Training Young Adult Peers in a Mobile Motivational Interviewing‐Based Mentoring Approach to Upstream HIV Prevention

Mentoring relationships are characterized by a sustained, high quality, and skill‐building relationship between a protégé and mentor (Handbook of Youth Mentoring, Los Angeles, SAGE, 2014). Within prevention science, youth mentoring programs emphasize creating a specific context that benefits a young person. Program‐sponsored relationships between youth and adults allow for creating a mentor–mentee partnership, but do not require the establishment of a strong bond in order to deliver prevention‐focused activities and experiences (Handbook of Youth Mentoring, Los Angeles, SAGE, 2014). Motivational Interviewing (MI) is a counseling style used widely to promote health behavior change and in prevention interventions. As part of an upstream approach to HIV prevention, we combined mentoring and MI by training peer mentors to use MI skills in their interactions as part of a large RCT of a mobile life skills intervention for adolescent men who have sex with men (AMSM). Our training model developed for training peer mentors in MI skills resulted in peers reaching and exceeding established MI fidelity thresholds (e.g., mean percentage of complex reflections = 80%, mean reflection to question ratio = 2.2:1). We offer reflections on lessons learned and future directions for those researchers and practitioners who may benefit from adapting this blended approach for mentoring AMSM.     

Solution‐Focused Counseling and Motivational Interviewing: A Consideration of Confluence

Solution‐focused counseling (SFC) and motivational interviewing (MI) have gained recognition over the past 2 decades. A review of the features of these counseling approaches is provided, as well as an examination of the similarities and differences on several dimensions of counseling. Attention is given to empirical research, and it is proposed that SFC and MI be considered concurrently, which appears consistent with calls in the literature for theoretical integration. A case study is included.     

Motor imagery in spinal cord injured people is modulated by somatotopic coding,perspective taking,and post‐lesional chronic pain

Motor imagery (MI) allows one to mentally represent an action without necessarily performing it. Importantly, however, MI is profoundly influenced by the ability to actually execute actions, as demonstrated by the impairment of this ability as a consequence of lesions in motor cortices, limb amputations, movement limiting chronic pain, and spinal cord injury. Understanding MI and its deficits in patients with motor limitations is fundamentally important as development of some brain–computer interfaces and daily life strategies for coping with motor disorders are based on this ability. We explored MI in a large sample of patients with spinal cord injury (SCI) using a comprehensive battery of questionnaires to assess the ability to imagine actions from a first‐person or a third‐person perspective and also imagine the proprioceptive components of actions. Moreover, we correlated MI skills with personality measures and clinical variables such as the level and completeness of the lesion and the presence of chronic pain. We found that the MI deficits (1) concerned the body parts affected by deafferentation and deefferentation, (2) were present in first‐ but not in third‐person perspectives, and (3) were more altered in the presence of chronic pain. MI is thus closely related to bodily perceptions and representations. Every attempt to devise tools and trainings aimed at improving autonomy needs to consider the cognitive changes due to the body–brain disconnection.     

Barriers to Learning Motivational Interviewing: A Survey of Motivational Interviewing Trainers' Perceptions

Trainers reported that motivational interviewing (MI)–inconsistent behaviors were frequently perceived during training and believed to create barriers to learning. More barriers were perceived in corrections than in mental health training audiences. Strategies to facilitate unlearning MI‐inconsistent behaviors may accelerate acquisition of MI.     

A Pilot Study of a Brief Motivational Intervention to Enhance Parental Engagement: A Brief Report

Although research has shown that multi-systemic interventions (MSIs) improve youth psychosocial functioning, MSI dissemination has been hampered by low levels of parent participation. The current pilot project was designed to examine the effectiveness of a brief motivational interviewing (MI) protocol to increase parental engagement in an MSI for youth suspended from middle and high school. Preliminary findings suggest that parents who received brief MI were more likely to attend a parent-training workshop and reported greater satisfaction with the parenting workshops than parents who did not. Parents in the brief MI group also reported a relatively high level of satisfaction with the MI procedures. Implications for future research and MSIs are discussed.     

Deliberate Self‐Harm in Adolescents Aged 12–18: A Cross‐Sectional Survey of 18,104 Students

Little is known about accurate prevalence and associated factors of deliberate self‐harm (DSH) among adolescents in Asian countries. In this study, the prevalence and associated factors of DSH among adolescents in Japan were examined. Data were derived from a cross‐sectional survey using an anonymous self‐report questionnaire and enrolling 8,620 adolescents aged 12–15 and 9,484 aged 15–18. DSH in the previous 12 months was reported by 3.3% (95% CI, 2.9–3.7) of junior and 4.3% (3.9%–4.7%) of senior high school respondents. The prevalence was more than four times as high among girls as among boys for both age groups. DSH was further strongly associated with having suicidal thoughts, having depression/anxiety symptoms, and having used recreational drugs. These associated factors were similar for both sexes and for both older and younger teenagers. A substantial minority of adolescents present with DSH, even among those aged 12–15. The prevalence of DSH in Japan was in the lower ranges of those reported for Western countries. The identified associated factors were not dissimilar from those reported in the West.     

Distinguishing Between Subgroups of Adolescents Who Self‐Harm

The differences in factors associated with subgroups of adolescents in the continuum of deliberate self‐harm (DSH) phenomena were investigated. In an anonymous self‐report survey of 6,020 adolescents aged 15 and 16 years, 3.2% of adolescents (5.3% females, 1.3% males) reported DSH with intent to die, 2.8% (4.3% females; 1.5% males) reported DSH without intent to die, and 15% (22.4% females; 8.5% males) reported thoughts of DSH without acts. Regression analysis indicated considerable overlap in vulnerability factors along the spectrum of DSH thoughts and acts. A uniquely distinct relationship was found between DSH of a friend and DSH without intent to die on one hand and DSH of a family member with DSH with intent to die on the other. Results indicate that familial and nonfamilial social influences on DSH behavior may be important in designing prevention programs and that educational programs for the promotion of psychological well‐being may be helpful for adolescents at any point along the spectrum of DSH that was examined.     

Social and non‐social measures of cognition for predicting self‐reported and informant‐reported functional outcomes in early psychosis

The main aim of this study was to investigate the individual contributions of neurocognitive and social‐cognitive domains to self‐reported and informant‐reported functional outcome in early psychosis. We also sought to further characterize the nature of cognitive impairments in this sample and explore the interrelationships between the social‐cognitive measures and how they correlate with measures of neurocognition and clinical symptoms. In this study, 70 patients (mean age: 24.1; 87.1% males) with primary psychotic disorder diagnosed in the previous 5 years were assessed on multiple neurocognitive (processing speed, attention, working memory, immediate verbal memory, delayed recall, visual reasoning, inhibition, planning, cognitive flexibility), and social‐cognitive domains (theory of mind (ToM), emotion recognition, attributional style, metacognitive overconfidence) as well as measures of clinical symptoms. Functional outcome was assessed with three self‐reports and two informant‐reports. On average, patients performed one or more SD below healthy controls on measures of delayed recall, ToM and metacognitive overconfidence. Emotion recognition and ToM were intercorrelated and correlated with multiple neurocognitive domains and negative symptoms. Attributional style correlated with positive symptoms. In the context of multiple variables, self‐reported functional outcomes were predicted by attributional style, whereas emotion recognition and immediate verbal memory predicted variance in informant‐reported community functioning. These results support the suggestion of a likely distinction between the predictive factors for self‐reported and informant‐reported functional outcome in early psychosis and suggest that consideration of self‐assessment of functional outcome is critical when attempting to evaluate the effects attributional style has on functional disability.     

Screening for Adolescent Substance‐Related Disorders Using the SASSI‐A2: Implications for Nonreporting Youth

In this study (N = 137), although 70.8% of participants reported no current substance use and 42.3% reported never using, the Adolescent Substance Abuse Subtle Screening Inventory (SASSI‐A2; Miller & Lazowski, 2001) screened 39.41% of the participants for a high level of probability of having a substance‐related disorder. SASSI‐A2 classified more females in our sample as having a high probability of substance‐related disorder than males. Among African American participants, male adolescents had substantially higher levels of drug use and significantly lower levels of alcohol use than did female adolescents. Implications, limitations, and future directions are provided.     

Clinical events in coronary patients who report low distress: adverse effect of repressive coping

OBJECTIVE: Coronary artery disease (CAD) patients who report low distress are considered to be at low psychological risk for clinical events. However, patients with a repressive coping style may fail to detect and report signals of emotional distress. The authors hypothesized that repressive CAD patients are at risk for clinical events, despite low self-rated distress. DESIGN: This was a prospective 5- to 10-year follow-up study, with a mean follow-up of 6.6 years. At baseline, 731 CAD patients filled out Trait-Anxiety (distress), Marlowe-Crowne (defensiveness), and Type D scales; 159 patients were classified as "repressive," 360 as "nonrepressive," and 212 as "Type D." MAIN OUTCOME MEASURES: The primary endpoint was a composite of total mortality or myocardial infarction (MI); the secondary endpoint was cardiac mortality/MI. RESULTS: No patients were lost to follow-up; 91 patients had a clinical event (including 35 cardiac death and 32 MI). Repressive patients reported low levels of anxiety, anger and depression at baseline, but were at increased risk for death/MI (21/159 = 13%) compared with nonrepressive patients (22/360 = 6%), p = .009. Poor systolic function, poor exercise tolerance, 3-vessel disease, index MI and Type-D personality--but not depression, anxiety or anger--also independently predicted clinical events. After controlling for these variables, repressive patients still had a twofold increased risk of death/MI, OR = 2.17, 95% CI = 1.10-4.08, p = .025). These findings were replicated for cardiac mortality/MI. CONCLUSION: CAD patients who use a repressive coping style are at increased risk for clinical events, despite their claims of low emotional distress. This phenomenon may cause an underestimation of the effect of stress on the heart. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Ready,Set, Go: The Transtheoretical Model of Change and Motivational Interviewing for “Fringe” Clients

The author explores the applicability of the Transtheoretical Model of Change (TTM) and motivational interviewing (MI) as a collaborative approach in counseling “resistant” or ambivalent clients. The TTM and MI provide an empirically tested framework for employment counselors to assess and empower clients who are often labeled resistant or ambivalent (e.g., youth, mandated clients, street workers, single parents) about readiness for change. Together, the TTM and MI focus counselors to accept clients' current levels of readiness and intrinsic motivation, thereby supporting clients in the effort to reduce their ambivalence. Examples are given of how the TTM and MI may be practiced.     

The Questionnaire Big Six in 26 Nations: Developing Cross‐Culturally Applicable Big Six,Big Five and Big Two Inventories

The Big Five is a useful model of attributes now commonly used in cross‐cultural research, but without the support of strong measurement invariance (MI) evidence. The Big Six has been proposed as a cross‐culturally informed update, and the broader Big Two (Social Self‐Regulation and Dynamism) draws on even more cross‐cultural evidence. However, neither has been rigorously tested for cross‐cultural MI. Here a Big Six inventory (36QB6) and measures of the Big Five and Big Two derived from it were tested and refined for cross‐cultural usability in samples from 26 nations, divided into three subsets. Confirmatory factor analysis of the models in the first subset of nations demonstrated fit as strong in translation as typical personality measures achieve in their nation of origin (although poor per standard benchmarks). Items that performed inconsistently across cultures were removed, and alternates considered in a second subset of nations. Fit and invariance were improved for refined 30‐item QB6, 25‐item Big Five and 14‐item Big Two measures in the third subset of nations. For all models, decrease in comparative fit index between MI levels was larger than .01, indicating lack of support for higher levels. Configural and factorial invariance were relatively stronger, compared to scalar and full. Copyright © 2014 European Association of Personality Psychology     

Motivational interviewing for employment: An exploration of practitioner skill and client change talk

Motivational interviewing (MI) is an evidenced-based approach for building and strengthening motivation for change. The effect of MI training on practitioner conversations with unemployed clients within a government work and income service was evaluated using a mixed-method approach, comprising a multiple-baseline across practitioner (n = 5) design and a pre/post quasi-experimental design. After workshop MI training, practitioners demonstrated greater MI skills in conversations with clients, and MI skills were maintained during the period of post-workshop feedback and coaching. There was also more change talk spoken by clients in conversations that occurred post-MI workshop training compared to pre-training, suggesting increased motivation for change.     

Self‐Harm in Young Offenders

The prevalence and correlates of self‐harm and suicidal behavior in 515 young offenders (mean age 17.3 years, SD = 1.7) serving community‐based orders (CBOs; n = 242) or custodial sentences (n = 273) in Victoria, Australia, are described. Results from structured interviews showed that 83 (16.1%) participants reported self‐harming in the previous 6 months, and this was more common among those serving custodial sentences than those serving CBOs (19.4% vs. 12.4%; OR 3.10, 95% CI: 1.74–5.55). Multiple incidents were more common in females and 24% (95% CI: 19–39) of participants who had self‐harmed reported having done so with suicidal intent. Self‐harm was associated with recent bullying victimization, expulsion from school, past year violent victimization, cannabis dependence, and risk‐taking behavior in the preceding year. The epidemiological profile of self‐harm in this population appears to be distinct from that seen in the general population. Young offenders who self‐harm are a vulnerable group with high rates of psychiatric morbidity, substance misuse problems, and social risk factors. They may benefit from targeted psychological interventions designed specifically to address impulsivity, delivered both within–and during the transition from–the youth justice system.     

Schadenfreude as a mate‐value‐tracking mechanism

This study proposed a new theoretical formulation of schadenfreude as a psychological mechanism that responds to misfortunes that lower competitors' mate value. In Study 1, participants reported schadenfreude in response to their friends' naturally occurring and hypothetical misfortunes. In Study 2, participants reported schadenfreude in response to an envied friend experiencing a hypothetical misfortune linked with female or male mate value. As predicted, females in both studies reported more schadenfreude when a same‐gender friend experienced a misfortune that lowered her physical attractiveness versus social status. Less consistent support was found for the prediction that males would report more schadenfreude when a same‐gender friend experienced a misfortune that lowered his social status versus physical attractiveness. This study suggests several directions for future research.     

Suicidal Ideation and Behavior in Adolescents Aged 12–16 Years: A 17‐Year Follow‐Up

The prevalence of suicidal ideation/behavior in 1983 or 1987 and its association with future mental health in 2001 were evaluated in a provincially representative sample of Canadian adolescents (n = 1,248) aged 12 to 16 years. Approximately 13.3% (95% CI = 11.5–15.3) of adolescents self‐reported suicidal ideation/behavior. Adolescent agreement with parent (κ = .07) and teacher (κ = .05) reports at baseline was low because adults identified so few subjects. In adulthood, the associations between adolescent self‐reports of suicidal behavior/ideation and major depression and other mental health indicators were explained by respondent sex and adolescent emotional problems reported in 1983/1987. Adolescents with suicidal behavior/ideation often are not recognized by their parents and teachers and may be at risk for persistent psychiatric problems attributable to coexisting mental health problems early‐on.     

Motivational interviewing as a way to promote physical activity in obese adolescents: A randomised-controlled trial using self-determination theory as an explanatory framework

Using self-determination theory (SDT) as an explanatory framework, this randomised-controlled study evaluates the effect of a motivational interviewing (MI)-based intervention as an addition to a standard weight loss programme (SWLP) on physical activity (PA) practice in obese adolescents over a six-month period. Fifty-four obese adolescents (mean age?=?13?years, mean BMI?=?29.57?kg/m²) were randomly assigned to an SWLP group (n?=?28) or SWLP?+?MI group (n?=?26). Both groups received two SWLP sessions, supplemented for the SWLP?+?MI group, by six MI sessions. Perceived autonomy support, perceived competence, motivational regulations, PA and BMI were assessed at baseline, three and six months (i.e. the end of the programme). MLM analyses revealed that compared to SWLP, the SWLP?+?MI group had a greater BMI decrease and a greater PA practice increase over time. Moreover, the SWLP?+?MI group reported greater autonomy support from medical staff at the end of the programme, greater increase in integrated and identified regulations and a stronger decrease in amotivation. MI appears as an efficient counselling method as an addition to an SWLP to promote PA in the context of pediatric obesity.     

The effects of anger management and social contact on risk of myocardial infarction in type as and type bs

Abstract

The risk of myocardial infarction (MI) associated with Type A behaviour, anger management and social contact was examined using a retrospective case-control design. Binary multiple regression analyses were used to compare 206 male and 67 female MI cases with 454 male and 316 female controls. To examine the potential moderating role of sex and Type A behaviour, moderated and subgroup regressions were run. Type A behaviour was significantly more prevalent in cases than controls. MI risk was further increased in males who combined Type A behaviour and aggressive expression of anger. In females MI risk was associated with the combination of Type A behaviour and not expressing anger. In addition female cases were significantly less likely than controls to discuss their anger, and reported fewer available social contacts. Discussion of results includes consideration of the problems generated by the retrospective case-control design.     

A randomized controlled trial of a single session motivational intervention for concerned gamblers

Motivational interviewing (MI) is a promising brief intervention for people who wish to cut down or quit gambling. The study was a randomized clinical trial that tested the efficacy of a single face-to-face MI compared with a control interview (CI) for reducing gambling behaviours in individuals who expressed concerns about their gambling. Eighty-one media recruited gamblers were followed at 1, 3, 6 and 12 months post-intervention. At 12 months post-intervention participants in the MI condition spent significantly less money on gambling per month, gambled fewer days per month, and reported significantly less distress than participants in the CI condition. Participants in both conditions showed overall reduction in gambling problem severity.     

Internet‐initiated sexual abuse: adolescent victims' reports about On‐ and Off‐line sexual activities

The purpose of the present study was to investigate how adolescent girls, who had been sexually (on‐ and off‐line) deceived and abused by an Internet hebephile, reported about these acts. As we had access to documentation of 68 girls' conversations (i.e. chat logs) and involvement with the perpetrator, we were able to gauge what the victims reported during the police interview against this detailed documentation. In contrast with findings from previous research, the majority of victims reported about the off‐line activities (real‐life meetings) with the perpetrator. However, the victims omitted and/or denied more of the on‐line activities, specifically the more severe sexual on‐line acts (sending nude photos and participating in sexual web shows). There is probably a gap between what the victims reported and what they presumably remembered about the on‐line activities. Factors that might have affected the victims' pattern of reports are discussed. Copyright © 2008 John Wiley & Sons, Ltd.