Lifestyle interventions for youth who are overweight: A meta-analytic review.

Objective: Clear evidence suggests that lifestyle interventions can be helpful in the treatment of youth who are overweight, but translational research is needed to address the gap between treatment research and clinical care. Design: This meta-analysis integrated the results of 66 treatment–control comparisons and 59 alternate treatment comparisons evaluating lifestyle interventions for children and adolescents who were overweight. Main Outcome Measures: Between-groups differences in weight-related outcomes and other health-related behaviors at the end of treatment. Results: Lifestyle interventions were effective in a range of settings and with a range of participants. Even relatively brief programs had benefits apparent months after the end of treatment. A key component appeared to be the expectation that parents would be actively involved in treatment. Program benefits included not only better weight management but also better eating habits. Conclusion: The results suggest that lifestyle interventions can be effective under a wide range of conditions not limited to the highly controlled conditions of efficacy studies. Parent involvement is associated with significantly better results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist adherence/competence and treatment outcome: A meta-analytic review.

Objective: The authors conducted a meta-analytic review of adherence–outcome and competence–outcome findings, and examined plausible moderators of these relations. Method: A computerized search of the PsycINFO database was conducted. In addition, the reference sections of all obtained studies were examined for any additional relevant articles or review chapters. The literature search identified 36 studies that met the inclusion criteria. Results: R-type effect size estimates were derived from 32 adherence–outcome and 17 competence–outcome findings. Neither the mean weighted adherence–outcome (r = .02) nor competence–outcome (r = .07) effect size estimates were found to be significantly different from zero. Significant heterogeneity was observed across both the adherence–outcome and competence–outcome effect size estimates, suggesting that the individual studies were not all drawn from the same population. Moderator analyses revealed that larger competence–outcome effect size estimates were associated with studies that either targeted depression or did not control for the influence of the therapeutic alliance. Conclusions: One explanation for these results is that, among the treatment modalities represented in this review, therapist adherence and competence play little role in determining symptom change. However, given the significant heterogeneity observed across findings, mean effect sizes must be interpreted with caution. Factors that may account for the nonsignificant adherence–outcome and competence–outcome findings reported within many of the studies reviewed are addressed. Finally, the implication of these results and directions for future process research are discussed. (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)     

Clinician's comment on treatment of childhood overweight meta-analysis.

Given the prevalence and urgency of the childhood overweight problem, pediatric providers are searching for evidence-based management to translate into clinical practice, particularly in primary care. There are numerous challenges to translation and therefore to more widespread adoption of childhood overweight treatment recommendations. In this article, the authors try to bridge this gap between childhood overweight treatment research and clinical care by discussing the current evidence-based recommendations through a clinical case and by examining the challenges of translation. Looking at this issue through the lens of a clinician, the authors consider the broader social context within which childhood overweight exists, and highlight areas for further translational work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress management interventions for HIV+ adults: A meta-analysis of randomized controlled trials, 1989 to 2006.

Objective: Numerous studies document that stress accelerates disease processes in a variety of diseases including HIV. As a result, investigators have developed and evaluated interventions to reduce stress as a means to improve health among persons living with HIV. Therefore, the current meta-analysis examines the impact of stress-management interventions at improving psychological, immunological, hormonal, and other behavioral health outcomes among HIV= adults. Design: This meta-analytic review integrated the results of 35 randomized controlled trials examining the efficacy of 46 separate stress management interventions for HIV+ adults (N = 3,077). Main Outcome Measures: Effect sizes were calculated for stress processes (coping and social support), psychological/psychosocial (anxiety, depression, distress, and quality of life), immunological (CD4+ counts and viral load), hormonal (cortisol, dehydroepiandrosterone sulfate [DHEA-S], cortisol/DHEA-S ratio, and testosterone) and other behavioral health outcomes (fatigue). Results: Compared to controls, stress-management interventions reduce anxiety, depression, distress, and fatigue and improve quality of life (d+s + 0.16 to 0.38). Stress-management interventions do not appear to improve CD4+ counts, viral load, or hormonal outcomes compared with controls. Conclusion: Overall, stress-management interventions for HIV+ adults significantly improve mental health and quality of life but do not alter immunological or hormonal processes. The absence of immunological or hormonal benefits may reflect the studies' limited assessment period (measured typically within 1-week postintervention), participants' advanced stage of HIV (HIV+ status known for an average of 5 years), and/or sample characteristics (predominately male and White participants). Future research might test these hypotheses and refine our understanding of stress processes and their amelioration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurocognition in first-episode schizophrenia: A meta-analytic review.

Compromised neurocognition is a core feature of schizophrenia. Following Heinrichs and Zakzanis’s (1998) seminal meta-analysis of middle-aged and predominantly chronic schizophrenia samples, the aim of this study is to provide a meta-analysis of neurocognitive findings from 47 studies of first-episode (FE) schizophrenia published through October 2007. The meta-analysis uses 43 separate samples of 2,204 FE patients with a mean age of 25.5 and 2,775 largely age- and gender-matched control participants. FE samples demonstrated medium-to-large impairments across 10 neurocognitive domains (mean effect sizes from ?0.64 to ?1.20). Findings indicate that impairments are reliably and broadly present by the FE, approach or match the degree of deficit shown in well-established illness, and are maximal in immediate verbal memory and processing speed. Larger IQ impairments in the FE compared to the premorbid period, but comparable to later phases of illness suggests deterioration between premorbid and FE phases followed by deficit stability at the group level. Considerable heterogeneity of effect sizes across studies, however, underscores variability in manifestations of the illness and a need for improved reporting of sample characteristics to support moderator variable analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prominent consequences of role stress: A meta-analytic review.

Role stress has received a lot of research attention in psychological, sociological, and organizational studies over the last several decades. Based on a literature review of about 300 journal articles, this article examines prominent consequences of role stress. Specific focus is on researching differences in relationships between facets of role stress (i.e., role ambiguity, role conflict, and role overload) and frequently cited consequences using techniques of meta-analysis. Findings indicate that each role stress facet has a different relationship with the eight consequences studied. Role stress research can benefit from looking at each facet individually in addition to role stress generally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression among Latinos in the United States: A meta-analytic review.

The authors conducted a meta-analytic review to assess the prevalence of major depressive disorder and depressive symptoms among Latinos compared with non-Latino Whites in the United States using community-based data. Random-effects estimates were calculated for 8 studies meeting inclusion criteria that reported lifetime prevalence of major depressive disorder (combined N = 76,270) and for 23 studies meeting inclusion criteria that reported current prevalence of depressive symptoms (combined N = 38,997). Findings did not indicate a group difference in lifetime prevalence of major depressive disorder (odds ratio = 0.89, 95% confidence interval = 0.72, 1.10). Latinos reported more depressive symptoms than non-Latino Whites (standardized mean difference = 0.19, 95% confidence interval = 0.12, 0.25); however, this effect was small and does not appear to suggest a clinically meaningful preponderance of depressive symptoms among Latinos. Findings are examined in the context of theories on vulnerability and resilience, and recommendations for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived discrimination and health: A meta-analytic review.

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study’s contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in cooperation: A meta-analytic review of social dilemmas.

Although it is commonly believed that women are kinder and more cooperative than men, there is conflicting evidence for this assertion. Current theories of sex differences in social behavior suggest that it may be useful to examine in what situations men and women are likely to differ in cooperation. Here, we derive predictions from both sociocultural and evolutionary perspectives on context-specific sex differences in cooperation, and we conduct a unique meta-analytic study of 272 effect sizes—sampled across 50 years of research—on social dilemmas to examine several potential moderators. The overall average effect size is not statistically different from zero (d = –0.05), suggesting that men and women do not differ in their overall amounts of cooperation. However, the association between sex and cooperation is moderated by several key features of the social context: Male–male interactions are more cooperative than female–female interactions (d = 0.16), yet women cooperate more than men in mixed-sex interactions (d = –0.22). In repeated interactions, men are more cooperative than women. Women were more cooperative than men in larger groups and in more recent studies, but these differences disappeared after statistically controlling for several study characteristics. We discuss these results in the context of both sociocultural and evolutionary theories of sex differences, stress the need for an integrated biosocial approach, and outline directions for future research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Culturally adapted mental health intervention: A meta-analytic review.

There is a pressing need to enhance the availability and quality of mental health services provided to persons from historically disadvantaged racial and ethnic groups. Many previous authors have advocated that traditional mental health treatments be modified to better match clients' cultural contexts. Numerous studies evaluating culturally adapted interventions have appeared, and the present study used meta-analytic methodology to summarize these data. Across 76 studies the resulting random effects weighted average effect size was d = .45, indicating a moderately strong benefit of culturally adapted interventions. Interventions targeted to a specific cultural group were four times more effective than interventions provided to groups consisting of clients from a variety of cultural backgrounds. Interventions conducted in clients' native language (if other than English) were twice as effective as interventions conducted in English. Recommendations are provided for improving the study of outcomes associated with mental health interventions adapted to the cultural context of the client. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational interviewing for smoking cessation: A meta-analytic review.

Objective: Motivational interviewing (MI) is a treatment approach that has been widely examined as an intervention for tobacco dependence and is recommended in clinical practice guidelines. Previous reviews evaluating the efficacy of MI for smoking cessation noted effects that were modest in magnitude but included few studies. The current study is a comprehensive meta-analysis of MI for smoking cessation. Method: The meta-analysis included 31 controlled trials with an abstinence outcome variable. Studies with nonpregnant (N = 23) and pregnant samples (N = 8) were analyzed separately. Results: For nonpregnant samples, combined results suggest that MI significantly outperformed comparison conditions at long-term follow-up points (dc = .17). The magnitudes of this result represented a 2.3% difference in abstinence rates between MI and comparison groups. All analyses investigating the impact of moderating participant, intervention, and study design characteristics on outcome were nonsignificant, with the exception of studies including international, non-U.S. samples, which had larger effects overall. Several subgroups of studies had significant combined effect sizes, pointing to potentially promising applications of MI, including studies that had participants with young age, medical comorbidities, low tobacco dependence, and, consistent with clinical practice guidelines, low motivation or intent to quit. Effects were smaller among pregnant samples. In addition, significant combined effect sizes were observed among subgroups of studies that administered less than 1 hr of MI and among studies that reported high levels of treatment fidelity. Conclusions: The results are interpreted in light of other behavioral approaches to smoking cessation, and the public health implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of bullying and victimization in childhood and adolescence: A meta-analytic investigation.

Research on the predictors of 3 bully status groups (bullies, victims, and bully victims) for school-age children and adolescents was synthesized using meta-analytic procedures. The primary purpose was to determine the relative strength of individual and contextual predictors to identify targets for prevention and intervention. Age and how bullying was measured were also considered as moderators. From an original pool of 1,622 studies conducted since 1970 (when research on bullying increased significantly), 153 studies were identified that met criteria for inclusion. A number of common and unique predictors were found for the bully status groups. The implications of the meta-analytic findings for future research on bullying and victimization prevention and intervention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prevention of depressive symptoms in children and adolescents: A meta-analytic review.

Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis. When all 30 studies were included, selective prevention programs were found to be more effective than universal programs immediately following intervention. Both selective and indicated prevention programs were more effective than universal programs at follow-up, even when the 2 studies with college students were excluded. Effect sizes for selective and indicated prevention programs tended to be small to moderate, both immediately postintervention and at an average follow-up of 6 months. Most effective interventions are more accurately described as treatment rather than prevention. Suggestions for future research include testing potential moderators (e.g., age, gender, anxiety, parental depression) and mechanisms, designing programs that are developmentally appropriate and gender and culturally sensitive, including longer follow-ups, and using multiple measures and methods to assess both symptoms and diagnoses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis.

There has been significant interest in the role of anxiety sensitivity (AS) in the anxiety disorders. In this meta-analysis, we empirically evaluate differences in AS between anxiety disorders, mood disorders, and nonclinical controls. A total of 38 published studies (N = 20,146) were included in the analysis. The results yielded a large effect size indicating greater AS among anxiety disorder patients versus nonclinical controls (d = 1.61). However, this effect was maintained only for panic disorder patients compared to mood disorder patients (d = 0.85). Panic disorder was also associated with greater AS compared to other anxiety disorders except for posttraumatic stress disorder (d = 0.04). Otherwise the anxiety disorders generally did not differ from each other in AS. Although these findings suggest that AS is central to the phenomenology of panic disorder and posttraumatic stress disorder, causal inferences regarding the role of AS in these anxiety disorders cannot be made. Moderator analyses showed that a greater proportion of female participants was associated with larger differences in AS between anxiety and nonclinical control groups. However, more female participants were associated with a smaller AS difference between anxiety and mood disorder groups. This finding suggests that AS is less robust in distinguishing anxiety from mood disorders among women. Age also moderated some observed effects such that AS was more strongly associated with anxiety disorders in adults compared to children. Type of AS measure used also moderated some effects. Implications of these findings for the conceptualization of AS in anxiety-related disorders are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame, guilt, and depressive symptoms: A meta-analytic review.

Recent theoretical and empirical work has facilitated the drawing of sharp conceptual distinctions between shame and guilt. A clear view of these distinctions has permitted development of a research literature aimed at evaluating the differential associations of shame and guilt with depressive symptoms. This study quantitatively summarized the magnitude of associations of shame and guilt with depressive symptoms. Two hundred forty-two effect sizes were obtained from 108 studies employing 22,411 participants. Shame showed significantly stronger associations with depressive symptoms (r = .43) than guilt (r = .28). However, the association of shame and depressive symptoms was statistically indistinguishable from the associations of 2 maladaptive variants of guilt and depressive symptoms (contextual-maladaptive guilt, involving exaggerated responsibility for uncontrollable events, r = .39; generalized guilt, involving “free-floating” guilt divorced from specific contexts, r = .42). Other factors also moderated the effects. External shame, which involves negative views of self as seen through the eyes of others, was associated with larger effect sizes (r = .56) than internal shame (r = .42), which involves negative views of self as seen through one's own eyes. Depressive symptom measures that invoked the term guilt yielded stronger associations between guilt and depressive symptoms (r = .33) than depressive symptom measures that did not (r = .21). Age, sex, and ethnicity (proportion of Whites to Asians) did not moderate the effects. Although these correlational data are ambiguous with respect to their causal interpretation, results suggest that shame should figure more prominently in understandings of the emotional underpinnings of depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological interventions and the immune system: A meta-analytic review and critique.

This article reviews evidence for the hypothesis that psychological interventions can modulate the inumme response in humans and presents a series of models depicting the psychobiological pathways through which this might occur. Although more than 85 trials have been conducted, meta-analyses reveal only in modest evidence that interventions can reliably alter immune parameters. The most consistent evidence emerges from hypnosis and conditioning trials. Disclosure and stress management show scattered evidence of success. Relaxation demonstrates little capacity to elicit immune change. Although these data provide only modest evidence of successful immune modulation, it would be premature to conclude that the immune system is unresponsive to psychological interventions. This literature has important conceptual and methodological issues that need to be resolved before any definitive conclusions can be reached. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does incubation enhance problem solving? A meta-analytic review.

A meta-analytic review of empirical studies that have investigated incubation effects on problem solving is reported. Although some researchers have reported increased solution rates after an incubation period (i.e., a period of time in which a problem is set aside prior to further attempts to solve), others have failed to find effects. The analysis examined the contributions of moderators such as problem type, presence of solution-relevant or misleading cues, and lengths of preparation and incubation periods to incubation effect sizes. The authors identified a positive incubation effect, with divergent thinking tasks benefiting more than linguistic and visual insight tasks from incubation. Longer preparation periods gave a greater incubation effect, whereas filling an incubation period with high cognitive demand tasks gave a smaller incubation effect. Surprisingly, low cognitive demand tasks yielded a stronger incubation effect than did rest during an incubation period when solving linguistic insight problems. The existence of multiple types of incubation effect provides evidence for differential invocation of knowledge-based vs. strategic solution processes across different classes of problem, and it suggests that the conditions under which incubation can be used as a practical technique for enhancing problem solving must be designed with care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer-assisted learning interventions with elementary school students: A meta-analytic review.

A meta-analytic review of group comparison design studies evaluating peer-assisted learning (PAL) interventions with elementary school students produced positive effect sizes (ESs) indicating increases in achievement (unweighted mean ES = 0.59, SD = 0.90; weighted ES, d = 0.33, p     

Detection of overreporting of psychopathology on the Personality Assessment Inventory: A meta-analytic review.

The Personality Assessment Inventory (L. C. Morey, 1991) includes 3 measures for identifying overreporting of psychopathology: the Negative Impression scale (NIM), Malingering Index (MAL), and Rogers Discriminant Function (RDF). Meta-analysis revealed that each measure was a strong predictor of uncoached (NIM, d = 1.48, k = 23; MAL, d = 1.15, k = 19; RDF, d = 1.13, k = 15) and coached malingering (NIM, d = 1.59, k = 8; MAL, d = 1.00, k = 6; RDF, d = 1.65, k = 3). For uncoached malingering, effects were larger in simulation than criterion groups studies, for identifying feigning of severe mental disorders than mood/anxiety disorders, and when feigners were compared to unimpaired honest respondents as opposed to patients. Cut scores of NIM ≥ 81 and MAL ≥ 3 resulted in the highest overall classification rates for identifying feigning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)