Group treatment of depression: Individual predictors of outcome.

The present study attempted to identify patient characteristics predictive of individual outcome in a psychoeducational group treatment for unipolar depression. Forty participants meeting Research Diagnostic Criteria for depressive disorders were assessed on demographic and psychological variables at both pre- and posttreatment and on participation variables during treatment. The treatment modality was the Coping With Depression Course. At the end of treatment, 85% of the subjects no longer met diagnostic criteria for depressive disorders. A stepwise multiple regression analysis attained a multiple correlation of .92, accounting for 85% of the variance in posttreatment depression level. Ten variables accounted for significant portions of the outcome variance beyond that explained by pretreatment Beck Depression Inventory scores. The results of previous studies were partially replicated; predictive ability was improved markedly over prior reports. The results suggest that the most robust predictors of outcome are pretreatment levels of depression, social functioning, perceived mastery over events, and early positive perceptions of group cohesiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttreatment functioning of alcoholic patients: Its relation to program participation.

Assessed the posttreatment functioning of 429 alcoholic patients selected from 5 different types of residential treatment facilities. Substantial improvement in 3 areas of functioning (drinking, occupational, and psychological) occurred among patients in each of the programs, although there were significant differences among the programs in the level of functioning at intake and at follow-up. The extent to which posttreatment adjustment could be predicted from patients' sociodemographic and drinking characteristics at intake was estimated from multiple regression analyses: 15 to 33% of the variance of several posthospital performance criteria was explained. Measures of relative improvement (differences between actual and predicted posttreatment functioning) were obtained and showed some variation among the programs. Analyses relating relative improvement to the treatment experiences of the patients in each program demonstrated that (a) patients who participated more actively tended to have better than expected outcomes, (b) patients given more medications tended to function relatively more poorly at follow-up, and (c) patients given Antabuse had better than expected outcomes. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family-based interventions for pediatric obesity: Methodological and conceptual challenges from family psychology.

Family-based interventions for pediatric obesity are defined by active parent involvement in treatment. In the current review the authors examine 31 family-based interventions with published outcome data and distinguish 4 categories of family-based interventions: (a) Target a narrow range of parent behaviors related to eating/exercise and assess change only in terms of child eating, exercise, or weight; (b) target a similarly narrow range of parent behaviors but nevertheless assess program-related changes in general parenting skills or family functioning; (c) target a broad range of parent behaviors related to general parenting and family functioning but do not assess program-related changes in these areas; and (d) target general parenting or family functioning and also assess program-related changes in these areas. The authors highlight methodological and conceptual challenges facing researchers in this area and argue for an even broader family focus in family-based interventions for pediatric obesity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Outcome of multimodal day treatment for children with severe behavior problems: a five-year follow-up

OBJECTIVE: To evaluate the long-term outcome of a multimodal day treatment program for children with severe behavior problems and to identify factors that may predict a positive outcome. METHOD: Thirty-three children who completed a day treatment program were assessed using a prospective, single-cohort design tested at intake, discharge, and 5-year follow-up. The child's functioning was assessed using the Revised Child Behavior Profile (RCBP), Hare Self-Esteem Scale, Depression Self-Rating Scale, Hopelessness Scale for Children, Index of Peer Relations, and a 5-point ordinal scale for scholastic reintegration. RESULTS: Repeated-measures analyses of variance showed that improvement was maintained on all measures between intake and 5-year follow-up. A stepwise multiple regression showed that 92% of the adjusted variance in the behavioral functioning of the children at 5-year follow-up, as assessed by the RCBP, was explained by parental cooperation, initial RCBP total and externalizing scores, and history of problem pregnancy. CONCLUSIONS: Children who were admitted to a day treatment setting appear to function well globally, even 5 years after discharge. Parental cooperation was the most important variable in predicting positive outcome.     

Predicting successful completion of an aftercare program following treatment for alcoholism: The role of dispositional optimism.

In this study we investigated several variables as potential predictors of success in completing a transition program after treatment for alcoholism. Subjects were 54 men who had completed a 30-day treatment program and who were subsequently admitted to a 90-day inpatient aftercare program. The outcome measure was successful completion of this latter program. Predictor variables were dispositional optimism, hassles, uplifts, and several demographic variables. Optimism was positively associated with successful outcome. The simple association between uplifts and outcome also approached significance, but in the opposite to expected direction. Discriminant analyses used both of these variables, as well as age and education level, as predictors of successful outcome. There was no evidence of a role for hassles. Discussion centers on the importance of dispositional optimism as a predictor of successful adaptation in a variety of behavioral domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of relationship functioning for patients with bipolar disorder and their partners.

Previous investigations have examined family functioning, including marital functioning, as an important predictor of the course of bipolar disorder, but limited research exists identifying the factors that influence relationship functioning in patients with bipolar disorder. In the current study, 56 patients with bipolar disorder and their partners were assessed for Axis II pathology, general family functioning, and relationship distress. Patient mood symptoms and Axis II pathology variables were examined as predictors of general relationship functioning (Family Assessment Device, McMaster Clinical Rating Scale, and Dyadic Adjustment Scale) in regression models. Analyses indicated that patients' depressive symptomatology was associated with patient ratings of general family functioning and couple functioning, while patients' manic symptoms were associated with partners' ratings of the romantic relationship. Partners' total Axis II pathology, but not patients' Axis II pathology, was associated with patient and partner perception of the couple's relationship. These findings highlight the importance of mood and personality pathology to relationship functioning, and represent one of the first investigations to verify the impact of personality pathology on patients' and partners' perceptions of relationship functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social-cognitive predictors of health behavior: Action self-efficacy and coping self-efficacy.

The effects of social-cognitive variables on preventive nutrition and behavioral intentions were studied in 580 adults at 2 points in time. The authors hypothesized that optimistic self-beliefs operate in 2 phases and made a distinction between action self-efficacy (preintention) and coping self-efficacy (postintention). Risk perceptions, outcome expectancies, and action self-efficacy were specified as predictors of the intention at Wave 1. Behavioral intention and coping self-efficacy served as mediates linking the 3 predictors with low-fat and high-fiber dietary intake 6 months later at Wave 2. Covariance structure analysis yielded a good model fit for the total sample and 6 subsamples created by a median split of 3 moderators: gender, age, and body weight. Parameter estimates differed between sample; the importance of perceived self-efficacy increased with age and weight. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of physical health functioning, mental health, and sociodemographic factors in determining the intensity of mental health care use among primary care medical patients.

The present study examined sociodemographic and attitudinal predisposing factors (gender, age, marital status, health insurance, household income, attitudes about mental health care), and need/illness variables (depression severity, physical and mental health functional status) as predictors of past-year mental health care use intensity (i.e., visit counts) and use/nonuse. The sample included 283 adult primary care patients from the Midwestern United States in a cross-sectional study. Nonlinear regression models demonstrated that past-year treatment use intensity was significantly associated with both married status and poorer physical health functioning, while the use (vs. nonuse) of treatment was associated with depression severity. A sociodemographic and attitudinal multivariate predictor model only explained 5% of the variance in treatment use intensity, but a need/illness model significantly contributed an additional 23% variance. Poorer physical health functioning was significant in predicting treatment use intensity, while depression severity was significant in predicting the use (vs. nonuse) of treatment. Results demonstrate the particular importance of physical health problems in determining the intensity of mental health care use, and depression severity in determining the use/nonuse of treatment, notwithstanding the restricted sociodemographic contour of the sample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of patient outcomes following interactions with nurses

A research and theory-based model was used to identify outcome predictors of hospitalized patients' perceptions of caring and support by nurses. The model tested the effects of cogent personal characteristics of patients (general level of self-esteem and need for control while hospitalized) on their perceptions of humanistic caring and support from nurses and, in turn, considered the effect of these variables on situational appraisal, coping strategies, psychological distress, and coping effectiveness. The 120 hospitalized adult patients indicated that the moderate amount of humanistic caring they received was beneficial. Several factors influenced caring ratings. Higher positive ratings were received from younger patients; however, people with low self-esteem and those desiring more control over their care or reporting a high degree of pain tended to perceive more threat and psychological distress as a results of their encounters with nurses. Following positive caring experiences with nurses, patients with higher self-esteem levels reported effective coping. Overall, positive caring experiences, along with coping strategies and decreased psychological distress levels, explained 40% of the variance of hospitalized patients' ability to cope effectively following their encounters with nurses.     

Prediction of individual outcome in a group intervention for depression.

75 Ss (mean age 36 yrs) who met Research Diagnostic Criteria for a current episode of Major, Minor, or Intermittent Depressive Disorder were assessed on a number of demographic and psychological variables prior to beginning treatment. Treatment outcome was assessed by the Beck Depression Inventory and the Schedule for Affective Disorders and Schizophrenia. Ss at all levels of depression severity improved markedly, but those who were initially more depressed tended to maintain their relative ranking at posttreatment. After accounting for pretreatment depression severity (PTDS), 6 additional variables emerged as significant predictors of outcome: Ss who improved most had expected to be least depressed posttreatment, had greater perceptions of mastery, had greater reading ability, were younger, perceived their families as more supportive, and were not receiving additional concurrent treatment for depression. These 7 variables, including PTDS, accounted for 51% of the variance in posttreatment depression level. These same variables, excluding PTDS, significantly discriminated between Ss who still met diagnostic criteria for depression at the posttreatment assessment and those who were no longer depressed. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder.

A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Length of stay and program component effects in the treatment of alcoholism: A comparison of two techniques for process analyses.

Evaluated the effects of length of treatment and specific treatment components (therapy sessions, Alcoholics Anonymous meetings, and films and lectures on alcoholism) of 3 residential alcoholism programs. Two statistical techniques—partial correlation and treatment-effect correlation—were compared for their estimates of treatment effects after controlling for patient background characteristics and functioning at intake. Longer periods of treatment were associated with better outcome for the 59 residents of a halfway house but not for the 92 patients at a milieu-oriented program or the 97 males at a Salvation Army center. Evidence suggest that the 3 program components tended to have moderately beneficial effects on outcome, although the results varied in some cases, depending on whether partial or treatment-effect correlation was used in the analysis. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

GRE predictive validity in a Master's program in clinical psychology.

Presents predictive validity data for GRE scores collected in the Master's program in clinical psychology at Acadia University. The program typically admits 4 or 5 students per year, and the current sample consists of 37 students (29 females, 8 males) who have completed their 2-yr residency requirement in the program over the past 10 years. Upon application, 12 of the admitted students did not provided GRE scores, and of the other 25, 4 did not write the Advanced test in psychology. Cumulative undergraduate 4-point GPAs and 4 GRE scores were used as predictors, and these means are lower than would be found in PhD graduate programs in larger schools or PhD-level programs. Outcome variables were whether students were accepted into a PhD program; external awards; graduating on time; and thesis publication. A series of t-tests were conducted to examine which predictors discriminated between outcome variables. Results show that GRE scores were highly predictive of a range of outcome variables in the Acadia Master's program where there is a higher degree of variability in predictors. The importance of how GRE scores are used in combination with other predictors is noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identifying survivors at risk: Long-term impairment following the Beverly Hills Supper Club fire.

Examined the chronic responses of survivors of a 1977 supper club fire, in which 165 people died, from the standpoint of linking individual differences in aspects of the fire experience to differential outcome. 117 Ss were interviewed on stress, life events, coping, social supports, psychopathology, and symptoms 1 yr postfire. 67 Ss were reinterviewed a year later. Hierarchical regression analyses for multiple outcome measures showed that the most predictable symptoms at 1 yr were those associated with stress disorders. The independent variables contributing most to that prediction were aspects of the S's experience (e.g., bereavement, injury). Predictability shifted somewhat in the 2nd yr for the outcome measures: Secondary measures (those with a hostility component) became more predictable. Overall, up to 45% of outcome variance 1-yr postfire could be explained by the individual's experiences surrounding the fire. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biofeedback treatment for pediatric migraine: Prediction of treatment outcome.

Despite a growing number of studies showing good effectiveness of nonpharmacological treatments such as thermal biofeedback (TBF) for pediatric migraine, little is known about psychosocial variables that might be predictive of treatment outcome. The identification of predictors appears especially important when children are treated in a home-based treatment format that tends to be somewhat less effective than a therapist-administered treatment. A total of 32 children between the ages 8 and 16 years completed a home-based TBF treatment program with treatment outcome being of similar magnitude as previously reported in the literature. Multiple regression analysis revealed externalizing behavior tendencies, initial level of psychosomatic complaints, and the child's age to be highly predictive of outcome, whereas dimensions of family functioning failed to exert a direct influence. The implications of these findings for the development and evaluation of future treatment programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes.

Tested a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N?=?362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model—largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling psychology students' interest in research: Examining the contribution of achievement goals.

The purpose of this study was to examine the predictive utility of achievement goal theory relative to the outcome of interest in research. The sample consisted of 114 doctoral students in counseling psychology. Results indicated that achievement goals accounted for 24% of the variance in interest in research over and above demographic and social-cognitive/contextual variables. Mastery approach and performance avoidance goals were shown to be significant positive and negative predictors of interest in research, respectively. In addition, age, year in program, and research outcome expectations were found to be significantly associated with interest in research. Implications for research training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goal importance, self-focus, and the goal-setting process.

In this study we examine the role played by perceived goal importance and self-focus in the goal-setting process. More specifically, this study tests the interactive hypotheses that (a) task performance is a function of goal level, self-focus, and perceived goal importance; (b) goal level is a function of perceptions of past performance, self-focus, and perceived goal importance; and (c) perceptions of past performance are a function of actual past performance, self-focus, and perceived goal importance. Hierarchical regression analysis, using a sample of 88 retail salespersons, revealed empirical support for the first two hypotheses. Specifically, the variables described by control theory account for an increment of 6 and 8% of the variance explained in task performance and self-set goal level, respectively. Finally, implications for theory, practice, and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The comparative effectiveness of cognitive processing therapy for male veterans treated in a VHA posttraumatic stress disorder residential rehabilitation program.

Objective: To examine the effectiveness of group cognitive processing therapy (CPT) relative to trauma-focused group treatment as usual (TAU) in the context of a Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) residential rehabilitation program. Method: Participants were 2 cohorts of male patients in the same program treated with either CPT (n = 104) or TAU (n = 93; prior to the implementation of CPT). Cohorts were compared on changes from pre- to posttreatment using the PTSD Checklist (PCL; Weathers, Litz, Herman, Huska, & Keane, 1993) and other measures of symptoms and functioning. Minorities represented 41% of the sample, and the mean age was 52 years (SD = 9.22). The CPT group was significantly younger and less likely to receive disability benefits for PTSD; however, these variables were not related to outcome. Results: Analyses of covariance controlling for intake symptom levels and cohort differences revealed that CPT participants evidenced more symptom improvement at discharge than TAU participants on the PCL, F(3, 193) = 15.32, p     

"Attitudinal Orientations and Cognitive Functioning Among Adolescents:: Erratum.

Reports an error in the original article by Amos Handel (Developmental Psychology, 1975[Nov], Vol 11[6], 667-675). On page 667, the sentence beginning on the fourth line in the third paragraph should read: "This trend focuses on process variables, that is, the actual experiences of children which contribute to their cognitive growth, rather than on status variables (social class, race), which are presumed to represent only surface characteristics of the environment (Wolf, 1964,1966).'In Table 1 on page 670, the first entry under the fourth column ("Progressive Matrices") should read: '-05." In Table 2 on page 671, the third entry under the first column ("Independent variable") should read: "C = A + B = background." (The following abstract of this article originally appeared in record 1976-06752-001.) Examined the pattern of relations of attitudinal orientations to cognitive functioning in 950 Israeli 7th graders. Following the 1966 study by J. S. Coleman et al, attitudinal orientations were represented by measures of locus of control, self-concept, and educational aspirations. Multiple regression analyses showed that 18.1-31.6% of the total variance in 4 measures of cognitive functioning was associated with attitudinal orientations, while only 10.6-18.9% of the total variance in these measures was associated with socioeconomic background variables. In the least economically advantaged group, locus of control was the most potent attitude variable; in the complementary 2 groups of higher socioeconomic status, more of the variance in cognitive functioning was associated with self-concept and aspirations than with locus of control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)