Long-Term Follow-Up of a Randomized Controlled Trial Comparing Acceptance and Commitment Therapy and Standard Cognitive Behavior Therapy for Anxiety and Depression

The present study represents one of the first comparisons of the long-term effectiveness of traditional cognitive behavior therapy (i.e., Beckian cognitive therapy; CT) and acceptance and commitment therapy (ACT). One hundred thirty-two anxious or depressed outpatients were randomly assigned to receive either CT or ACT, and were assessed at posttreatment (n = 90) and at 1.5-year (n = 91) follow-up. As previously reported, the two treatments were equivalently effective at posttreatment according to measures of depression, anxiety, overall (social/occupational/symptom-related) functioning, and quality of life. However, current results suggest that treatment gains were better maintained at follow-up in the CT condition. Clinical significance analyses revealed that, at follow-up, one-third more CT patients were in the clinically normative range in terms of depressive symptoms and more than twice as many CT patients were in the normative range in terms of functioning levels. The possible long-term advantage of CT relative to ACT in this population is discussed.     

Acceptance and Commitment Therapy for Depression: A Preliminary Randomized Clinical Trial for Unemployed on Long-Term Sick Leave

This preliminary study investigated the feasibility of a brief Acceptance and Commitment Therapy (ACT) in a Swedish sample of unemployed individuals on long-term sick leave due to depression. Participants were randomized to a nonstandardized control condition (N = 16) or to the ACT condition (N = 18) consisting of 1 individual and 5 group sessions. From pretreatment to 18-month follow-up the ACT participants improved significantly on measures of depression, general health, and quality of life compared to participants in the control condition. The conditions did not differ regarding sick leave and employment status at any time point. The results indicate that ACT is a promising treatment for depression. The need for further refinements of future ACT protocols for this population is discussed.     

An Open Trial Investigation of a Transdiagnostic Group Treatment for Children With Anxiety and Depressive Symptoms

The current study investigates the feasibility and preliminary outcomes associated with a transdiagnostic emotion-focused group protocol for the treatment of anxiety disorders and depressive symptoms in youth. Twenty-two children (ages 7 to 12; M = 9.79) with a principal anxiety disorder and varying levels of comorbid depressive symptoms were enrolled in an open trial of the Emotion Detectives Treatment Protocol (EDTP; Ehrenreich-May & Bilek, 2009), an intervention adapted from existent unified protocols for the treatment of emotional disorders among adults and adolescents. Results indicate that participants experienced significant improvements in clinician-rated severity of principal anxiety disorder diagnoses (d = 1.38), the sum of all anxiety and depressive disorder severity ratings (d = 1.07), and child-reported anxiety (d = 0.47) and parent-reported depressive symptoms (d = 0.54) at the posttreatment assessment. EDTP had good retention rates and reports of high satisfaction. Thus, preliminary evidence suggests that EDTP is a feasible and potentially efficacious treatment of youth anxiety disorders and co-occurring depressive symptoms. Children experiencing a range of internalizing symptoms may benefit from this more generalized, emotion-focused treatment modality, as it offers flexibility to families and the mental health clinician, while maintaining a concurrent focus on the provision of cognitive-behavioral treatment skills vital to the amelioration of anxiety and depressive disorder symptoms in youth.     

Factorial Validity of the Cooperative Preschool Inventory for English- and Spanish-Speaking Hispanic Children

The Cooperative Preschool Inventory (CPI) in both English and Spanish was administered to preschool Hispanic children who were monolingual in either English or Spanish. Subscales were factor-analyzed separately. When the factors were compared using coefficients of congruence, we concluded that both measures appeared to assess the same underlying construct.     

个体与群体情境下幼儿延迟策略的实验研究

采用实验法以90名3～5岁的儿童为被试,探讨其在个体和群体情境中延迟策略的使用状况。研究结果表明：在注意转移策略的使用上,存在着显著的年龄差异;在被动策略的使用上4岁组的幼儿具有显著差异;在个体与群体情境下,除了寻求帮助策略上有显著的差异外,其他延迟策略上均无显著差异;在延迟策略的使用上没有显著的性别差异。     

A Measure for the Reliability of a Rating Scale Based on Longitudinal Clinical Trial Data

A new measure for reliability of a rating scale is introduced, based on the classical definition of reliability, as the ratio of the true score variance and the total variance. Clinical trial data can be employed to estimate the reliability of the scale in use, whenever repeated measurements are taken. The reliability is estimated from the covariance parameters obtained from a linear mixed model. The method provides a single number to express the reliability of the scale, but allows for the study of the reliability’s time evolution. The method is illustrated using a case study in schizophrenia. The authors are grateful to J&J PRD for kind permission to use their data. We gratefully acknowledge support from the Belgian IUAP/PAI network “Statistical Techniques and Modeling for Complex Substantive Questions with Complex Data.”     

Becoming Fathers: A Mixed-methods Study of the Feasibility and Acceptability of a Mindfulness-Based Group Intervention for Perinatal Fathers

Journal of Child and Family Studies - The transition to parenthood can be stressful for mothers and fathers, yet education and psychosocial supports are far less available for fathers. When fathers...     

Investigating the Effectiveness of an Arts-Based and Mindfulness-Based Group Program for the Improvement of Resilience in Children in Need

We discuss preliminary findings from a study that investigated the effectiveness of a Holistic Arts-Based Group Program (HAP) for the development of resilience in children in need. The HAP teaches mindfulness using arts-based methods, and aims to teach children how to understand their feelings and develop their strengths. We assessed the effectiveness of the HAP by using comparison and control groups, and standardized measures. We hypothesized that children who participated in the HAP would have better scores on resilience and self-concept compared with children who took part in an Arts and Crafts group (the comparison group), and children who were waiting to attend the HAP (the control group). A total of 36 children participated in the study; 20 boys aged 8–13?years and 16 girls aged 8–14?years. A mixed-designed MANOVA was conducted using scores from 21 participants. We found evidence that the HAP program was beneficial for the children in that they self-reported lower emotional reactivity (a resilience measure) post-intervention. No changes were noted for perceptions of self-concept. Consideration should be given to how we can attend to young people’s needs in relevant ways as resilience is a condition of a community’s ability to provide resources as much as it is part of an individual’s capacity for growth. Programs such as the HAP can engage children in a creative and meaningful process that is enjoyable and strengths-based.     

Psychometric Properties and Clinical Utility of the Scale for Suicide Ideation with Inpatient Children

The purpose of the current study was to examine the psychometric properties and clinical utility of the Scale for Suicide Ideation (SSI) for children. The SSI was administered to 100 children who were hospitalized. Data were not used from 13 subjects due to the presence of a psychotic disorder or IQ less than 70, leaving 87 participants. The SSI was examined regarding its internal consistency, concurrent validity, construct validity, and factor structure when used with children. Based on the findings, the SSI appears to have adequate psychometric properties and can be used by clinicians and researchers examining children in an inpatient setting. Recommendations for clinicians are included to help make the SSI more functional in use for children.     

Activating Veterans Toward Sources of Reward: A Pilot Report on Development,Feasibility, and Clinical Outcomes of a 12-Week Behavioral Activation Group Treatment

This pilot study evaluates a 12-week group Behavioral Activation protocol adapted to meet the needs of a Veteran population seeking treatment in an outpatient mental health clinic at a Veteran Affairs Medical Center. In a detailed Method we describe the treatment structure. Acceptability and feasibility are addressed by providing data on referral sources, treatment retention, attendance, and patient satisfaction. Initial clinical outcomes are presented, focusing on symptom reduction, improved quality of life, and changes in the hypothesized mechanism of treatment: improving motivated behavior to pursue rewards (decisional anhedonia). Finally, feedback from individual exit interviews is presented. We conclude with implementation tips and challenges in the service of continuing to improve our evidence-based interventions in Veteran Affairs facilities.     

Children as Mystics, Activists, Sages, and Holy Fools: Understanding the Spirituality of Children and Its Significance for Clinical Work

This article explores children's spirituality and its significance for health care providers seeking to provide “spiritually competent care” of children amidst religious and spiritual diversity. Four metaphors of different spiritualities evidenced among children are explored: mystics, activists, sages, and holy fools. The article addresses issues clinicians face such as the problem of defining spirituality in relation to religion, and countertransference around religious and spiritual matters. Current research shows that spiritual and religious involvements constitute positive factors promoting resiliency and health in children. James W. Fowler's theory of faith development facilitates an exploration of questions concerning how children develop a belief system, leading to a view of children's spirituality as multidimensional. This article preserves the less formal conversational style of an earlier version's presentation in Grand Rounds at the UCLA Medical Center's Neuropsychiatric Hospital on December 10, 2003.     

A Meta-Analysis on the Efficacy of Technology Mediated CBT for Anxious Children and Adolescents

Several meta-analyses indicate that cognitive-behavioral therapy (CBT) via electronic/technological devices or applications (i.e., eCBT) is an effective alternative to standard therapist-delivered CBT for anxious adults. However, we know little about the efficacy of eCBT interventions for anxious children and adolescents. The present meta-analysis set out to investigate the efficacy of eCBT in comparison to standard CBT or waitlist control for anxious children and adolescents. Eight randomized controlled studies (N = 404 participants) that targeted anxiety at post-intervention and follow-up were included in the analysis. The results indicated that eCBT was as effective as standard CBT (g = .295) and more effective than waitlist (g = 1.410) in reducing anxiety symptoms. Moderation analyses revealed that anxious children and adolescents benefited the most from eCBT in the minimal therapist involvement condition (g = 2.682) in contrast to the significant therapist involvement group (g = .326). Furthermore, older participants seemed to extract greater clinical benefits from eCBT in contrast to younger participants (slope = .514). Current eCBT interventions for anxious children and adolescents appear to be promising, but require further investigation.     

Measuring Treatment Outcome for Children with Serious Emotional Disturbances: Discriminant Validity and Clinical Significance of the Child and Adolescent Functioning Assessment Scale

We investigated the use of a popular measure, the Children and Adolescent Functional Assessment Scale (CAFAS), in treatment outcome research. The sample included 70 children who had been discharged from an elementary therapeutic classroom (Intensive Mental Health Program). Significant relationships were found between decreases in CAFAS scores and optimal educational placement, contributing to evidence of the scale’s discriminant validity. Clinically significant change in CAFAS scores was also investigated, with a 30 point change in score most accurately discriminating between placements after discharge. Further investigations of real world outcomes versus changes in score on this measure are warranted.     

Exploring the Clinical Implications of the International CS Reference Data for Children and Adolescents (Meyer,Erdberg, & Shaffer, 2007)

As part of an ongoing study on the prediction of suicide, a replication study was carried out on the Neuropsychiatric Hospital Suicide Potential Scale (NPHSPS), a recently constructed schedule for prediction of potentiality for committed suicide among hospitalized neuropsychiatric patients at the time of release from the hospital. The population consisted of 54 patients who had committed suicide and 50 patients who had not. Overall accuracy of the scale was 81.7 percent, with 95.2 percent accuracy for prediction of the high risk group and 80.0 percent accuracy for prediction of nonsuicidal controls. By computation of posterior probability, the scale is shown to increase accuracy of prediction more than five-fold over use of the base rate (or prior probability) alone, but it is also evident the level of prediction of suicide is still too minimal to permit individual clinical application.     

Comparing children with and without dyslexia on the Movement Assessment Battery for Children and the Test of Gross Motor Development

Dyslexia is the most commonly occurring learning disability in the United States, characterized by difficulties with word recognition, spelling, and decoding. A growing body of literature suggests that deficits in motor skill performance exist in the dyslexic population. This study compared the performance of children with and without dyslexia on different subtests of the Test of Gross Motor Development and Movement Assessment Battery for Children and assessed whether there were developmental changes in the scores of the dyslexic group. Participants included 26 dyslexic children (19 boys and 7 girls; 9.5 yr. old, SD = 1.7) and 23 age- and sex-matched typically developing (17 boys and 6 girls; 9.9 yr. old, SD = 1.3) children as a control group. Mann-Whitney U tests indicated that the dyslexic group performed significantly lower than the control group only on the Total Balance subtest of the Movement Assessment Battery for Children. Additionally, the young dyslexic group performed significantly better on the Total Balance subtest, compared to the older dyslexic group. These results suggest that cerebellar dysfunction may account for differences in performance.     

A Pilot Randomized Controlled Trial of the Effects of Cognitive-Behavioral Therapy for Insomnia on Sleep and Daytime Functioning in College Students

The purpose of this study was to pilot test if cognitive behavioral therapy for insomnia (CBT-I) is an effective intervention for insomnia and daytime functioning in college students. College students’ developmental stage and lifestyle are significantly different than the general adult population, yet there have been no studies of CBT-I in this age group.     

Clinical perspectives on the combination of D-cycloserine and cognitive-behavioral therapy for the treatment of anxiety disorders

In a particular success for translational research agendas, characterization of the neuronal circuits underlying fear extinction, and basic research in animal extinction paradigms, has led to intervention studies examining the use of D-cycloserine (DCS) to enhance therapeutic learning from exposure-based cognitive-behavioral therapy (CBT). In this article, we review these intervention studies, and discuss DCS augmentation of CBT relative to more traditional combination-treatment strategies in the treatment of anxiety disorders. We offer an accounting, based on evidence for internal context effects, of current limitations in the combination of antidepressant or benzodiazepine medications with CBT and discuss the advantages of isolated-dosing strategies with DCS relative to these limitations. This strategy is contrasted with the chronic-dosing applications of DCS for schizophrenia and Alzheimer's disease, and future directions for isolated-dosing strategies are discussed.     

Effects of Stimulant Medication Treatment on Mothers' and Children's Attributions for the Behavior of Children with Attention Deficit Hyperactivity Disorder

Participants were 55 children with attention deficit hyperactivity disorder (ADHD) who were receiving ongoing treatment with stimulant medications and their mothers, and 31 children with ADHD who were beginning stimulant medication and their mothers. Mothers and children offered attributions for child behaviors that occurred when the child was medicated and not medicated. Mothers rated child compliance and prosocial behavior as more global and stable when the child was medicated and rated noncompliance, ADHD symptoms, and oppositional behavior as more externally caused, less global and stable, but more controllable by the child when the child was medicated. Children rated both their compliance and noncompliance as more controllable in the medicated condition. On a forced-choice measure, both mothers and children selected ability, effort, and task attributions for compliance more in the not-medicated condition, and pill-taking attributions more in the medicated condition. This was reversed for noncompliance, which was attributed more to effort, task, or ability in the medicated condition and more to not taking a pill in the not-medicated condition. The potential risks and benefits for parent–child interactions and children's self-perceptions of these medication-related differences in attributions are discussed.     

高校青年教师心理健康及团体心理训练设计研究

随着高校青年教师的比例日益上升。高校青年教师的心理健康问题必须予以足够的重视。本研究采用临床症状自评量表(SCL-90)和艾森克个性问卷(EPQ)对高校青年教师心理健康状况进行调查．结果显示高校青年教师主要存在的问题表现在生理与心理问题、人际关系问题、心理压力问题、情绪稳定性问题等四方面。依据高校青年教师的心理特点及其现状。其团体心理训练的主要内容有改善心智模式训练、情绪管理训练、意志力训练、人格魅力训练、人际沟通训练、缓解压力训练、适应与发展训练、身心保健训练等．主要的训练方法是团体讨论和角色扮演。