Management and treatment of febrile seizures

This article explores the relationship between sociopsychological factors, sexual activity, and sexual satisfaction in a sample of 1,216 elderly people (mean age = 77.3). Almost 30% had participated in sexual activity in the past month and 67% were satisfied with current level of sexual activity. Men are more likely to be sexually active, but less apt than women to be satisfied with their level of sexual activity. Regarding predictors of sexual activity, for men the strongest predictors were being younger and having more education. For women, the strongest predictor by far was being married. For both men and women the strongest predictors for satisfaction were being sexually active and having positive mental health scores. In summary, the main variables predicting sexual activity were being married, having more education, being younger, being male, and having good social networks. The main predictors for satisfaction with sexual activity were, in addition to being sexually active, being female, having good mental health, and better functional status.     

The relationship between stress and depression in first onsets versus recurrences: A meta-analytic review.

S. M. Monroe and K. L. Harkness (see record 2005-02750-005) reviewed the empirical evidence supporting R. M. Post's (see record 1992-43211-001) kindling model, which suggests the 1st episode of depression is more likely to be preceded by major stressors than are subsequent episodes. Their review highlighted the diverse interpretations of Post's premise in the current literature and the changes in research methods that have contributed to this interpretive shift. The authors conducted a meta-analysis (N=13 studies) to test Post's premise that integrated early and recent research and examined potential moderators. A proportion difference effect size was used. Results indicated that 1st onsets of depression were more likely than recurrences to be preceded by severe life events, supporting Post's premise. The moderator analyses suggested that support may be most evident in patient samples and may vary according to age and gender, with less support for Post's premise evidenced in younger samples and in women. Although these results are preliminary, as the analysis included a small number of studies, they suggest that future research should further examine factors that influence the stress-depression relationship with successive recurrences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist adherence/competence and treatment outcome: A meta-analytic review.

Objective: The authors conducted a meta-analytic review of adherence–outcome and competence–outcome findings, and examined plausible moderators of these relations. Method: A computerized search of the PsycINFO database was conducted. In addition, the reference sections of all obtained studies were examined for any additional relevant articles or review chapters. The literature search identified 36 studies that met the inclusion criteria. Results: R-type effect size estimates were derived from 32 adherence–outcome and 17 competence–outcome findings. Neither the mean weighted adherence–outcome (r = .02) nor competence–outcome (r = .07) effect size estimates were found to be significantly different from zero. Significant heterogeneity was observed across both the adherence–outcome and competence–outcome effect size estimates, suggesting that the individual studies were not all drawn from the same population. Moderator analyses revealed that larger competence–outcome effect size estimates were associated with studies that either targeted depression or did not control for the influence of the therapeutic alliance. Conclusions: One explanation for these results is that, among the treatment modalities represented in this review, therapist adherence and competence play little role in determining symptom change. However, given the significant heterogeneity observed across findings, mean effect sizes must be interpreted with caution. Factors that may account for the nonsignificant adherence–outcome and competence–outcome findings reported within many of the studies reviewed are addressed. Finally, the implication of these results and directions for future process research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of febrile seizures with intermittent clobazam

Fifty children, 24 female and 26 male, with ages varying from 6 to 72 months (mean = 23.7 m.) that experienced at least one febrile seizure (FS) entered a prospective study of intermittent therapy with clobazam. Cases with severe neurological abnormalities, progressive neurological disease, afebrile seizures, symptomatic seizures of other nature, or seizures during a central nervous system infection were excluded. Seizures were of the simple type in 25 patients, complex in 20 and unclassified in 5. The mean follow-up period was 7.9 months (range = 1 to 23 m.), and the age at the first seizure varied from 5 to 42 months (mean = 16.8 m.). Clobazam was administered orally during the febrile episode according to the child's weight: up to 5 kg, 5 mg/day; from 5 to 10 kg, 10 mg/day; from 11 to 15 kg, 15 mg/day, and over 15 kg, 20 mg/day. There were 219 febrile episodes, with temperature above 37.8 degrees C, in 40 children during the study period. Twelve children never received clobazam and 28 received the drug at least once. Drug efficacy was measured by comparing FS recurrence in the febrile episodes that were treated with clobazam with those in which only antipyretic measures were taken. Ten children (20%) experienced a FS during the study period. Of the 171 febrile episodes treated with clobazam there were only 3 recurrences (1.7%), while of the 48 episodes treated only with antipyretic measures there were 11 recurrences (22.9%), a difference highly significant (p < 0.0001). Adverse effects occurred in 10/28 patients (35.7%), consisting mainly in vomiting, somnolence and hyperactivity. Only one patient had recurrent vomiting which lead to drug interruption. These effects did not necessarily occurred in every instance the drug was administered, being present in one febrile episode and not in the others. We conclude that clonazepam is safe and efficacious in preventing FS recurrence. It may be an alternative to diazepam in the intermittent treatment of FS recurrence.     

Children's friendship relations: A meta-analytic review.

Children's friendships represent mutual dyadic relationships that differ from peer relations, which have lesser affective ties. This meta-analytic review fit categorical models (L. V. Hedges, 1982) to examine the behavioral and affective manifestations of children's friendships as evinced by comparisons of friends and nonfriends. Analysis of our broadband categories revealed that friendships, compared with nonfriend relations, are characterized by more intense social activity, more frequent conflict resolution, and more effective task performance. Also, relationships between friends are marked by reciprocal and intimate properties of affiliation. At the level of narrowband categories, friendship relations afford a context for social and emotional growth. These behavioral and affective manifestations of friendship are moderated by the age level of participants, the strength of the relationship, and the methodology of the study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-disclosure and liking: A meta-analytic review.

Self-disclosure plays a central role in the development and maintenance of relationships. One way that researchers have explored these processes is by studying the links between self-disclosure and liking. Using meta-analytic procedures, the present work sought to clarify and review this literature by evaluating the evidence for 3 distinct disclosure-liking effects. Significant disclosure-liking relations were found for each effect: (1) People who engage in intimate disclosures tend to be liked more than people who disclose at lower levels, (2) people disclose more to those whom they initially like, and (3) people like others as a result of having disclosed to them. In addition, the relation between disclosure and liking was moderated by a number of variables, including study paradigm, type of disclosure, and gender of the discloser. Taken together, these results suggest that various disclosure-liking effects can be integrated and viewed as operating together within a dynamic interpersonal system. Implications for theory development are discussed, and avenues for future research are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and immunity: A meta-analytic review.

A meta-analysis indicated that clinical depression was associated with several large alterations in cellular immunity. Analyzing only methodologically sound studies, reliable immune alterations included lowered proliferative response of lymphocytes to mitogens (effect size rs?=?.24–.45), lowered natural killer cell activity (r?=?.28), and alterations in numbers of several white blood cell populations (rs?=?.11–.77). Immune alterations were greater in both older and hospitalized samples. There was also evidence of a linear relation between intensity of depressive affect and indicators of cellular immunity. Estimates of sample sizes needed to detect reliable effects for each immune outcome are provided. How neuroendocrine mechanisms or health practices might link depression to immunity is discussed, and design features needed to better understand these pathways are specified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of relapse prevention: A meta-analytic review.

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lifestyle interventions in the treatment of childhood overweight: A meta-analytic review of randomized controlled trials.

Context: Evaluating the efficacy of pediatric weight loss treatments is critical. Objective: This is the first meta-analysis of the efficacy of RCTs comparing pediatric lifestyle interventions to no-treatment or information/education-only controls. Data Sources: Medline, PsycINFO, and Cochrane Controlled Trials Register. Study Selection: Fourteen RCTs targetting change in weight status were eligible, yielding 19 effect sizes. Data Extraction: Standardized coding was used to extract information on design, participant characteristics, interventions, and results. Data Synthesis: For trials with no-treatment controls, the mean effect size was 0.75 (κ = 9, 95% confidence interval [CI] = 0.52-0.98) at end of treatment and 0.60 (κ = 4, CI = 0.27-0.94) at follow-up. For trials with information/education-only controls, the mean ES was 0.48 (κ = 4, CI = 0.13-0.82) at end of treatment and 0.91 (κ = 2, CI = 0.32-1.50) at follow-up. No moderator effects were identified. Conclusions: Lifestyle interventions for pediatric overweight are efficacious in the short term with some evidence for extended persistence. Future research is required to identify moderators and mediators and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of the effectiveness of inpatient group psychotherapy.

The effectiveness of inpatient group therapy was estimated in a meta-analysis of 24 controlled and 46 studies with pre-post-measures published between 1980 and 2004. Diagnosis, theoretical orientation and the role of the group in the particular treatment setting were used to examine differential effectiveness. Beneficial effects were found for inpatient group therapy in controlled studies (d = 0.31) as well as in the studies with pre-post-data (d = 0.59). Differences in the homogeneity of patient improvement effect sizes were found across different diagnostic categories. Furthermore, greater improvement was exhibited in mood disorder patients when compared to mixed, psychosomatic, post traumatic stress disorder (PTSD), and schizophrenic patients replicating recent findings from meta-analyses of outpatient group treatment. A comparison between controlled studies and pre-post-measure studies indicated no improvement for waitlist patients which contradicts previous reports. Implications for therapy and future research are discussed within the context of methodical considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of benefit finding and growth.

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of the relationship between absence and turnover.

A meta-analysis that combined 33 correlations from 17 studies found a corrected average correlation of .330 between absence and turnover. The type of absence measure did not moderate the covariation between absence and turnover, but industry type and study duration did act as moderators. The results are discussed in the context of the "withdrawal" approach to understanding employee behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The duration of febrile seizures and peripheral leukocytosis

In 203 consecutive children with febrile seizures, no clear association (odds ratio = 1.0 [95% CI, 0.9-1.1], P = .59) was found between seizure duration and blood leukocytosis (> or = 15.0 x 10(9) cells/L). Increased leukocyte counts may be misinterpreted because of seizure duration. In children with febrile seizures, leukocyte counts should be used to evaluate the underlying cause of fever.     

Perceived discrimination and health: A meta-analytic review.

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study’s contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious involvement and mortality: A meta-analytic review.

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio?=?1.29; 95% confidence interval: 1.20–1.39), indicating that people high in religious involvement were more likely to be alive at follow-up than people lower in religious involvement. Although the strength of the religious involvement–mortality association varied as a function of several moderator variables, the association of religious involvement and mortality was robust and on the order of magnitude that has come to be expected for psychosocial factors. Conclusions did not appear to be due to publication bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributional style in depression: A meta-analytic review.

Conducted a meta-analysis of the attribution–depression relation in studies appearing in the clinical, social, personality, and educational literatures. In 104 studies involving nearly 15,000 Ss, several attributional patterns had reliable associations with depression scores. For negative events, attributions to internal, stable, and global causes had a reliable and significant association with depression. Studies in which the attribution factors of ability and luck were measured also showed a reliable association with depression. Ability and luck attribution factors for positive events were also associated with depression. The relations for positive events, however, were weaker than the corresponding ones for negative events. In general, these patterns of relations were independent of a number of potential mediators suggested by authors in this literature, including the type of S studied (psychiatric vs college student), the type of event about which the attribution is made (real vs simulated), the depression measure used, or the publication status of the research report. Conclusions are compared with those of other reviews. Implications for attributional models of depression are discussed. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurocognition in first-episode schizophrenia: A meta-analytic review.

Compromised neurocognition is a core feature of schizophrenia. Following Heinrichs and Zakzanis’s (1998) seminal meta-analysis of middle-aged and predominantly chronic schizophrenia samples, the aim of this study is to provide a meta-analysis of neurocognitive findings from 47 studies of first-episode (FE) schizophrenia published through October 2007. The meta-analysis uses 43 separate samples of 2,204 FE patients with a mean age of 25.5 and 2,775 largely age- and gender-matched control participants. FE samples demonstrated medium-to-large impairments across 10 neurocognitive domains (mean effect sizes from ?0.64 to ?1.20). Findings indicate that impairments are reliably and broadly present by the FE, approach or match the degree of deficit shown in well-established illness, and are maximal in immediate verbal memory and processing speed. Larger IQ impairments in the FE compared to the premorbid period, but comparable to later phases of illness suggests deterioration between premorbid and FE phases followed by deficit stability at the group level. Considerable heterogeneity of effect sizes across studies, however, underscores variability in manifestations of the illness and a need for improved reporting of sample characteristics to support moderator variable analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of competency to stand trial research.

The present study is a meta-analysis of competency to stand trial research. One meta-analysis was previously conducted in this area, but the large number of empirical studies that have been conducted since and the introduction of new instruments and revision of old instruments warranted updating and expanding upon the previously conducted study via contemporary meta-analytic methods. We meta-analyzed 68 studies published between 1967 and 2008 that compared competent and incompetent defendants on a number of demographic, psychiatric, and criminological variables. Categorical and continuous variables commonly investigated in competency research were coded and aggregated to generate cumulative effect sizes in the form of odds ratios and Cohen's d statistics, and moderation was tested via meta-F and meta-regression analyses. The most robust findings were that defendants diagnosed with a Psychotic Disorder were approximately eight times more likely to be found incompetent than defendants without a Psychotic Disorder diagnosis and the likelihood of being found incompetent was approximately double for unemployed defendants as compared to employed defendants. The likelihood of being found incompetent was also double for defendants with a previous psychiatric hospitalization compared to those without a hospitalization history. Comparative data on 12 competency assessment instruments and three traditional instruments were also explored and the effect sizes associated with the competency measures were substantially larger (i.e., approximately one Cohen's d-point) than those for the traditional measures. Limitations of the primary research and the previous and present meta-analyses are presented and future directions in this area are outlined. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Underreporting of psychopathology on the MMPI-2: A meta-analytic review.

Meta-analytic techniques were applied to studies of the MMPI-2 in which participants given standard instructions were compared with participants instructed or believed to have been underreporting. Traditional and supplementary indices of underreporting yielded a mean effect size of 1.25, suggesting that underreporting respondents differ from those responding honestly by a little more than 1 standard deviation, on the average, on these scales. Analyses of classification accuracy suggested that several scales are moderately effective in detecting underreporting, although accuracy decreases if participants have been coached about validity scales. Base rates of defensive responding in relevant populations are reviewed, and methodological issues, including research designs, coaching, and incremental validity of supplementary underreporting scales, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prominent consequences of role stress: A meta-analytic review.

Role stress has received a lot of research attention in psychological, sociological, and organizational studies over the last several decades. Based on a literature review of about 300 journal articles, this article examines prominent consequences of role stress. Specific focus is on researching differences in relationships between facets of role stress (i.e., role ambiguity, role conflict, and role overload) and frequently cited consequences using techniques of meta-analysis. Findings indicate that each role stress facet has a different relationship with the eight consequences studied. Role stress research can benefit from looking at each facet individually in addition to role stress generally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)