The role of adult attachment styles in psychopathology and psychotherapy outcomes.

Attachment theory provides a model for understanding how the attachment styles formed in infancy systematically affect subsequent psychological functioning across the life span. Attachment styles provide the cognitive schemas, or working models, through which individuals perceive and relate to their worlds. In turn, these schemas predispose the development of psychopathologies and influence outcomes when people undergo psychotherapy. After reviewing recent empirical findings, the authors conclude that an understanding of attachment theory facilitates the conceptualization of clients' problems and the selection of appropriate interventions. Accordingly, attachment styles should be assessed as a standard part of treatment planning. Furthermore, the authors propose that attachment styles should be assessed as individual difference variables in psychotherapy outcome research because adult attachment styles dictate how people perceive and respond to their environments and, therefore, how clients respond differentially to various treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is 201Tl a reliable agent in tumour imaging?

Periodontal health states are difficult to quantify and no formal scale quantifying patients' utilities for periodontal health states exits. Multi-attribute utility (MAU) techniques were used to develop such a scale. The MAU scale may be used to quantify patients' assessment of their current periodontal health and that of possible treatment outcomes. Such data, combined with probability values in formal decision analysis techniques would result in improved rationality of treatment planning for periodontal disease. 20 patients attending for routine undergraduate care were interviewed. Data from these interviews were sorted into groups of common interest (domains). Intra-domain health statements were complied from the interview content. 21 patients ranked the intra-domain statements on a scale of 0-100. This same group of patients also performed an inter-domain weighting. Mean results showed that patients were 2X as concerned with how they felt and with the prognosis of possible outcomes, than with how they looked and what facts they knew about their oral health. However, the real value of utilities research lies in application of individual results to treatment planning as there is a wide range of opinion regarding outcome health states.     

Attachment, psychotherapy, and assessment: A commentary.

This article, a commentary, discusses questions and issues generated by 7 articles (see records 2006-22003-002, 2006-22003-003, 2006-22003-004, 2006-22003-005, 2006-22003-006, 2006-22003-007, 2006-22003-008) on the relationship between attachment theory and research, and psychotherapy and clinical assessment. The issues include the following: attachment-based therapeutic interventions for adults and child-caregiver dyads, change in attachment status as an outcome goal of therapeutic intervention, attachment pattern as a moderator of treatment outcome and therapeutic approach, clinical use of attachment measures, narrative/discourse and self-report measures of attachment patterns, and application of attachment theory to new areas. In the discussion of each of these issues, suggestions are made for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy for children and adolescents: Current progress and future research directions.

Psychotherapy research for children and adolescents has progressed considerably in the past decade. In this article, reviews of treatment outcome research, individual outcome studies, programmatic studies of specific interventions, and treatments for specific clinical dysfunctions are highlighted to convey progress. Current advances in treatment have been augmented greatly by psychological theory and research on the nature of child dysfunction as well as by improved methods for assessing children and specifying and evaluating treatments. In light of the current status of research, several priorities are identified that include expanding the range of research questions asked about treatment, evaluating a broader range of treatments, examining long-term treatment effects, bridging research and practice, extending treatment further to underserved and understudied populations, and integrating developmental theory and research into child treatment research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of social support on success of therapeutic interventions: A meta-analytic review.

Researchers view social support as an important extratherapeutic factor in the field of psychotherapeutic research. In an effort to verify the accuracy of this view, and to determine the degree to which social support influences the outcome of psychotherapeutic interventions, the authors conducted an exhaustive review of studies published until 2007. This search yielded 27 studies, including 29 independent samples that composed a meta-analysis. The results demonstrated a small mean correlation of r = .13 between social support and psychotherapy outcome on an almost homogeneous data set. Different operationalizations of social support and forms of interventions did not result in different effect sizes on a statistically significant level. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comment on Turner (2000).

Field research like that of A. L. Turner (see record 2000-03669-001) has the potential to develop theory about coping and treatment processes. We discuss theoretical concepts from social support research, social comparison theory, and emotional processing models, which can help to understand what is happening in group-based interventions and to plan interventions that address the interface between socially supportive processes and individual differences in anxiety reactions. We discuss methodological approaches that can be used to assess how treatment effects are mediated and suggest settings where controlled evaluations are possible. Such research can enrich theory about group processes and build the effectiveness of group-based interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Barriers to implementing treatment integrity procedures: Survey of treatment outcome researchers.

Treatment integrity refers to implementing interventions as intended. Teatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity implementation by surveying psychotherapy researchers. Results indicate that lack of theory and guidelines on treatment integrity procedures, as well as time, cost, and labor constraints, were regarded as strong barriers. The lack of general knowledge about treatment integrity and the lack of editorial requirement for reporting integrity procedures were also perceived as barriers to its implementation. However, psychotherapy researchers indicated awareness of the importance of treatment integrity for the experimental validity of a study and did not regard lack of its appreciation as a barrier for implementing integrity procedures. Further, a higher number of endorsed barriers predicted lower adequacy of treatment integrity procedures in the authors' own research. Recommendations for improving how integrity is addressed include journal and editorial enforcement of treatment integrity implementation, funding for integrity procedures, and provision of specific guidelines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress management during noxious medical procedures: An evaluative review of outcome studies.

Presents an evaluative review of outcome studies that have employed information, relaxation, cognitive-behavioral, and modeling interventions for stress management in patients during noxious medical procedures. There was some evidence to support the use of each of these interventions, with cognitive-behavioral and modeling approaches yielding stronger effects over a wider range of measures. Methodological deficiencies were common across all of the approaches reviewed. More research aimed at revealing possible key components common to many of these interventions should be undertaken. Some examples include enhancement of patients' sense of predictability and control over an aversive situation, provision of cognitive-behavioral coping strategies, and nonspecific aspects of intervention such as emotional supportiveness. Pertinent research is presented from the domain of experimental personality and social psychology, bearing on elucidation of situational and individual difference factors mediating successful preparation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The interpreter in an intercultural clinical milieu

This article serves as a primer for those beginning clinical research in complementary and alternative medicine. The authors provide a basic overview of important experimental design and statistical issues, of which clinical researchers in the area of complementary and alternative medicine must be aware when attempting to demonstrate the effectiveness of particular treatment modalities. As the article suggests, science is an inferential process, and experimental investigations can vary greatly in methodological integrity. Key concepts in clinical outcome research such as internal validity, statistical conclusion validity, and the appropriate measurement and operational definitions of outcomes are discussed. New scientific approaches that are evolving because of paradigm shifts in science (e.g., chaos theory) are also reviewed. Suggestions are provided to further develop an understanding of clinical outcome research methodology.     

Role of perfectionism and personality disorder features in response to brief treatment for depression.

Using data from the Treatment of Depression Collaborative Research Program (TDCRP), the authors compared the role of patients' perfectionism and features of personality disorder (PD) in the outcome of brief treatment for depression. Data were extracted as to patients' intake levels of symptoms; perfectionism; and PD features, measured as continuous variables, as well as their symptoms at termination; their contribution to the therapeutic alliance; and their satisfaction with social relations. Poorer therapeutic outcome was demonstrated for patients with elevated levels of perfectionism and odd-eccentric and depressive PD features. Patients' contribution to therapeutic alliance and satisfaction with social relations were predicted by perfectionism but not by PD features. Results highlight the central role played by patients' personality in the course of brief treatment for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions.

Reviews the book, Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions by Ronald T. Brown, David O. Antonuccio, George J. Dupaul, Mary A. Fristad, Cheryl A. King, Laurel K. Leslie, Gabriele S. McCormick, William E. Pelham Jr., John C. Piacentini, and Benedetto Vitiello (see record 2007-15067-000). This volume stands as a significant contribution to the current state of affairs in child and adolescent mental health. Unassuming in size (a total of 207 pages including references and author and subject indexes), this compilation is not only of value to researchers and clinicians within the professions of psychology and psychiatry but holds significance across other professions (e.g., social work, occupational therapy, nursing) that serve and support the mental health care of children. This book consists of 13 chapters, of which 11 address common child and adolescent mental health disorders. The authors offer readers a concise summary of the status of support for psychosocial, pharmacological, and combined interventions balanced in the context of safety and potential harm. Recommendations are offered on the most appropriate first-line treatment for a particular disorder (which predominantly favours psychosocial interventions over psychoactive medications). This is a book that will be a significant resource for those seeking evidence-based guideposts to intervention with children, adolescents, and their families. It is a timely, accessible, well-organised text, giving fair consideration to pharmaceutical, psychosocial, and combined interventions. As the authors allude, this compilation represents a "snapshot in time" but sets forth a strong foundation for practise and an agenda to further clinical and research attention to children's mental health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues of measurement and mechanism in meta-analyses: Comment on Westen and Morrision (2001).

The authors suggest that D. Westen and K. Morrison's (2001) meta-analysis of treatment (see record 2001-05666-001) is critically limited in the consideration of measurement and mechanisms of therapeutic change. The measures included in the analysis fail to represent a comprehensive coverage of the domains within which change is expected. Moreover, they do not measure the theoretically derived constructs currently conceived as being central to each disorder. Further, the particular meta-analytical approach taken prohibits evaluation of the treatment components responsible for change. The authors reviewed the most recent data on comorbidity as an issue of treatment efficacy and generalizability, proffer an interpretation for the difference in outcome results across the 3 diagnostic groups, and discuss internally valid methodologies for the bridging from research to clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal examination of the social-cognitive model applied to high school girls' choices of nontraditional college majors and aspirations.

This study tested a partial version of R. W. Lent, S. D. Brown, and G. Hackett's (1994) social-cognitive career theory model. Among 204 high school girls who attended science, math, and engineering (SME) career conferences, the authors used a 4-year longitudinal design to predict the choice of an SME college major and SME self-efficacy and outcome expectations in college. In addition, among students who had declared SME majors, variables assessed in high school and college were used to predict aspirations to become leaders in SME fields. The results generally provided empirical validation of the model. Regression analyses revealed that college SME outcome expectations were associated with plans to become a leader in an SME field. Implications for research and interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-discrepancy as an important factor in addressing women's emotional reactions to infertility.

Researchers have failed to establish infertility as a crisis or to identify an emotional reaction that is common to women who are faced with an inability to conceive. Many women, however, express a desire for counseling in conjunction with infertility treatment. This discrepancy in the research presents confusion for the clinician who is developing psychological interventions while working with infertile women. Infertility is approached in this article as a personal crisis that is based on a conflict between an ideal self as mother or woman and a real self as infertile. E. T. Higgins's (see record 1987-34444-001) self-discrepancy theory is proposed as a model for understanding the variability in the levels of distress and the types of emotional reactions to infertility. Clinical implications are discussed in relation to the variability of emotional reactions in female infertility clients, the selection of assessment techniques, and the selection of intervention techniques. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distinctiveness of behavioral versus insight-oriented marital therapy: An empirical analysis.

The present study determined whether behavioral and insight-oriented marital therapy could be rendered in a distinct and uncontaminated fashion in manual-guided outcome research in which therapists were crossed with treatment condition. Results indicated that therapist interventions could be reliably coded into techniques specific to the respective approaches and into additional interventions not specific to either treatment modality. When provided with explicit treatment manuals and ongoing case supervision, therapists were able to administer both treatment conditions faithfully without contamination from techniques that were inconsistent with that theoretical approach. Behavioral marital therapy (BMT) was shown to be highly structured, with 93% of therapist interventions reflecting techniques specific to that approach. In contrast, insight-oriented marital therapy (IOMT) comprised a large percentage of nonspecific interventions (62%) compatible with but not unique to a psychodynamic orientation. Implications for the two treatment approaches and for future marital therapy outcome research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Transformative relationships: The control-mastery theory of psychotherapy.

Reviews the book, Transformative relationships: The control-mastery theory of psychotherapy by George Silberschatz (see record 2005-00928-000). This book is an edited text that thoroughly reviews theory, research, and practice on control-mastery theory, a psychodynamic method developed at the San Francisco Psychoanalytic Institute. Overall, this is an impressive research program summarized in this chapter in a very accessible manner. The research program is a good case study of an effort to build an evidence-based treatment close to clinical reality. In addition, the book as a whole is probably the best way to get a summary of all aspects of control-mastery theory as well as a clear and interesting exposition of different aspects of the theory, research, and practice. One important clinical implication of the testing concepts is that the meaning of a therapist's interventions will vary depending on what specific pathogenic beliefs the client is testing. Control-mastery theory is highly case specific; a technique that is helpful to one client may not be appropriate or helpful to another. How effective the therapy is will be determined not by the technique used but by the extent to which the therapist can disconfirm the client's pathogenic beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expanding the concept of acculturation in Mexican American rehabilitation psychology research and practice.

The acculturation process is increasingly being viewed as an important variable that provides a context for understanding Mexican American health disparities. Although rehabilitation psychologists have noted the importance of utilizing acculturation in research and practice, scholars continue to use out-dated conceptualizations and models of acculturation. Objectives: The authors provide a brief overview of current trends in acculturation theory and research. Limitations of current rehabilitation research and how acculturation theory can help explain Mexican American health outcomes are discussed. Finally, recommendations for rehabilitation research and practice are provided. Conclusions: The authors recommend that rehabilitation scholars develop and test theoretical models that incorporate multiple dimensions of acculturation in order to understand how it influences Mexican American health outcomes. Rehabilitation professionals should incorporate acculturation theory and culturally informed interventions into rehabilitation practice with Mexican Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized trial of a representational intervention for cancer pain: Does targeting the dyad make a difference?

Objective: To determine the efficacy in overcoming attitudinal barriers to reporting cancer pain and using analgesics of an educational intervention presented to patients accompanied by a significant other (SO) as compared with patients alone. Design: Patient–SO pairs (N = 161) were randomized to the dyad condition (patient and SO received the intervention), solo condition (patient received the intervention), or care as usual. Dyad and solo conditions received the intervention at baseline (T1) and 2 and 4 weeks later. Main Outcome Measures: Patients' and SOs' attitudes about analgesic use and patients' pain outcomes (pain severity, pain relief, interference with life, negative mood, and global quality of life [QOL]) at T1, 5 weeks later (T2), and 9 weeks later (T3). Results: Completers' analyses revealed no significant differences between groups at T2. At T3, patients in the dyad and the solo groups showed greater decreases in attitudinal barriers as compared with controls. T1–T3 changes in patients' barriers mediated between the dyad and solo interventions and pain severity, pain relief, pain interference, negative mood, and global QOL. Conclusion: The intervention was no more efficacious when it was presented to dyads than to patients alone. Conditions under which SOs should be included in interventions need to be determined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Freud versus Adler on dreams.

Comments on the article by L. T. Benjamin, Jr. and D. N. Dixon (see record 83-32709) that describes Freud's attempt to help an American girl named Mary Fields by interpreting her dream in which there was some conflict between Fields and her parents regarding the man with whom she was involved. For Freud, dreams were the royal road to the unconscious mind, and they represented a disguised fulfillment of a repressed wish. The authors discuss the Adlerian perspective on dreams which states that the purpose of dreams is to support the lifestyle against the demands of logic or common sense, and sees dreams as an attempt to make a bridge between an individual's lifestyle and present problems. From an Adlerian perspective, Field's dream had a connection with her problem, which was her anxiety over her attraction to and desire to see her friend, and also the possible negative outcome of this dilemma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)