Abstract: This randomized controlled trial evaluated the efficacy of a brief intervention designed to reduce the harmful consequences of heavy drinking among high-risk college students. Students screened for risk while in their senior year of high school (188 women and 160 men) were randomly assigned to receive an individualized motivational brief intervention in their freshman year of college or to a no-treatment control condition. A normative group selected from the entire screening pool provided a natural history comparison. Follow-up assessments over a 2-year period showed significant reductions in both drinking rates and harmful consequences, favoring students receiving the intervention. Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period, most showed a decline in problems over time, suggesting a developmental maturational effect.
881Â citations
TL;DR: Child and adolescent therapy outcome research findings attest to the efficacy of a variety of treatments, but continued research progress will depend on greater attention to magnitude and maintenance of therapeutic change, long-term follow-up, moderators and mediators of change, and development and testing of treatment in conditions relevant to clinical practice.
Abstract: Child and adolescent therapy outcome research findings attest to the efficacy of a variety of treatments. This article illustrates promising treatments for selected internalizing (anxiety and depression), externalizing (oppositional, and antisocial behavior), and other (obesity and autism) conditions, and for other aims (preparation for medical and dental procedures). Studies in these areas illustrate worthwhile characteristics that can help inform the search for empirically supported treatments. These characteristics include randomized controlled trials, well-described and replicable treatments, tests with clinical samples, tests of clinical significance, broad-based outcome assessment including measures of real-world functioning, and others. Continued research progress will depend on greater attention to magnitude and maintenance of therapeutic change, long-term follow-up, moderators and mediators of change, and development and testing of treatment in conditions relevant to clinical practice.
740Â citations
TL;DR: In this paper, the effectiveness of a parenting program with 394 Head Start mothers was examined, and the intervention children were observed to exhibit significantly fewer conduct problems, less noncompliance, less negative affect, and more positive affect than control children.
Abstract: The effectiveness of a parenting program with 394 Head Start mothers was examined. Nine Head Start centers were randomly assigned to either an experimental condition in which parents, teachers, and family service workers participated in the intervention or a control condition in which the regular Head Start program was offered. Mothers in the intervention group were observed at home to have significantly fewer critical remarks and commands, to use less harsh discipline, and to be more positive and competent in their parenting when compared with control mothers. Teachers reported that intervention mothers were more involved in their children's education and that their children were more socially competent. Intervention children were observed to exhibit significantly fewer conduct problems, less noncompliance, less negative affect, and more positive affect than control children. One year later most of the improvements were maintained.
723Â citations
TL;DR: In this article, the lifetime prevalence of traumatic events and current posttraumatic stress disorder (PTSD) in 275 patients with severe mental illness (e.g., schizophrenia and bipolar disorder) receiving public mental health services in Concord and Manchester, New Hampshire, and Baltimore, Maryland.
Abstract: This research assessed the lifetime prevalence of traumatic events and current posttraumatic stress disorder (PTSD) in 275 patients with severe mental illness (e.g., schizophrenia and bipolar disorder) receiving public mental health services in Concord and Manchester, New Hampshire, and Baltimore, Maryland. Lifetime exposure to traumatic events was high, with 98% of the sample reporting exposure to at least 1 traumatic event. The rate of PTSD in our sample was 43%, but only 3 of 119 patients with PTSD (2%) had this diagnosis in their charts. PTSD was predicted most strongly by the number of different types of trauma, followed by childhood sexual abuse. The findings suggest that PTSD is a common comorbid disorder in severe mental illness that is frequently overlooked in mental health settings. Language: en
619Â citations
TL;DR: This article evaluates the efficacy, effectiveness, and clinical significance of empirically supported couple and family interventions for treating marital distress and individual adult disorders, including anxiety disorders, depression, sexual dysfunctions, alcoholism and problem drinking, and schizophrenia.
Abstract: This article evaluates the efficacy, effectiveness, and clinical significance of empirically supported couple and family interventions for treating marital distress and individual adult disorders, including anxiety disorders, depression, sexual dysfunctions, alcoholism and problem drinking, and schizophrenia. In addition to consideration of different theoretical approaches to treating these disorders, different ways of including a partner or family in treatment are highlighted: (a) partner-family-assisted interventions, (b) disorder-specific partner-family interventions, and (c) more general couple-family therapy. Findings across diagnostic groups and issues involved in applying efficacy criteria to these populations are discussed.
565Â citations
TL;DR: This study examined 2 process variables, emotional engagement and habituation, and outcome of exposure therapy for posttraumatic stress disorder, and three distinct groups of clients with different patterns of distress were found: high initial engagement and gradual habituation between sessions, high initial Engagement without habituated, and moderate initial engagement without habituation.
Abstract: 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.
475Â citations
TL;DR: The experimental literature on individual and group psychological treatments for adult disorders is reviewed, and Behavioral and cognitive-behavioral treatments dominate the lists, especially in the anxiety disorders, with notable exceptions.
Abstract: The experimental literature on individual and group psychological treatments for adult disorders is reviewed. For each of the 11 disorders or problems covered, treatments that fall into the following categories, as defined by D.L. Chambless and S. D. Hollon (1998), are identified: efficacious and specific, efficacious, and possibly efficacious. Behavioral and cognitive-behavioral treatments dominate the lists, especially in the anxiety disorders, with notable exceptions. Reasons for the hegemony of the behavioral and cognitive modalities are discussed, and some limitations of the empirically supported treatment concept are addressed. Continued research is recommended on Aptitude x Treatment interactions, cost-benefit ratios, and generalization of treatments to a variety of patient populations, therapists, and treatment settings.
TL;DR: The strong predictive power of acute numbing, depersonalization, a sense of relieving the trauma, and motor restlessness indicates that only a subset of ASD symptoms is strongly related to the development of chronic PTSD.
Abstract: Motor vehicle accident survivors (n = 92) were assessed for acute stress disorder (ASD) within 1 month of the trauma and reassessed (n = 71) for posttraumatic stress disorder (PTSD) 6 months posttrauma. ASD was diagnosed in 13% of participants, and a further 21% had subclinical levels of ASD. At follow-up, 78% of ASD participants and 60% of subclinical ASD participants met criteria for PTSD. The strong predictive power of acute numbing, depersonalization, a sense of relieving the trauma, and motor restlessness, in contrast to the low to moderate predictive power of other symptoms, indicates that only a subset of ASD symptoms is strongly related to the development of chronic PTSD. Although these findings support the use of the ASD diagnosis, they suggest that the dissociative and arousal clusters may require revision.
TL;DR: In this article, the authors assigned children aged 7 to 14 who met diagnostic criteria for an anxiety disorder were assigned to conditions according to parental anxiety level, and the results indicated that within the child-anxiety-only condition, 82% of the children in the CBT condition no longer met criteria for anxiety disorder compared with 80% in CBT + PAM condition.
Abstract: Sixty-seven children aged 7 to 14 who met diagnostic criteria for an anxiety disorder were assigned to conditions according to parental anxiety level. Within these conditions, children were randomly assigned to 1 of 2 treatments: child-focused cognitive-behavioral therapy (CBT) or child-focused CBT plus parental anxiety management (CBT + PAM). At posttreatment, results indicated that within the child-anxiety-only condition, 82% of the children in the CBT condition no longer met criteria for an anxiety disorder compared with 80% in the CBT + PAM condition. Within the child + parental anxiety condition, 39% in the CBT condition no longer met criteria compared with 77% in the CBT + PAM condition. At follow-up, these differences were maintained, with some weakening over time. Results were not consistent across outcome measures. The interpretation and potential clinical implications of these findings are discussed.
TL;DR: This study represents the 1st demonstration of successful treatment of ASD with CBT and its efficacy in preventing chronic PTSD.
Abstract: Acute stress disorder (ASD) is a precursor of chronic posttraumatic stress disorder (PTSD). Twenty-four participants with ASD following civilian trauma were given 5 sessions of either cognitive-behavioral therapy (CBT) or supportive counseling (SC) within 2 weeks of their trauma. Fewer participants in CBT (8%) than in SC (83%) met criteria for PTSD at posttreatment. There were also fewer cases of PTSD in the CBT condition (17%) than in the SC condition (67%) 6 months posttrauma. There were greater statistically and clinically significant reductions in intrusive, avoidance, and depressive symptomatology among the CBT participants than among the SC participants. This study represents the 1st demonstration of successful treatment of ASD with CBT and its efficacy in preventing chronic PTSD.
TL;DR: PTSD can be precipitated by diagnosis and treatment of breast cancer, and the PCL-C can be a cost-effective screening tool for this disorder.
Abstract: The presence of a posttraumatic stress disorder (PTSD) diagnosis in women (n = 82) diagnosed with Stage 0-IIIA breast cancer was assessed 6 to 72 months after cancer therapy. The PTSD Checklist-Civilian Version (PCL-C) and the PTSD module for the Structured Clinical Interview for DSM-IV, Nonpatient Version, PTSD module (SCID-NP-PTSD) were administered in a telephone interview. SCID-NP-PTSD results indicated prevalence rates of 6% and 4% for current and lifetime PTSD, respectively. Use of the recommended cutoff score of 50 on the PCL-C to determine diagnosis of current cancer-related PTSD resulted in a sensitivity of .60 and a specificity of .99 with 2 false-negative diagnoses. In conclusion, PTSD can be precipitated by diagnosis and treatment of breast cancer, and the PCL-C can be a cost-effective screening tool for this disorder.
TL;DR: High levels of anxiety symptoms at 1 point in time predicted high levels of depressive symptoms at subsequent points in time even after controlling for prior levels of depression symptoms.
Abstract: Elementary school students (n = 330) and their parents (n = 228) participated in a 3-year longitudinal study of the temporal relation between anxiety and depressive symptoms in children. Every 6 months, children and parents completed depression and anxiety questionnaires for a total of 6 waves. Structural equation modeling revealed that individual differences on all measures were remarkably stable over time. Nevertheless, high levels of anxiety symptoms at 1 point in time predicted high levels of depressive symptoms at subsequent points in time even after controlling for prior levels of depression symptoms. These findings were consistent across self- and parent reports. Results support the temporal hypothesis that anxiety leads to depression in children and adolescents.
TL;DR: Results showed that the use of religious coping was generally associated with better adjustment both concurrently and over time in both patients and significant others and was related to adjustment beyond the effects of the proposed mediators.
Abstract: The effects of religious coping, the potential moderation of such effects by religious affiliation (i.e., Catholic, Protestant), and the potential mediation of such effects by various factors (i.e., cognitive restructuring, social support, perceived control) were investigated in patients and significant others coping with the stress of kidney transplant surgery. At 3 and 12 months after transplantation, results showed that the use of religious coping was generally associated with better adjustment both concurrently and over time in both patients and significant others. These effects were moderated by religious affiliation, such that religious coping was more effective in promoting adjustment for Protestants than for Catholics. Religious coping was related to adjustment beyond the effects of the proposed mediators. Implications of these results for future research and practice are discussed.
TL;DR: It is suggested that positive responses to stressful events, specifically the discovery of meaning, may be linked to positive immunologic and health outcomes.
Abstract: This study investigated whether finding meaning in response to an HIV-related stressor was associated with changes in immune status and health. Forty HIV-seropositive men who had recently experienced an AIDS-related bereavement completed interviews assessing cognitive processing and rinding meaning after the loss and provided blood samples for a 2- to 3-year follow-up. AIDS-related mortality over an extended follow-up was determined from death certificates. As predicted, men who engaged in cognitive processing were more likely to find meaning from the loss. Furthermore, men who found meaning showed less rapid declines in CD4 T cell levels and lower rates of AIDS-related mortality (all ps < .05), independent of health status at baseline, health behaviors, and other potential confounds. These results suggest that positive responses to stressful events, specifically the discovery of meaning, may be linked to positive immunologic and health outcomes. The ways in which individuals respond to stressful life events may influence their immune status and, potentially, their physical health. A growing number of studies in the field of psychoneuroimmunology have found that exposure to stressful experiences is associated with changes in the human immune system (for review, see Cohen & Herbert, 1996; Kemeny, Solomon, Morley, & Herbert, 1992). It has been hypothesized that these immune changes are related to cognitive and emotional responses elicited by the stressor (e.g., Cohen & Herbert, 1996). However, studies have generally failed to assess the associations between particular ways of responding to a stressor, both positive and negative, and immune outcomes. In addition, few studies have examined the health consequences of immune changes associated with stressful experiences and the psychological responses they provoke. One important way of responding to a stressful experience
TL;DR: In this article, newly married couples participated in two interaction tasks: a problem-solving task in which spouses discussed a marital conflict and a social support task where spouses discussed personal, non-marital difficulties.
Abstract: How spouses help each other contend with personal difficulties is an unexplored but potentially important domain for understanding how marital distress develops. Newly married couples participated in 2 interaction tasks: a problem-solving task in which spouses discussed a marital conflict and a social support task in which spouses discussed personal, nonmarital difficulties. Observational coding of these interactions showed that wives' support solicitation and provision behaviors predicted marital outcomes 2 years later, independent of negative behaviors during marital problem-solving discussions. In addition, couples who exhibited relatively poor skills in both behavioral domains were at particular risk for later marital dysfunction. These results suggest that social support exchanges should be incorporated into social learning analyses of marriage and into programs designed to prevent marital distress.
TL;DR: Results show that boys who participated in MTFC had significantly fewer criminal referrals and returned to live with relatives more often, and assignment to a treatment condition predicted official and self-reported criminality in follow-up beyond other well-known predictors of chronic juvenile offending.
Abstract: The relative effectiveness of group care (GC) and multidimensional treatment foster care (MTFC) was compared in terms of their impact on criminal offending, incarceration rates, and program completion outcomes for 79 male adolescents who had histories of chronic and serious juvenile delinquency. Results show that boys who participated in MTFC had significantly fewer criminal referrals and returned to live with relatives more often. Multiple regression analyses showed that assignment to a treatment condition (i.e., GC or MTFC) predicted official and self-reported criminality in follow-up beyond other well-known predictors of chronic juvenile offending (i.e., age at 1st offense, number of previous offenses, age at referral).
TL;DR: Planned comparisons revealed that violence exposure had the strongest effect on well-being among children with low social support or high levels of social strains, and children with high Levels of intrusive thinking were most likely to show heightened internalizing symptoms when they had inadequate social support.
Abstract: This study examined associations of community violence exposure and psychological well-being among 99 8-12 year old children (M = 10.7 years) using home interviews with mothers and children. Both moderators and mediators of the links between violence exposure and well-being were tested. After demographics and concurrent life stressors were controlled for violence exposure was significantly associated with intrusive thinking, anxiety, and depression. Regression analyses indicated that intrusive thinking partially mediated associated between violence exposure and internalizing symptoms. Planned comparisons revealed that violence exposure had the strongest effect on well-being among children with low social support or high levels of social strains. Furthermore, children with high levels of intrusive thinking were most likely to show heightened internalizing symptoms when they had inadequate social support.
TL;DR: Cognitive-behavioral therapy for depression was no more effective than its components in preventing relapse and clinical and theoretical implications of these findings are discussed.
Abstract: This study presents 2-year follow-up data of a comparison between complete cognitive-behavioral therapy for depression (CT) and its 2 major components: behavioral activation and behavioral activation with automatic thought modification. Data are reported on 137 participants who were randomly assigned to 1 of these 3 treatments for up to 20 sessions with experienced cognitive-behavioral therapists. Long-term effects of the therapy were evaluated through relapse rates, number of asymptomatic or minimally symptomatic weeks, and survival times at 6-, 12-, 18-, and 24-month follow-ups. CT was no more effective than its components in preventing relapse. Both clinical and theoretical implications of these findings are discussed.
TL;DR: Two clinicians provided opposite answers to the title question: Persons argued that information from randomized controlled trials (RCTs) is vital to clinicians, and Silberschatz argued that Information from RCTs is irrelevant to clinicians.
Abstract: Two clinicians provided opposite answers to the title question: Persons argued that information from randomized controlled trials (RCTs) is vital to clinicians, and Silberschatz argued that information from RCTs is irrelevant to clinicians. Persons argued that clinicians cannot provide top quality care to their patients without attending to findings of RCTs and that clinicians have an ethical responsibility to inform patients about, recommend, and provide treatments supported by RCTs before informing patients about, recommending, and providing treatments shown to be inferior in RCTs or not evaluated in RCTs. Silberschatz argued that RCTs do not and cannot answer questions that concern practicing clinicians. He advocates alternative research approaches (effectiveness studies, quasi-experimental methods, case-specific research) for studying psychotherapy.
TL;DR: Children's predisaster behavioral and academic functioning as a predictor of posttraumatic stress (PTS) following Hurricane Andrew and whether children who were exposed to the disaster would display a worsening of prior functioning are examined.
Abstract: This study examined (a) children's predisaster behavioral and academic functioning as a predictor of posttraumatic stress (PTS) following Hurricane Andrew and (b) whether children who were exposed to the disaster would display a worsening of prior functioning. Fifteen months before the disaster, 92 4th through 6th graders provided self-reports of anxiety; peers and teachers rated behavior problems (anxiety, inattention, and conduct) and academic skills. Measures were repeated 3 months postdisaster; children also reported PTS symptoms and hurricane-related experiences (i.e., exposure). PTS symptoms were again assessed 7 months postdisaster. At 3 months postdisaster, children's exposure to the disaster, as well as predisaster ratings of anxiety, inattention, and academic skills, predicted PTS symptoms. By 7 months, only exposure, African American ethnicity, and predisaster anxiety predicted PTS. Prior anxiety levels also worsened as a result of exposure to the disaster. The findings have implications for identifying and treating children at risk for stress reactions following a catastrophic disaster.
TL;DR: This article illustrates a program evaluation approach for the study of family intervention outcomes in general populations by randomly assigned rural schools to the Preparing for the Drug-Free Years Program, the Iowa Strengthening Families Program, and a minimal-contact control group.
Abstract: Recent literature underscores the need for studies of family-based preventive interventions oriented toward public health objectives. This article illustrates a program evaluation approach for the study of family intervention outcomes in general populations. Thirty-three rural schools were randomly assigned to 1 of 3 conditions: the Preparing for the Drug-Free Years Program (PDFY), the Iowa Strengthening Families Program (ISFP), and a minimal-contact control group. Self-report and observational data collected from 523 families were used to develop measurement models of 3 latent parenting constructs that included measurement method effects. Analyses were conducted to ensure initial and attrition-related group equivalencies and to assess school effects. Structural equation models of the hypothesized sequence of direct and indirect effects for both PDFY and ISFP were then fit to the data. All hypothesized effects were significant for both interventions. The discussion addresses the potential public health benefits of evaluation research on universal preventive interventions.
TL;DR: Feasibility of brief smoking interventions with teen patients was supported by high rates of recruitment, retention, and quit attempts, and long periods of continuous abstinence, although between-groups differences on smoking measures were not significant at 3-month follow-up.
Abstract: This study tested the feasibility and efficacy of a brief smoking intervention for adolescents in a hospital setting. Forty adolescent patients were randomized to receive either brief advice or a motivational interview, a nonconfrontational therapeutic intervention. Feasibility of brief smoking interventions with teen patients was supported by high rates of recruitment, retention, and quit attempts, and long periods of continuous abstinence. Although between-groups differences on smoking measures were not significant at 3-month follow-up, an effect size of h = .28 was noted. The sample showed significant decreases in smoking dependence and number of days smoked. Baseline stage of change, smoking rate, and depression were significant prospective predictors of smoking outcome. Implications for smoking intervention research with adolescents are discussed.
TL;DR: The present study suggests that panic control treatment can be transported to a CMHC, and clients showed significant reductions in anticipatory anxiety, agoraphobic avoidance, generalized anxiety, and symptoms of depression.
Abstract: This work examines the transportability of cognitive-behavioral therapy (CBT) for panic disorder to a community mental health center (CMHC) setting by comparing CMHC treatment outcome data with the results obtained in two controlled efficacy trials. Participants were 110 clients with a primary diagnosis of panic disorder with or without agoraphobia; clients were not excluded on the basis of medication use or changes, severity or frequency of panic attacks, age, or the presence of agoraphobia. Clients completed a 15-session CBT protocol. Despite differences in settings, clients, and treatment providers, the treatment outcomes for clients completing treatment in the CMHC and the efficacy studies were comparable: Of the CMHC clients who completed treatment, 87% were panic-free at the end of treatment, and clients showed significant reductions in anticipatory anxiety, agoraphobic avoidance, generalized anxiety, and symptoms of depression. The present study suggests that panic control treatment can be transported to a CMHC. Challenges facing the transportability of research-based treatment to CMHC clients, settings, and treatment providers are discussed.
TL;DR: This article examined the relation between intelligence and posttraumatic stress disorder (PTSD) by studying the association among pre-combat intelligence, current intelligence, and self-reported PTSD symptoms.
Abstract: The authors examined the relation between intelligence and posttraumatic stress disorder (PTSD) by studying the association among precombat intelligence, current intelligence, and self-reported PTSD symptoms. Military aptitude test results were obtained in 59 PTSD and 31 non-PTSD Vietnam combat veterans who had undergone a psychodiagnostic interview and current intelligence testing. People with lower precombat intelligence were more likely to develop PTSD symptoms as assessed by the Clinician-Administered PTSD Scale even after adjustment for extent of combat exposure. The association between current intelligence and PTSD was no longer significant after adjusting for precombat intelligence. These results suggest that lower pretrauma intelligence increases risk for developing PTSD symptoms, not that PTSD lowers performance on intelligence tests.
TL;DR: The field needs to foster a more productive collaboration between clinician and researcher; study theoretically integrated interventions; use process research findings to improve therapy manuals; make greater use of replicated clinical case studies; focus on less heterogeneous, dimensionalized clinical problems; and find a better way of disseminatingResearch findings to the practicing clinician.
Abstract: Despite the advances in psychotherapy outcome research, findings are limited because they do not fully generalize to the way therapy is conducted in the real world. Research's clinical validity has been compromised by the medicalization of outcome research, use of random assignment of clients without regard to appropriateness of treatment, fixed number of therapy sessions, nature of the therapy manuals, and use of theoretically pure therapies. The field needs to foster a more productive collaboration between clinician and researcher; study theoretically integrated interventions; use process research findings to improve therapy manuals; make greater use of replicated clinical case studies; focus on less heterogeneous, dimensionalized clinical problems; and find a better way of disseminating research findings to the practicing clinician.
TL;DR: Follow-up analyses indicate that veterans with current PTSD who do not react physiologically to the challenge task manifest less reexperiencing symptoms, depression, and guilt.
Abstract: This multisite study tested the ability of psychophysiological responding to predict posttraumatic stress disorder (PTSD) diagnosis (current, lifetime, or never) in a large sample of male Vietnam veterans. Predictor variables for a logistic regression equation were drawn from a challenge task involving scenes of combat. The equation was tested and cross-validated demonstrating correct classification of approximately 2/3 of the current and never PTSD participants. Results replicate the finding of heightened psychophysiological responding to trauma-related cues by individuals with current PTSD, as well as differences in a variety of other domains between groups with and without the disorder. Follow-up analyses indicate that veterans with current PTSD who do not react physiologically to the challenge task manifest less reexperiencing symptoms, depression, and guilt. Discussion addresses the value of psychophysiological measures for assessment of PTSD.