Showing papers in "Journal of Consulting and Clinical Psychology in 2006"
TL;DR: Benefit finding was related to less depression and more positive well-being but also more intrusive and avoidant thoughts about the stressor and was unrelated to anxiety, global distress, quality of life, and subjective reports of physical health.
Abstract: The authors conducted a meta-analysis to examine the relations of benefit finding to psychological and physical health as well as to a specific set of demographic, stressor, personality, and coping correlates. Results from 87 cross-sectional studies reported in 77 articles showed that benefit finding was related to less depression and more positive well-being but also more intrusive and avoidant thoughts about the stressor. Benefit finding was unrelated to anxiety, global distress, quality of life, and subjective reports of physical health. Moderator analyses showed that relations of benefit finding to outcomes were affected by the amount of time that had passed since stressor onset, the benefit finding measured used, and the racial composition of the sample.
1,620 citations
TL;DR: Among more severely depressed patients, behavioral activation was comparable to antidepressant medication, and both significantly outperformed cognitive therapy, and the implications of current treatment guidelines and dissemination are discussed.
Abstract: Antidepressant medication is considered the current standard for severe depression, and cognitive therapy is the most widely investigated psychosocial treatment for depression. However, not all patients want to take medication, and cognitive therapy has not demonstrated consistent efficacy across trials. Moreover, dismantling designs have suggested that behavioral components may account for the efficacy of cognitive therapy. The present study tested the efficacy of behavioral activation by comparing it with cognitive therapy and antidepressant medication in a randomized placebo-controlled design in adults with major depressive disorder (N = 241). In addition, it examined the importance of initial severity as a moderator of treatment outcome. Among more severely depressed patients, behavioral activation was comparable to antidepressant medication, and both significantly outperformed cognitive therapy. The implications of these findings for the evaluation of current treatment guidelines and dissemination are discussed.
1,447 citations
TL;DR: This trial provides some of the most encouraging results of PTSD treatment for veterans with chronic PTSD and supports increased use of cognitive- behavioral treatments in this population.
Abstract: Sixty veterans (54 men, 6 women) with chronic military-related posttraumatic stress disorder (PTSD) participated in a wait-list controlled trial of cognitive processing therapy (CPT). The overall dropout rate was 16.6% (20% from CPT, 13% from waiting list). Random regression analyses of the intention-to-treat sample revealed significant improvements in PTSD and comorbid symptoms in the CPT condition compared with the wait-list condition. Forty percent of the intention-to-treat sample receiving CPT did not meet criteria for a PTSD diagnosis, and 50% had a reliable change in their PTSD symptoms at posttreatment assessment. There was no relationship between PTSD disability status and outcomes. This trial provides some of the most encouraging results of PTSD treatment for veterans with chronic PTSD and supports increased use of cognitive- behavioral treatments in this population.
794 citations
TL;DR: Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis and selective prevention programs were found to be more effective than universal programs immediately following intervention and at follow-up.
Abstract: Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis. When all 30 studies were included, selective prevention programs were found to be more effective than universal programs immediately following intervention. Both selective and indicated prevention programs were more effective than universal programs at follow-up, even when the 2 studies with college students were excluded. Effect sizes for selective and indicated prevention programs tended to be small to moderate, both immediately postintervention and at an average follow-up of 6 months. Most effective interventions are more accurately described as treatment rather than prevention. Suggestions for future research include testing potential moderators (e.g., age, gender, anxiety, parental depression) and mechanisms, designing programs that are developmentally appropriate and gender and culturally sensitive, including longer follow-ups, and using multiple measures and methods to assess both symptoms and diagnoses.
769 citations
TL;DR: It is suggested that 1 year of intensive TFP can increase patients' narrative coherence and RF, with TFP showing increases in both constructs during treatment.
Abstract: Changes in attachment organization and reflective function (RF) were assessed as putative mechanisms of change in 1 of 3 year-long psychotherapy treatments for patients with borderline personality disorder (BPD). Ninety patients reliably diagnosed with BPD were randomized to transference-focused psychotherapy (TFP), dialectical behavior therapy, or a modified psychodynamic supportive psychotherapy. Attachment organization was assessed with the Adult Attachment Interview and the RF coding scale. After 12 months of treatment, participants showed a significant increase in the number classified secure with respect to attachment state of mind for TFP but not for the other 2 treatments. Significant changes in narrative coherence and RF were found as a function of treatment, with TFP showing increases in both constructs during treatment. No changes in resolution of loss or trauma were observed across treatments. Findings suggest that 1 year of intensive TFP can increase patients’ narrative coherence and RF. Future research should establish the relationship between these 2 constructs and relevant psychopathology, identify treatment components responsible for effecting these changes, and examine the long-term outcome of these changes.
729 citations
TL;DR: CT appears to be superior to EXP = AR in the treatment of social phobia and at the 1-year follow-up, differences in outcome persisted.
Abstract: A new cognitive therapy (CT) program was compared with an established behavioral treatment. Sixty-two patients meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria for social phobia were randomly assigned to CT, exposure plus applied relaxation (EXP = AR), or wait-list (WAIT). CT and EXP = AR were superior to WAIT on all measures. On measures of social phobia, CT led to greater improvement than did EXP = AR. Percentages of patients who no longer met diagnostic criteria for social phobia at posttreatment-wait were as follows: 84% in CT, 42% in EXP = AR, and 0% in WAIT. At the 1-year follow-up, differences in outcome persisted. In addition, patients in EXP = AR were more likely to have sought additional treatment. Therapist effects were small and nonsignificant. CT appears to be superior to EXP = AR in the treatment of social phobia. (
557 citations
TL;DR: Results suggest that the Circle of Security protocol is a promising intervention for the reduction of disorganized and insecure attachment in high-risk toddlers and preschoolers.
Abstract: The Circle of Security intervention uses a group treatment modality to provide parent education and psychotherapy that is based on attachment theory. The purpose of this study was to track changes in children’s attachment classifications pre- and immediately postintervention. Participants were 65 toddler– or preschooler–caregiver dyads recruited from Head Start and Early Head Start programs. As predicted, there were significant within-subject changes from disorganized to organized attachment classifications, with a majority changing to the secure classification. In addition, only 1 of the 13 preintervention securely attached children shifted to an insecure classification. Results suggest that the Circle of Security protocol is a promising intervention for the reduction of disorganized and insecure attachment in high-risk toddlers and preschoolers.
438 citations
TL;DR: This meta-analysis synthesizes the available data on the strength of association between anger and posttraumatic stress disorder (PTSD) and between hostility and PTSD, covering 39 studies with trauma-exposed adults, showing that effect sizes were substantially larger with increasing time since the event.
Abstract: This meta-analysis synthesizes the available data on the strength of association between anger and posttraumatic stress disorder (PTSD) and between hostility and PTSD, covering 39 studies with trauma-exposed adults. Effect sizes did not differ for anger and hostility, which could therefore be combined; effect sizes for anger expression variables were analyzed separately. The analyses revealed large effects. The weighted mean effect size (r) was .48 for anger-hostility, .29 for anger out, .53 for anger in, and -.44 for anger control. Moderator analyses were conducted for anger-hostility, showing that effect sizes were substantially larger with increasing time since the event and that effect sizes were larger in samples with military war experience than in samples that had experienced other types of traumatic events.
406 citations
TL;DR: Dissonance and healthy weight participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month follow-up, suggesting that both interventions have public health potential.
Abstract: In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only control condition. Dissonance participants showed significantly greater reductions in eating disorder risk factors and bulimic symptoms than healthy weight, expressive writing, and assessment-only participants, and healthy weight participants showed significantly greater reductions in risk factors and symptoms than expressive writing and assessment-only participants from pretest to posttest. Although these effects faded over 6-month and 12-month follow-ups, dissonance and healthy weight participants showed significantly lower binge eating and obesity onset and reduced service utilization through 12-month follow-up, suggesting that both interventions have public health potential.
377 citations
TL;DR: Structural equation path modeling indicated that exposure to terrorism was significantly related to greater loss and gain of psychosocial resources and to greater posttraumatic stress disorder (PTSD) and depressive symptoms.
Abstract: The authors conducted a large-scale study of terrorism in Israel via telephone surveys in September 2003 with 905 adult Jewish and Palestinian citizens of Israel (PCIs). Structural equation path modeling indicated that exposure to terrorism was significantly related to greater loss and gain of psychosocial resources and to greater posttraumatic stress disorder (PTSD) and depressive symptoms. Psychosocial resource loss and gain associated with terrorism were, in turn, significantly related to both greater PTSD and depressive symptoms. PCIs had significantly higher levels of PTSD and depressive symptoms than Jews. Further, PTSD symptoms in particular were related to greater authoritarian beliefs and ethnocentrism, suggesting how PTSD may lead to a self-protective style of defensive coping.
357 citations
TL;DR: The results from this study support the continued use and development of Internet-distributed, self-help programs for people diagnosed with social phobia.
Abstract: Sixty-four individuals with social phobia (social anxiety disorder) were assigned to a multimodal cognitive-behavioral treatment package or to a waiting list control group. Treatment consisted of a ...
TL;DR: It is suggested that benefit finding may be a unique and useful addition to efforts to help people forgive interpersonal transgressions through structured interventions.
Abstract: The authors examined the effects of writing about the benefits of an interpersonal transgression on forgiveness. Participants (N 304) were randomly assigned to one of three 20-min writing tasks in which they wrote about either (a) traumatic features of the most recent interpersonal transgression they had suffered, (b) personal benefits resulting from the transgression, or (c) a control topic that was unrelated to the transgression. Participants in the benefit-finding condition became more forgiving toward their transgressors than did those in the other 2 conditions, who did not differ from each other. In part, the benefit-finding condition appeared to facilitate forgiveness by encouraging participants to engage in cognitive processing as they wrote their essays. Results suggest that benefit finding may be a unique and useful addition to efforts to help people forgive interpersonal transgressions through structured interventions. The Transgression-Related Interpersonal Motivations Inventory—18-Item Version (TRIM–18) is appended.
TL;DR: The intervention was associated with reductions in disruptive behavior and greater maternal involvement and was particularly effective for children at greater risk for a persistent trajectory of conduct problems.
Abstract: Despite recent research indicating that 1 of the pivotal times for identifying pathways to early conduct problems is the toddler period, few family-based preventive interventions have been specifically designed to modify child disruptive behavior during this age period. This randomized trial tested the effectiveness of the Family Check-Up in sustaining maternal involvement and preventing the exacerbation of child conduct problems among 120 at-risk toddler-age boys, half of whom were randomly assigned to a treatment condition. The intervention was associated with reductions in disruptive behavior and greater maternal involvement and was particularly effective for children at greater risk for a persistent trajectory of conduct problems. The results are discussed in relation to other preventive interventions for young children.
TL;DR: This study compares forgiveness therapy with an alternative treatment (AT) for emotionally abused women who had been permanently separated for 2 or more years and found participants in FT experienced significantly greater improvement than AT participants in depression, trait anxiety, posttraumatic stress symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering.
Abstract: Emotionally abused women experience negative psychological outcomes long after the abusive spousal relationship has ended. This study compares forgiveness therapy (FT) with an alternative treatment (AT; anger validation, assertiveness, interpersonal skill building) for emotionally abused women who had been permanently separated for 2 or more years (M = 5.00 years, SD = 2.61; n = 10 per group). Participants, who were matched, yoked, and randomized to treatment group, met individually with the intervener. Mean intervention time was 7.95 months (SD = 2.61). The relative efficacy of FT and AT was assessed at p < .05. Participants in FT experienced significantly greater improvement than AT participants in depression, trait anxiety, posttraumatic stress symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering, with gains maintained at follow-up (M = 8.35 months, SD = 1.53). FT has implications for the long-term recovery of postrelationship emotionally abused women.
TL;DR: VIPP-SD proved to be effective in enhancing maternal attitudes toward sensitivity and sensitive discipline and in promoting sensitive discipline interactions in the intervention group as compared with the control group, and should become an important module in attachment-based interventions.
Abstract: The home-based intervention program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) was tested in a randomized controlled trial with 237 families screened for their 1- to 3-year-old children's relatively high scores on externalizing behavior. VIPP-SD, based on attachment theory and coercion theory, focuses on mirroring and discussing actual parent-child interactions in six 1.5-hr sessions with individual families at home. VIPP-SD proved to be effective in enhancing maternal attitudes toward sensitivity and sensitive discipline and in promoting sensitive discipline interactions in the intervention group as compared with the control group. Moreover, in families with more marital discord and in families with more daily hassles, the intervention resulted in a decrease of overactive problem behaviors in the children. The authors conclude that VIPP-SD should become an important module in attachment-based interventions.
TL;DR: CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05).
Abstract: Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive- behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed at baseline, 1 month later, posttreatment, and at 6- and 12-month follow-ups. CB treatment reduced gambling relative to GA referral alone during the treatment period and resulted in clinically significant improvements, with some effects maintained throughout follow-up ( ps = .05). Individual CB therapy improved some outcomes compared with the CB workbook. Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach.
TL;DR: This intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention.
Abstract: The range of effects of psychosocial interventions on quality of life among women with breast cancer remains uncertain. Furthermore, it is unclear which components of multimodal interventions account for such effects. To address these issues, the authors tested a 10-week group cognitive-behavioral stress management intervention among 199 women newly treated for nonmetastatic breast cancer, following them for 1 year after recruitment. The intervention reduced reports of social disruption and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect for up to 12 months (indeed, some effects strengthened over time). With respect to mechanisms tested, the intervention increased confidence in being able to relax at will. There was also evidence that effects of the intervention on the various outcomes examined were mediated by change in confidence about being able to relax. Thus, this intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention.
TL;DR: The authors pose 7 major theoretical and empirical questions regarding perceived growth, including issues of measurement, validity, mechanisms, links with well-being, and clinical implications, and suggest suggestions for future research.
Abstract: Interest in the phenomenon of perceived growth following highly stressful experiences continues to proliferate. Already there is abundant evidence that perceptions of growth are commonly reported, often by the majority of people experiencing even the most traumatic of events. However, much remains to be learned about perceptions of growth. In this article, the authors pose 7 major theoretical and empirical questions regarding perceived growth, including issues of measurement, validity, mechanisms, links with well-being, and clinical implications. The authors summarize the current status of psychologists' knowledge, including articles in the present special section, and conclude that there is much to learn about perceived growth. The authors end with suggestions for future research.
TL;DR: The results demonstrate the efficacy of toddler-parent psychotherapy in fostering secure attachment relationships in young children of depressed mothers.
Abstract: The development of insecure attachment relationships in the offspring of mothers with major depressive disorder (MDD) may initiate a negative trajectory leading to future psychopathology. Therefore, the provision of theoretically guided interventions designed to promote secure attachment is of paramount importance. Mothers who had experienced MDD since their child's birth were recruited (n = 130) and randomized to toddler-parent psychotherapy (DI) or to a control group (DC). Nondepressed mothers with no current or history of major mental disorder and their toddlers also were recruited for a nondepressed comparison group (NC; n = 68). Children averaged 20.34 months of age at the initial assessment. Higher rates of insecure attachment were present in both the DI and the DC groups at baseline, relative to the NC group. At postintervention, at age 36 months, insecure attachment continued to predominate in the DC group. In contrast, the rate of secure attachment had increased substantially in the DI group and was higher than that for the DC and the NC groups. These results demonstrate the efficacy of toddler-parent psychotherapy in fostering secure attachment relationships in young children of depressed mothers.
TL;DR: The authors examined temporal trends in Black-White differences and also examined whether these differences generalize across various age groups and measures, finding more favorable body image evaluations among Black than White females.
Abstract: Proponents of the sociocultural model of eating disorders have suggested that ethnic differences in body dissatisfaction may be diminishing as the thin ideal of beauty becomes more widely disseminated among minority women. In a meta-analysis, the authors examined temporal trends in Black-White differences and also examined whether these differences generalize across various age groups and measures. Results confirmed more favorable body image evaluations among Black than White females, with the greatest differences at the age period of the early 20s. Although results confirmed that ethnic differences have diminished, this trend was limited to weight-focused measures. On more global body image measures, ethnic differences actually increased. These results suggest that the relationship between Black-White ethnicity and body image is more complex than previously suggested.
TL;DR: The results revealed that the RPMT facilitated the frequency of generalized turn taking and generalized initiating joint attention more than did the PECS, and the effect sizes were large.
Abstract: This randomized group experiment compared the efficacy of 2 communication interventions (Responsive Education and Prelinguistic Milieu Teaching [RPMT] and the Picture Exchange Communication System [PECS]) in 36 preschoolers with autism spectrum disorders. Each treatment was delivered 3 times per week, in 20-min sessions, for 6 months. The results revealed that the RPMT facilitated the frequency of generalized turn taking and generalized initiating joint attention more than did the PECS. The latter effect occurred only for children who began treatment with at least some initiating joint attention. In contrast, the PECS facilitated generalized requests more than the RPMT in children with very little initiating joint attention prior to treatment. These effect sizes were large.
TL;DR: The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended, and previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.
Abstract: This study examined rates of improvement in psychotherapy as a function of the number of sessions attended. The clients (N=1,868; 73.1% female; 92.4% White; average age=40), who were seen for a variety of problems in routine primary care mental health practices, attended 1 to 12 sessions, had planned endings, and completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended. Among clients who began treatment above the CORE-OM clinical cutoff (n=1,472), the RCSI rate ranged from 88% for clients who attended 1 session down to 62% for clients who attended 12 sessions (r=-.91). Previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.
TL;DR: It is suggested that a program of abstinence-based vouchers is a potent treatment option for extended periods of continuous marijuana abstinence during treatment, and cognitive-behavioral therapy enhanced the posttreatment maintenance of the initial positive effect of vouchers on abstinence.
Abstract: Ninety cannabis-dependent adults seeking treatment were randomly assigned to receive cognitive-behavioral therapy, abstinence-based voucher incentives, or their combination. Treatment duration was 14 weeks, and outcomes were assessed for 12 months posttreatment. Findings suggest that (a) abstinence-based vouchers were effective for engendering extended periods of continuous marijuana abstinence during treatment, (b) cognitive-behavioral therapy did not add to this during-treatment effect, and (c) cognitive-behavioral therapy enhanced the posttreatment maintenance of the initial positive effect of vouchers on abstinence. This study extends the literature on cannabis dependence, indicating that a program of abstinence-based vouchers is a potent treatment option. Discussion focuses on the strengths of each intervention, the clinical significance of the findings, and the need to continue efforts toward development of effective interventions.
TL;DR: The authors performed 5-year prospective follow-up (retention rate = 92%) with an ethnically diverse sample of girls, aged 11-18 years, who had been diagnosed in childhood with attention-deficit/hyperactivity disorder (ADHD; N = 140) and a matched comparison group (N = 88).
Abstract: The authors performed 5-year prospective follow-up (retention rate = 92%) with an ethnically diverse sample of girls, aged 11-18 years, who had been diagnosed in childhood with attention-deficit/ hyperactivity disorder (ADHD; N = 140) and a matched comparison group (N = 88). Hyperactive-impulsive symptoms were more likely to abate than inattentive symptoms. Across multiple domains of symptoms and functional impairment, girls with ADHD continued to display deficits of moderate to large effect size in relation to the comparison girls, but few differences emerged between the inattentive versus combined types. Follow-up effects withstood statistical control of crucial covariates for most outcomes, meaning that there were specific effects of childhood ADHD on follow-up status; in other instances, baseline disruptive disorders accounted for adolescent effects. For outcomes identical at baseline and follow-up, girls with ADHD showed more improvement across time than comparison girls (except for math achievement). Overall, ADHD in girls portends continuing impairment 5 years after childhood ascertainment.
TL;DR: Risk reduction achieved by brief interventions maintained throughout the follow-up year by improving all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not.
Abstract: In this randomized controlled trial, the authors evaluated brief motivational interventions (BMIs) for at-risk college drinkers. Heavy drinking students (N = 509; 65% women, 35% men) were randomized into 1 of 6 intervention conditions formed by crossing the baseline Timeline Followback (TLFB) interview (present versus absent) and intervention type (basic BMI, BMI enhanced with a decisional balance module, or none). Assessments completed at baseline, 1, 6, and 12 months measured typical and risky drinking as well as drinking-related problems. Relative to controls, the TLFB interview reduced consumption but not problems at 1 month. The basic BMI improved all drinking outcomes beyond the effects of the TLFB interview at 1 month, whereas the enhanced BMI did not. Risk reduction achieved by brief interventions maintained throughout the follow-up year.
TL;DR: The results suggest that early family transitions that strain couple relationships provide critical opportunities for preventive interventions to strengthen marriage.
Abstract: Couples expecting their first child were randomly assigned to intervention (n 28) and comparison groups (n 38) to assess the efficacy of a couples intervention and examine marital satisfaction trajectories across the transition to parenthood. The primarily European American sample (M age 30 years) completed assessments of marital satisfaction at 5 points from the final trimester of pregnancy to 66 months postpartum. Growth curve analyses indicated a normative linear decline in marital satisfaction. Intervention participants experienced significantly less decline than comparison participants, providing support for the efficacy of the intervention. Comparable childless couples (n 13) did not show a decline in marital satisfaction. The results suggest that early family transitions that strain couple relationships provide critical opportunities for preventive interventions to strengthen marriage.
TL;DR: Children in the clinic and clinic-plus-Internet conditions showed significantly greater reductions in anxiety from pre- to posttreatment and were more likely to be free of their anxiety diagnoses, compared with the WL group.
Abstract: Seventy-two clinically anxious children, aged 7 to 14 years, were randomly allocated to clinic-based, cognitive-behavior therapy, the same treatment partially delivered via the Internet, or a wait-list control (WL). Children in the clinic and clinic-plus-Internet conditions showed significantly greater reductions in anxiety from pre- to posttreatment and were more likely to be free of their anxiety diagnoses, compared with the WL group. Improvements were maintained at 12-month follow-up for both therapy conditions, with minimal difference in outcomes between interventions. The Internet treatment content was highly acceptable to families, with minimal dropout and a high level of therapy compliance.
TL;DR: Findings supported the view that drug court was more effective than family court services in decreasing rates of adolescent substance use and criminal behavior and that the use of evidence-based treatments within the drug court context improved youth substance-related outcomes.
Abstract: Evaluated the effectiveness of juvenile drug court for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether the integration of evidence-based practices enhanced the outcomes of juvenile drug court. Over a 1-year period, a four-condition randomized design evaluated outcomes for family court with usual community services, drug court with usual community services, drug court with multisystemic therapy, and drug court with multisystemic therapy enhanced with contingency management for adolescent substance use, criminal behavior, symptomatology, and days in out-of-home placement. In general, findings supported the view that drug court was more effective than family court services in decreasing rates of adolescent substance use and criminal behavior. Possibly due to the greatly increased surveillance of youths in drug court, however, these relative reductions in antisocial behavior did not translate to corresponding decreases in rearrest or incarceration. In addition, findings supported the view that the use of evidence-based treatments within the drug court context improved youth substance-related outcomes. Clinical and policy implications of these findings are discussed.
TL;DR: The results support the attachment injury resolution model and suggest that resolution during EFT is beneficial to couples.
Abstract: The goal of this study was to use task analysis to verify that the attachment injury resolution model described in this article discriminates resolved from nonresolved couples. Twenty-four couples with an attachment injury received, on average, 13 sessions of emotionally focused therapy (EFT). At the end of treatment, 15 of the 24 couples were identified as resolved. Segments of best sessions for all couples were transcribed and rated on 2 process measures. Resolved couples were found to be significantly more affiliative and achieved deeper levels of experiencing than nonresolved couples. They also showed significant improvements in dyadic satisfaction and forgiveness than nonresolved couples. The results support the attachment injury resolution model and suggest that resolution during EFT is beneficial to couples.
TL;DR: Results indicate the importance of measuring quality of life in future investigations of PTSD treatment and indicate there were synchronous effects of symptom change on change inquality of life but no significant lagged effects.
Abstract: This study examined how change in posttraumatic stress disorder (PTSD) symptoms relates to change in quality of life. The sample consisted of 325 male Vietnam veterans with chronic PTSD who participated in a randomized trial of group psychotherapy. Latent growth modeling was used to test for synchronous effects of PTSD symptom change on psychosocial and physical health-related quality of life within the same time period and lagged effects of initial PTSD symptom change on later change in quality of life. PTSD symptoms were associated with reduced quality of life before treatment. There were synchronous effects of symptom change on change in quality of life but no significant lagged effects. Results indicate the importance of measuring quality of life in future investigations of PTSD treatment.