当事人的投入与会谈效果、咨询效果的关系研究

本研究探索了当事人会谈时的投入与即时会谈效果的关系;当事人咨询初期的投入与整体咨询效果的关系。结果发现当事人会谈时的投入与即时会谈效果、在咨询初期的投入与整体咨询效果都呈现显著的正相关。进一步回归分析发现,当事人在咨询初期的投入与整体咨询效果呈现正U型的偏态分布,少数投入水平最低的当事人获得中等水平的咨询效果,中等投入水平的当事人咨询效果最差,投入水平最高的当事人的咨询效果最好。     

心理治疗效果研究的进展

自Eysenck(1952)以来,心理治疗的效果评价问题一直存在争议。该介绍了近年来西方心理治疗领域有关心理治疗有效性的理论发展和研究设计,并就进一步研究的方向提出了看法。     

工作同盟和领悟对咨询效果的影响

为了解短程咨询中工作同盟和领悟对咨询效果的影响,以12个个案94次会谈为对象,考察工作同盟、领悟分别与会谈效果、治疗效果的关系,并考察二者共同作用于效果的方式。结果表明,咨访双方评定的工作同盟都可以正向预测会谈效果,但不能预测治疗效果;领悟与会谈有效性正相关,领悟正向预测治疗效果;咨询师评定的同盟的三个维度以领悟为中介影响其对会谈效果的评价。     

高中生沉思与应激性生活事件对抑郁症状的影响:1年追踪研究

探讨沉思及沉思亚型与应激性生活事件的交互作用对抑郁症状的影响。采用流调中心用抑郁量表、青少年生活事件问卷和沉思反应量表等自评量表对527名高中生的抑郁症状、应激性生活事件和沉思进行评估,随后每3个月测评一次抑郁症状和应激性生活事件的发生情况,追踪调查1年,用多层线性模型分析数据。结果表明:沉思和强迫性冥思对抑郁症状的主效应显著,而反思不显著;沉思、强迫性冥思和反思与生活事件对抑郁症状的交互作用均不显著。结论:应激性生活事件和强迫性冥思会加重抑郁症状,而反思没有加重抑郁症状;沉思及亚型均不会改变应激性生活事件对抑郁症状的影响程度。     

童年期攻击行为发展的追踪研究

本研究采用"班级戏剧问卷"对中部一所小学3、4年级的285名儿童进行了3年追踪调查,研究了3年来儿童的外部攻击和关系攻击发展趋势及其在个体间的差异,并探讨了两类攻击行为发展趋势之间的关系。结果表明:(1)童年中后期外部攻击和关系攻击的变化趋势不显著。并且初始测量的外部攻击水平高的儿童,其关系攻击水平也较高;外部攻击行为变化较快的儿童,其关系攻击变化也比较快。(2)男生的外部攻击水平显著高于女生,而关系攻击的性别差异不显著。四年级关系攻击的上升速度快于三年级;初始为关系攻击较高组相对于较低组,他们的关系攻击随时间的上升速度也比较快。     

学龄儿童失调态度在应激与抑郁间的作用：一项多波段追踪研究

通过对3年级和7年级学龄儿童的追踪研究,探讨儿童群体中Beck抑郁理论认知易感因素在应激事件与抑郁症状间的作用。对追踪数据的多层线性模型和多层结构方程模型分析发现,作为Beck抑郁理论中认知易感因素的失调态度在3年级儿童中既没有显著的中介作用也没有显著的调节作用,而在7年级儿童中虽然失调态度仍然没有显著的调节作用,但却有显著的中介作用。研究结果可能初步揭示了失调态度在应激事件与抑郁症状关系中的发展性特征,这一发现对在儿童群体中实施抑郁的有效干预将具有较为重要的启示意义。     

教师背景变量对教师教学效果影响的多层线性分析

用《教师教学效果评价问卷(学生版)》问卷对高校181名教师的教学效果进行调查,用多层次分析法对影响教师教学效果的教师背景变量:教师性别、年龄、学历、职称、所教专业、年级、班级大小以及课程类别对教师教学效果影响程度进行分析,目的在于通过用多层分析法更合理分析教师背景变量对教学效果产生的影响,为客观比较教师教学效果之间的差异提供依据。研究结果表明:(1)多层次分析法得到比传统回归分析和方差分析更合理更准确的结果;(2)教师背景变量教师中性别、学历、专业以及所教班级的大小对于教师教学效果评价效果没有显著影响;(3)教师职称、年龄、所教学生年级、课程类别对教师的教学效果有显著影响;(4)所考察的教师水平背景变量对教学效果各个维度教师水平总变异的解释率介于3351%-4278%之间。     

小学生学习动机的培养:五年追踪研究

采用聚合交叉研究设计,利用"学思维"活动课程,对某小学1～3年级学生的学习动机进行了4年的干预培养,停止培养一年后,再次收集了数据,分析了变化趋势、即时效果及其长时效应。结果表明:(1)随着年龄的增大,儿童的表层动机和成就动机呈下降趋势;深层动机呈先上升后下降的趋势;(2)男生的表层动机和成就动机都高于女生;(3)年级越高,表层动机、深层动机和成就动机越低;(4)培养一年后,实验组学生的深层动机显著高于控制组,且长时效应显著。     

小学儿童互选友谊的发展趋势及攻击行为的影响：3年追踪研究

对小学3、4年级的285名儿童进行了3年追踪调查,分析了儿童分别与男、女生互选友谊数的变化趋势及其在个体间的差异,探讨了外部攻击和关系攻击分别对两类互选友谊数的影响。结果表明：（1）儿童的男、女生互选友谊数在3年时间内都有显著的增加趋势,并表现出显著的性别差异,儿童与同性互选友谊数显著多于他们与异性的互选友谊数,男生与女生互选友谊数的增加速度比女生与女生互选友谊数增加速度慢,儿童与男生的互选友谊数越多,他/她与女生的互选友谊数就越少,表明了性别隔离现象的存在。（2）在控制了关系攻击的影响后,儿童的外部攻击对他们在各时间点测得的与女生的互选友谊数有显著的消极影响,而对他们与男生的互选友谊数影响不显著;在控制了外部攻击的影响后,儿童的关系攻击对他们在各时间点测得的与女生的互选友谊数有显著的积极影响,而对他们与男生的互选友谊数影响不显著。这说明外部攻击和关系攻击对儿童互选友谊数的影响存在性别差异     

神经质人格调节青少年应激与抑郁症状的追踪研究

探讨神经质人格对青少年应激与抑郁症状的调节作用。采用自评的流调中心用抑郁量表、大五人格问卷-神经质分量表和青少年生活事件量表对618名在校高中生进行了首次测查,随后每隔3个月对被试的抑郁症状和生活事件进行追踪测查,追踪时间为期一年,结果发现:与低神经质青少年相比,随着生活事件应激水平的升高,高神经质青少年的抑郁躯体症状与心理症状增长速度更快。结论:神经质人格在青少年生活事件应激和抑郁症状的关系中起调节作用。     

Psychotherapy and Pharmacotherapy Treatment Outcome Research in Pediatric Populations

Reviewed treatment interventions for pediatric populations involving the combination of pharmacotherapy or psychotherapy or either treatment employed alone. The literature revealed a dearth of psychotherapy and pharmacotherapy outcome studies, with the exception of investigations of children diagnosed with attention-deficit hyperactivity disorder (ADHD). Issues pertaining to design, including sample selection, treatment integrity and comparability, and placebo controls also are reviewed. A potpourri of other issues are noted including parental attitudes toward the use of medication versus psychotherapy, treatment adherence, and patient/provider relationship. For children diagnosed with ADHD, the use of stimulant medication appears to be superior to psychotherapy employed alone in managing the behavior of these children as well as their classroom functioning. Recommendations are made for multimodal trials that examine the combined and individual use of pharmacotherapies and psychotherapies for various developmental and psychiatric disorders that occur in childhood and adolescence. Future studies also need to address the durable effects of these treatment options.     

Negative Treatment Effects in Dyadic Psychotherapy: A Focus on Prevention and Intervention Strategies

Therapy holds the potential to harm as well as help. This paper highlights approaches that may help prevent or decrease the incidence of negative effects in psychotherapy. These approaches include supervision, peer consultation, ongoing assessment of the therapeutic process, therapist-client matching, and referrals and transfers. We hope that this paper will serve as a stimulus for clinicians, psychotherapy researchers, and educators to put forth collabo-rative effort into identifying variables directly associated with adverse treat- ment outcomes and determining appropriate prevention and intervention strategies.     

A Data Analysis Method for Using Longitudinal Binary Outcome Data from a SMART to Compare Adaptive Interventions

Sequential multiple assignment randomized trials (SMARTs) are a useful and increasingly popular approach for gathering information to inform the construction of adaptive interventions to treat psychological and behavioral health conditions. Until recently, analysis methods for data from SMART designs considered only a single measurement of the outcome of interest when comparing the efficacy of adaptive interventions. Lu et al. proposed a method for considering repeated outcome measurements to incorporate information about the longitudinal trajectory of change. While their proposed method can be applied to many kinds of outcome variables, they focused mainly on linear models for normally distributed outcomes. Practical guidelines and extensions are required to implement this methodology with other types of repeated outcome measures common in behavioral research. In this article, we discuss implementation of this method with repeated binary outcomes. We explain how to compare adaptive interventions in terms of various summaries of repeated binary outcome measures, including average outcome (area under the curve) and delayed effects. The method is illustrated using an empirical example from a SMART study to develop an adaptive intervention for engaging alcohol- and cocaine-dependent patients in treatment. Monte Carlo simulations are provided to demonstrate the good performance of the proposed technique.     

Treatment Outcome Studies With Children: Principles of Proper Practice

This article addresses ethical issues in conducting randomized clinical trials (RCTs) with youth. Ethical considerations that occur prior to treatment (matters of research design, the risk–benefit ratio, issues concerning assent/consent, the influence of payment for participation), during treatment (issues of privacy, protocol adherence, premature termination), and following treatment (needs for posttreatment referrals and/or follow-up contacts, archiving of treatment data) are reviewed. Recommendations, based on empirical evidence and clinical experience, are offered for conducting ethical treatment research with youth and future directions for carrying out research on the ethics of conducting RCTs with youth are offered.     

儿童的同伴交往与孤独感:一项2年纵向研究

用提名法和问卷法对小学的3、4年级274名儿童进行两年追踪调查,采用交叉滞后设计,考察了同伴交往4个特征水平上的变量与孤独感的相互预测关系。结果发现：（1）自我报告的同伴交往变量——友谊质量和社交自我知觉与孤独感之间的交叉滞后效应显著;而同伴评定的同伴交往变量——积极提名、消极提名、受同伴欺负、消极退缩与孤独感之间的交叉滞后效应不显著;另外,前测的互选朋友数能显著负向预测后测的孤独感,前测的孤独感不能显著预测后测的互选朋友数。（2）在排除了早期其它变量的效应之后,积极提名分、消极提名分、受同伴欺负得分、消极退缩得分、互选朋友数在两年之间仍然呈现出高度的稳定性;友谊质量和社交自我知觉以及孤独感则表现出中等程度的稳定性     

Outcome Trajectories for Adolescents in Residential Treatment: A Statewide Evaluation

Although residential treatment represents one of the largest and most expensive components of the mental health service system for children and adolescents, little is known about the anticipated outcomes of this service. Still less is known about the trajectory through which change occurs within these settings. We examined the clinical status of 285 adolescents over a 2-year period after placement in residential treatment by the Department of Mental Health in a western state. Using a growth modeling technique, the rate of change was determined over a set of symptoms measured by the Acuity of Psychiatric Illness—Child and Adolescent Version (CAPI). Results suggest that while adolescents tended to improve overall during the course of their stays, there was considerable variation in which symptoms improved and which did not. Two symptoms actually became reliably worse with treatment. In addition, significant variation in outcomes was demonstrated across sites, with adolescents in one site getting reliably worse during the course of residential treatment. Our findings demonstrate the utility of outcomes management and have significant implications for how residential services for children and adolescents should be managed.     

Changes in Distress Intolerance and Treatment Outcome in a Partial Hospital Setting

Despite the well-established role of distress intolerance (DI) in a wide range of psychological disorders, few studies have examined whether DI improves during treatment and whether these changes are associated with symptom outcomes. Patients (N = 626) enrolled in a brief cognitive-behavioral partial hospital program completed pre- and posttreatment measures of DI. Results indicated that DI decreased significantly during treatment, with more than 30% of the sample exhibiting a reduction of more than 2 standard deviations from the sample mean. Women reported higher DI than men at baseline; however, there were no gender differences in changes in DI over time. Participants also completed a pre- and posttreatment measure of depression and a subset completed a measure of anxiety (n = 167). DI was associated with more severe depression and anxiety at pre- and posttreatment, with participants who reported a decrease in DI also reporting lower depression and anxiety symptoms at post-treatment. These results further highlight the transdiagnostic relevance of DI and suggest that DI may be a relevant factor in treatment outcome for depression and anxiety.     

Longitudinal Dynamics of Substance Use and Psychiatric Symptoms in Count Data with Zero Inflation

We examine the dynamics of substance use and psychiatric symptoms from childhood to adolescence using a longitudinal study of Mexican-origin families (N = 674). We present a longitudinal model capturing the trajectories of substance use and psychiatric symptoms (depression, conduct disorder), as well as the interrelations between these trajectories over time. Such a model is an extension of latent change score models designed to account for the occurrence of psychiatric symptoms while also accommodating a large amount of zeros for nonoccurrence and characterizing the changes over time in the count data. We compare this model with a more traditional approach based on a log transformation of the data. We describe differences between these approaches and highlight the benefits of using the two-part model when the data include a large amount of zeros for nonoccurrence of the behavior.     

结果评价中自我体验与替代体验的参照点效应:一项赌博游戏的ERPs研究

本研究采用"投注—反馈"的虚拟赌博游戏范式,通过2个实验分别检测个体在评价自己决策结果 (实验1)和观察他人决策结果 (实验2)过程中赌注大小(即参照点)对大脑活动的影响。结果发现:(1)体验自我决策结果时,输钱比赢钱诱发更负的FRN,仅有一个负反馈(-10元)表现出以赌注为界的分离,且相对效价一样的反馈值诱发的FRN差异不显著;(2)体验他人决策结果时,无论输赢,有赌注比无赌注诱发的FRN更负;而且相对效价相同的反馈值诱发的FRN差异不显著。据此可以认为,FRN一定程度上反映了以赌注为基准的主观标准对社会信息的评价判断:自我体验中的个体对损失的敏感度远高于收益;而替代体验中的个体更倾向于将"损失更多"看作一种负性结果。     

Inclusion: Considerations from social validity and Functional Outcome Analysis

Inclusion and particularly full inclusion has become a hotly debated topic. While proponents of inclusion believe that social, behavioral, academic, and developmental benefits occur for children with disabilities as well as for other, nondisabled, children in the classroom, research into inclusion provides equivocal results. This paper (a) describes inclusion, highlighting the inconsistencies in definitions and research; (b) discusses the importance of social validity in making inclusion decisions; and (c) presents an approach to inclusion using Functional Outcome Analysis (Noell & Gresham, 1993). While inclusion may be philosophically desirable, the research does not support its application as an all-inclusive approach. Inclusion decisions must be made on a case-by-case basis after a functional analysis of the student's behavior has been conducted.