Evaluating the effectiveness of family therapies: An integrative review and analysis.

A number of previous reviews of studies evaluating the effectiveness of family therapy have varied in their conclusions. This review is the first attempt at an integrated statistical analysis of family therapy effectiveness research. Family therapy was found to have positive effects compared with both no-treatment and alternative treatment controls, as measured by family interactions and behavior ratings. Follow-up data demonstrated that family therapy continued to show positive effects over time, but the effects were diminished and more variable than at posttreatment assessment. Future research should concentrate on comparative outcome studies with specific populations and with both legitimate alternative treatments and placebo controls. In addition, researchers need to describe in greater detail the family therapy procedures that are used. Outcome measures should represent multiple vantage points and should include measures of family interactions, preferably using both self-report and observational methods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical implications of attentional bias in anxiety disorders: An integrative literature review.

Research on information processing biases has been motivated by the hope that it would lead to new and more efficient psychotherapeutic interventions. The literature is abundant with empirical data of attentional biases toward threat stimuli in anxiety disorders. This article aims to review the existing literature on the topic of attentional bias in anxiety disorders and discuss important implications for clinical practice. We adopted an integrative approach to link research data on attentional bias, information processing, and cognitive accounts (automaticity and controllability) with clinical practice in cognitive-behavioral therapy. It is important to develop and apply therapeutic interventions that can effectively reduce negative attentional biases while treating the main problems associated with anxiety disorders. However, it remains to be seen whether cognitive therapy interventions targeting more voluntary, strategic information processing can have a positive impact on automatic, involuntary processing involved in attentional biases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The emerging field of emotion regulation: An integrative review.

The emerging field of emotion regulation studies how individuals influence which emotions they have, when they have them, and how they experience and express them. This review takes an evolutionary perspective and characterizes emotion in terms of response tendencies. Emotion regulation is defined and distinguished from coping, mood regulation, defense, and affect regulation. In the increasingly specialized discipline of psychology, the field of emotion regulation cuts across traditional boundaries and provides common ground. According to a process model of emotion regulation, emotion may be regulated at five points in the emotion generative process: (a) selection of the situation, (b) modification of the situation, (c) deployment of attention, (d) change of cognitions, and (e) modulation of responses. The field of emotion regulation promises new insights into age-old questions about how people manage their emotions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children of depressed parents: An integrative review.

Reviews the literature on the adjustment of children of depressed parents, difficulties in parenting and parent–child interaction in these families, and contextual factors that may play a role in child adjustment and parental depression. First, issues arising from the recurrent, episodic, heterogeneous nature of depression are discussed. Second, studies on the adjustment of children with a depressed parent are summarized. Early studies that used depressed parents as controls for schizophrenic parents found equivalent risk for child disturbance. Subsequent studies using better-defined samples of depressed parents found that these children were at risk for a full range of adjustment problems and at specific risk for clinical depression. Third, the parenting difficulties of depressed parents are described and explanatory models of child adjustment problems are outlined. Fourth, important gaps in the literature are identified, and a consistent, if unintentional, "mother-bashing" quality in the existing literature is noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A quantitative literature review of the effectiveness of suicide prevention centers.

Qualitative literature reviews suggest that mixed evidence exists concerning whether suicide prevention centers have attracted individuals at risk for suicide and have lowered suicide rates in the communities they serve. In the present investigation, the more formal methods of meta-analysis were applied to several series of studies to evaluate more objectively the effectiveness of prevention centers. Results indicate that centers do attract a high-risk population: center clients were more likely to commit suicide than were members of the general population, and individuals who committed suicide were more likely to have been clients than were members of the general population. However, existing studies, when considered as a set, provide no evidence of center effects on community suicide rates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Duration and outcome in psychotherapy: An integrative review.

Research and practice trends are fueling a strong interest in brief therapy, highlighting the question of the relationship between treatment duration and outcome. A number of investigations have reported a weak or nonexistent relationship between duration and outcome, yielding the possible conclusion that there are few differences between brief and longer term treatments. A finer-grained analysis, however, based on such methodological factors as the nature, source, and timing of outcome measures, reveals intriguing dose–effect linkages within particular helping modalities. Summarizing process and outcome research, this article identifies potential client, therapist, and contextual mediators of the brevity of treatment. Recent research concerning stages of change within psychotherapy is advanced as an integrative framework that yields researchable hypotheses concerning the factors that facilitate outcomes at various points in the helping process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of the clinical nurse specialist: an integrative review of the literature

This review of the literature related to the role of the clinical nurse specialist was commissioned by the AACN in order to provide a comprehensive resource for advanced practice nurses. This review provides a historical overview of clinical nurse specialists and some of the gaps or barriers to practice that have been experienced. A summary of these gaps shows that many have repeated themselves over the years. Also provided are potential solutions to facilitate the progression of this role in the future.     

Implicit affective cues and attentional tuning: An integrative review.

A large and growing number of studies support the notion that arousing positive emotional states expand, and that arousing negative states constrict, the scope of attention on both the perceptual and conceptual levels. However, these studies have predominantly involved the manipulation or measurement of conscious emotional experiences (e.g., subjective feelings of happiness or anxiety). This raises the question: Do cues that are merely associated with benign versus threatening situations but do not elicit conscious feelings of positive or negative emotional arousal independently expand or contract attentional scope? Integrating theoretical advances in affective neuroscience, positive psychology, and social cognition, the authors propose that rudimentary intero- and exteroceptive stimuli may indeed become associated with the onset of arousing positive or negative emotional states and/or with appraisals that the environment is benign or threatening and thereby come to moderate the scope of attention in the absence of conscious emotional experience. Specifically, implicit “benign situation” cues are posited to broaden, and implicit “threatening situation” cues to narrow, the range of both perceptual and conceptual attentional selection. An extensive array of research findings involving a diverse set of such implicit affective cues (e.g., enactment of approach and avoidance behaviors, incidental exposure to colors signaling safety vs. danger) is marshaled in support of this proposition. Potential alternative explanations for and moderators of these attentional tuning effects, as well as their higher level neuropsychological underpinnings, are also discussed along with prospective extensions to a range of other situational cues and domains of social cognitive processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events.

Interest in meaning and meaning making in the context of stressful life events continues to grow, but research is hampered by conceptual and methodological limitations. Drawing on current theories, the author first presents an integrated model of meaning making. This model distinguishes between the constructs of global and situational meaning and between “meaning-making efforts” and “meaning made,” and it elaborates subconstructs within these constructs. Using this model, the author reviews the empirical research regarding meaning in the context of adjustment to stressful events, outlining what has been established to date and evaluating the strengths and weaknesses of current empirical work. Results suggest that theory on meaning and meaning making has developed apace, but empirical research has failed to keep up with these developments, creating a significant gap between the rich but abstract theories and empirical tests of them. Given current empirical findings, some aspects of the meaning-making model appear to be well supported but others are not, and the quality of meaning-making efforts and meanings made may be at least as important as their quantity. This article concludes with specific suggestions for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-therapist boundary issues: An integrative review of theory and research.

Boundary issues, which regularly arise in therapy, can present difficult dilemmas for clinicians. The purpose of this article is to help clinicians resolve these dilemmas by integrating some of the theoretical positions with empirical evidence reported in the literature on boundary issues in counseling and psychotherapy. The authors review the concept of treatment boundaries and the ethical principles that underpin them. They also review common boundary violations and provide recommendations to attenuate harm done to clients when such boundary violations occur in therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the impact of mood on behavior: An integrative theory and a review.

Empirical evidence for effects of moods (both naturally occurring and experimentally manipulated) on behavior is reviewed in terms of an integrative theory: the mood-behavior model (MBM). It is posited that moods can influence behavior via 2 processes: (a) by informational effects on behavior-related judgments and appraisals, which in turn will result in behavioral adjustments (i.e., the informational mood impact on behavior), and (b) by influencing behavioral preferences and interests in compliance with a hedonic motive (i.e., the directive mood impact on behavior). The strength of the informational mood impact depends on moods' effective informational weight for behavior-related judgments and on mood-primed associations. The strength of the directive mood impact is predicted to be jointly determined by 2 variables: the strength of a hedonic motive and the instrumentality of possible acts for affect regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The conceptualization of marital commitment: An integrative analysis.

Although theoretical statements regarding the conceptualization of marital commitment abound in the literature, no research has attempted to compare these conceptualizations empirically. Six studies involving 1,787 participants explored the conceptual structure of marital commitment through a variety of empirical methods. Results suggested the existence of 3 primary dimensions of marital commitment: an attraction component based on devotion, satisfaction, and love, a moral normative component based on a sense of personal responsibility for maintaining the marriage and on the belief that marriage is an important social and religious institution, and a constraining component based on fear of the social, financial, and emotional costs of relationship termination. These factors most strongly resemble the three dimensions proposed by M. P. Johnson (1991) but also appear to represent the general features of interpersonal commitment described in most theoretical treatments of the construct and correspond well with couples' personal accounts of what it feels like to be in a committed relationship. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Topical application of stannous fluoride inside of cavity preparations: a review of the literature

A literature review concerning the topical application of fluorides inside of cavity preparations is presented. Several aspects, such as the type of compound to use, the time of application, and the advantages of the most recommended and used techniques, are discussed.     

The induction of pain: an integrative review

The highly disagreeable sensation of pain results from an extraordinarily complex and interactive series of mechanisms integrated at all levels of the neuroaxis, from the periphery, via the dorsal horn to higher cerebral structures. Pain is usually elicited by the activation of specific nociceptors ('nociceptive pain'). However, it may also result from injury to sensory fibres, or from damage to the CNS itself ('neuropathic pain'). Although acute and subchronic, nociceptive pain fulfils a warning role, chronic and/or severe nociceptive and neuropathic pain is maladaptive. Recent years have seen a progressive unravelling of the neuroanatomical circuits and cellular mechanisms underlying the induction of pain. In addition to familiar inflammatory mediators, such as prostaglandins and bradykinin, potentially-important, pronociceptive roles have been proposed for a variety of 'exotic' species, including protons, ATP, cytokines, neurotrophins (growth factors) and nitric oxide. Further, both in the periphery and in the CNS, non-neuronal glial and immunecompetent cells have been shown to play a modulatory role in the response to inflammation and injury, and in processes modifying nociception. In the dorsal horn of the spinal cord, wherein the primary processing of nociceptive information occurs, N-methyl-D-aspartate receptors are activated by glutamate released from nocisponsive afferent fibres. Their activation plays a key role in the induction of neuronal sensitization, a process underlying prolonged painful states. In addition, upon peripheral nerve injury, a reduction of inhibitory interneurone tone in the dorsal horn exacerbates sensitized states and further enhance nociception. As concerns the transfer of nociceptive information to the brain, several pathways other than the classical spinothalamic tract are of importance: for example, the postsynaptic dorsal column pathway. In discussing the roles of supraspinal structures in pain sensation, differences between its 'discriminative-sensory' and 'affective-cognitive' dimensions should be emphasized. The purpose of the present article is to provide a global account of mechanisms involved in the induction of pain. Particular attention is focused on cellular aspects and on the consequences of peripheral nerve injury. In the first part of the review, neuronal pathways for the transmission of nociceptive information from peripheral nerve terminals to the dorsal horn, and therefrom to higher centres, are outlined. This neuronal framework is then exploited for a consideration of peripheral, spinal and supraspinal mechanisms involved in the induction of pain by stimulation of peripheral nociceptors, by peripheral nerve injury and by damage to the CNS itself. Finally, a hypothesis is forwarded that neurotrophins may play an important role in central, adaptive mechanisms modulating nociception. An improved understanding of the origins of pain should facilitate the development of novel strategies for its more effective treatment.     

Attachment theory and psychotherapy integration: An introduction and review of the literature.

As an introduction to the special issue on attachment theory as a foundation for psychotherapy integration, this article will review the uses to which the theory has been employed by integrative theorists and clinicians during the past four decades. Reasons that this theory has been so influentially within psychotherapy integration are discussed, as are some of the models that are explicitly based on attachment theory. (PsycINFO Database Record (c) 2011 APA, all rights reserved)