Denoting the base-free measure of change

Bond criticized the base-free measure of change proposed by Tucker, Damarin, and Messick by pointing to an incorrect derivation which is here viewed instead as a correct derivation entailing an inadequately specified tacit assumption. Bond's revision leads to estimates of the correlation between initial position and change which are negatively biased by correlated errors, whereas the original approach, with the tacit assumption properly denoted, leads to unbiased values.     

On the base-free measure of change proposed by Tucker,Damarin and Messick

Tucker, Damarin and Messick proposed a base-free measure of change which involves the computation of residual scores that are uncorrelated with true scores on the pretest. The present note discusses this change measure and demonstrates that, because of an incorrect derivation by the authors, properties they attribute to (the coefficient for the regression of true scores from the second testing on true scores from the first testing) are, in fact, properties ofb, the ordinary regression coefficient. A correct derivation of the initial position—change correlation in terms of is obtained, and Tucker et al.'s discussion of the law of initial values is reconsidered.The preparation of this paper was supported by the Learning Research and Development Center supported in part as a research and development center by funds from the National Institute of Education.     

The relative error magnitude in three measures of change

Formulas for the standard error of measurement of three measures of change—simple difference scores, residualized difference scores, and the measure introduced by Tucker, Damarin, and Messick—are derived. Equating these formulas by pairs yields additional explicit formulas which provide a practical guide for determining the relative error of the three measures in any pretest-posttest design. The functional relationship between the standard error of measurement and the correlation between pretest and posttest observed scores remains essentially the same for each of the three measures despite variations in other test parameters (reliability coefficients, standard deviations), even when pretest and posttest errors of measurement are correlated.     

Reliable change in neuropsychological test scores is associated with brain atrophy in older adults

The reliable change index (RCI) is a commonly used method for interpreting change in neuropsychological test scores over time. However, the RCI is a psychometric method that, to date, has not been validated against neuroanatomical changes. Longitudinal neuroimaging and neuropsychological data from baseline and one-year follow-up visits were retrieved from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The RCI was used to identify participants showing reliable decline on memory (ADNI-Mem; N = 450) and executive functioning (ADNI-EF; N = 456) factor scores. For each factor score, two groups (reliable change vs. no reliable change) were matched on potential baseline confounding variables. Longitudinal neuroanatomical data were analysed using tensor-based morphometry. Analysis revealed that reliable change on ADNI-Mem was associated with atrophy in the medial temporal cortex, limbic cortex, temporal lobe and some regions of the parietal lobe. Similar atrophy patterns were found for reliable change on ADNI-EF, except that atrophy extended to the frontal lobe and the atrophy was more extensive and of higher magnitude. The current study not only validates clinical usage of the RCI with neuroanatomical evidence of associated underlying brain change but also suggests patterns of likely brain atrophy when reliable cognitive decline is detected.     

Examining the reliability of ADAS-Cog change scores

The purpose of this study was to estimate and examine ways to improve the reliability of change scores on the Alzheimer’s Disease Assessment Scale, Cognitive Subtest (ADAS-Cog). The sample, provided by the Alzheimer’s Disease Neuroimaging Initiative, included individuals with Alzheimer’s disease (AD) (n = 153) and individuals with mild cognitive impairment (MCI) (n = 352). All participants were administered the ADAS-Cog at baseline and 1 year, and change scores were calculated as the difference in scores over the 1-year period. Three types of change score reliabilities were estimated using multivariate generalizability. Two methods to increase change score reliability were evaluated: reweighting the subtests of the scale and adding more subtests. Reliability of ADAS-Cog change scores over 1 year was low for both the AD sample (ranging from .53 to .64) and the MCI sample (.39 to .61). Reweighting the change scores from the AD sample improved reliability (.68 to .76), but lengthening provided no useful improvement for either sample. The MCI change scores had low reliability, even with reweighting and adding additional subtests. The ADAS-Cog scores had low reliability for measuring change. Researchers using the ADAS-Cog should estimate and report reliability for their use of the change scores. The ADAS-Cog change scores are not recommended for assessment of meaningful clinical change.     

Indirect measures as a signal for evaluative change

Implicit and explicit attitudes can be changed by using evaluative learning procedures. In this contribution we investigated an asymmetric effect of order of administration of indirect and direct measures on the detection of evaluative change: A change in explicit attitudes is more likely detected if they are measured after implicit attitudes, whereas these latter change regardless of the order. This effect was demonstrated in two studies (n=270; n=138) using the self-referencing task whereas it was not found in a third study (n=151) that used a supraliminal sequential evaluative conditioning paradigm. In all studies evaluative change was present only for contingency aware participants. We discuss a potential explanation underlying the order of measure effect entailing that, in some circumstances, an indirect measure is not only a measure but also a signal that can be detected through self-perception processes and further elaborated at the propositional level.     

Psychometric assessment of the processes of change scale for sun protection

The fourteen-factor Processes of Change Scale for Sun Protection assesses behavioral and experiential strategies that underlie the process of sun protection acquisition and maintenance. Variations of this measure have been used effectively in several randomized sun protection trials, both for evaluation and as a basis for intervention. However, there are no published studies, to date, that evaluate the psychometric properties of the scale. The present study evaluated factorial invariance and scale reliability in a national sample (N = 1360) of adults involved in a Transtheoretical model tailored intervention for exercise and sun protection, at baseline. Invariance testing ranged from least to most restrictive: Configural Invariance (constraints only factor structure and zero loadings); Pattern Identity Invariance (equal factor loadings across target groups); and Strong Factorial Invariance (equal factor loadings and measurement errors). Multi-sample structural equation modeling tested the invariance of the measurement model across seven subgroups: age, education, ethnicity, gender, race, skin tone, and Stage of Change for Sun Protection. Strong factorial invariance was found across all subgroups. Internal consistency coefficient Alpha and factor rho reliability, respectively, were .83 and .80 for behavioral processes, .91 and .89 for experiential processes, and .93 and .91 for the global scale. These results provide strong empirical evidence that the scale is consistent, has internal validity and can be used in research interventions with population-based adult samples.     

Analysing cycling as a social practice: An empirical grounding for behaviour change

Despite significant national and local efforts over the last decade to stimulate uptake of cycling in the UK, levels of cycling (particularly utility cycling) remain at around 2% of journeys. Understanding of cycling behaviour and subsequent development of interventions has typically been undertaken using an individualist approach, often relying on psychologically based models of behaviour. This paper argues that Social Practice Theory (SPT) may be a valuable addition to practitioner’s toolboxes by providing an alternative means of understanding the complex dynamics between the elements that constitute the practice of utility cycling, allowing it to be considered as a social issue, rather than focusing solely on individual behaviour. This is demonstrated within the paper by the use of SPT to reanalyse quantitative and qualitative datasets that explore views and experiences of both cyclists and non-cyclists. Therein, the practice of utility cycling is described according to its three elements; materials, meaning and competences and the potential benefits of this approach are discussed; particularly its ideological shift away from ‘victim blaming’ and its natural support of interdisciplinary intervention design.     

Systems change as an outcome and a process in the work of community collaboratives for health

The widespread development of comprehensive community initiatives that aim to improve community health is driven by the need to change the systems charged with delivering the services and creating the policies related to a variety of health outcomes. Georgia's Family Connection initiative is the nation's largest statewide network of community collaboratives for health, with collaboratives operating in 159 counties. Data on community context, collaborative processes, engagement in systems change, and changes in programs and activities implemented, gathered consistently at the collaborative level over 3 years, will be used to answer the following questions. How do community contexts and the structure and processes of collaboratives affect implementation of systems change? How do systems changes affect intermediate outcomes such as the type of programs offered in a community? Longitudinal change in systems change and program implementation is described and significant predictors of between‐collaborative variation in longitudinal change for each outcome are identified.     

On the identification of clinically significant client changes: Reinterpretation of Jacobson's cut scores

Cut points or cut scores play a central role in Jacobson's popular method of identifying clinically significant changes in psychotherapy. When pre- and posttherapy scores of a client are on different sides of one of these cut scores, the change is considered clinically significant, provided that it is also reliable (i.e., not due to measurement errors). This article critically examines the meanings and implications of these cut scores. Contrary to popular beliefs, they are generallynot the test scores for which the probability of belonging to the Functional population is equal to the probability of belonging to the Dysfunctional population. When the Functional population distribution is above that of the Dysfunctional population, persons scoring above these cut scores can, in fact, have much greater probabilities of belonging to the Dysfunctional than to the Functional population. Goals of Jacobson's method can be attained only with Bayesian methods. Bayesian modifications of Jacobson's cut scores are proposed, although their use is limited by the availability of relevant base rates. Bayesian methods (a) can provide information about the probability that an individual belongs to each population, given his (her) score, and (b) are expected to yield total misdiagnosis rates that are many times lower than those of Jacobson's method. Users of Jacobson's method are cautioned against interpreting ratios of likelihoods as if they were ratios of posterior probabilities.     

An analysis of the effectiveness of university counselling services

It is important to demonstrate replicable evidence of the effectiveness of counselling procedures. The study aimed to contribute to the currently limited evidence base examining the effectiveness of university student counselling in the UK. Information on therapeutic outcome [based on Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) scores] for 305 individuals attending a large UK university counselling service was analysed. Following counselling intervention: there was a statistically significant improvement in CORE-OM scores with 63% of individuals showing a reliable improvement and only 2% showing a reliable deterioration. Of those who began with a score in the clinical range, 49% showed a clinically significant change. These results provide additional evidence for the effectiveness of university counselling interventions. Future research should aim to build on this preliminary research using randomised controlled trial designs.     

An Evaluation of the Body Dysmorphic Disorder Symptom Scale as a Measure of Treatment Response and Remission in Psychotherapy and Medication Trials

The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a self-report tool that captures an array of representative behavioral and cognitive symptoms commonly displayed by individuals with BDD. The BDD-SS is regularly used among experts in the field, though its utility as a measure of treatment response has not yet been formally evaluated. Results from two clinical trials of BDD treatment were pooled from an archived database to create a sample of 220 BDD participants who received either psychosocial or medication-based interventions for BDD. We used baseline BDD-SS scores to describe psychometric properties, baseline correlations with other scales to examine the content validity of the BDD-SS, and longitudinal symptom data to evaluate capacity to detect clinically relevant change. Results indicated that the BDD-SS has good psychometric properties and is able to detect symptom change over time, although it showed lower rates of reliable change with treatment relative to the gold standard rater-administered Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS). The BDD-SS offers meaningful information about treatment response in a self-report format and may be particularly useful to employ in clinical practice settings as a means of gathering symptom and treatment response data via self-report when rater-administered interviews are not feasible, although it may underestimate the extent of improvement with treatment.     

Mindfulness‐based cognitive therapy is effective as relapse prevention for patients with recurrent depression in Scandinavian primary health care

This study examined the effectiveness of mindfulness‐based cognitive therapy (MBCT) in primary care for patients with recurrent depression (major depressive disorder: MDD). According to the World Health Organization (WHO), MDD is now the leading cause of disease burden in middle‐ and high‐income countries. Patients (N = 45) with three or more previous depressive episodes were recruited to participate in MBCT as a preventative intervention. Using a benchmarking approach, outcome data was compared with data from a recent efficacy study. The methodology is a rigorous approach to assessing effectiveness when evidence‐based UK protocols are transferred into the existing Scandinavian service delivery. Additionally, a person‐centred methodological approach was used to assess clinical significance on the Reliable Change Index (RCI). The analysis revealed comparable or larger effects from pre‐test to post‐test in reduced psychiatric symptoms, increased quality of life and level of mindfulness, and the effects were maintained over 14 months. Analysis of the relapse rate in the current study (16%) compared to the TAU in the efficacy study (68%) yielded an h value of 0.78, a moderate effect size. Only 13% dropped out of the treatment. According to the RCI findings, 65% to 67% of participants in the clinical group improved, no individual worsened, and women showed a significantly greater improvement of depression and anxiety than men. Therapeutic alliance and motivation had no impact on the outcome. The overall result suggests that MBCT can be implemented successfully in Scandinavian primary health care as a preventive intervention for patients with recurrent depression.     

When rock bottom rocks your world: Crisis of belief as a catalyst for change

An experience of severe difficulty can turn the world upside-down, causing individuals to question important beliefs with which they identify. This phenomenon, which we label as Crisis of Belief (COB), amalgamates the disparate conceptualizations of crisis that exist across several subdisciplines of psychology. Unlike existing ideas of crisis, COB distinguishes itself from stress or trauma alone, and is a clearly specified construct that lends itself to practical operationalization and study. Thus, COB addresses a key gap in literature and offers unique value for understanding how hardship that affects closely held beliefs can catalyze change. We conclude by describing the potential utility of COB as a predictor of both positive (e.g., life satisfaction) and negative (e.g., depression) outcomes and the pressing need for a validated measure.     

Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory.     

Personality change goals and plans as predictors of longitudinal trait change in young adults: A replication with an Iranian sample

Goals and plans for changing one’s personality traits have been found to be commonly held, particularly in young adults. Evidence for whether such goals and plans can predict actual trait change is mixed. The current study replicated and extended the methodology of a previous study to investigate whether trait change goals and plans predict change over a year in a sample of Iranian students. It was found that goals and plans before and after the 12-month period predicted longitudinal change in Openness to Experience, but no association was found for other traits. To explore whether this relationship between goals and change in Openness to Experience is replicable, further research with samples of differing ages and cultures is needed.