Protection, Dissociation, and Internal Roles: Modeling and Treating the Effects of Child Abuse.

This article presents a theory of the long-term effects of child abuse that emphasizes the development of internal working models of protection. The theory proposes that abused children do not receive adequate caregiver protection and do not form internal representations of an effective protector. As a result, they have ongoing difficulty defending themselves against interpersonal aggression and internal self-criticism. The model integrates current research and theory in attachment behavior, developmental psychopathology, trauma, dissociation, and experiential psychotherapy. It accounts for many of the clinical symptoms presented by adult survivors of child abuse and suggests specific strategies for treatment. The author provides 3 examples of psychotherapy interventions derived from the model, distinguishes protection and "rescuing", and suggests directions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Influence of Therapist Adherence and Competence on Client Reprocessing of Child Abuse Memories.

This study follows previous research examining change processes in emotion-focused therapy for adult survivors of child abuse (N = 37). Therapist (n = 10) adherence to intervention principles and competence with an imaginal confrontation (IC) intervention were examined in the context of relationship skills. The Therapist Facilitating Scale assessed competence with IC. Therapists differed in technical (but not relationship) skills; relationship skills and IC competence (but not adherence) improved over therapy. Therapist competence predicted better client processes during IC. Relationship skills independently contributed to abuse resolution; the potency of IC (Competence x Frequency of Implementation) independently contributed to reduced interpersonal problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized Trial of Cognitive-Behavioral Therapy for Chronic Posttraumatic Stress Disorder in Adult Female Survivors of Childhood Sexual Abuse.

The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioral therapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be more effective than PCT and WL in decreasing PTSD and related symptoms. CBT participants were significantly more likely than PCT participants to no longer meet criteria for a PTSD diagnosis at follow-up assessments. CBT and PCT were superior to WL in decreasing PTSD symptoms and secondary measures. CBT had a significantly greater dropout rate than PCT and WL. Both CBT and PCT were associated with sustained symptom reduction in this sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intrapersonal and Familial Effects of Child Sexual Abuse on Female Partners of Male Survivors.

Intrapersonal and familial effects of childhood sexual abuse (CSA) were investigated by interviewing 10 female partners of male survivors. Consensual qualitative research analysis (C. Hill, B. Thompson, & E. Nutt Williams, 1997) yielded 13 domains describing male partner, female partner, couple, and family functioning. Findings concerning emotional reactions, coping strategies, communication patterns, and sexual functioning correspond to the 3 components of C. Maltas and J. Shay's (1995) trauma contagion model (i.e., threatened beliefs, chronic stress, and reenactment of aspects of CSA). Additional findings suggest themes of recovery from trauma contagion. Whereas results concerning threatened beliefs and chronic stress may replicate to other populations (e.g., partners of war veterans), reenactment of aspects of CSA seems unique. Practice and research recommendations are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rejoinder: The what, when, and how of immediacy.

In this rejoinder, I respond to Muran and Samstag's (2008; see record 2008-13167-003) and Anchin's (2008; see record 2008-13167-004) reactions to the investigation of immediacy in two case studies (Hill et al., 2008; see record 2008-13167-001; Kasper, Hill, & Kivlighan, 2008; see record 2008-13167-002). In particular, I focus on theoretical and methodological issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental Differences in the Function and Use of Anatomical Dolls During Interviews With Alleged Sexual Abuse Victims.

The impact of anatomical dolls on reports provided by 3- to 12-year-old alleged sexual abuse victims (N = 178) was examined. Children produced as many details in response to open-ended invitations with and without the dolls. In response to directive questions, the 3- to 6-year-olds were more likely to reenact behaviorally than to report verbally, whereas the 7- to 12-year-olds produced more verbal details than enactments when using the dolls. With the dolls, the younger children were more likely than the older children to play suggestively and to contradict details provided without the dolls, whereas the older children were more likely to provide details that were consistent. Children in both age groups produced proportionally more fantastic details with the dolls than without the dolls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group Climate, Cohesion, Alliance, and Empathy in Group Psychotherapy: Multilevel Structural Equation Models.

This study examined the definitional and statistical overlap among 4 key group therapeutic relationship constructs--group climate, cohesion, alliance, and empathy--across member-member, member-group, and member-leader relationships. Three multilevel structural equation models were tested using self-report measures completed by 662 participants from 111 counseling center and personal growth groups. As hypothesized, almost all measures of therapeutic relationship were significantly correlated. Hypothesized 1-factor, 2-factor (Working and Bonding factors), and 3-factor (Member, Leader, and Group factors) models did not fit the data adequately. An exploratory model with Bonding, Working, and Negative factors provided the best fit to the data. Group members distinguished among relationships primarily according to relationship quality rather than the status or role of others (i.e., leader, member, or whole group). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist Alienation: Foreseeing and Forestalling Third-Party Dynamics Undermining Psychotherapy With Children of Conflicted Caregivers.

The phenomena of impasse and rupture in the psychotherapy relationship have been discussed mostly in terms of the dynamics of the therapist-patient dyad. Therapist alienation identifies the disruptive impact of third-party contamination of the patient's therapeutic alliance with the therapist. Therapist alienation and its intrafamilial cousin, parental alienation, are examined here from an attachment perspective, emphasizing the role of the cognitive schemas underlying each relationship. Case examples are drawn from the author's experience conducting psychotherapy with children of highly conflicted caregivers. Specific recommendations are offered to minimize the likelihood of therapeutic rupture due to therapist alienation. How to respond when and if therapist alienation is suspected and future directions for clinical work, empirical research, and legal process are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models of addiction: Introduction to the Special Issue.

This Special Issue contains articles that highlight empirical approaches to addiction that have clear theoretical relevance as well as articles that present significant theoretical perspectives on addiction. This collection reflects the implicit assumption that types of addiction are more similar than dissimilar. The characteristics of drug exposure that promote physical dependence, the occurrence of tolerance, the associative elicitation of tolerance, the time course of relapse to drug use, the phenomenology of drug urges or cravings, the precipitants of relapse, the obsessive concern with securing and using drugs are all commonalities among addictive disorders that underscore the fact that addiction is expressed through universal motivational mechanisms and processes. Diverse addictive disorders are phenotypically similar because their motivational bases are similar; if not in particular, then in principle. The selections in this Special Issue reflect a set of assumptions that can be seen as promising areas for future research and theorizing. The first area concerns the application of traditional motivational models and concepts to addictive disorders. The second area for future research and theorizing deals with cognitive or information processing models of addiction. The third area covered in this Special Issue concerns interpersonal/social context. The final area covered in this issue deals with genetics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child Sexual Abuse and Number of Sexual Partners in Young Women: The Role of Abuse Severity, Coping Style, and Sexual Functioning.

The authors proposed and tested a model describing distinct pathways through which childhood sexual abuse (CSA) may lead to relatively low or high numbers of sexual partners in adulthood. Path analyses were conducted on survey responses of young female US Navy recruits who reported CSA (N=547). Use of avoidant strategies to cope with CSA was expected to produce higher levels of sexual problems and fewer heterosexual sex partners, whereas use of self-destructive coping strategies was expected to result in more dysfunctional sexual behavior and more heterosexual sex partners. As predicted, the effect of CSA on number of sex partners was largely mediated by coping strategies and dysfunctional sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary on "The 'Ins and Outs' of Enactment: A Relational Bridge for Psychotherapy Integration" by Frank.

This commentary reviews and critiques Kenneth A. Frank's (2002) article, in which he discusses the concept and nature of enactment and its power as a tool for integrating action -oriented, cognitive-behavioral treatments and insight-oriented psychodynamic treatments. Frank convincingly shows how enactments-both in and out of therapy-are pervasive, play a central part in personality difficulties, and can be used to effect change. Additionally, the concept of enactment is a valuable tool for psychotherapy integration. Suggestions are given for further, increasing the power of the concept through incorporation of the family systems perspective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric Properties of the Posttraumatic Cognitions Inventory (PTCI): A Replication With Motor Vehicle Accident Survivors.

This study examined the factor structure, internal consistency, concurrent validity, discriminant validity, and discriminative validity of the Posttraumatic Cognitions Inventory (PTCI; E. B. Foa, A. Ehlers, D. M. Clark, D. F. Tolin, & S. M. Orsillo, 1999) in a sample of 112 individuals who had experienced a serious motor vehicle accident. Results generally supported the 3-factor structure of the PTCI: (a) Negative Cognitions About Self, (b) Negative Cognitions About the World, and (c) Self-Blame. Subscales reflecting negative thoughts of the self and world showed adequate internal consistency, as well as good concurrent, discriminant, and discriminative validity. However, difficulties with the subscale representing self-blame emerged, specifically poor concurrent and discriminant validity. Potential reasons for this finding are discussed. The PTCI seems to be a promising measure of negative and dysfunctional posttrauma cognitions, which deserves continuing attention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating Parenting Capacity: Validity Problems With the MMPI-2, PAI, CAPI, and Ratings of Child Adjustment.

Practitioners who conduct assessments of parenting capacity for the courts are faced with the challenge of determining the extent to which positive self-presentation by parents distorts test findings. This study examined positive self-presentation bias on commonly used psychological tests in cases referred following removal of children from the home because of abuse or neglect. Substantial positive self-presentation bias was apparent on the measures examined, and parents who presented themselves positively on one test tended to do so on others. Intellectual functioning did not account for these findings. The results demonstrate the pervasive problem of positive self-presentation bias in compromising the validity of test results in this population. Recommendations for conducting clinical assessments with this population are offered, including direction for the use and interpretation of psychological tests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Beyond the therapeutic relationship: Behavioral, biological, and cognitive foundations of psychotherapy.

Reviews the book, Beyond the therapeutic relationship: Behavioral, biological, and cognitive foundations of psychotherapy by Frederic J. Leger (see record 1997-36714-000). Leger has tackled the very large task of presenting an integrative, eclectic theory of psychotherapy which specifies the behavioural, biological, and cognitive processes that underlie psychotherapeutic change. In doing so, he follows in the tradition of other integrationists who have strived to outline frameworks that can encompass the diversity of explanatory emphases and practices in the dozens of present-day psychological therapies. In part, Leger's goal in proposing a "higher-order theory" is to lessen the "confusion which threatens to overwhelm the field" and to hasten a "convergence of scientific opinion." Leger supports his higher-order theory by drawing from a massive amount of literature in areas as seemingly diverse as nonverbal interaction, cognitive science, physiology, neurology, and discursive psychology, as well as from his own clinical experience. And it is the scope of his knowledge and his attempt to focus the reader's attention on the importance of the often ignored influence of therapists' nonverbal behaviours and the frequently taken-for-granted effects of maximal client self-disclosure that are the most impressive features of the book. However, the reviewer feels that the book may not have much impact, first because there have been several previous attempts by other writers to propose models of eclectic psychotherapy or to develop frameworks for integrating diverse forms of psychotherapy, and second because the style in which it is written quickly becomes rather tiresome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Notes on lifelong resilience. Perceptual and personality factors implicit in the creation of a particular adaptive style.

Resilience in children has conventionally been defined as the capacity to negotiate ordinary developmental tasks successfully in spite of cumulative adversity (P. Fonagy et al., 1994; A. S. Masten et al., 1999; H. Stein et al., 2000; E. Werner & R. S. Smith, 1992). It has been attributed in part to the presence of "protective factors" in the child or in the environment (M. Rutter, 1985). The case of "Rita," a young African American woman, is presented as an example of a person who developed extraordinary resilience as a child in the face of chronic abuse. She was able to create sustaining relationships in the "safe space" (J. Sandler, 1960) she achieved through the use of eye contact. The way she put eye contact to use to develop resilience is explored by means of attachment and psychoanalytic theory. Finally, her work in psychoanalytically oriented psychotherapy is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parenting education with expectant and new parents: A meta-analysis.

The present meta-analysis integrates the effects of randomized controlled trials that focus on promoting effective parenting in the transition to parenthood. We included 142 papers on interventions which started during pregnancy or in the first 6 months after birth. Computations were based on random-effects models. On average, interventions had small to very small significant effects on parenting (d = .35 SD units), parental stress (d = .20), child abuse (d = .13), health-promoting behavior of parents (d=.15), cognitive development (d = .24), social development (d = .30), motor development of the child (d = .15), child mental health (d = .40), parental mental health (d = .31), and couple adjustment (d = .13). Most of the effects were maintained at follow-up. Effects varied by onset of the intervention, delivery mode, qualification of the intervener, length of intervention, intervention goals, and gender distribution. In addition, we found that older studies reported greater effect sizes. We conclude that parenting-focused interventions are effective and should be made accessible to more expectant and new parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's representations of multiple family relationships: Organizational structure and development in early childhood.

The authors examine mutual family influence processes at the level of children's representations of multiple family relationships, as well as the structure of those representations. From a community sample with 3 waves, each spaced 1 year apart, kindergarten-age children (105 boys and 127 girls) completed a story-stem completion task, tapping representations of multiple family relationships. Structural equation modeling with autoregressive controls indicated that representational processes involving different family relationships were interrelated over time, including links between children's representations of marital conflict and reactions to conflict, between representations of security about marital conflict and parent-child relationships, and between representations of security in father-child and mother-child relationships. Mixed support was found for notions of increasing stability in representations during this developmental period. Results are discussed in terms of notions of transactional family dynamics, including family-wide perspectives on mutual influence processes attributable to multiple family relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation, self–other representations, and rupture–repair processes: Predicting child maltreatment risk.

This set of studies was designed to examine the relational underpinnings of child abuse potential in a sample of 51 urban families. In Study 1, lower maternal differentiation of self—most notably, greater emotional reactivity and greater emotional cutoff—along with self-attacking introjects distinguished mothers at higher risk (vs. lower risk) for child maltreatment. In Study 2, patterns of interactive rupture and repair were examined in a subsample of 15 families and found to vary as a function of risk for child maltreatment. Specifically, Structural Analysis of Social Behavior coding (SASB; Benjamin, 1996, 2003) of mother–children interactions during 2 moderately stressful lab tasks revealed higher rates of interactive mismatch and mother-initiated ruptures and fewer successful repairs in families at higher risk for child maltreatment, relative to families at lower risk. Implications for counseling and directions for further translational research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Assessing dangerousness: Violence by sexual offenders, batterers and child abusers.

Reviews the book, Assessing dangerousness: Violence by sexual offenders, batterers and child abusers by Jacqueline C. Campbell (see record 1995-98215-000). This is a valuable volume of consistently well written chapters by authors of diverse backgrounds. The book's chapters identify research on clusters of risk factors for child abuse, wife assault, homicide by battered women and sexual offending. The identification of risk factors is the prevalent concept in contemporary violence prediction research. Risk factors are determined by researching actual circumstances of violence and statistically identifying antecedent events that appear to be pertinent. The current text is a readable and well referenced overview of the contemporary state of research efforts to address the notion of dangerousness potential. Dangerousness is reviewed in several key interpersonal areas. We anticipate that the text will be attractive to many average readers who unfortunately may be mislead not only by the series editor's stated aspiration, but also by the misguided illusion that the field is slowly progressing towards actual empirical prediction of dangerousness. For the professional reader who has practical experience with violent behavior, we anticipate that the text will be a valuable concise resource for at least the next several years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)