Meta-analysis of the Long-Term Treatment Effects of Psychological Interventions in Youth with PTSD Symptoms

To date, the long-term effectiveness of psychological treatments in reducing post-traumatic stress disorder symptoms in children and adolescents has not been investigated extensively. This meta-analysis quantifies the long-term effects of psychological interventions in children and adolescents with PTSD symptoms and examines the period-dependent follow-up (FU) effects based on 47 studies. The mean FU effect sizes (ESs) for PTSD symptoms ranged from medium (between treatment ESs for controlled studies) to large (within treatment ESs for uncontrolled studies; pooled analysis including all studies). These effects were comparable to the post-treatment ESs, which suggests that the treatment effects remained stable. ESs did not differ depending on the length of the FU period (</>6 months). In randomized controlled trials (RCTs), as well as trials conducted with treatment as usual or active control groups, the long-term treatment effects for the reduction of PTSD symptoms were small. These results demonstrate the long-term effectiveness of psychological interventions in the treatment of PTSD in youth. However, more studies should include a FU assessment. Further research should focus on RCTs with long-term assessments, report comorbid symptoms and investigate the influence of potential moderators. Research is also warranted to determine how to improve the long-term effects of treatments for PTSD in youth.     

Impact of Well-being Interventions for Siblings of Children and Young People with a Chronic Physical or Mental Health Condition: A Systematic Review and Meta-Analysis

Siblings of children and young people with a chronic illness are at increased risk of poor psychological functioning. A number of studies have attempted to implement and evaluate interventions targeting the psychological well-being of this at-risk group. This systematic review summarises the evidence regarding psychological functioning of siblings following an intervention targeting their well-being. The meta-analysis considered behaviour and knowledge, two of the most frequently studied outcomes. The following databases were used: PsycINFO, EMBASE, CINAHL, PubMed, Scopus and Web of Science. Seventeen studies were eligible to be included in the systematic review and eight in the meta-analysis. Results from the systematic review reflected the inconsistency of intervention evaluations in this area with a high level of heterogeneity and a total of 23 outcomes considered across the 17 included studies. The meta-analysis estimated effect sizes using a standardised mean difference (SMD) approach. Pre-post analysis suggested significant improvement in behavioural outcomes and knowledge of their sibling’s health conditions with a SMD of ? 0.44 [95% CI (? 0.6, ? 0.29); p = 0.000] and 0.69 [(95% CI = 0.42, 0.96); p = 0.000], respectively. The SMD was not significant for behavioural outcomes when considering treatment–control studies. In conclusion, the findings suggest interventions for well-being have a positive effect on the psychological functioning of siblings of children and young people with a chronic illness, but their specificity needs to be established. There is a need for further, more methodologically robust research in this area.     

Psychological Treatments for Symptoms of Posttraumatic Stress Disorder in Children,Adolescents, and Young Adults: A Meta-Analysis

Meta-analyses of the treatment of posttraumatic stress disorder (PTSD) in childhood and adolescence are restricted to specific trauma, selected interventions, and methodologically rigorous studies. This large meta-analysis quantifies the effects of psychological treatments for PTSD symptoms in children and adolescents. An extensive literature search yielded a total of 13,040 articles; 135 studies with 150 treatment conditions (N = 9562 participants) met the inclusion criteria (psychological interventions with children and/or adolescents with PTSD symptoms that report quantitative measures of symptom change). The mean effect sizes (ESs) for PTSD symptoms ranged from large to small, depending on the control condition. Cognitive behavioral therapy (CBT) yielded the highest ESs. Age and caretaker involvement were identified as moderators. CBT, especially when conducted in individual treatment with the inclusion of parents, is a highly effective treatment for trauma symptoms. Psychological treatments need to be modified to address younger patients’ specific needs.     

Meta-analysis of CBT for Bulimia Nervosa: Investigating the Effects Using DSM-III-R and DSM-IV Criteria

This meta-analysis reports the effects of cognitive-behavioural treatment (CBT) on bulimia nervosa as defined by the DSM-III-R or DSM-IV criteria. In a previous meta-analysis, 26 studies were included using less strict diagnostic criteria for inclusion. The present meta-analysis only included randomized controlled studies fulfilling the DSM-III-R or DSM-IV criteria. Computer searches in MedLine, PsychLIT and references cited herein resulted in a large number articles, of which only seven fulfilled the criteria for inclusion. Effect sizes for binge eating and purging frequency were estimated using both between-group (treatment vs control) and within-group (pre- vs post-treatment) comparisons. The combined within-group effect size for binge eating was r = 0.55 ( d = 1.32) and for purging r = 0.61 ( d = 1.54). The corresponding combined effects for the between-group comparisons were r = 0.23 ( d = 0.47) and r = 0.28 ( d = 0.58), respectively. The combined probabilities for frequency of purging in between- and within-group comparisons were p = 0.00001 and p = 0.00000001, respectively. Although the number of studies included in the meta-analysis was limited, the obtained results are in line with the findings of the previous meta-analysis, and support the efficacy of CBT for the treatment of bulimia nervosa. This suggestion is also supported by the fact that in all the studies except one, comparison groups had received other active treatments.     

The Validity of the Rorschach and the Minnesota Multiphasic Personality Inventory: Results from Meta-Analyses

Results from meta-analyses have been widely cited to defend the validity of the Rorschach. However, the meta-analyses have been flawed. For example, one meta-analysis included results that were obtained by calculating correlations but not results that were obtained by conducting t tests or analyses of variance. When we reanalyzed the data from the most widely cited meta-analysis (Parker, Hanson, & Hunsley, 1988), we found that for confirmatory studies (also called convergent-validity studies), the Minnesota Multiphasic Personality Inventory (MMPI) explained 23% to 30% of the variance, whereas the Rorschach explained only 8% to 13% of the variance. These results indicate that the Rorschach is not as valid as the MMPI.     

儿童青少年创伤后应激障碍(PTSD)治疗的研究热点——基于美国文献的知识图谱分析

为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结果表明,近10年来美国儿童青少年PTSD治疗研究可分为两个大的研究领域。领域一为儿童青少年PTSD的精神科和神经生物学相关的治疗,包括了两个小的研究热点:(1)儿童青少年PTSD精神科药物治疗相关的研究;(2)儿童青少年PTSD眼动脱敏再加工治疗等神经生物学机制的疗法。领域二为儿童青少年PTSD的心理学治疗,包括了两个小的研究热点:(1)家庭暴力导致的儿童青少年PTSD心理学治疗研究;(2)儿童青少年PTSD的认知行为治疗研究。其中关于儿童青少年PTSD的认知行为治疗研究是研究的热点和重点领域,但关于儿童青少年PTSD治疗效果的长期纵向研究还较为缺乏,未来研究者应加强对儿童青少年PTSD治疗效果的追踪研究,并开展心理治疗与药物治疗相结合的疗效研究。     

Altered stress responses in children exposed to early adversity: a systematic review of salivary cortisol studies

Pathological stress responses are implicated in numerous disorders. Hypothalamic-pituitary-adrenal axis function is influenced by gene-environment interaction, with early-life environmental adversity having long-lasting effects. We examine the evidence that, in humans, these effects are apparent from infancy. We systematically reviewed published findings on cortisol response to a stressor, in 0-5-year-olds already exposed to adversity. Adversity was defined as a negative environmental influence present post-conception. We searched Ovid MEDLINE (1950-May 2010), EMBASE (1980-May 2010) and PsychINFO (1806-May 2010). We included peer-reviewed, English language studies that analysed salivary cortisol before and after a standardised stressor. We identified 30 studies, of which 27 reported a significant effect of adversity on the cortisol response to stress. Six of these demonstrated an effect of prenatal substance exposure. Thirteen studies found that psychosocial adversity increased cortisol reactivity. Three studies reported that cortisol reactivity could be normalised by intervention programmes. The studies were heterogeneous, both in nature of adversity studied and in stressor used, precluding meta-analysis and assessment of publication bias. Our review presents evidence that adversity disrupts the stress response from an early age. Longitudinal studies are required to determine whether effects persist, alter with time, or are reversible with intervention.     

Perceived Parental Warmth, and Children’s Psychological Adjustment, and Personality Dispositions: A Meta-analysis

The purpose of this meta-analysis is to address three questions drawn from one of the basic postulates of parental acceptance–rejection theory: (1) To what extent are children’s perceptions of parental warmth related to their psychological adjustment? (2) To what extent are children’s perceptions of parental warmth related to their personality dispositions? (3) Do relations found in these questions vary by the gender of parents? The meta-analysis was based on 30 studies from 16 countries in five continents involving 12,087 children (52 % boys and 48 % girls). All studies included in the meta-analysis, used child versions of the Parental Acceptance–Rejection Questionnaire for Mothers and for Fathers (Child PARQ: Mothers and Fathers), as well as the child version of the Personality Assessment Questionnaire (Child PAQ). Results showed that perceived parental warmth correlated significantly with psychological adjustment and personality dispositions—including hostility and aggression, independence, positive self-esteem, positive self-adequacy, emotional responsiveness, emotional stability, and positive worldview of children across ethnicities, cultures, gender, and geographical boundaries.     

Monitoring psychotherapy with performance-based measures of personality functioning

In this commentary, I review a meta-analysis and three original research reports concerning the Rorschach (Exner, 2003; Rorschach, 1921/1942) and the Thematic Apperception Test (TAT; Murray, 1943) assessment in psychological treatment planning and outcome evaluation. The information in these four articles bears witness to the potential utility of performance-based personality assessment measures for this purpose. The strengths and limitations of the articles suggest several guidelines for future research designed to examine this Rorschach and TAT application including an emphasis on effectiveness studies, longitudinal data, integrated independent variables, observable dependent variables, sophisticated data analysis combining nomothetic and idiographic presentation, and the incremental contribution of performance-based measures to psychotherapy-related personality assessment.     

The Ethics of Bias in Counselor Terminology

Mental health counselors (MHCs) are generally perceived as empathic, caring professionals. However, the terms that mental health counselors use to describe their clients sometimes contribute little to the valid assessment and treatment of psychological problems and are disrespectful to clients. This article reviews the literature on counselor terminology with foci on the types of terms used, the effects such terminology has on clients, the corresponding ethical responsibilities of MHCs, and the implications for practice.     

Perceived racism and mental health among Black American adults: a meta-analytic review

The literature indicates that perceived racism tends to be associated with adverse psychological and physiological outcomes; however, findings in this area are not yet conclusive. In this meta-analysis, we systematically reviewed 66 studies (total sample size of 18,140 across studies), published between January 1996 and April 2011, on the associations between racism and mental health among Black Americans. Using a random-effects model, we found a positive association between perceived racism and psychological distress (r = .20). We found a moderation effect for psychological outcomes, with anxiety, depression, and other psychiatric symptoms having a significantly stronger association than quality of life indicators. We did not detect moderation effects for type of racism scale, measurement precision, sample type, or type of publication. Implications for research and practice are discussed.     

Experimental disclosure and its moderators: a meta-analysis

Disclosing information, thoughts, and feelings about personal and meaningful topics (experimental disclosure) is purported to have various health and psychological consequences (e.g., J. W. Pennebaker, 1993). Although the results of 2 small meta-analyses (P. G. Frisina, J. C. Borod, & S. J. Lepore, 2004; J. M. Smyth, 1998) suggest that experimental disclosure has a positive and significant effect, both used a fixed effects approach, limiting generalizability. Also, a plethora of studies on experimental disclosure have been completed that were not included in the previous analyses. One hundred forty-six randomized studies of experimental disclosure were collected and included in the present meta-analysis. Results of random effects analyses indicate that experimental disclosure is effective, with a positive and significant average r-effect size of .075. In addition, a number of moderators were identified.     

Gender Schemas, Gender Roles, and Expressive Writing: Toward a Process-focused Model

Range and Jenkins (2010) timely and compelling review of Pennebaker’s (1989, 1993) Expressive Writing Paradigm (EWP) provides a valuable framework for conceptualizing the role of gender-related variables in EWP studies, and for examining these variables in the context of gender schema theory, social role theory, and gender socialization theory. This comment contributes to Range and Jenkins efforts by integrating their analysis with: 1) findings regarding multimodal assessment of individual differences and outcomes; and 2) process-focused studies of participants’ responses to different psychological assessment tools. When multimodal assessment procedures are coupled with experimental manipulations that differentially impact different measures, researchers’ understanding of the benefits of trauma writing will increase and the efficacy of disclosure interventions in applied settings will be enhanced.     

Does Age Moderate the Relation Between Social Negativity and Psychological Distress?: A Meta-Analytic Investigation

Recently, Finch et al. (Journal of Personality, 1999) reported the results of a meta-analysis in which social negativity was demonstrated to be positively related to psychological distress. In the present investigation, we employed meta-analytic techniques to test competing hypotheses as to whether age amplifies or dampens the relation of social negativity and psychological distress. A total of 104 effect sizes (e.g., concurrent correlations between self-report measures of social negativity and psychological distress) from 53 independent samples were extracted from 46 journal articles. Contrary to hypotheses, the relation between social negativity and psychological distress was not significantly different for samples of older (60 + years) and younger (<60 years) adults. An explanation was provided for why the present meta-analysis and previous narrative reviews have resulted in discrepant conclusions about negativity effects.     

Effectiveness of treatments for social phobia in an applied field

Social phobia is one of the most common disorders and one that requires the most attention from psychological clinics. The aim of this article was to study the effectiveness of psychological treatments in a University Psychological Clinic. Seventy-one social phobia patients requested psychological assistance. The average number of assessment sessions was 3.8 and the average number of treatment sessions was 16.1. Therapeutic success reached 64.2%, withdrawal percentage was 11.3%, and drop-out percentage was 24.5%. The effect size (Cohen's d) achieved in the Social Avoidance and Distress Scale (SAD) and Fear of Negative Evaluation Scale (FNE) were 1.96 and 1.78, respectively. Comparing these results with efficacy research (particularly meta-analysis), it has been shown that the treatment effectiveness achieved is very similar. It is concluded that cognitive behavioural treatments for social phobia can be transferred from research settings to clinical practice.     

Examining reproducibility in psychology: A hybrid method for combining a statistically significant original study and a replication

The unrealistically high rate of positive results within psychology has increased the attention to replication research. However, researchers who conduct a replication and want to statistically combine the results of their replication with a statistically significant original study encounter problems when using traditional meta-analysis techniques. The original study’s effect size is most probably overestimated because it is statistically significant, and this bias is not taken into consideration in traditional meta-analysis. We have developed a hybrid method that does take the statistical significance of an original study into account and enables (a) accurate effect size estimation, (b) estimation of a confidence interval, and (c) testing of the null hypothesis of no effect. We analytically approximate the performance of the hybrid method and describe its statistical properties. By applying the hybrid method to data from the Reproducibility Project: Psychology (Open Science Collaboration, 2015), we demonstrate that the conclusions based on the hybrid method are often in line with those of the replication, suggesting that many published psychological studies have smaller effect sizes than those reported in the original study, and that some effects may even be absent. We offer hands-on guidelines for how to statistically combine an original study and replication, and have developed a Web-based application (https://rvanaert.shinyapps.io/hybrid) for applying the hybrid method.     

Goal conflict and psychological well-being: A meta-analysis

Goal conflict has long been an important aspect of motivation theories, but the results of research on the relationship between goal conflict and psychological well-being have been inconsistent. A meta-analytic review of the literature (k = 54) was conducted to examine this association. Higher levels of goal conflict are related to lower levels of positive psychological outcomes and greater psychological distress, though this relationship is stronger for distress outcomes. Other moderators that produced significant differences in effect sizes were whether a goal matrix was used to assess goal conflict, whether unipolar or bipolar assessment of goal conflict was used, and whether adult or student samples were studied. This meta-analysis provides evidence that goal conflict has a negative association with psychological well-being.     

A meta-analysis of psychological and pharmacological treatments for Body Dysmorphic Disorder

Although psychological and pharmacological treatment approaches for Body Dysmorphic Disorder have been evaluated, the relative effectiveness of these two types of interventions has not been examined. We conducted a meta-analysis of randomized clinical trials and case series studies involving psychological (i.e., behavioural, cognitive-behavioural, cognitive) or medication therapies. Our findings support the effectiveness of both types of therapy, but suggest that cognitive-behavioural treatment may be the most useful. These findings require cross-validation through large-scale clinical trials.     

Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: a meta-analysis

A meta-analysis of the group intervention research for parents of children with developmental disabilities was conducted in order to characterize the efficacy of treatments in reducing depressive symptoms and other forms of psychological distress associated with stress in parents of children with developmental disabilities. An extensive search led to the identification of 17 studies which were divided into three categories for comparative purposes: parenting education studies usually based on behavioral parent training, coping skills education studies based primarily on cognitive behavioral training, and studies that combined these methods along with other support services. Studies were rated for the quality of the research designs and of the reports. Consistent positive benefits were found in the form of reductions in parents' distress, and these effects were comparable to those reported in other syntheses of parenting interventions for parents of children without disabilities. The studies were evaluated in order to assess whether or not they met standards for established evidence-based practices. On the basis of the quality and number of the randomized trials, we present evidence to support the claim that there are established evidence-based interventions for reducing psychological distress at least in middle-class mothers in the short term. The interventions for fathers are promising as are the data on somewhat longer-term effects. The need for replications with a more diverse group of parents and longer-term follow-up were discussed. Multiple component interventions addressing both parent well-being and behavioral parent training were significantly more effective than either behavioral parent training or cognitive behavioral training along.     

Computer-administered interviews and rating scales

To evaluate the value of computer-administered interviews and rating scales, the following topics are reviewed in the present article: (a) strengths and weaknesses of structured and unstructured assessment instruments, (b) advantages and disadvantages of computer administration, and (c) the validity and utility of computer-administered interviews and rating scales. Computer-administered evaluations are more comprehensive and reliable and less biased than evaluations routinely conducted in clinical practice. Also, the use of continuous monitoring systems, which increasingly entail the use of computer administration, has been related to improved treatment outcome. However, the use of computer-administered interviews and rating scales will sometimes lead to false positive diagnoses, and for this reason, it is recommended that computer assessment be combined with clinical judgment.