Meta-Analyses of the Associations Between Disinhibited Social Engagement Behaviors and Child Attachment Insecurity or Disorganization

Children with disinhibited social engagement disorder show reduced reticence with strangers, do not check back with their caregiver after venturing away, and may willingly leave with an unfamiliar adult. The recent DSM-5 has moved away from an attachment framework to understand disinhibited social engagement behavior (DSEB) due to studies indicating its presence in previously institutionalized children even after these children are adopted and show a selective, more secure attachment with their substitute caregiver (e.g. Chisholm et al., 1998). This meta-analysis aims to clarify the size of the associations between DSEB and attachment insecurity or disorganization. It also examines whether studies effect sizes differ according to various moderators (e.g., child age, type of attachment and DSEB measures). The results (k?=?24) showed that the associations between DSEB and attachment insecurity (d?=?0.48) or attachment disorganization (d?=?0.47) were of small magnitude. There were no publication biases. As for moderator analyses on both attachment insecurity and disorganization, the effect sizes in studies using DSEB observational measures (respectively d?=?0.63 and 0.57) were of moderate magnitude and stronger than those in studies not using an observational component (respectively d?=?0.28 and 0.32). Given these small-to-moderate associations, attachment can be considered a relationship process associated with DSEB, and attachment-informed interventions could be potential tools to reduce DSEB in children. Nevertheless, given the sizable unshared portion of variance between DSEB and child attachment, future studies should examine other variables related to caregiving and noncaregiving contexts to further understand DSEB.

     

Meta‐Analysis of Trauma‐Focused Therapies for Treating the Symptoms of Posttraumatic Stress Disorder

This meta‐analysis of 46 between‐groups studies published between 1997 and 2015 detected treatment effects ranging from large to small when comparing trauma‐focused therapies with no treatment (g = ?1.05), supportive interventions (g = ?0.91), other interventions (g = ?0.57), and non‐trauma‐focused cognitive behavior therapies (g = ?0.08) for the treatment of posttraumatic stress disorder (PTSD). The independent random‐effects models detected modest publication bias and a negligible influence of moderating variables on treatment outcomes. Considerations for counselors who treat PTSD and suggestions for researchers are provided.     

Parents Plus Systemic,Solution‐Focused Parent Training Programs: Description,Review of the Evidence Base,and Meta‐Analysis

Parents Plus (PP) programs are systemic, solution‐focused, group‐based interventions. They are designed for delivery in clinical and community settings as treatment programs for families with child‐focused problems, such as behavioral difficulties, disruptive behavior disorders, and emotional disorders in young people with and without developmental disabilities. PP programs have been developed for families of preschoolers, preadolescent children, and teenagers, as well as for separated or divorced families. Seventeen evaluation studies involving over 1,000 families have shown that PP programs have a significant impact on child behavior problems, goal attainment, and parental satisfaction and stress. The effect size of 0.57 (p < .001) from a meta‐analysis of 10 controlled studies for child behavior problems compares favorably with those of meta‐analyses of other well‐established parent training programs with large evidence bases. In controlled studies, PP programs yielded significant (p < .001) effect sizes for goal attainment (d = 1.51), parental satisfaction (d = 0.78), and parental stress reduction (d = 0.54). PP programs may be facilitated by trained front‐line mental health and educational professionals.     

A META‐ANALYTIC REVIEW OF RELATIONSHIP‐BASED INTERVENTIONS FOR LOW‐INCOME FAMILIES WITH INFANTS AND TODDLERS: FACILITATING SUPPORTIVE PARENT–CHILD INTERACTIONS

Relationship‐based intervention programs are increasingly being implemented as a way to enhance parent‐child interaction quality. In this meta‐analytic review, we examined the effectiveness of 19 recent relationship‐based interventions serving socioeconomically disadvantaged families with infants and toddlers (N = 6,807). This review specifically focused on intervention effectiveness in terms of improving supportive parenting behaviors, as measured by observational assessments of dyadic parent–child interactions. Meta‐analytic results indicated significant, yet modest, effectiveness across all interventions (d = .23). Intervention characteristics such as participant randomization, breadth of intervention services offered, duration, child age at the start of the intervention, professional qualifications of the intervenor, and type of play task used during assessment were tested as possible moderators of effectiveness. Significant differences in effectiveness were found between randomized and nonrandomized interventions. Within the subsample of randomized interventions, programs that were shorter in duration, that provided direct services to the parent–child dyad, used intervenors with professional qualifications, and assessed parent‐child interactions with free‐play tasks were the most effective, highlighting important considerations for designing effective intervention protocol tailored to the needs of this high‐risk population.     

Clinical research on behavioral activation as treatment for post‐traumatic stress disorder: A brief review and meta‐analysis

Behavioral activation (BA), an effective treatment for depression, has recently been receiving attention as a possible intervention for PTSD. BA interventions could be particularly useful in treating underserved populations (i.e., individuals with lower socioeconomic status). A literature search was conducted, which identified seven outcome studies that examined the effectiveness of stand‐alone BA treatment for individuals with PTSD. All studies identified for this brief review demonstrated clinically significant reductions in PTSD symptoms using BA as an intervention. A meta‐analysis of these few studies revealed a nonsignificant effect (Cohen's d = 0.713, p = .512) despite reporting an average symptom reduction of 25.8%. Other studies utilizing BA treatment for PTSD do so in tandem with other interventions and were excluded from analysis. This brief review summarizes the literature on the use of BA as a stand‐alone treatment for PTSD and suggests that future research seek to confirm the usefulness of BA as a potential treatment modality for mental health‐care providers treating individuals with PTSD.     

Which preventive interventions effectively enhance depressed mothers' sensitivity? A meta‐analysis

Improving depressed mothers' sensitivity is assumed to be a key element in preventing adverse outcomes for children of such mothers. This meta‐analysis examines the short‐term effectiveness of preventive interventions in terms of enhancing depressed mothers' sensitivity toward their child and investigates what type of intervention is most effective. Thirteen interventions, reported in 10 controlled outcome studies, met the inclusion criteria (N = 918). Meta‐analytic results showed a small to medium, significant mean effect size (g = 0.32) with large variation in individual effect sizes (?0.56–1.76). Interventions including baby massage were highly effective in improving maternal sensitivity (g = 0.85). In contrast, individual therapy for the mother proved ineffective in terms of improving maternal sensitivity (g = ?0.00). Two other significant predictors of greater effect sizes were the inclusion of a support group and the use of a higher number of intervention methods; however, the significance of these results was largely accounted for by one single study. Our meta‐analysis confirms that depressed mothers' sensitivity can be improved by preventive intervention and suggests that baby massage may be an effective intervention method to evoke short‐term changes in maternal sensitivity. It is unclear whether these changes are maintained over time.     

On the Origins of Disorganized Attachment and Internal Working Models: Paper II. An Empirical Microanalysis of 4-Month Mother–Infant Interaction

A microanalysis of 4-month mother–infant face-to-face communication predicted 12-month infant disorganized (vs. secure) attachment outcomes in an urban community sample. We documented a dyadic systems view of the roles of both partners; the roles of both self- and interactive contingency; and the importance of attention, orientation, and touch, as well as facial and vocal affect, in the co-construction of attachment disorganization. The analysis of different communication modalities identified striking intrapersonal and interpersonal intermodal discordance or conflict, in the context of intensely distressed infants, as the central feature of future disorganized dyads at 4 months. Lowered maternal contingent coordination, and failures of maternal affective correspondence, constituted maternal emotional withdrawal from distressed infants. This maternal withdrawal compromises infant interactive agency and emotional coherence. We characterize of the nature of emerging internal working models of future disorganized infants as follows: Future disorganized infants represent states of not being sensed and known by their mothers, particularly in moments of distress; they represent confusion about both their own and their mothers' basic emotional organization, and about their mothers' response to their distress. This internal working model sets a trajectory in development which may disturb the fundamental integration of the person. The remarkable specificity of our findings has the potential to lead to more finely focused clinical interventions.     

Meta‐Analysis of Counseling Outcomes for the Treatment of Posttraumatic Stress Disorder

This meta‐analysis of 152 published posttraumatic stress disorder (PTSD) clinical trials from 1990 to 2012 concluded that counseling generally produced a small to large effect of treatment across all comparison conditions at termination (d+ = 0.30 to 0.89). These gains were maintained at longest follow‐up (d+ = 0.58 to 0.86) for the wait‐list, treatment‐as‐usual, and single‐group comparisons, but not for the follow‐up placebo comparison (d+ = 0.15), probably because of the low power (j = 3 placebo studies). Clinical trial findings were synthesized using a random‐effects model. No effects of publication bias or moderating variables were evident. No difference was found between trauma‐focused and non‐trauma‐focused approaches. Implications for counseling practice and future PTSD outcome research are addressed.     

Body language reading of emotion in schizophrenia: Associations with symptoms and functional outcome

Our aim was to explore how body language reading of emotion relates to neurocognition, symptoms and functional outcome in schizophrenia. Fifty‐four individuals with schizophrenia and eighty‐four healthy controls participated in the study. Emotion perception was assessed with a point‐light display (PLD) task, the Emotion in Biological Motion (EmoBio) test, neurocognition was measured with the MATRICS Consensus Cognitive Battery (MCCB), and functioning was indexed by one measure of functional capacity and by one self‐report questionnaire. Clinical symptoms were assessed with a five factor Positive and Negative Syndrome Scale (PANSS) symptoms model. Participants with schizophrenia had impaired body language reading of emotions compared to healthy controls (Cohen's d = 0.69). In participants with schizophrenia, emotion perception was associated with neurocognition (r = 0.42), functional capacity (r = 0.27) and disorganization symptoms (r = –0.27). Mediation analyses showed that disorganization symptoms mediated the effects of emotion perception and neurocognition, respectively, on social functional capacity. These results suggest that in individuals with schizophrenia, reduced emotion perception from body movements has negative consequences for functional outcome, but that the effect is mediated through disorganization symptoms.     

The Efficacy of Interventions Aimed at Reducing Procrastination: A Meta‐Analysis of Randomized Controlled Trials

This meta‐analysis investigated the efficacy of interventions aimed at reducing procrastination in randomized controlled trials. Twelve studies, with a total of 646 participants, met inclusion criteria. The significant meta‐analytic effect size, Hedges's g = 1.18, indicates that the interventions had a large positive effect. Three variables significantly moderated effect size: Higher effects were associated with interventions delivered in person, student samples, and a no‐treatment control condition. The results lay a foundation for procrastination treatment and future research.     

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta‐analysis

Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent–infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta‐analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta‐analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta‐analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta‐analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: –0.46; 95% confidence interval [CI] [–0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent–infant interaction (SMD: –0.10; 95% CI [–0.46, 0.26]), parental depression (SMD: –1.55; 95% CI [–3.74, 0.64]) or parental global distress (SMD: –0.19, 95% CI [–3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation‐based treatment with non‐mentalization‐based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.     

Is a .51 validity coefficient good? Value sensitivity for interview validity

Human‐resource professionals (n = 201) were presented with meta‐analytic validity coefficients associated with unstructured and structured employment interviews. When presented alone, the unstructured interview received a higher effectiveness rating—despite having a smaller validity coefficient—than the structured interview received (d = −.30). When presented together, however, the structured interview was strongly favored (d = .61). The inclusion of the endpoints of the range of operational validities for all selection methods made the presentation‐mode by interview‐structure interaction disappear.     

Diminished ability to identify facial emotional expressions in children with disorganized attachment representations

The development of children's ability to identify facial emotional expressions has long been suggested to be experience dependent, with parental caregiving as an important influencing factor. This study attempts to further this knowledge by examining disorganization of the attachment system as a potential psychological mechanism behind aberrant caregiving experiences and deviations in the ability to identify facial emotional expressions. Typically developing children (N = 105, 49.5% boys) aged 6–7 years (M = 6 years 8 months, SD = 1.8 months) completed an attachment representation task and an emotion identification task, and parents rated children's negative emotionality. The results showed a generally diminished ability in disorganized children to identify facial emotional expressions, but no response biases. Disorganized attachment was also related to higher levels of negative emotionality, but discrimination of emotional expressions did not moderate or mediate this relation. Our novel findings relate disorganized attachment to deviations in emotion identification, and therefore suggest that disorganization of the attachment system may constitute a psychological mechanism linking aberrant caregiving experiences to deviations in children's ability to identify facial emotional expressions. Our findings further suggest that deviations in emotion identification in disorganized children, in the absence of maltreatment, may manifest in a generally diminished ability to identify emotional expressions, rather than in specific response biases.     

Job attitudes of part‐time vs. full‐time workers: A meta‐analytic review

A meta‐analysis was conducted (k =38, N =51,231) to examine the size of the difference between full‐ and part‐time employees on job attitudes. Results indicated that there was little difference between full‐time (FT) and part‐time (PT) employees on job satisfaction, organizational commitment, intentions to leave and facets of job satisfaction. Full‐time employees were found to be more involved with their jobs than PT employees (d_c=0.39). Moderating variables were examined (type of job, sex of the sample and sampling strategy used), but these variables explained little of the variability in effect sizes across the studies. An additional analysis of voluntary vs. involuntary employment status was conducted on job satisfaction, but only small differences were found. The theoretical implications are discussed.     

Mother–child attachment,emotion regulation,and anxiety symptoms in middle childhood

This study examined whether the relation of mother–child attachment with anxiety symptoms is mediated by emotion regulation (ER) processes (poor emotional awareness, biased interpretations of emotionally charged events, and coping strategies). Attachment patterns were assessed in a sample of eighty‐seven 10‐ to 12‐year‐olds using story‐stem interviews. Children who were less secure and more disorganized reported more anxiety. Attachment was also related to ER; security was associated with less difficulty identifying emotions, and disorganization was associated with more catastrophizing interpretations and less active coping. Anxiety symptoms were related to all three ER processes. Finally, relations of security or disorganization with anxiety symptoms were partially mediated by ER processes.     

Can Disorganized and Positive Schizotypy Be Discriminated From Dissociation?

ABSTRACT Schizotypy is thought to reflect liability for schizophrenia and involves at least 3 facets: disorganized, positive, and negative. However, it is unclear whether disorganized and positive facets can be discriminated from dissociation. In the current study with college students (N=325), the best‐fitting confirmatory factor model included 3 factors: (a) disorganization, (b) positive‐dissociation, and (c) negative. In addition, the pattern of associations with the disorganization and the positive‐dissociation factors with individual difference variables was very different. Disorganization was associated with (a) poor cognitive estimation and increased ADHD symptoms, (b) increased emotional confusion, and (c) increased neuroticism and decreased conscientiousness. In contrast, the positive‐dissociation factor was associated with (a) an increased influence of emotion on thinking, (b) self‐reported childhood abuse, and (c) increased openness to experience. Overall, these results suggest that disorganized schizotypy can be discriminated from dissociation but that positive schizotypy may not be easily discriminated from dissociation.     

Models of child–parent attachment in attention deficit hyperactivity disorder: Links to executive functions

This study explored multiple attachment relationships and examined four conceptual models of child–mother/father attachment—monotropy, hierarchy, independence, integration—to explain executive functioning (EF) in attention deficit hyperactivity disorder (ADHD) versus typical development (TD; n = 50 each; age: M = 11.45, SD = .50). Significant ADHD versus TD differences emerged on all EF measures and on distribution into four clusters (secure attachment to both parents, neither parent, only father, only mother). For both groups, results supported two attachment models: (a) monotropy: child–mother attachment predicted all EF measures; child–father attachment predicted none and (b) integration: clusters differed significantly on all EF measures. Children with ADHD comprised ～74% of the high‐risk cluster (concordant insecure attachment, highest EF difficulties). Discussion focused on unique risk/protective roles played by each parental attachment for understanding EF in children with ADHD or TD.     

An Examination of Alcohol Use Disorder Symptoms and Neighborhood Disorganization from Age 21 to 39

Living in disorganized neighborhoods characterized by high levels of poverty, crime, violence, and deteriorating buildings has been associated with increased alcohol consumption and mental health problems. Data drawn from the Seattle Social Development Project (N = 790), a theory‐driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of Alcohol Use Disorder (AUD) symptoms from age 21 to 39. Time‐varying measures of neighborhood disorganization, psychological distress, and sociodemographic factors were associated with deviations from average AUD symptoms at each wave. Results indicated that, on average, AUD symptoms decreased as individuals got older. Living in more disorganized neighborhoods and experiencing psychological distress was associated with increased AUD symptoms after accounting for average reductions from AUD symptoms over time and time‐varying measures of relevant sociodemographic factors. Results of mediation analysis suggested that psychological distress is a mechanism by which disorganized neighborhoods increased risk of AUD from age 21 to 39.     

Terror management among Taiwanese: Worldview defence or resigning to fate?

Terror management theory (TMT) proposes that people who are reminded of their mortality should be motivated to defend their cultural worldview. Studies 1 and 2 examined whether the TMT worldview defence‐buffering effect found in Western cultures could be generalized to Asians in Taiwan. No such effect was found in the present studies. This non‐significant result was robust when either a stronger distraction task was used (study 1) or when a subliminal manipulation of mortality salience was utilized (study 2). A meta‐analysis, including 24 TMT experiments in East Asia, was also conducted (study 3). The average effect size (d = 0.11, r = 0.055) of worldview defence among these experiments was not significantly different from zero. Study 4 found that mortality salience manipulation also did not change Taiwanese participants' view of reincarnation; however, it did make them more inclined to resign to fate, suggesting that they might be using this symbolic means to defend their anxiety of death. The issue of the generality of TMT to Asians was discussed.