Is heavy drinking really associated with attrition from college? The alcohol-attrition paradox.

Student attrition at colleges across the United States poses a significant problem for students and families, higher educational institutions, and the nation's workforce competing in the global economy. Heavy drinking is a highly plausible contributor to the problem. However, there is little evidence that it is a reliable predictor of attrition. Notably, few studies take into account indicators of collegiate engagement that are associated with both heavy drinking and persistence in college. Event-history analysis was used to estimate the effect of heavy drinking on attrition among 3,290 undergraduates at a large midwestern university during a 4-year period, and student attendance at a number of college events was included as covariates. Results showed that heavy drinking did not predict attrition bivariately or after controlling for precollege predictors of academic success. However, after controlling for event attendance (an important indicator of collegiate engagement), heavy drinking was found to predict attrition. These findings underscore the importance of the college context in showing that heavy drinking does in fact predict attrition and in considering future intervention efforts to decrease attrition and also heavy drinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating interventions with differential attrition: The importance of nonresponse mechanisms and use of follow-up data.

Evaluations of psychological interventions are often criticized because of differential attrition (DA), which is cited as a severe threat to validity. The present study shows that DA is not a problem unless the mechanism causing the attrition is inaccessible (unavailable for analysis). With a simulation study, it is shown that conclusions about program effects (1) are unbiased when there is no DA, even with usual complete cases analysis; (2) may be severely biased when based on usual complete cases analyses and there is DA; (3) are unbiased when based on the expectation-maximization (EM) algorithm, even when there is DA, as long as the attrition mechanism is accessible; and (4) are biased, even with the EM algorithm, when the attrition mechanism is inaccessible. Following R. J. Little and D. B. Rubin (1987), the collection of new data from a random sample of Ss with initially missing data is advocated. On the basis of these data a simple correction is proposed to the EM algorithm estimates. The correction produces unbiased estimates of program effects parameters, even with an inaccessible attrition mechanism and substantial DA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early withdrawal from mental health treatment: Implications for psychotherapy practice.

[Correction Notice: An erratum for this article was reported in Vol 46(2) of Psychotherapy: Theory, Research, Practice, Training (see record 2009-08897-009). The fourth author’s name was mistakenly left out of the author byline and table of contents. The correct author listing for this article is presented in the erratum.] Despite more than 50 years of research on client attrition from therapy, obstacles to the delivery and success of treatments remain poorly understood, and effective methods to engage and retain clients in therapy are lacking. This article offers a review of the literature on attrition, highlighting the methodological challenges in effectively addressing the complex nature of this problem. Current interventions for reducing attrition are reviewed, and recommendations for implementing these interventions into psychotherapy practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Early withdrawal from mental health treatment: Implications for psychotherapy practice": Correction to Barrett et al (2008).

Reports an error in "Early withdrawal from mental health treatment: Implications for psychotherapy practice" by Marna S. Barrett, Wee-Jhong Chua, Paul Crits-Christoph, Mary Beth Gibbons and Don Thompson (Psychotherapy: Theory, Research, Practice, Training, 2008[Jun], Vol 45[2], 247-267). The fourth author’s name was mistakenly left out of the author byline and table of contents. The correct author listing for this article is presented in the erratum. (The following abstract of the original article appeared in record 2008-07317-011.) Despite more than 50 years of research on client attrition from therapy, obstacles to the delivery and success of treatments remain poorly understood, and effective methods to engage and retain clients in therapy are lacking. This article offers a review of the literature on attrition, highlighting the methodological challenges in effectively addressing the complex nature of this problem. Current interventions for reducing attrition are reviewed, and recommendations for implementing these interventions into psychotherapy practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of attrition on baseline comparability in randomized experiments in education: A meta-analysis.

Using meta-analysis, randomized experiments in education that either clearly did or clearly did not experience student attrition were examined for the baseline comparability of groups. Results from 35 studies suggested that after attrition, the observed measures of baseline comparability of groups did not differ more than would be expected given sampling error. The degree of either overall or differential attrition did not relate to baseline comparability, a finding that held under sensitivity analyses. Also, both overall and differential attrition rates were unrelated to posttest effect sizes. All of these analyses, however, lacked sufficient statistical power to detect small but potentially meaningful effects. Results suggest caution is warranted when applying quality scales and other blanket rules pertaining to attrition that are meant to either serve as inclusion-exclusion criteria or in scoring study quality. Much greater attention is needed to both the reporting of attrition in primary studies and to the development of conceptual and empirical models of the attrition process. These developments would aid further investigation of the relation between attrition and study outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The hour of departure: Predicting attrition in the training clinic from role expectancies.

In addition to having potentially deleterious effects on clients in distress, client attrition also thwarts efforts by trainee clinicians to develop psychotherapy competencies that are uniquely associated with providing middle- or late-stage treatment. Within the established literature, one well-replicated correlate of attrition is client expectations. Thus, the following study investigated whether client attrition within a training clinic could be prospectively predicted from pretreatment expectancies. To that end, all adult clients presenting for an intake at a training clinic completed the Psychotherapy Expectancy Inventory—Revised (PEI–R). First, normative reference ranges for the PEI–R total and factor scores were developed. Next, analyses revealed that these reference ranges had good specificity in prospectively identifying clients that subsequently prematurely terminated treatment. Moreover, the computed positive likelihood ratios revealed that an individual who obtains a total score outside of the reference range is 7 times more likely to prematurely terminate therapy in comparison with individuals obtaining scores within the normative reference range. Training clinics are therefore encouraged to routinely administer the PEI–R as a means of identifying individuals at risk for attrition and defining which role expectations may need to be modified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Engaging families in longitudinal preventive intervention research: Discrete-time survival analysis of socioeconomic and social–emotional risk factors.

This study examined whether family risk factors predicted attrition in a prevention research project that incorporated procedures to increase retention in assessment and intervention activities. Analyses used data from 667 rural families collected over 4 waves and consisted of (a) young adolescent and parent reports of internalizing and externalizing problems, (b) observer ratings of distress in parent–child interactions, and (c) family socioeconomic status (SES). Analyses failed to identify any risk factors as significant predictors of intervention participation. Only SES was found to be significant as a predictor of assessment attrition. This SES result appeared to reflect an association between lower educational attainment and an increased likelihood of attrition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of attrition in health intervention research among older subjects with osteoarthritis.

Attrition in an experimental osteoarthritis intervention was studied among 364 (130 male) volunteers (aged 60–87 yrs). Ss were randomly assigned to control, social support, education, or combined treatment groups. A series of discriminant function analyses showed that the final intervention groups were more homogeneous than the original samples. The most robust predictor of attrition was having either high or very low depression scores. Social support variables were predictors of poor attendance in the social support group, indicating possible attrition bias in evaluating this treatment. The results indicate that psychosocial variables may be the best predictors of attrition in health intervention research among older Ss and that variables related to attrition can be related to the content of the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of dopaminergic drugs, occlusal disharmonies, and chronic stress on non-functional masticatory activity in the rat, assessed by incisal attrition

Observational methods and the recording of nonspecific jaw movements or masticatory muscle activity have been used to evaluate oral parafunctional movements in animal models of bruxism. In this study, we have used a new approach in which the non-functional masticatory activity in the rat was assessed by the measurement of incisal attrition, with the aim of investigating the role of diverse factors involved in the etiology of bruxism. We quantified the attrition rate weekly by making superficial notches in the lower incisors and measuring the distances to the incisor edges. Repeated stimulation of the dopaminergic system with apomorphine led to an enhancement of the non-functional masticatory activity (p < 0.0001). The severity of the apomorphine-induced oral behavior was positively correlated (r(s) = 0.69, p < 0.01) with an increase in the incisal attrition rate (20.9%, p < 0.0001). Apomorphine-induced non-functional masticatory activity was strongly enhanced by the placement of an acrylic cap on both lower incisors (306%, p < 0.0001), but not by the cutting of a lower incisor. Repeated cocaine administration also increased the attrition rate (22.5%, p < 0.0001). However, neither chronic blockade of dopaminergic receptors with haloperidol, nor its withdrawal, modified attrition. In addition, since emotional disturbances are considered to be causal factors of bruxism, we tested whether experimental stress might accelerate tooth wear. Exposure to two different chronic stress regimes did not induce significant changes in incisal attrition. Moreover, exposure to chronic stress after the withdrawal of chronic haloperidol treatment did not alter attrition either. These results partially support the role of the central dopaminergic system in bruxism and suggest that stress, in general, may not be a relevant factor in tooth wear.     

Behavioral weight-loss intervention at the worksite: Feasibility and maintenance.

Investigated the feasibility of conducting a behavioral weight-loss program at the worksite and evaluated the effectiveness of a structured-maintenance training protocol. A total of 133 20–60 yr olds in 3 groups completed a 10-wk behavioral treatment program. The treatment program included organizational behavior modification techniques in addition to traditional small-group behavior-therapy procedures for weight control. After treatment, 2 groups received a 4-session structured-maintenance program, and 1 group served as a nonspecific (contact time) control. Follow-ups were conducted at 3 and 6 mo. Although attrition rates were high, the results indicate that the 3 groups lost a significant amount of weight during the 18 wks of treatment plus maintenance training. There were no differential effects of either weight loss or attrition among the 3 groups over the course of treatment or maintenance. Comparison of the structured- vs nonspecific-maintenance training groups at 3- and 6-mo follow-up indicates that the structured training group maintained their weight loss significantly better than the nonspecific control group. Results are interpreted to be consistent with the hypothesis that the skills required to lose weight are different from skills necessary to maintain weight loss over time. Although behavioral weight-loss programs at the worksite appear feasible, high attrition remains a significant problem. Results are discussed in terms of cost-effectiveness of worksite weight-loss intervention and directions for future research. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A method for exploring the effects of attrition in randomized experiments with dichotomous outcomes.

Attrition from conditions in randomized experiments is common. Yet it is difficult to assess the possible effects of attrition because the outcome status of the dropouts is usually unknown. This article develops methods to assess those effects in studies with dichotomous outcomes, illustrating the methods with randomized experiments in drug abuse treatment, smoking cessation treatment, and alcoholism treatment. The methods include computing the lowest and highest possible effect sizes that could have been observed, enumerating the percent of possible study outcomes below a given threshold, estimating the probability that an outcome beyond any given threshold would be observed if all participants were measured, and constructing attrition analysis plots showing the effects of attrition under varied assumptions. For the kind of study to which they apply, these methods should replace the treatment of missing participants as failures in an "intent-to-treat" analysis. A user-friendly personal computer program is available to implement all of these analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interplay of advances between theory, research, and application in treatment interventions aimed at behavior problem children and adolescents.

This article examines the important role that the interplay between theory, research, and application has in fostering breakthroughs in the treatment of clinical problems. This issue is presented in the context of an ongoing program of psychotherapy research that targets for intervention of Hispanic behavior problem youth and their families. Findings and breakthroughs in structural family therapy, the measurement of family and child psychodynamic functioning, the development of culturally appropriate interventions, the role of attrition as a measure of outcome, and the investigation of theoretically postulated mechanisms in behavior change are discussed. Recommendations for future research directions are made. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term administration study of propiverine hydrochloride (BUP-4 tablets) in pollakiuria and urinary incontinence

The purpose of this study was to investigate the relationship between osseous changes in the temporomandibular joint (TMJ) and dental attrition in the Japanese macaque. One hundred and thirty Japanese macaque skulls (54 male and 76 female) from animals which had been bred in the same environment, were randomly sampled from a collection at the Primate Research Institute of Kyoto University. The age at death had been recorded in all cases. TMJ osseous changes were independently evaluated by three examiners, and were defined as an irregular surface or a perforated compact bone layer with a markedly irregular surface on either the temporal or condylar components. Age was a significant factor in predicting TMJ osseous changes (P < 0.001). A strong relation was observed between age and dental attrition (P < 0.001), while dental attrition was not a significant factor in predicting TMJ osseous changes (P = 0.334). The prevalence TMJ osseous changes in male animals was slightly higher than in females (P = 0.057). The results of this study suggest that osseous changes in the macaque TMJ are mainly related to age, not to dental attrition.     

A meta-analysis of predictors of offender treatment attrition and its relationship to recidivism.

Objective: The failure of offenders to complete psychological treatment can pose significant concerns, including increased risk for recidivism. Although a large literature identifying predictors of offender treatment attrition has accumulated, there has yet to be a comprehensive quantitative review. Method: A meta-analysis of the offender treatment literature was conducted to identify predictors of offender treatment attrition and examine its relationship to recidivism. The review covered 114 studies representing 41,438 offenders. Sex offender and domestic violence programs were also examined separately given their large independent literatures. Results: The overall attrition rate was 27.1% across all programs (k = 96), 27.6% from sex offender programs (k = 34), and 37.8% from domestic violence programs (k = 35). Rates increased when preprogram attrition was considered. Significant predictors included demographic characteristics (e.g., age, rw = ?.10), criminal history and personality variables (e.g., prior offenses, rw = .14; antisocial personality, rw = .14), psychological concerns (e.g., intelligence, rw = ?.14), risk assessment measures (e.g., Statistical Information on Recidivism scale, rw =.18), and treatment-related attitudes and behaviors (e.g., motivation, rw = ?.13). Results indicated that treatment noncompleters were higher risk offenders and attrition from all programs significantly predicted several recidivism outcomes ranging from rw = .08 to .23. Conclusions: The clients who stand to benefit the most from treatment (i.e., high-risk, high-needs) are the least likely to complete it. Offender treatment attrition can be managed and clients can be retained through an awareness of, and attention to, key predictors of attrition and adherence to responsivity considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment strategies for therapists conducting weight control programs.

Discusses 7 major problem areas that often arise in treating the obese client—the recalcitrant client, attrition, nonstandardized improvement criteria, deficiencies in monitoring treatment effectiveness, therapist characteristics and credibility, achieving weight or fat loss, and maintaining the weight or fat loss. Specific therapeutic recommendations, derived from a review of the weight control literature, are made for dealing with each of these areas. (103 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder.

Attrition from smoking cessation treatment by individuals with a history of major depression was investigated. An investigation of preinclusion attrition examined differences between 258 eligible smokers who did and 100 who did not attend an initial assessment session. Postinclusion attrition was investigated by comparing the 33 early dropouts, 27 late dropouts, and 117 treatment completers. Those who failed to attend the assessment session were more likely to be female, to smoke cigarettes with higher nicotine content, and to have a history of psychotropic medication use. Early-treatment dropouts reported a higher smoking rate than late-treatment dropouts and endorsed more symptoms of depression than late dropouts and treatment completers. Results are compared with previous investigations of smoking cessation attrition, and implications for treatment and attrition prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Panel attrition and external validity in adolescent substance use research.

Panel attrition threatens external validity in adolescent substance use research. A 7-yr adolescent panel was examined to determine whether attrition effects varied by (1) type of substance assessed and (2) method of measurement and type of statistical analysis. Chi-squares and multivariate analyses of variance (MANOVAs) revealed that study dropouts were more likely to use substances and reported higher mean use of substances at baseline than stayers; attrition effects varied by substance; and mean use comparisons were more likely to detect attrition effects than use–nonuse comparisons. Implications of these findings for adolescent substance use research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues in the education and training of women in Canadian psychology.

The high attrition rate of female students in graduate programmes in psychology is documented. Some of the literature (largely American) on the problems of female students is explored for possible reasons for this high rate. The problem areas identified are: admissions practices, financial support, inflexibility of graduate programmes, faculty attitudes toward graduate students, scarcity of female role models, and psychology as a "masculine" discipline. Recommendations for action by the Canadian Psychological Association are made in each of the problem areas with a special plea for the inclusion, in both graduate and undergraduate psychology programmes, of courses on the female experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sometimes you need a reminder: The effects of prompting self-regulation on regulatory processes, learning, and attrition.

Prompting self-regulation involves asking trainees reflective questions to stimulate self-regulatory engagement. Research has found positive effects for prompting self-regulation on learning, but a scarcity of evidence exists regarding whether self-regulatory processes mediate the effect of prompting self-regulation, whether the intervention reduces attrition, and the optimal timing of implementing the intervention. Using a longitudinal design, we found that prompting self-regulation throughout training increased learning and reduced attrition, relative to the control condition. Moreover, the effect on learning was fully mediated by time on task. The intervention also moderated the effect of learning on subsequent self-regulatory activity and attrition. Learning performance had less of a positive effect on subsequent self-regulatory activity and less of a negative effect on subsequent attrition when trainees were prompted to self-regulate. These results highlight the importance of adopting a longitudinal design to examine how self-regulatory interventions affect the cyclical relationships among self-regulatory processes, learning, and attrition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of working conditions on vision in microcomputer users

Tooth wear is becoming more common in both adults and children. The triad of attrition, abrasion and erosion has been known for many years, but the contribution of erosion (irreversible loss of dental hard tissue due to a chemical process not involving bacteria, or the loss of tooth surface not directly associated with mechanical or traumatic factors or caries) to excessive loss of tooth tissue is now being emphasized. The authors of this paper examine the problem and suggest ways of overcoming it.