Research on psychotherapy integration: Recommendations and conclusions from an NIMH workshop.

Although the trend toward psychotherapy integration and eclecticism has gathered momentum, research on eclectic approaches to psychotherapy has lagged behind. To address this gap, the National Institute of Mental Health (NIMH) held a 2-day workshop in March 1986 on psychotherapy integration. Fourteen psychotherapy researchers were invited to consider the key issues associated with psychotherapy integration in order to advise the NIMH on guidelines for launching a program to stimulate relevant empirical research. Recommendations were developed to initiate such a research program that encompassed (a) conceptual clarification, (b) efficacy studies of systematic eclectic therapies, (c) the role of traditional psychotherapy process research, and (d) the training of integrative or eclectic therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Television and behavior: Research conclusions of the 1982 NIMH report and their policy implications.

Research on TV and behavior in the 1970's has recently been reviewed and evaluated in a 2-volume report from the National Institute of Mental Health (NIMH). The most widely publicized conclusion of the report was that violence on TV does lead to aggressive behavior by children. The TV networks' response to this conclusion has been one of denial. Research also documented that young children are often unable to relate a series of complex actions to their final consequence. Another area in the cognitive and affective aspects of TV concerns the effects of TV viewing on child development and on academic achievement. Findings suggest a need for increased emphasis on teaching children critical TV viewing skills. TV also has the potential to affect social beliefs and behaviors, such as beliefs about sex roles, minorities, prosocial behavior, and products advertised on TV. The impact of TV on social relations, especially familial relations, and on health is also addressed. The NIMH report demonstrates a need to see TV viewing as a continuing form of informal education. What is needed is more creativity on the part of the industry and more discrimination on the part of the viewer. The teaching of critical viewing skills and parental interest in what children watch are especially important. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The NIMH community violence project: II. Children's distress symptoms associated with violence exposure

The rising tide of violence in American cities has placed the causes and consequences of violence squarely on the public health agenda. The U.S. Government's Year 2000 National Health Promotion and Disease Prevention Objectives includes a full chapter devoted to violence issues and delineates a number of goals and programs aimed at reducing the number of deaths and injuries associated with violence (Public Health Service 1990). Notably absent from these objectives, however, is attention to the possible adverse psychological consequences of exposure to acute or chronic violence. Nonetheless, in light of numerous media reports of children's exposure to community violence and recent reports documenting high levels of exposure even among very young children (Richters and Martinez 1993), it is reasonable to question whether the risks of exposure extend beyond death and physical injury to psychological well-being.     

Morton. (NIMH, Bethesda, Md.) Composite index of the Kent-Rosanoff Free Association Test.

A composite index that combines the scores of most common, individual, and unusual responses is proposed for the Kent-Rosanoff Association Test. Norms, based on index scores for 200 normal Ss, as well as scores for 100 schizophrenic Ss are given. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic alliance and clinical outcome in the NIMH Treatment of Depression Collaborative Research Program: Preliminary findings.

Investigated the effect of the therapeutic alliance on clinical outcome in the 7 most improved and 7 least improved cases in the 4 treatments investigated in a study (I. Elkin et al; see PA, Vols 72:20648 and 77:10249) of treatment of depression. The treatments were interpersonal therapy (IPT), cognitive-behavior therapy, imipramine plus clinical management, and placebo plus clinical management. Clinical observer ratings of alliance, using Vanderbilt Therapeutic Alliance Total Scale scores, were compared across and within treatment groups and were related to clinical status at termination. Despite selective, significant relationships between alliance and outcome across treatments, the alliance–outcome relationship was significant only for IPT within treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ventricular remodeling. Mechanisms and prevention

The changes that take place in the structure and form of the left ventricle have become closely related to increase in clinical events in patients with heart failure. These changes are included in the term remodeling and occur as a response to the initial loss of left ventricular muscle mass. The mechanisms that initiate and maintain this remodeling process have become of great importance since a variety of effective pharmacologic agents have become available. A more complete understanding of remodeling has the potential of preventing the progression of heart failure. This article considers the various aspects of left ventricular remodeling including the cardiomyocytes, the myocardial interstitium, the importance that apoptosis plays the remodeling process.     

Revolutions and counterrevolutions in prevention.

The new prevention science put forward by the National Institute of Mental Health and by the Institute of Medicine advocates strict experimental interventions with controls to reduce risks for psychiatric disorders. Articles by R. F. Mu?oz et al (see record 84-09322), K. Heller (see record 84-09313), and D. Reiss and R. H. Price (see record 84-09329) support, elaborate, and discuss this agenda. Issues that seem controversial include (a) the use of risk reduction of psychiatric disorders as the criteria for acceptable research, (b) rejection of studies of competence promotion as not aimed at specific disorders, and (c) rejection of prevention studies, done before the counterrevolution that occurred in 1980 and thereafter, that advocated social and political change aimed at achieving social equality for disadvantaged groups. Arguments against the restricted new approach are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescents and prevention of AIDS.

For adolescents to learn to avoid behavior that increases the risk of human immunodeficiency virus (HIV) infection, educational programs must increase the personal salience of such risks. Information about risks should be complemented by problem-solving programs designed to counteract social inhibitions on use of contraception and environmental manipulations designed to increase access to condoms. Market-based regulatory strategies show some potential to decrease needle sharing. There exists a compelling need for a large behavioral research initiative to develop a body of knowledge necessary for prevention of HIV infection. Social inhibitions about studying "adult" behavior among adolescents should be overcome, and legal protection of the privacy of adolescent research participants should be expanded. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feline leukemia virus. Immunization and prevention

Our understanding of the pathogenesis of FeLV infection is little changed from what was described by Hardy and his colleagues in the mid-1970s. The prevention of FeLV infection consists, first, of avoiding the agent and, second, of providing optimum immunologic resistance. In multi-cat environments, the former is achieved through test-and-removal methods perennially reviewed in the literature and by minimizing exposure to outdoor cats. The latter is possible by attempting to maintain a low-stress, pathogen-free household and by the use of appropriate, effective immunization programs. Simple immunologic concepts used for the development of vaccines against feline distemper and rabies have evolved to enable generation of products that can now protect against retroviruses. The use of more complex biologic methods, such as recombinant technology and the manipulation of antigen presentation, bears encouragement, so that perhaps one day the most destructive of feline infectious diseases may be checked.     

Cost analysis and HIV prevention interventions.

Comments on the review by J. A. Kelly et al (see record 1994-10963-001) regarding public health interventions designed to prevent, reduce, or eliminate behavior that put individuals at risk for becoming HIV-infected. D. R. Holtgrave expands on the review by discussing important economic policy issues, including the cost of HIV prevention interventions and the societal economic benefits of prevention programs. Methods for estimating the cost of an HIV prevention intervention are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

History of prevention and prevention groups: Legacy for the 21st century.

This article provides a context for this special journal issue devoted to the topic of evidence-based prevention groups. To begin, a history of the field of prevention is presented. Second, the authors highlight how prevention groups have evolved as part of the broader history of prevention. Finally, the authors discuss the implications of the history of prevention and prevention groups for future research and practice in the field of group work. The overall goal of this article is to provide a base of knowledge that practitioners and researchers may utilize to expand and advance the field of prevention group practice and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prevention of mindlessness.

We conducted three experiments to assess the hypothesis that mindlessness could be prevented with a simple linguistic variation. Subjects in the first two experiments were either introduced to new objects conditionally (e.g., this could be an X) or unconditionally (e.g., this is an X), and the objects used were either unfamiliar or familiar. In each study a different need was then generated for which the object in question was not explicitly suited but could fulfill. Only those subjects in the conditional-unfamiliar group gave the creative response and met the need. When subjects were asked explicitly to generate novel uses for the target items, they had no difficulty doing so. However, given the way we are traditionally taught, it simply does not occur to us to think creatively unless explicitly instructed to do so. In the third experiment we introduced an unfamiliar item in one of three ways. In addition to the groups used in the earlier experiments, we added a group that was led to believe that the object was identifiable (unconditional) but was currently unknown. We also added a second need to determine whether the original conditional group truly learned conditionally or if they were in search of an absolute understanding of the target object. Significantly more of the subjects in the conditional group gave the creative response to both needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Public support for prevention.

Comments on the statement by G. W. Albee (see record 84-09296) that prevention efforts are largely supported by money from taxes (public revenue). The author suggests that successful preventative programs are those that respond to the need for incorporating observable components (e.g., effectiveness and intervention variables) into their approaches. This idea of observability is an important factor in determining whether an innovation (e.g., a preventative program) is publicly embraced or not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

NIDA's HIV prevention programs.

Comments on the review by J. A. Kelly et al (see record 1994-10963-001) regarding HIV prevention programs. Programs that Kelly et al did not describe are discussed, focusing on the large-scale community trials coordinated by the National Institute on Drug Abuse (NIDA) for injection drug users, crack users, and sex partners of drug users. R. H. Needle et al agree that stronger partnerships should be forged between research and community organizations and that dissemination of successful strategies should be improved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Failures in alcoholism prevention.

Comments on an article by P. E. Nathan (see record 1984-02298-001), in which Nathan attributes the absence of alcoholism prevention in the workplace to industry's failure to recognize the value of prevention and to the shift of programs from alcohol-focused to broader-based employee assistance programs (EAPs). It is argued that the EAPs, which involve themselves in all aspects of employee problems and reach a wider audience of employees, would be the best source for mounting alcoholism prevention programs. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two pathways to prevention.

Health promotion and disease prevention programs are becoming important components of contemporary health care. There are at least 2 pathways to the enhancement of population health status through disease prevention. The first pathway requires the early diagnosis and treatment of disease. The second pathway promotes healthy lifestyles and disregards the requirement that a condition must be diagnosed before intervention is recommended. Data from several evaluations suggest that prevention efforts that rely on diagnosis have produced somewhat limited benefits, whereas primary prevention efforts may have substantial benefits. Current health policy places greater emphasis on secondary prevention. The objectives of improved population health might be better achieved by devoting relatively more resources to primary prevention through the promotion of healthy behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prevention of sexism.

Defines sexism as the act of ascribing superiority or inferiority, unsupported by evidence, in traits, abilities, social values, and personal worth to males or females as a group. It is also considered a form of psychopathology—delusional and dangerous to others. An examination of the origins of sexism suggests religious and economic causation. Therefore, prevention of sexism is seen to go beyond consciousness-raising among psychologists and to require social and political efforts. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The different prevention science.

Comments on the similarities between prevention research (R. F. Mu?oz [Ed.], 1996; and K. Heller, see record 84-09313) and the field of safety research. Both can be defined as disciplines focused on the systematic study of precursors of risk and protective factors, and both use telic methods of analysis, meaning that they begin with the event to be explained, and use the event to define its antecedent(s). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute side-effects of drugs. Causes and prevention

A successful therapy with causative acting drugs (e.g. antibiotics, hormones) or with symptomatic acting drugs (e.g. antihypertensive, psychopharmacological drugs, anticoagulants) cannot be practicable without secondary effects. These unavoidable "side-effects" either are of no consequence or, these have to be risked and to be controlled, especially in long-term-therapy. Often, it is impossible to foresee allergic reactions. Avoidable "side-effects" may be dangerous in case of patient's self-medication, medical negligence or in case of drug interactions. 5 classes of drugs with possible threatening secondary effects are demonstrated: glykosides, sulfonylureas (antidiabetics), coumarin derivatives (anticoagulants), corticosteroids and parenteral contrast mediums.