Showing papers in "Journal of Consulting and Clinical Psychology in 1999"
TL;DR: Compared with other recent crime victims, lesbian and gay hate-crime survivors manifested significantly more symptoms of depression, anger, anxiety, and posttraumatic stress.
Abstract: Questionnaire data about criminal victimization experiences were collected from 2,259 Sacramento-area lesbians, gay men, and bisexuals (N = 1,170 women, 1,089 men). Approximately 1/5 of the women and 1/4 of the men had experienced victimization because of their adult sexual orientation. Hate crimes were less likely than nonbias crimes to have been reported to police. Compared with other recent crime victims, lesbian and gay hate-crime survivors manifested significantly more symptoms of depression, anger, anxiety, and posttraumatic stress. They also displayed significantly more crime-related fears and beliefs, lower sense of mastery, and more attributions of their personal setbacks to sexual prejudice than did nonbias crime victims and nonvictims. Comparable differences were not observed among bisexuals. The findings highlight the importance of recognizing hate-crime survivors' special needs in clinical settings and in public policy.
834 citations
TL;DR: In this paper, female assault victims with chronic posttraumatic stress disorder (PTSD) were randomly assigned to four treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE-SIT) or wait-list control (WL).
Abstract: Ninety-six female assault victims with chronic posttraumatic stress disorder (PTSD) were randomly assigned to 4 treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE-SIT), or wait-list control (WL). Treatment consisted of 9 twice-weekly, individual sessions. Independent evaluations were conducted at pretreatment; posttreatment; and 3-, 6-, and 12-month follow-ups. All 3 active treatments reduced severity of PTSD and depression compared with WL but did not differ significantly from each other, and these gains were maintained throughout the follow-up period. However, in the intent-to-treat sample, PE was superior to SIT and PE-SIT on posttreatment anxiety and global social adjustment at follow-up and had larger effect sizes on PTSD severity, depression, and anxiety. SIT and PE-SIT did not differ significantly from each other on any outcome measure.
833 citations
TL;DR: This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications.
Abstract: This article summarizes and scrutinizes the growth of the development of clinically relevant and psychometrically sound approaches for determining the clinical significance of treatment effects in mental health research by tracing its evolution, by examining modifications in the method, and by discussing representative applications. Future directions for this methodology are proposed.
795 citations
TL;DR: The harm-reduction focus of the MI was evident in that MI reduced negative outcomes related to drinking, beyond what was produced by the precipitating event plus SC alone.
Abstract: This study evaluated the use of a brief motivational interview (MI) to reduce alcohol-related consequences and use among adolescents treated in an emergency room (ER) following an alcohol-related event. Patients aged 18 to 19 years (N = 94) were randomly assigned to receive either MI or standard care (SC). Assessment and intervention were conducted in the ER during or after the patient's treatment. Follow-up assessments showed that patients who received the MI had a significantly lower incidence of drinking and driving, traffic violations, alcohol-related injuries, and alcohol-related problems than patients who received SC. Both conditions showed reduced alcohol consumption. The harm-reduction focus of the MI was evident in that MI reduced negative outcomes related to drinking, beyond what was produced by the precipitating event plus SC alone.
735 citations
TL;DR: Both recruitment strategy and the social support manipulation affected treatment completion and weight-loss maintenance in participants recruited alone or with 3 friends or family members.
Abstract: To determine the benefits of social support for weight loss and maintenance, this study recruited participants (N = 166) either alone or with 3 friends or family members and then randomly assigned them to a standard behavioral treatment (SBT) or SBT with social support strategies. Participants recruited with friends had greater weight losses at the end of the 4-month treatment and at Month 10 follow-up. Both recruitment strategy and the social support manipulation affected treatment completion and weight-loss maintenance. In those recruited alone and given SBT, 76% completed treatment and 24% maintained their weight loss in full from Months 4 to 10. Among those recruited with friends and given SBT plus social support, 95% completed treatment and 66% maintained their weight loss in full.
570 citations
TL;DR: More than twice as many women receiving advocacy services experienced no violence across the 2 years postintervention compared with women who did not receive such services.
Abstract: An intensive community-based advocacy intervention was designed and evaluated by randomly assigning 278 battered women to an experimental or control condition Participants were interviewed 6 times over a period of 2 years Retention rate averaged 95% over the 2 years The 10-week postshelter intervention involved providing trained advocates to work 1-on-1 with women, helping generate and access the community resources they needed to reduce their risk of future violence from their abusive partners Women who worked with advocates experienced less violence over time, reported higher quality of life and social support, and had less difficulty obtaining community resources More than twice as many women receiving advocacy services experienced no violence across the 2 years postintervention compared with women who did not receive such services
567 citations
TL;DR: In this article, the authors found that patients who experienced sudden gains were less depressed than the other patients at post-treatment, and they remained so 18 months later, suggesting a three-stage model for patients' recovery: preparation-->critical session/sudden gain-->upward spiral.
Abstract: In this study of cognitive-behavioral therapy for depression, many patients experienced large symptom improvements in a single between-sessions interval. These sudden gains' average magnitude was 11 Beck Depression Inventory points, accounting for 50% of these patients' total improvement. Patients who experienced sudden gains were less depressed than the other patients at posttreatment, and they remained so 18 months later. Substantial cognitive changes were observed in the therapy sessions preceding sudden gains, but few cognitive changes were observed in control sessions, suggesting that cognitive change in the pregain sessions triggered the sudden gains. Improved therapeutic alliances were also observed in the therapy sessions immediately after the sudden gains, as were additional cognitive changes, suggesting a three-stage model for these patients' recovery: preparation-->critical session/sudden gain-->upward spiral.
532 citations
TL;DR: Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.
Abstract: This study examined the prospective relations of naturalistic weight-reduction efforts to growth in relative weight and onset of obesity with data from a community study of female adolescents (N = 692). Initial self-labeled dieting, appetite suppressant/laxative use, incidental exercise, vomiting for weight-control purposes, and binge eating predicted elevated growth in relative weight over the 4-year period. Dietary restraint, self-labeled dieting, exercise for weight-control purposes, and appetite suppressant/laxative use predicted an increased risk for obesity onset. Data imply that the weight-reduction efforts reported by adolescents are more likely to result in weight gain than in weight loss and suggest the need to educate youth on more effective weight-control strategies.
526 citations
TL;DR: Interventions focusing on family interactions that take into account the contributions of both members of the dyad may be more effective in curbing transmission than interventions that solely address maternal or child symptomatology.
Abstract: The present study assessed interactions between anxious mothers and their children, using observational techniques to elucidate potential mechanisms of anxiety transmission. Results revealed that anxious mothers were less warm and positive in their interactions with their children, less granting of autonomy, and more critical and catastrophizing in comparison with normal control mothers. Maternal anxiety status appeared to be the primary predictor of maternal warmth during interactions. Child anxiety status was most predictive of maternal granting of autonomy behavior. Maternal behaviors exhibited during interactions were the most salient predictors of child anxiety, contributing more than maternal psychopathology or ongoing strain to the development of child anxiety. Interventions focusing on family interactions that take into account the contributions of both members of the dyad may be more effective in curbing transmission than interventions that solely address maternal or child symptomatology.
490 citations
Journal Article•
TL;DR: This study examined the effectiveness of the universal component of the Fast Track prevention model: the PATHS curriculum and teacher consultation, and indicated significant effects on peer ratings of aggression and hyperactive-disruptive behavior and observer ratings of classroom atmosphere.
Abstract: JOURNAL ABSTRACT This study examined the effectiveness of the universal component of the Fast Track prevention model: the PATHS (Promoting Alternative THinking Strategies) curriculum and teacher consultation. This randomized clinical trial involved 198 intervention and 180 comparison classrooms from neighborhoods with greater than average crime in 4 U.S. locations. In the intervention schools, Grade 1 teachers delivered a 57-lesson social competence intervention focused on self-control, emotional awareness, peer relations, and problem solving. Findings indicated significant effects on peer ratings of aggression and hyperactive-disruptive behavior and observer ratings of classroom atmosphere. Quality of implementation predicted variation in assessments of classroom functioning. The results are discussed in terms of both the efficacy of universal, school-based prevention models and the need to examine comprehensive, multiyear programs. (Abstract Adapted from Source: Journal of Consulting and Clinical Psychology, 1999. Copyright © 1999 by the American Psychological Association) For more information on the FAST Track (Families and Schools Together) Project, a Blueprints for Violence Prevention Promising Program, see VioPro record number 307. Washington Tennessee Pennsylvania North Carolina School Achievement School Failure School Achievement School Adjustment School Based Youth Development Child Development Elementary School Student Grade 1 At Risk Child At Risk Juvenile At Risk Youth Middle Childhood Social Skills Development Friendship Skills Communication Skills Prosocial Skills Child Antisocial Child Problem Behavior Child Behavior Behavior Prevention Behavior Intervention Intervention Program Prevention Program Program Effectiveness Program Evaluation Blueprints Promising Reference 11-04
488 citations
Journal Article•
TL;DR: Intervention included a universal-level classroom program plus social skills training, academic tutoring, parent training, and home visiting to improve competencies and reduce problems in a high-risk group of children selected in kindergarten.
Abstract: JOURNAL ABSTRACT Fast Track is a multisite, multicomponent preventive intervention for young children at high risk for long-term antisocial behavior. Based on a comprehensive developmental model, intervention included a universal-level classroom program plus social skills training, academic tutoring, parent training, and home visiting to improve competencies and reduce problems in a high-risk group of children selected in kindergarten. At the end of Grade 1, there were moderate positive effects on children's social, emotional, and academic skills; peer interactions and social status; and conduct problems and special-education use. Parents reported less physical discipline and greater parenting satisfaction/ease of parenting and engaged in more appropriate/consistent discipline, warmth/positive involvement, and involvement with the school. Evidence of differential intervention effects across child gender, race, site, and cohort was minimal. (Abstract Adapted from Source: Journal of Consulting and Clinical Psychology, 1999. Copyright © 1999 by the American Psychological Association) For more information on the FAST Track (Families and Schools Together) Project, a Blueprints for Violence Prevention Promising Program, see VioPro record number 307. Washington Tennessee Pennsylvania North Carolina School Achievement School Failure School Achievement School Adjustment School Based Youth Development Child Development Elementary School Student Grade 1 At Risk Child At Risk Juvenile At Risk Youth Middle Childhood Social Skills Development Friendship Skills Communication Skills Prosocial Skills Child Antisocial Child Problem Behavior Child Behavior Behavior Prevention Behavior Intervention Intervention Program Prevention Program Program Effectiveness Program Evaluation Blueprints Promising Reference 11-04
TL;DR: It was concluded that either exposure or a challenge to cognition can result in symptom reduction, although neither resulted in complete improvement.
Abstract: A randomized trial was performed in which imaginal exposure (IE) and cognitive therapy (CT) were compared in the treatment of chronic posttraumatic stress disorder (PTSD). Patients who continued to meet PTSD caseness at the end of a 4-week symptom-monitoring baseline period (n = 72) were randomly allocated to either IE or CT. There was a significant improvement in all measures over treatment and at follow-up, although there were no significant differences between the 2 treatments at any assessment. A significantly greater number of patients who showed worsening over treatment received IE, although this effect was not found at follow-up. Patients who worsened showed a greater tendency to miss treatment sessions, rated therapy as less credible, and were rated as less motivated by the therapist. It was concluded that either exposure or a challenge to cognition can result in symptom reduction, although neither resulted in complete improvement.
TL;DR: Main and Hesse's (1990) model in which frightening (threatening, frightened, or dissociated) parental behavior explains why infants of parents with unresolved loss develop disorganized attachment relationships was tested and predicted infant dis organized attachment irrespective of maternal security.
Abstract: Main and Hesse's (1990) model in which frightening (threatening, frightened, or dissociated) parental behavior explains why infants of parents with unresolved loss develop disorganized attachment relationships was tested. Unresolved loss using the Adult Attachment Interview in a nonclinical middle-class sample of 85 mothers who had experienced the loss of someone important was assessed. Disorganized attachment was examined in the Strange Situation. Parental behavior was recorded during 22-hr home visits. The model applied to mothers with currently insecure attachment representations. Secure mothers with unresolved loss displayed less frightening behavior than other mothers, and unresolved loss in secure mothers did not predict disorganized attachment of their infants. Frightening behavior predicted infant disorganized attachment irrespective of maternal security.
TL;DR: In this article, the authors evaluated the efficacy of CBT and interpersonal psychotherapy (IPT) with depressed adolescents in Puerto Rico and found that IPT was superior to the WL condition in increasing self-esteem and social adaptation.
Abstract: This study evaluated the efficacy of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) with depressed adolescents in Puerto Rico. Seventy-one adolescents meeting Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) criteria for a diagnosis of depression were randomly assigned to 1 of 3 conditions: CBT, IPT, or wait list (WL). Pretreatment, posttreatment, and 3-month follow-up measures of depression symptoms, self-esteem, social adjustment, family emotional involvement and criticism, and behavioral problems were completed. Results suggest that IPT and CBT significantly reduced depressive symptoms when compared with the WL condition. IPT was superior to the WL condition in increasing self-esteem and social adaptation. Clinical significance tests suggested that 82% of adolescents in IPT and 59% of those in CBT were functional after treatment. The results suggest that both IPT and CBT are efficacious treatments for depressed Puerto Rican adolescents. IPT's impact in other levels of outcome is discussed in terms of its consonance with Puerto Rican cultural values.
TL;DR: Regression analyses revealed that the H CR-20 added incremental validity to the PCL:SV and that only HCR-20 subscales predicted violence.
Abstract: This study evaluated the predictive validity of the HCR-20 (Historical, Clinical, and Risk Management) violence risk assessment scheme and the Psychopathy Checklist: Screening Version (PCL:SV). Files of 193 civilly committed patients were coded. Patients were followed up in the community for an average of 626 days. Receiver operating characteristic analyses with the HCR-20 yielded strong associations with violence (areas under curve [AUCs] = .76-.80). Persons scoring above the HCR-20 median were 6 to 13 times more likely to be violent than those scoring below the median. PCL:SV AUCs were more variable (.68-.79). Regression analyses revealed that the HCR-20 added incremental validity to the PCL:SV and that only HCR-20 subscales predicted violence. Implications for risk assessment research, and the clinical assessment and management of violence, are discussed.
TL;DR: The authors identified predictors of weight gain versus continued maintenance among individuals already successful at long-term weight loss and found that several years of successful weight maintenance increase the probability of future weight maintenance and that weight regain is due at least in part to failure to maintain behavior changes.
Abstract: This study identified predictors of weight gain versus continued maintenance among individuals already successful at long-term weight loss Weight, behavior, and psychological information was collected on entry into the study and 1 year later Thirty-five percent gained weight over the year of follow-up, and 59% maintained their weight losses Risk factors for weight regain included more recent weight losses (less than 2 years vs 2 years or more), larger weight losses (greater than 30% of maximum weight vs less than 30%), and higher levels of depression, dietary disinhibition, and binge eating levels at entry into the registry Over the year of followup, gainers reported greater decreases in energy expenditure and greater increases in percentage of calories from fat Gainers also reported greater decreases in restraint and increases in hunger, dietary disinhibition, and binge eating This study suggests that several years of successful weight maintenance increase the probability of future weight maintenance and that weight regain is due at least in part to failure to maintain behavior changes
TL;DR: A step-by-step statistical methodology for conducting normative comparisons in the context of treatment-outcome research is presented and attention is paid to potential theoretical, statistical, and methodological challenges to the implementation of normative comparisons.
Abstract: Normative comparisons are a procedure for evaluating the clinical significance of therapeutic interventions. This procedure, consisting of comparing data on treated individuals with that of normative individuals, is described, and a step-by-step statistical methodology for conducting normative comparisons in the context of treatment-outcome research is presented. Four examples of the methodology are outlined in detail. Attention is paid to potential theoretical, statistical, and methodological challenges to the implementation of normative comparisons, as well as to the advantages of normative comparisons in providing evidence for the beneficial gains of treatment.
TL;DR: 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.
Abstract: 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.
TL;DR: Fundamental issues raised by the concept of clinical significance and the methods discussed in the previous articles serve as the basis of the present comments.
Abstract: The previous articles in this special section make the case for the importance of evaluating the clinical significance of therapeutic change, present key measures and innovative ways in which they are applied, and more generally provide important guidelines for evaluating therapeutic change. Fundamental issues raised by the concept of clinical significance and the methods discussed in the previous articles serve as the basis of the present comments. Salient among these issues are ambiguities regarding the meaning of current measures of clinical significance, the importance of relating assessment of clinical significance to the goals of therapy, and evaluation of the construct(s) that clinical significance reflects. Research directions that are discussed include developing a typology of therapy goals, evaluating cutoff scores and thresholds for clinical significance, and attending to social as well as clinical impact of treatment.
TL;DR: RP was most effective when applied to alcohol or polysubstance use disorders, combined with the adjunctive use of medication, and when evaluated immediately following treatment using uncontrolled pre-post tests.
Abstract: Although relapse prevention (RP) has become a widely adopted cognitive-behavioral treatment intervention for alcohol, smoking, and other substance use, outcome studies have yielded an inconsistent picture of the efficacy of this approach or conditions for maximal effectiveness. A meta-analysis was performed to evaluate the overall effectiveness of RP and the extent to which certain variables may relate to treatment outcome. Twenty-six published and unpublished studies with 70 hypothesis tests representing a sample of 9,504 participants were included in the analysis. Results indicated that RP was generally effective, particularly for alcohol problems. Additionally, outcome was moderated by several variables. Specifically, RP was most effective when applied to alcohol or polysubstance use disorders, combined with the adjunctive use of medication, and when evaluated immediately following treatment using uncontrolled pre-post tests.
TL;DR: The magnitude and consistency of the gender differential, coupled with an inability to account for it, highlights a compelling need for additional research specifically aimed at elucidating the relation between gender and abstinence.
Abstract: Gender differences in smoking quit rates are frequently reported and are the subject of much speculation. This study examined the generalizability of gender differences in abstinence across study sites, treatments, and time of relapse, as well as potential mediators and moderators of gender effects. Participants were smokers who participated in 3 randomized clinical trials of the nicotine patch (N = 632). Men had higher cessation rates than women at all follow-ups. The impact of gender on abstinence was unaffected by controlling for study site, treatment, or time of relapse. There was little evidence for mediation or moderation of this relation by any of a host of predictor variables. The magnitude and consistency of the gender differential, coupled with an inability to account for it, highlights a compelling need for additional research specifically aimed at elucidating the relation between gender and abstinence.
TL;DR: The authors evaluated the effectiveness of a parent-training program in a sample of 238 divorcing mothers with sons in Grades 1-3 and provided an experimental test of coercion theory, finding that the intervention produced reductions in observed coercive parenting, prevented decay in positive parenting, and generally improved effective parenting practices in comparisons of mothers in experimental and control groups.
Abstract: This randomized experimental prevention study (a) evaluated the effectiveness of a parent-training program in a sample of 238 divorcing mothers with sons in Grades 1-3 and (b) provided an experimental test of coercion theory. The intervention produced reductions in observed coercive parenting, prevented decay in positive parenting, and generally improved effective parenting practices in comparisons of mothers in experimental and control groups. Moreover, coercion theory was supported. Improved parenting practices correlated significantly with improvements in teacher-reported school adjustment, child-reported maladjustment, and mother-reported maladjustment. The intervention indirectly benefitted child outcomes through improved parenting practices for a model based on child report and, to a lesser extent, on teacher report. The intervention did not produce direct effects on child outcomes.
TL;DR: A need to improve rape prevention and treatment programs for female adolescents is highlighted as female students who had ever been raped were significantly more likely than those who had not to report a wide range of health-risk behaviors to be raped.
Abstract: This study analyzed data from the 1995 National College Health Risk Behavior Survey (NCHRBS) to assess the prevalence of lifetime rape among female college students and to examine the association between rape and health-risk behaviors. The NCHRBS used a mail questionnaire to assess health-risk behaviors among a nationally representative sample of undergraduate students. Twenty percent of female students reported ever having been forced to have sexual intercourse, most often during adolescence. When analyses controlled for demographic characteristics, female students who had ever been raped were significantly more likely than those who had not to report a wide range of health-risk behaviors. These results highlight a need to improve rape prevention and treatment programs for female adolescents.
TL;DR: In this article, the authors examined factors related to depression, hopelessness, and suicidality in gay, lesbian, and bisexual adolescents compared with demographically similar heterosexual adolescents, and found that environmental factors associated with sexual orientation play a major role in predicting distress in this population.
Abstract: In the present study, the researchers examined factors related to depression, hopelessness, and suicidality in gay, lesbian, and bisexual adolescents, compared with demographically similar heterosexual adolescents. Sexual minority adolescents reported greater depression, hopelessness, and past and present suicidality than did heterosexual adolescents. However, when controlling for other psychosocial predictors of present distress, significant differences between the 2 samples disappeared. For past suicidality scores, the effects of sexual orientation were reduced, but still significant, when accounting for the other predictor variables. These results suggest that environmental factors associated with sexual orientation, which can be targeted and changed through prevention and intervention efforts, play a major role in predicting distress in this population.
TL;DR: Children in both the CM and SC conditions showed substantial improvement on all of the outcome measures, and Interestingly, children in the ES condition also showed comparable improvements at posttreatment and at 3-, 6-, and 12-month follow-ups.
Abstract: This study evaluated the relative efficacy of an exposure-based contingency management (CM) treatment condition and an exposure-based cognitive self-control (SC) treatment condition relative to an education support (ES) control condition for treating children with phobic disorders. Eighty-one children and their parents completed a 10-week treatment program in which children and parents were seen in separate treatment sessions with the therapist, followed by a brief conjoint meeting. Children in both the CM and SC conditions showed substantial improvement on all of the outcome measures. These gains were maintained at 3-, 6-, and 12-month follow-ups. Interestingly, children in the ES condition also showed comparable improvements at posttreatment and at 3-, 6-, and 12-month follow-ups. Implications of the findings are discussed with respect to knowledge development and clinical practice.
TL;DR: Methods used to evaluate various aspects of social validity and the applicability of these concepts and methods in clinical treatment research are discussed.
Abstract: Social validity is a term coined by behavior analysts to refer to the social importance and acceptability of treatment goals, procedures, and outcomes. This article discusses dimensions of social validity, methods used to evaluate various aspects of social validity, and the applicability of these concepts and methods in clinical treatment research.
TL;DR: Conceptual and methodological issues related to the use of quality of life measures in mental health, including the lack of a good operational definition of the construct, theUse of subjective versus objectivequality of life indicators, and the nature of the relationship between symptoms and quality ofLife judgments are examined.
Abstract: Clinical researchers have turned their attention to quality of life assessment as a means of broadening the evaluation of treatment outcomes. This article examines conceptual and methodological issues related to the use of quality of life measures in mental health. These include the lack of a good operational definition of the construct, the use of subjective versus objective quality of life indicators, and the nature of the relationship between symptoms and quality of life judgments. Of special concern is the ability of quality of life measures to detect treatment-related changes. The authors review the application of quality of life assessment across diverse patient groups and therapies and provide recommendations for developing comprehensive, psychometrically sophisticated quality of life measures.
TL;DR: DeRubeis et al. as mentioned in this paper attempted to replicate an earlier study of the prediction of symptom change from process variables in cognitive therapy for depressed outpatients and found that therapist behavior and therapist-patient interactions were correlated with prior and subsequent symptom change.
Abstract: This study attempted to replicate an earlier study (R. J. DeRubeis & M. Feeley, 1990) of the prediction of symptom change from process variables in cognitive therapy for depressed outpatients. Measures of in-session therapist behavior and therapist-patient interactions were correlated with prior and subsequent symptom change. One of the positive findings was confirmed, but the other received only marginal support. A "concrete" subset of theory-specified therapist actions, measured early in treatment, predicted subsequent change in depression. The therapeutic alliance was predicted by prior symptom change in 1 of the 2 later assessments, but only at a trend level. Several negative findings were similar to those obtained in the earlier study. Specifically, the alliance, an "abstract" subset of theory-specified therapist actions, and facilitative conditions did not predict subsequent change. Implications for causal inferences in psychotherapy process research are discussed.
TL;DR: Follow-up results show that a brief school-based intervention for children can produce durable reductions in anxiety problems, and the superiority of the intervention group was evident at 2-year follow-up.
Abstract: The Queensland Early Intervention and Prevention of Anxiety Project evaluated a child- and family-focused group intervention for preventing anxiety problems in children. This article reports on 12- and 24-month follow-up data to previously reported outcomes at posttreatment and at 6-month follow-up. A total of 1,786 7- to 14-year-olds were screened for anxiety problems using teacher nominations and children's self-report. After diagnostic interviews, 128 children were selected and assigned to either a 10-week school-based child- and parent-focused psychosocial intervention or a monitoring group. Both groups showed improvements immediately at postintervention and at 6-month follow-up; the improvement was maintained in the intervention group only reducing the rate of existing anxiety disorder and preventing the onset of new anxiety disorders. At 12 months, the groups converged, but the superiority of the intervention group was evident again at 2-year follow-up. Severity of pretreatment diagnoses, gender, and parental anxiety predicted poor initial response to intervention, whereas pretreatment severity was the only predictor of chronicity at 24 months. Overall, follow-up results show that a brief school-based intervention for children can produce durable reductions in anxiety problems.
TL;DR: The present study examined the impact of Project DARE (Drug Abuse Resistance Education), a widespread drug-prevention program, 10 years after administration, and found few differences were found in terms of actual drug use, drug attitudes, or self-esteem.
Abstract: The present study examined the impact of Project DARE (Drug Abuse Resistance Education), a widespread drug-prevention program, 10 years after administration. A total of 1,002 individuals who in 6th grade had either received DARE or a standard drug-education curriculum, were reevaluated at age 20. Few differences were found between the 2 groups in terms of actual drug use, drug attitudes, or self-esteem, and in no case did the DARE group have a more successful outcome than the comparison group. Possible reasons why DARE remains so popular, despite the lack of documented efficacy, are offered.