Mediators and moderators of change in cognitive therapy of depression.

Reviews the theoretical and empirical literature associated with the mediators and moderators of change in cognitive therapy (CT) of depression. Covariation between change in cognition and change in depression, specific effects for cognitive vs behavioral components of CT, specific effects for CT vs other treatments, moderating influence of nonspecific and technical aspects of the therapeutic environment, and moderating influence of client characteristics are reviewed. The clinical implications of prior research and suggestions for future research on identifying the critical ingredients of change in CT of depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators and moderators of a psychosocial intervention for children affected by political violence.

Objective: The authors examined moderators and mediators of a school-based psychosocial intervention for children affected by political violence, according to an ecological resilience theoretical framework. Method: The authors examined data from a cluster randomized trial, involving children aged 8–13 in Central Sulawesi, Indonesia (treatment condition n = 182, waitlist control condition n = 221). Mediators (hope, coping, peer/emotional/play social support) and moderators (gender, age, family connectedness, household size, other forms of social support, exposure to political violence, and displacement) of treatment outcome on posttraumatic stress symptoms and function impairment were examined in parallel process latent growth curve models. Results: Compared with the waitlist group, those receiving treatment showed maintained hope, increased positive coping, maintained peer social support, and increased play social support. Of these putative mediators, only play social support was found to mediate treatment effects, such that increases in play social support were associated with smaller reductions in posttraumatic stress disorder (PTSD) symptoms. Furthermore, the authors identified a number of moderators: Girls showed larger treatment benefits on PTSD symptoms; girls, children in smaller households, and children receiving social support from adults outside the household showed larger treatment benefits on function impairment. Conclusions: Findings provide limited evidence for an ecological resilience theoretical framework. On the basis of these findings, the authors recommend a stronger separation between universal prevention (e.g., resilience promotion through play) and selective/indicated prevention (e.g., interventions aimed at decreasing posttraumatic stress symptoms). Play-based interventions should be careful to exclude children with psychological distress. In addition, treatment effects may be augmented by selecting girls and socially vulnerable children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arbitration, mediation, and sexual harassment.

The 1998 Supreme Court decisions in Faragher v. City of Boca Raton and Burlington Industries, Inc. v. Ellerth recognized an affirmative defense to hostile environment sexual harassment claims based in part on the existence of an effective policy prohibiting sexual harassment in the workplace. The promulgation or refinement of policies prohibiting sexual harassment will likely lead to an increase in complaints of sexual harassment. This article concludes that mediation and arbitration procedures which follow recognized standards of due process are appropriate means to resolve these claims and may substantially contribute to the Title VII goal of eradicating discrimination from the workplace. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analysis of biofeedback for tension-type headache: Efficacy, specificity, and treatment moderators.

The aims of the present meta-analysis were to investigate the short- and long-term efficacy, multidimensional outcome, and treatment moderators of biofeedback as a behavioral treatment option for tension-type headache. A literature search identified 74 outcome studies, of which 53 were selected according to predefined inclusion criteria. Meta-analytic integration resulted in a significant medium-to-large effect size (d = 0.73; 95% confidence interval = 0.61, 0.84) that proved stable over an average follow-up phase of 15 months. Biofeedback was more effective than headache monitoring, placebo, and relaxation therapies. The strongest improvements resulted for frequency of headache episodes. Further significant effects were observed for muscle tension, self-efficacy, symptoms of anxiety, depression, and analgesic medication. Moderator analyses revealed biofeedback in combination with relaxation to be the most effective treatment modality; effects were particularly large in children and adolescents. In intention-to-treat and publication-bias analyses, the consistency of these findings was demonstrated. It is concluded that biofeedback constitutes an evidence-based treatment option for tension-type headache. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Divorce mediation.

Mediation is a growing alternative to the adversarial settlement of divorce disputes that is part of a broader movement toward the private ordering of divorce. Problems with the indeterminant "best interests" standard and evidence from psychological research make mediation particularly appealing for settling child-custody disputes. Although some encouraging evidence is available on diversion of disputes from courts and consumer satisfaction with mediation, there is a considerable need for further research. Moreover, a number of practical, legal, and ethical questions about mediation remain unanswered. Psychologists can play a vital role in systematically evaluating divorce mediation and in shaping policy in regard to its practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Claridge and Birchall, different forms of the P scale, and dependable moderators.

With respect to the Psychoticism (P) scale in the Eysenck Personality Inventory (EPI), the present author agrees with G. S. Claridge and P. Birchall (see record 1979-26131-001) that because the P scale previously employed by Claridge derives from the Psychoticism-Extraversion-Neuroticism Inventory and is importantly different from the P scale imbedded within the EPI, the findings by Claridge and his colleagues have uncertain relevance for the construct validity of the EPI. The basis for previously expressed concern (see record 1978-28560-001) regarding the analysis of the G. S. Claridge and H. J. Chappa study (see record 1974-02520-001) is clarified and extended, using the moderator variable paradigm. It is concluded that psychoticism, however defined, has not yet been established empirically as a strong and generally replicable moderator of the relation between 2-flash threshold and skin conductance level. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examination of predictors and moderators for self-help treatments of binge-eating disorder.

Predictors and moderators of outcomes were examined in 75 overweight patients with binge-eating disorder (BED) who participated in a randomized clinical trial of guided self-help treatments. Age variables, psychiatric and personality disorder comorbidity, and clinical characteristics were tested as predictors and moderators of treatment outcomes. Current age and age of BED onset did not predict outcomes. Key dimensional outcomes (binge frequency, eating psychopathology, and negative affect) were predominately predicted, but not moderated, by their respective pretreatment levels. Presence of personality disorders, particularly Cluster C, predicted both posttreatment negative affect and eating disorder psychopathology. Negative affect, but not major depressive disorder, predicted attrition, posttreatment negative affect, and eating disorder psychopathology. Despite the prognostic significance of these findings for dimensional outcomes, none of the variables tested were predictive of binge remission (i.e., a categorical outcome). No moderator effects were found. The present study found poorer prognosis for patients with negative affect and personality disorders, suggesting that treatment outcomes may be enhanced by attending to the cognitive and personality styles of these patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cortical, hippocampal, and striatal mediation of schedule-induced behaviors.

The sequential occurrence of licking, locomotor activity, entries into the food magazine (panel pressing), and nonreinforced lever pressing engendered by a periodic schedule of food presentation were measured in each 60-s interreinforcement interval in normal and brain-damaged rats. The development of these responses was measured over 20 days in different groups of food-deprived rats that had received aspirations of the hippocampus, small lesions of the cortex overlying the hippocampus (hippocampal-operated control group), decortication, or 6-hydroxydopamine lesions of the caudate nucleus or nucleus accumbens. All lesions produced distinctive patterns of change in the measured behaviors, and dissociations as well as similarities in their effects were evident. These results are discussed with respect to dissociations in the motor and motivational effects of the various lesions and in terms of contemporary hypotheses of schedule-induced behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive and family therapies for adolescent depression: Treatment specificity, mediation, and moderation.

The specificity of cognitive and family therapies, and potential treatment mediators and moderators, was examined in a randomized clinical trial for adolescent depression. After acute treatment, cognitive-behavioral therapy (CBT) exerted specific effects on cognitive distortions relative to either systemic-behavioral family therapy (SBFT) or nondirective supportive therapy (NST). At 2-year follow-up, SBFT was found to impact family conflict and parent–child relationship problems more than CBT; NST and CBT tended to show a greater reduction in anxiety symptoms than SBFT. Nonspecific therapist variables qualified few outcome analyses. No measures of cognitive distortion or family dysfunction mediated or moderated treatment outcome. As in adult studies, relatively few areas of treatment specificity or mediation were identified. The implications of these findings for clinical treatment and research in adolescent depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental disclosure and its moderators: A meta-analysis.

Disclosing information, thoughts, and feelings about personal and meaningful topics (experimental disclosure) is purported to have various health and psychological consequences (e.g., J. W. Pennebaker, 1993). Although the results of 2 small meta-analyses (P. G. Frisina, J. C. Borod, & S. J. Lepore, 2004; J. M. Smyth, 1998) suggest that experimental disclosure has a positive and significant effect, both used a fixed effects approach, limiting generalizability. Also, a plethora of studies on experimental disclosure have been completed that were not included in the previous analyses. One hundred forty-six randomized studies of experimental disclosure were collected and included in the present meta-analysis. Results of random effects analyses indicate that experimental disclosure is effective, with a positive and significant average r-effect size of .075. In addition, a number of moderators were identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-concept and self-esteem as moderators of client transference.

Operationalized transference as (a) the similarity of clients' perceptions of their therapist and their perceptions of their parents and (b) therapists' ratings on a transference scale, Therapy Session Check Sheet (TSCS; H. Graff and L. Luborsky, 1977), and examined the moderating role of self-esteem and ego development on client transference. Ss were 62 clients (aged 19–63 yrs) who were already involved in therapy, and 29 therapists (aged 25–61 yrs). The Barrett-Lennard Relationship Inventory (G. T. Barrett Lennard, 1962, 1973) measured the facilitative conditions (regard, empathy, and unconditionality) and therapist–parent similarity and the TSCS measured the therapists' perceptions of transference. Additional measures were the Ego Identity Scale (A. L. Tan, et al, 1977) and the Rosenberg Self-Esteem Scale (M. Rosenberg, 1979). Results support the idea that self-esteem and ego development impact a client's view of the therapist and parental figures and are associated with therapists' views of transference. Persons with low ego identity and low self-esteem tended to see their therapists and parental figures more dissimilarly; and the more transference that a therapist perceived, the greater the tendency for the client to have low ego identity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators of telephone-based continuing care for alcohol and cocaine dependence.

A previous randomized trial with 224 alcohol and/or cocaine addicts who had completed an initial phase of treatment indicated that 12 weeks of telephone-based continuing care yielded higher abstinence rates over 24 months than did group counseling continuing care. The current study examined mediators of this treatment effect. Results suggested that self-help involvement during treatment and self-efficacy and commitment to abstinence 3 months after treatment mediated subsequent abstinence outcomes. These analyses controlled for substance use prior to the assessment of mediators. Conversely, there was no evidence that self-help beliefs or social support mediated the treatment effect. These results are consistent with a model in which treatment effects are first accounted for by changes in behavior, followed by changes in self-efficacy and in commitment to abstinence. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Bayesian mediation analysis.

In this article, we propose Bayesian analysis of mediation effects. Compared with conventional frequentist mediation analysis, the Bayesian approach has several advantages. First, it allows researchers to incorporate prior information into the mediation analysis, thus potentially improving the efficiency of estimates. Second, under the Bayesian mediation analysis, inference is straightforward and exact, which makes it appealing for studies with small samples. Third, the Bayesian approach is conceptually simpler for multilevel mediation analysis. Simulation studies and analysis of 2 data sets are used to illustrate the proposed methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ability tests, measurements, and markets.

Considers the progress, or lack thereof, that has been made in the development of ability testing. It is argued that the lack of progress is best understood in terms of the consumer market for tests and what it seeks. Current tests, inadequate though they may be, largely respond to the demands of test consumers. However, these demands are showing some signs of changing, and the time has come for test publishers to take these signs seriously, rather than continuing to produce products that represent changes in superficial appearance more so than in substance. Although the available alternatives to conventional tests have often been inadequate themselves, they do point the way toward measurement of skills beyond basic memory and analytical abilities, namely, skills such as creative and practical aspects of intelligence, as well as thinking and learning styles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traits, tests, and personality research.

Skepticism regarding the utility of personality tests seems widespread in contemporary personality, clinical, and social psychology. Five sources of this skepticism can be identified. First, the trait concept has been widely criticized in the recent literature; since tests are assumed to measure traits, their role in developing psychological theory is also questioned. Second, it is frequently claimed that tests simply don't work very well, that social behavior is largely a function of situational constraints. Third, current enthusiasm for experimental research tends to minimize the importance of individual differences and the tests that are used to assess them. Fourth, behavior therapy and labeling theory have encouraged the view that tests are irrelevant as adjuncts to psychotherapy. Finally, the ease with which test data can be collected encourages mindless research. Each of these issues is reviewed, and arguments are presented to suggest that personality assessment continues to be an intellectually and scientifically defensible enterprise. (70 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intrinsic religiousness and religious coping as life stress moderators for Catholics versus Protestants.

Two prospective studies were conducted to test the stress-moderating effects of intrinsic religiousness and overall religious coping on the depression and trait anxiety of Catholic and Protestant college students. Both studies found a significant cross-sectional interaction between controllable life stress and religious coping in the prediction of Catholics' depression, with religious coping serving a protective function at a high level of controllable negative events. Both studies also found a significant prospective interaction between uncontrollable life stress and intrinsic religiousness in the prediction of Protestants' depression; the relationship between uncontrollable stress and depression was positive for low intrinsic Protestants, flat for medium intrinsic Protestants, but negative for high intrinsic Protestants. The findings are discussed in terms of their implications for the role of religion in life stress adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators of outcome of psychosocial treatments for cocaine dependence.

This study examined endorsement of 12-step philosophy and engagement in recommended 12-step activities as a mediator of the outcomes of individual plus group counseling for cocaine dependence. Assessments of drug use outcomes and the mediator were made at baseline and monthly for 6 months. Engagement in recommended 12-step activities was found to be a partial statistical mediator of drug use outcomes of individual (plus group) drug counseling, but no evidence for change in the mediator preceding change in drug use was found. In addition, a measure of beliefs about addiction developed to test mediation of outcome of cognitive therapy was found to correlate moderately with drug use outcomes in both cognitive therapy and individual drug counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding, prediction, and control as moderators of the relationships between perceived stress, satisfaction, and psychological well-being.

This study provides a preliminary test of a model proposed by Sutton and Kahn (1986). In the model, the ability to understand, predict, and control events in the work environment can reduce the potential adverse effects generally associated with certain work conditions. Using a sample of physicians, dentists, and nurses (N?=?206) from a large naval medical hospital, the present study examined the moderating effects of understandable, predictable, and controllable work situations on the relationship between perceived role stress, satisfaction, and psychological well-being. Understanding and control were found to have moderating effects on the relationship between perceived stress and satisfaction. Understanding, prediction, and control were found to have direct relationships with perceived stress, but only control had a significant direct relationship with satisfaction. None of these variables were found to have significant direct relationships with psychological well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive moderators of the relationship between behavioral intentions and behavior.

A prospective study associating prior behavioral intentions with subsequent actual behaviors explored whether locus-of-control expectancies and values on the outcome of the behavior would influence the relationship between behavioral intentions and behavior. Survey questionnaires were mailed to 115 15–68 yr old prospective adult female patients at a weight reduction clinic immediately prior to their beginning treatment; 79 respondents completed the 6-wk program. The strength of the relationship between initial behavioral intentions and actual behavior was influenced both by expectancies for control of weight loss and by values relevant to weight reduction. Weight-locus-of-control internals with high outcome values for physical appearance or health were significantly more likely than externals with high outcome values to translate their intentions to lose weight into successful actions. More generally, it may be the case that among individuals who believe that certain behaviors lead to highly valued outcomes, internals are more likely than externals to perform those behaviors. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediators of change for multisystemic therapy with juvenile sexual offenders.

The mediators of favorable multisystemic therapy (MST) outcomes achieved at 12 months postrecruitment were examined within the context of a randomized effectiveness trial with 127 juvenile sexual offenders and their caregivers. Outcome measures assessed youth delinquency, substance use, externalizing symptoms, and deviant sexual interest/risk behaviors; hypothesized mediators included measures of parenting and peer relations. Data were collected at pretreatment, 6 months postrecruitment, and 12 months postrecruitment. Consistent with the MST theory of change and the small extant literature in this area of research, analyses showed that favorable MST effects on youth antisocial behavior and deviant sexual interest/risk behaviors were mediated by increased caregiver follow-through on discipline practices as well as decreased caregiver disapproval of and concern about the youth’s bad friends during the follow-up. These findings have important implications for the community-based treatment of juvenile sexual offenders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)