Behavioral and personality correlates of epilepsy: A review, methodological critique, and conceptual model.

Assesses the psychological risk associated with temporal lobe epilepsy and epilepsy in general and identifies other variables associated with an increased risk of psychopathology in epilepsy by reviewing 64 studies published since 1962. Methodological problems include the definition of epilepsy and the interictal state, sample selections, and the need for appropriate controls; until these problems are overcome, the behavioral ramifications of limbic system dysfunction in epilepsy will remain controversial. Greater methodological rigor in the field of epilepsy/psychopathology research will help assess whether animal studies of kindling of limbic structures with subsequent behavior changes have any validity for human psychopathology. There is a growing interest in the behavioral ramifications of neurological disease; however many factors outside of those that are biologically indigenous to the disorder play significant roles in the determination of psychopathology. A conceptual model (brain-, non-brain-, and treatment-related factors) is offered to help explain different proportions of variance for different behavior disorders. (6 p ref) (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)     

Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review.

To identify underlying patterns in the alliance literature, an empirical review of the many existing studies that relate alliance to outcome was conducted. After an exhaustive literature review, the data from 79 studies (58 published, 21 unpublished) were aggregated using meta-analytic procedures. The results of the meta-analysis indicate that the overall relation of therapeutic alliance with outcome is moderate, but consistent, regardless of many of the variables that have been posited to influence this relationship. For patient, therapist, and observer ratings, the various alliance scales have adequate reliability. Across most alliance scales, there seems to be no difference in the ability of raters to predict outcome. Moreover, the relation of alliance and outcome does not appear to be influenced by other moderator variables, such as the type of outcome measure used in the study, the type of outcome rater, the time of alliance assessment, the type of alliance rater, the type of treatment provided, or the publication status of the study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring parental attributions: Conceptual and methodological issues.

A selective review is offered of current issues and new developments in the measurement of parental attributions for social behavior. Attributions have alternatively been conceptualized as involving (a) memory-dependent knowledge structures (i.e., interpretive styles that are dependent on the parent's history) or (b) stimulus-dependent appraisal processes (i.e., interpretations that are dependent on information available in the immediate context). Consideration is given to the theoretical underpinnings of different types of attributional measures and the implicit models within attribution research (e.g., attributions as mediators, attributions as moderators). Finally, psychometric issues within different attributional approaches are discussed, including consideration of the factors that optimize or constrain the utility of different measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intact perceptual and conceptual priming in temporal lobe epilepsy: Neuroanatomical and methodological implications.

Explicit memory appears to be supported by medical temporal lobe structures, whereas separate neocortical regions may mediate perceptual and conceptual implicit memory. Children and adults with temporal lobe epilepsy (TLE) and matched controls were administered experimental verbal memory tests. Performance on implicit tests--word identification and word generation--was contrasted with explicit recognition and recall. Encoding conditions emphasized either conceptual or perceptual aspects of study words and were crossed with presentation modality. The priming performance of participants with TLE did not differ from controls, but participants with TLE did show deficits on recognition and recall measures. Thus, intact left temporal cortex does not appear to be necessary for normal implicit memory performance, even when conceptual processing is emphasized at study or test. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research with families in palliative care: conceptual and methodological challenges

The aims of the present study were to investigate the ability of 3 experienced clinicians to detect occlusal carious lesions, assess their depth, diagnose their activity and define a logical management for each lesion. The material consisted of 35 third molars scheduled for extraction or surgical removal making it possible to validate the accuracy of the clinical recordings histologically. Examinations were carried out at baseline and after 4 months in order to monitor lesion progression. At the first visit a radiograph was taken; the number of filled surfaces was counted and the oral hygiene assessed generally and by disclosing occlusal plaque of the tooth under examination. After cleaning the occlusal surface caries was recorded in a selected investigation site using a visual ranked caries scoring system, as well as an electrical conductance recording (ECM). Apart from counting fillings and taking new radiographs the same procedure was performed at the second visit, which then was followed by extraction of the tooth. After sectioning the tooth lesion depth was recorded, and lesion activity, based on acid production, was assessed using methyl red dye. Lesion activity was also judged by means of polarized light microscopic examinations of the sections. Results showed strong relationships between the visual, ECM and radiographic assessments and both lesion depth and lesion activity. In contrast, all other parameters were poorly related to lesion activity. Changes in visual assessments and in conductance readings from first to second examination were poorly associated with lesion activity. In conclusion, clinicians are able to detect lesions, predict activity and severity and define a logical management of occlusal caries on the basis of a single examination.     

Role of psychosocial treatments in management of schizophrenia: a meta-analytic review of controlled outcome studies

This meta-analytic review sought to answer questions concerning the role of psychosocial treatments in the comprehensive management of patients with schizophrenia. The review focused on the effects of combining psychosocial treatment with somatic treatment. Findings demonstrated the additive and supplementary effects of psychosocial treatments and the durability of these effects. Patients with more chronic illness appeared to be more responsive to psychosocial treatments, as were patients in studies conducted in non-Western countries. Among the Western countries, studies from Scandinavian countries reported the least effectiveness for psychosocial treatments. There was some evidence for differential effect of psychosocial treatments on different dimensions of illness as the measures of disorganized behavior and employment showed little difference in treated and control groups. There was also some evidence for differences between different modalities of treatment as group treatments produced smaller effects. Implications for practice and future research are discussed.     

Changing self-esteem in children and adolescents: a meta-analytic review

Conducted a meta-analytic review of 116 studies, which indicated significant improvement in children's and adolescents' self-esteem and self-concept, and significant concomitant changes in behavioral, personality, and academic functioning. Interventions specifically focused on changing self-esteem and self-concept were significantly more effective (mean effect size = 0.57) than programs focused on another target, such as behavior or social skills (0.10). Treatment programs were also more effective (0.47) than primary prevention programs (0.09) in changing self-esteem. Four variables emerged as significant predictors of self-esteem outcomes: 2 methodological features (type of design and control group), the use of a theoretical or empirical rationale, and the type of program (treatment or prevention). Future research needs to examine the causal connection between changes occurring in self-esteem and other areas of adjustment, assess intervention success for different ethnic groups and for children of different ages and sex, and determine the long-term impact of interventions.     

Shame, guilt, and depressive symptoms: A meta-analytic review.

Recent theoretical and empirical work has facilitated the drawing of sharp conceptual distinctions between shame and guilt. A clear view of these distinctions has permitted development of a research literature aimed at evaluating the differential associations of shame and guilt with depressive symptoms. This study quantitatively summarized the magnitude of associations of shame and guilt with depressive symptoms. Two hundred forty-two effect sizes were obtained from 108 studies employing 22,411 participants. Shame showed significantly stronger associations with depressive symptoms (r = .43) than guilt (r = .28). However, the association of shame and depressive symptoms was statistically indistinguishable from the associations of 2 maladaptive variants of guilt and depressive symptoms (contextual-maladaptive guilt, involving exaggerated responsibility for uncontrollable events, r = .39; generalized guilt, involving “free-floating” guilt divorced from specific contexts, r = .42). Other factors also moderated the effects. External shame, which involves negative views of self as seen through the eyes of others, was associated with larger effect sizes (r = .56) than internal shame (r = .42), which involves negative views of self as seen through one's own eyes. Depressive symptom measures that invoked the term guilt yielded stronger associations between guilt and depressive symptoms (r = .33) than depressive symptom measures that did not (r = .21). Age, sex, and ethnicity (proportion of Whites to Asians) did not moderate the effects. Although these correlational data are ambiguous with respect to their causal interpretation, results suggest that shame should figure more prominently in understandings of the emotional underpinnings of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of the work environment on cardiovascular health: a historical, conceptual, and methodological perspective

The framework of psychosocial epidemiology is used to examine research developments that characterize the accumulation of knowledge regarding the role of the work environment in cardiovascular health and disease. The discussion of current programs of research focuses on the work of T. Theorell and R. Karasek (1996) and J. Siegrist (1996) as exemplars of European and American studies that have contributed the most to the understanding of occupational cardiovascular health. It is argued that researchers need to maintain and nurture relatively broad conceptual models of etiology because cardiovascular disease involves multiple biomedical risk factors and because specific aspects of the work environment are embedded in a large, complex matrix of other psychosocial influences. At the same time, investigators need to push ahead with focused research strategies to clarify the precise nature of the work environmental risk factors that emerge in the broad, somewhat imprecise epidemiologic study designs.     

Stage theories of health behavior: conceptual and methodological issues

Despite growing interest in stage theories of health behavior, there is considerable confusion in the literature concerning the essential characteristics of stage theories and the manner in which such theories should be tested. In this article, the 4 key characteristics of a stage theory-a category system, an ordering of categories, similar barriers to change within categories, and different barriers to change between categories--are discussed in detail. Examples of stage models of health behavior also are described. Four major types of research designs that might be used for testing stage theories are examined, including examples from the empirical literature. The most commonly used design, which involves cross-sectional comparisons of people believed to be in different stages, is shown to have only limited value for testing whether behavior change follows a stage process.     

Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review.

Results from 23 studies examining associations between therapeutic relationship variables and treatment outcomes in child and adolescent therapy were reviewed with meta-analytic procedures. Results indicated that the overall strength of the relationship-outcome associations was modest and quite similar to results obtained with adults. This modest association was moderated by 1 substantive factor, type of patient problem, and 5 methodological factors, timing and source of relationship measurement, type and source of outcome, and shared versus cross-source measurement of relationship and outcome variables. Type, mode, structure, and context of treatment did not moderate associations between relationship variables and outcomes. Findings indicated that the association between the therapeutic relationship and treatment outcome was consistent across developmental levels and across diverse types and contexts of child and adolescent therapy. Recommendations for future process research on the therapeutic relationship in child psychotherapy are offered. (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)     

The role of cognitions in marital relationships: Definitional, methodological, and conceptual issues.

Although there have recently been numerous investigations exploring the role of couples' cognitions in an attempt to understand marital distress, at present there is little cohesion and direction in the study of how couples think about their relationships. The current article asserts that this lack of direction results from at least three factors: (a) a lack of delineation of the important cognitive variables to be considered in marital functioning, (b) conceptual and methodological difficulties that arise in attempts to operationalize cognitive variables, and (c) a dearth of models of marital functioning that incorporate cognitions in a detailed manner. These three factors are discussed, along with a review of empirical investigations supporting the importance of cognitions in intimate relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk mechanisms in development: Some conceptual and methodological considerations.

This commentary focuses on several issues concerning research on risk mechanisms that are raised in this special issue. First, we focus on what marks this special issue as distinctive in the ways in which risk research is conducted. Second, several general issues in research are highlighted, including sample characteristics, measurement strategies, specificity of risk factors and risk mechanisms, categorical vs. dimensional approaches to samples and measures, and definitions of development and transitions. Third, the challenges for integrating alternative models of risk are discussed, with special references to research on genetic and environmental influences on developmental psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting successful school completion: Critical conceptual and methodological guidelines.

Conceptual issues related to dropping out, student engagement, and school completion are raised. Thirteen criteria are described as guidelines for designing, evaluating, and documenting programs to enhance successful school completion for all students. The status of the current intervention research is summarized relative to the specified criteria. Recommendations for future research and practice include implementation of interventions, systematic application of criteria in evaluating interventions, focus on school completion across school years, and capturing students' experiences and using the information to develop contextualized interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Carbohydrates, tryptophan, and behavior: A methodological review.

In this methodological review, we examine the behavioral effects of carbohydrates and tryptophan and conclude that high-carbohydrate foods do not provoke hyperactivity, contrary to popular beliefs. Unbalanced carbohydrate meals, however, often induce fatigue and can impair performance among both children and adults. Although tryptophan hastens sleep onset, dulls pain sensitivity, and may reduce aggressiveness, it is unclear whether similar effects can be obtained through carbohydrate ingestion. We provide support for the hypothesis that carbohydrates and tryptophan function similarly and like drugs that modify brain biochemistry and accompanying mood and behavior. We also examine implications for clinical populations who selectively crave carbohydrates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and cognition: methodological differences in outcome

A series of longitudinal and cross sectional studies, collected as part of the Seattle Study, were reanalyzed. A longitudinal sequential analysis (N = 232), wherein subjects were measured every seven years for four time periods, was completed on the Primary Mental Abilities test. Cohort differences were at least as strong as age differences; cohorts were generally relatively stable over the measured periods, showing little cognitive decline. A cross-sectional sequential analysis (N = 2813) was completed for the same time periods; decline with age was more evident than with the longitudinal sequential analysis. A cross-sectional analysis for the fourth time period (N = 611) showed the most marked decline of all. Interpretation of outcome was highly dependent on the analysis used.     

Religion in the home in the 1980s and 1990s: A meta-analytic review and conceptual analysis of links between religion, marriage, and parenting.

The authors reviewed 94 studies published in journals since 1980 on religion and marital or parental functioning. Meta-analytic techniques were used to quantify religion-family associations examined in at least 3 studies. Greater religiousness appeared to decrease the risk of divorce and facilitate marital functioning, but the effects were small. Greater Christian conservatism was modestly associated with greater endorsement and use of corporal punishment with preadolescents. Isolated findings suggested that greater parental religiousness relates to more positive parenting and better child adjustment. The scope, meaningfulness, and potential strength of findings were restricted because of reliance on global or single-item measures of religious and family domains. To facilitate more conceptually and methodologically sophisticated research, the authors delineated mechanisms by which the substantive and psychosocial elements of religion could benefit or harm family adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)