The Efficacy of Systemic Therapy for Internalizing and Other Disorders of Childhood and Adolescence: A Systematic Review of 38 Randomized Trials

Systemic therapy (ST) is one of the most widely applied psychotherapeutic approaches in the treatment of children and adolescents, yet few systematic reviews exist on the efficacy of ST with this age group. Parallel to a similar study on adults, a systematic review was performed to analyze the efficacy of ST in the treatment of children and adolescents. All randomized or matched controlled trials (RCT) evaluating ST in any setting with child and adolescent index patients were identified by database searches and cross‐references, as well as in existing meta‐analyses and reviews. Inclusion criteria were: index patient diagnosed with a DSM‐IV or ICD‐10 listed psychological disorder, or suffering from other clinically relevant conditions, and trial published by December 2011. Studies were analyzed according to their sample, research methodology, interventions applied, and results at end‐of‐treatment and at follow‐up. This article presents findings for internalizing and mixed disorders. Thirty‐eight trials were identified, with 33 showing ST to be efficacious for the treatment of internalizing disorders (including mood disorders, eating disorders, and psychological factors in somatic illness). There is some evidence for ST being also efficacious in mixed disorders, anxiety disorders, Asperger disorder, and in cases of child neglect. Results were stable across follow‐up periods of up to 5 years. Trials on the efficacy of ST for externalizing disorders are presented in a second article. There is a sound evidence base for the efficacy of ST as a treatment for internalizing disorders of child and adolescent patients.     

Review of B. F. Skinner's The Behavior of Organisms

As I reread my review nearly 50 years later, I think of the circumstances. I had heard a paper by Fred at the Ithaca meeting of the APA in 1932, and recall the praise by Edna Heidbreder, who was sitting next to me, whose remark was that “He has a clean mind.” The year before his book appeared, I had already cited eight of his published papers in a review of the conditioned response in relation to conventional learning experiments that appeared in the Psychological Bulletin (1937, 34, 61–102). It may be because of that the editor sent me Fred's book to review.

When I received the copy of his new book to review, I read it carefully, and soon reported on it orally before Lewis Terman's weekly seminar to get comments and questions before revising my review. I was pleased by Terman's excitement over the originality of Fred's approach.

     

Early Childhood Discipline: A Review of the Literature

In this literature review concerning early childhood discipline we particularly highlight American children's discipline with respect to historical perspectives, generational theories, gender issues, parental styles, methods of discipline, and corporal punishment. We also address corporal punishment's history, the debate among experts, beliefs and practices among parents, the controversy in public schools, religious influences, and a conflation of the issues.     

Treatment of Childhood Obesity: A Systematic Review

Childhood obesity trends have increased dramatically over the past three decade’s. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment effect size. Searches revealed 61 relevant articles published from January 2000 to 2009, including both randomized and non-randomized controlled trials of childhood and adolescent obesity treatment interventions. The review identified scant measurement and reporting of issues around treatment fidelity, an increase in the number of interventions outside of the US, (particularly across Europe) and an emergence of studies involving older children and adolescents in a range of settings. Interventions comprising a dietary, exercise, and behavioral component, supported by family involvement and delivered by trained interventionists in specialized or supervised settings, appeared to offer a potentially effective treatment for obesity. However, concern remains over study quality (particularly sample size), dropout rates and study design. Variations in outcome measures and intervention designs means generalizable conclusions cannot be easily be made. Of greater concern is the lack of consideration for treatment fidelity, which has implications for the transfer of knowledge and the reliability of interventions. Conclusions from the review include; the need for increased accuracy of reporting and objective measurement of treatment fidelity; the need for further investigation of potential cost-effective treatment options (including maintenance strategies to enhance sustainability of current interventions); and an increase in the number of longitudinal trials beyond 1?year in duration.     

Altruistic Discourse in the Informed Consent Process for Childhood Cancer Clinical Trials

Scholars have debated the role that altruistic considerations play—and should play—in recruitment and decision-making processes for clinical trials. Little empirical data are available to support their various perspectives. We analyzed 140 audiotaped pediatric informed consent sessions, of which 95 (68%) included at least one discussion of how participation in a cancer clinical trial might benefit: 1) the pursuit of scientific knowledge generally; 2) other children with cancer specifically; and 3) “the future” and other vaguely defined recipients. Clinicians initiated most (80%) of these discussions of altruism. The enrollment rate of children in the clinical trial was high (83%) overall, but not higher among children whose parents were involved in an altruism-oriented discussion. These findings suggest that: (1) clinicians invoke a spectrum of altruistic considerations rather than a single monothematic notion of altruism, and (2) the effect of altruistic considerations on subsequent enrollment decisions is marginal. While further research on this topic is warranted, bioethical debate should strive to reflect the diversity of altruistic discourse in clinical research encounters and to place this discourse in the context of other, including nonaltruistic, considerations.     

Cognitive Processing of Traumas: The Role of Intrusive Thoughts and Reappraisals1

Cognitive processing theories of post-traumatic adaptation (Horowitz, 1986a; Janoff-Bulman, 1992) propose that repeated comparisons of trauma content with preexisting cognitive schemas result in trauma reappraisal or schematic revision. Thus, intrusive ruminations should facilitate cognitive integration and resolution of past traumas. However, research has shown that some survivors become stuck in endless, repetitive rumination cycles. This raises the issue of how to differentiate ruminations that promote cognitive integration from those that merely prolong or exacerbate psychological distress. Identifying substantive dimensions for categorizing cognitions about past traumas could enhance prediction of their effects on adjustment and inform clinical treatment interventions. This paper seeks to: (a) Assess the current state of theoretical knowledge concerning cognitive adaptation to trauma, (b) integrate theoretical postulates with empirical research findings, (c) define gaps or inconsistencies in our understanding of the cognitive adaptation process, and (d) identify foci for future theory and research.     

Escape From Traumas: Emigration And Hungarian Jewish Identity After The Holocaust

Unlike other European countries, at the turn of the 20th century, Hungary ensured complete legal and religious equality for Jews living in the country. As a result, they became strongly assimilated and identified themselves as Hungarian. Leading up to and during WWII, there was a gradual and steady deterioration of those legal and religious conditions, and the “betrayal” and persecution of Jews caused unspeakable trauma all over the world. After the defeat of the Nazis, only a small number of Holocaust survivors returned to their home country; the majority emigrated. This study provides a psychoanalytical analysis of the changes in Hungarian survivors’ psychic realities and the construction of their new identities, depending on the survival strategy they chose. The hypothesis is that the rebuilding of the demolished identity and the level of trauma elaboration depend on whether this process was done at the place of the trauma or in a different society. The study uses psychoanalytic and social psychology literature to follow the impacts of the emigration process, to draw conclusions and apply them to trauma elaboration after the Holocaust.

     

Family Adjustment to Childhood Cancer: A Systematic Review

This systematic review integrates qualitative and quantitative research findings regarding family changes in the context of childhood cancer. Twenty-eight quantitative, 42 qualitative, and one mixed-method studies were reviewed. Included studies focused on family functioning, marital quality, and/or parenting in the context of pediatric cancer, were written in English, and were published between 1996 and 2009. Overall, qualitative findings show that families alter roles, responsibilities, and day-to-day functioning to accommodate the needs of children with cancer. Although some degree of family reorganization is normative, the extent and impact of these changes varies. Quantitative work shows that mean levels of family functioning (e.g., cohesion, flexibility) are similar between families facing cancer and normative or comparison samples. However, families follow different trajectories of improvement, decline, or stability in family closeness and marital quality. Parenting has received limited quantitative research attention, but qualitative work suggests that parents perceive deeper bonds with ill children and may spoil or overprotect them. Conclusions support future work examining the influence of family-level variables on the adjustment of individual family members.     

大鱼小池效应研究回顾及展望

大鱼小池效应(Big Fish Little Pond Effect)是解释不同教育情境中学生自我概念水平的一个特定概念,Marsh将其定义为：能力同等的学生,在平均成绩较高的学校或班级里的学业自我概念较低,而在平均成绩较低的学校或班级则学业自我概念会较高。大鱼小池效应包括学生采用概括他人和特定他人的比较标准所分别产生的同化效应和对比效应,社会比较对学业自我概念形成具有特定影响。大鱼小池效应的未来研究可以从研究方法的改进、调节变量的控制和跨文化比较等方面拓展。