Mid‐ and Long‐Term Effects of Family Constellation Seminars in a General Population Sample: 8‐ and 12‐Month Follow‐Up

In a previous randomized controlled trial (RCT), short‐term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid‐ and long‐term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3‐day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ‐45.2) at 8‐ and 12‐month follow‐up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals’ experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning (d = 0.41 at 8‐month follow‐up, p = .000; d = 0.40 at 12‐month follow‐up, p = .000). Results were confirmed for psychological distress, motivational incongruence, the participants’ experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid‐ and long‐term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed.     

Gender and age differences in parent–child emotion talk

This study examined gender differences in emotion word use during mother–child and father–child conversations. Sixty‐five Spanish mothers and fathers and their 4‐ (M = 53.50, SD = 3.54) and 6‐year‐old (M = 77.07, SD = 3.94) children participated in this study. Emotion talk was examined during a play‐related storytelling task and a reminiscence task (conversation about past experiences). Mothers mentioned a higher proportion of emotion words than did fathers. During the play‐related storytelling task, mothers of 4‐year‐old daughters mentioned a higher proportion of emotion words than did mothers of 4‐year‐old sons, whereas fathers of 4‐year‐old daughters directed a higher proportion of emotion words than did fathers of 4‐year‐old sons during the reminiscence task. No gender differences were found with parents of 6‐year‐old children. During the reminiscence task daughters mentioned more emotion words with their fathers than with their mothers. Finally, mothers' use of emotion talk was related to whether children used emotion talk in both tasks. Fathers' use of emotion talk was only related to children's emotion talk during the reminiscence task.     

Reducing reactive aggression in schoolchildren through child,parent, and conjoint parent‐child group interventions: An efficacy study of longitudinal outcomes

This study was the first to evaluate the effectiveness of three different group interventions to reduce children's reactive aggression based on the social information processing (SIP) model. In the first stage of screening, 3,734 children of Grades 4–6 completed the Reactive–Proactive Aggression Questionnaire (RPQ) to assess their reactive and proactive aggression. Respondents with a total score of z ≥ 1 on the RPQ were shortlisted for the second stage of screening by qualitative interview. Interviews with 475 children were conducted to select those who showed reactive aggression featuring a hostile attributional bias. Finally, 126 children (97 males and 29 females) aged 8 to 14 (M = 9.71, SD = 1.23) were selected and randomly assigned to one of the three groups: a child group, a parent group, and a parent–child group. A significant Time × Intervention effect was found for general and reactive aggression. The parent–child group and child group showed a significant drop in general aggression and reactive aggression from posttest to 6‐month follow‐up, after controlling for baseline scores, sex, and age. However, the parent group showed no treatment effect: reactive aggression scores were significantly higher than those in the child group at 6‐month follow‐up. This study has provided strong evidence that children with reactive aggression need direct and specific treatment to reconstruct the steps of the SIP involving the selection and interpretation of cues. The intervention could help to prevent severe violent crimes at the later stage of a reactive aggressor.     

The Effectiveness of the Within Our Reach Relationship Education Program for Couples: Findings from a Federal Randomized Trial

This study examined the effectiveness of a couple‐based relationship education program, Within Our Reach. Secondary data (n = 3,609) were analyzed from the federal Supporting Healthy Marriage project. Couples were randomly assigned to receive Within Our Reach and associated services or to a no‐treatment (treatment‐as‐usual) control group. Those assigned to Within Our Reach reported better couple and individual outcomes on 8 of 12 outcomes measured (M ES = .15) at the 12‐month follow‐up and 6 of 10 outcomes measured at the 30‐month follow‐up (M ES = .14), including higher relationship happiness, more warmth and support, more positive communication, less negative behavior and emotion, less psychological abuse, less physical assault (for men), lower psychological distress (for women), and less infidelity. They were also less likely to report that their marriage was in trouble. These effects were generally small in size and many were replicated across the two follow‐ups. There were no significant differences between those assigned to Within Our Reach versus control on cooperative parenting, severe psychological assault, or percent married. Implications for future research, programming, and policy are discussed.     

Five‐year outcomes of ADHD diagnosed in adulthood

There is a dearth of long‐term follow‐up studies of adults diagnosed with ADHD. Here, the aim was to evaluate long‐term outcomes in a group of ADHD patients diagnosed in adulthood and receiving routine psychiatric health care. Adults diagnosed with any type of ADHD (n = 52) and healthy controls (n = 73) were assessed at baseline and at a 5‐year follow‐up, using Global Assessment of Functioning (GAF), Clinical Global Impression (CGI), Brown ADD Scale (BADDS) and Adult ADHD Self‐Report Scale (ASRS). A multivariate regression method was used to identify factors predicting 5‐year outcomes, including baseline ratings, medication intensity, comorbidity, intelligence quotient (IQ), age, and sex. After 5 years, ADHD patients reported fewer and/or less severe symptoms compared to baseline, but remained at clinically significant symptom levels and with functional deficits. Baseline self‐reports of ADHD symptoms predicted their own 5‐year outcome and low baseline functioning level predicted improved global functioning at follow‐up. Factors previously reported to predict short‐term outcomes (i.e., medication, comorbidity, IQ, age, and sex) did not anticipate long‐term outcomes in present study.     

Multilingual assessment of early child development: Analyses from repeated observations of children in Kenya

In many low‐ and middle‐income countries, young children learn a mother tongue or indigenous language at home before entering the formal education system where they will need to understand and speak a country's official language(s). Thus, assessments of children before school age, conducted in a nation's official language, may not fully reflect a child's development, underscoring the importance of test translation and adaptation. To examine differences in vocabulary development by language of assessment, we adapted and validated instruments to measure developmental outcomes, including expressive and receptive vocabulary. We assessed 505 2‐to‐6‐year‐old children in rural communities in Western Kenya with comparable vocabulary tests in three languages: Luo (the local language or mother tongue), Swahili, and English (official languages) at two time points, 5–6 weeks apart, between September 2015 and October 2016. Younger children responded to the expressive vocabulary measure exclusively in Luo (44%–59% of 2‐to‐4‐year‐olds) much more frequently than did older children (20%–21% of 5‐to‐6‐year‐olds). Baseline receptive vocabulary scores in Luo (β = 0.26, SE = 0.05, p < 0.001) and Swahili (β = 0.10, SE = 0.05, p = 0.032) were strongly associated with receptive vocabulary in English at follow‐up, even after controlling for English vocabulary at baseline. Parental Luo literacy at baseline (β = 0.11, SE = 0.05, p = 0.045) was associated with child English vocabulary at follow‐up, while parental English literacy at baseline was not. Our findings suggest that multilingual testing is essential to understanding the developmental environment and cognitive growth of multilingual children.     

Effectiveness of the ‘Hold me Tight’ Relationship Enhancement Program in a Self‐referred and a Clinician‐referred Sample: An Emotionally Focused Couples Therapy‐Based Approach

While evidence‐based couple therapies are available, only a minority of troubled couples seek help and they often do this too late. To reach more couples earlier, the couple relationship education (CRE) group program “Hold me Tight” (HmT) based on Emotionally Focused Couples Therapy (EFCT) was developed. This study is the first to examine the effectiveness of HmT. Using a three‐wave (waiting period, treatment, and follow‐up) within‐subject design, HmT was delivered to 79 self‐referred couples and 50 clinician‐referred couples. We applied a comprehensive outcome measure battery. Our main findings were that (1) self‐referred couples significantly improved during HmT on all measures, that is relationship satisfaction, security of partner‐bond, forgiveness, daily coordination, maintenance behavior, and psychological complaints, with a moderate‐to‐large mean effect size (d = .63), which was maintained (d = .57) during the 3.5 month follow‐up; (2) in clinician‐referred couples, who were vulnerable in terms of insecure attachment status and psychopathology, the improvement during HmT was moderate (d = .42), but this was reduced during the 3.5‐month follow‐up to a small effect (d = .22); (3) emotional functioning (typical HmT target) as well as behavioral functioning (typical Behavioral Couples Therapy‐based CRE target) improved during HmT; and (4) individual psychological complaints, although not specifically targeted, were reduced during HmT. These findings suggest that HmT is a promising intervention for enhancement of relationship functioning. Clinical implications are discussed.     

Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents

Adolescents can be at heightened risk for anxiety and depression, with accumulating research reporting on associations between anxiety and depression and cognitive impairments, implicating working memory and attentional control deficits. Several studies now point to the promise of adaptive working memory training to increase attentional control in depressed and anxious participants and reduce anxiety and depression symptoms, but this has not been explored in a non‐clinical adolescent population. The current study explored the effects of adaptive dual n‐back working memory training on sub‐clinical anxiety and depression symptomology in adolescents. Participants trained on either an online adaptive working memory task or non‐adaptive control task for up to 20 days. Primary outcome measures were self‐reported anxiety and depression symptomology, before and after intervention, and at 1‐month follow‐up. Self‐reported depression (p = 0.003) and anxiety (p = 0.04) decreased after training in the adaptive n‐back group relative to the non‐adaptive control group in the intention‐to‐treat sample (n = 120). These effects were sustained at follow‐up. Our findings constitute proof of principle evidence that working memory training may help reduce anxiety and depression vulnerability in a non‐clinical adolescent population. We discuss the findings’ implications for reducing risk of internalizing disorders in youth and the need for replication.     

Inhibitory control and emotion regulation in preschool children

This research investigated the relation between individual differences in inhibitory control and emotion regulation. Preschool children (N = 53) ages 4–6 (M = 5; 0) were assessed on brief batteries of inhibitory control of prepotent responses and emotion regulation. Individual differences in inhibitory control were significantly correlated with children's ability to regulate their emotions. This relation held up even after controlling for age and verbal ability, and persisted for both Emotion Understanding and “online” control of emotional expressions that were negative (Disappointing Gift) or positive (Secret Keeping). Parent report of children's self-control and emotion regulation corroborated the behavioral results. These findings suggest that executive control of attention, action, and emotion are skills that develop in concert in the preschool period. However, there was also evidence of a quadratic relation in which emotion regulation was optimal at intermediate levels of inhibition, highlighting the interplay of both cognitive control and temperament in socio-emotional functioning.     

An Implementation Study of Relationship Checkups as Home Visitations for Low‐Income At‐Risk Couples

Couples with the greatest need for relationship health maintenance and intervention are often least able to afford and access it; therefore, accessible, affordable, effective, and brief interventions are needed to improve relationship health for those who need it most. Consequently, this paper examined whether a brief relationship intervention could be effectively implemented with a low‐income, underserved population. All enrolled participants (N = 1,312) received the Relationship Checkup, which consists of an assessment and a feedback session delivered in their homes or at a local clinic at their request. Measures assessed relationship satisfaction, communication, psychological and physical aggression, and intimacy at baseline and 1‐month follow‐up, and program and relationship satisfaction at 6‐month follow‐up. All participants reported significant improvements on all outcomes with small effect sizes. However, moderation analyses suggested that distressed couples reported significantly larger effects across the board. Overall, participants reported that they were highly satisfied with the intervention both immediately after its delivery and 6 months later. Findings provide preliminary support for the effectiveness of this brief checkup and point to the utility of offering these kinds of low‐cost brief interventions in flexible formats for those who might have the most difficulty accessing them.     

Suicidality Among Chronically Homeless People with Alcohol Problems Attenuates Following Exposure to Housing First

This study is the first to document suicidality among chronically homeless people with alcohol problems (N = 134) and examine its trajectory following exposure to immediate, permanent, low‐barrier housing (i.e., Housing First). Suicidal ideation, intent, plans, and prior attempts were assessed at baseline and during a 2‐year follow‐up. Baseline suicidal ideation was over four times higher than in the general population. Two‐year, within‐subjects, longitudinal analyses indicated severity of suicidal ideation decreased by 43% from baseline to follow‐up. Significant decreases were also found for intent and clinical significance of ideation. No participants died by suicide during the 2‐year follow‐up.     

Predicting Persistence of Nonsuicidal Self‐Injury in Suicidal Adolescents

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.     

Contributions of Observed Parent Socialization of Coping and Skin Conductance Level Reactivity to Childhood Adjustment

This research examined the longitudinal association between parent socialization of coping and child adjustment, as well as the moderating role of children's skin conductance level reactivity (SCLR). Participants were a community sample of children (n = 64, M age = 9.02, 54.5% females, 93.2% Caucasian) and their parent(s). Parent coping suggestions were observed while their child engaged in a stressful challenge task, during which the child's SCLR, a measure of children's physiological reactivity to stress, was also measured. Parent(s) completed the Child Behavior Checklist (Achenbach & Rescorla, 2001) at baseline and a 6‐month follow‐up to assess internalizing and externalizing problems. Results revealed that secondary control engagement suggestions predicted fewer internalizing problems over time. In addition, disengagement suggestions predicted fewer externalizing problems over time among children with high SCLR. This study provides evidence that parent coping suggestions serve as a resource that protects youth from developing adjustment problems.     

Testing the bi‐dimensional effects of attitudes on behavioural intentions and subsequent behaviour

Attitudes are typically treated as unidimensional predictors of both behavioural intentions and subsequent behaviour. On the basis of previous research showing that attitudes comprise two independent, positive and negative dimensions, we hypothesized that attitudes would be bi‐dimensional predictors of both behavioural intentions and subsequent behaviour. We focused on health‐risk behaviours. We therefore also hypothesized that the positive dimension of attitude (evaluations of positive behavioural outcomes) would better predict both behavioural intentions and subsequent behaviour than would the negative dimension, consistent with the positivity bias/offset principle. In Study 1 (cross sectional design), N = 109 university students completed questionnaire measures of their intentions to binge‐drink and the positive and negative dimensions of attitude. Consistent with the hypotheses, both attitude dimensions independently predicted behavioural intentions and the positive dimension was a significantly better predictor than was the negative dimension. The same pattern of findings emerged in Study 2 (cross sectional design; N = 186 university students) when we predicted intentions to binge‐drink, smoke and consume a high‐fat diet. Similarly, in Study 3 (prospective design; N = 1,232 speed limit offenders), both the positive and negative dimensions of attitude predicted subsequent (6‐month post‐baseline) speeding behaviour on two different road types and the positive dimension was the better predictor. The implications for understanding the motivation of behaviour and the development of behaviour‐change interventions are discussed.     

Determinants and Predictive Value of Clinician Assessment of Short‐Term Suicide Risk

We examine the interrelations among clinicians' judgment of patients' suicide risk, clinicians' emotional responses, and standard risk factors in the short‐term prediction of suicidal thoughts and behaviors. Psychiatric outpatients (n = 153) with a lifetime history of suicide ideation/attempt and their treating clinicians (n = 67) were evaluated at intake. Clinicians completed a standard suicide risk instrument (modified SAD PERSONS scale), a 10‐point Likert scale assessment of judgment of patient suicide risk (Clinician Prediction Scale), and a measure of their emotional responses to the patient (Therapist Response Questionnaire‐Suicide Form). The Columbia Suicide Severity Rating Scale and the Beck Scale for Suicide Ideation were administered at a one‐month follow‐up assessment (n = 114, 74.5%). Clinician judgment of risk significantly predicted suicidal thoughts and behaviors at follow‐up. Both the standard suicide risk instrument and clinician emotional responses contributed independently to the clinician assessment of risk, which, in turn, mediated their relationships with suicidal thoughts and behaviors. Our findings validate the importance of clinical judgment in assessing suicide risk. Clinical judgment appears to be informed both by concrete risk factors and clinicians' emotional responses to suicidal patients, highlighting emotional awareness as a promising area for research and training.     

Parent Socialization of Coping and Child Emotion Regulation Abilities: A Longitudinal Examination

This study examined the hypothesis that parent socialization of coping (SOC) would have a longitudinal relation with child emotion regulation abilities. Participants included a sample of 256 parents of 5- to 12-year-old children (child M age = 8.36, SD = 2.03, 54.7% male; parent M age = 34.49, SD = 6.20, 59% female). Data on demographic information, parenting behaviors, and child emotion regulation abilities were collected via online questionnaires at baseline and 12 months. Results from longitudinal structural equation modeling (SEM) analyses suggested that parent SOC, measured at baseline, predicted child adaptive and maladaptive emotion regulation, measured 12 months later. More specifically, parental engagement coping suggestions predicted child's adaptive emotion regulation, whereas parental disengagement coping suggestions predicted child's maladaptive emotion regulation. Further, child gender emerged as a moderator in the longitudinal association between socialization of engagement coping and child adaptive emotion regulation: Whereas this association was small and marginally significant for girls, it was large and statistically significant for boys. Results highlight the importance of parent SOC as potentially contributing to emotion regulation abilities of 5- to 12-year-olds.     

Mental health among people with psoriasis undergoing patient education in climate therapy

This study investigated the mental health of people with psoriasis undergoing patient education in climate therapy. A prospective design included a baseline assessment and two follow‐ups after a 3‐week patient education program. Participants were 254 adults. Positive mental health was measured by the mental health continuum short form (0–70), and negative mental health by the emotional distress subscale (1–4) of the health education impact questionnaire. Paired‐samples t‐tests were used to evaluate changes in mental health from baseline to follow‐up. Multiple linear regression was used to analyse the ability of socio‐demographic and clinical variables and emotional distress to predict changes in positive mental health. To predict change in negative mental health we repeated the same analysis but with a change in negative mental health as a dependent variable and positive mental health as an independent variable. The results show that positive mental health and health‐related emotional distress improved significantly from before to after the intervention by 7.1 points, p < 0.001 and 0.21 points, p < 0.001) respectively. At the second follow‐up, health‐related emotional distress remained significantly improved compared with baseline levels by 0.11 points, p = 0.004. The longer participants had lived with psoriasis ( β = 146, p = 0.027), and the presence of co‐morbid health problems (β  =  111, p = 0.051) the greater the improvement in the positive mental health immediately after the intervention. No predictors were identified for negative mental health. This study indicates that the promotion of positive mental health needs to be integrated into the climate therapy program, and sustained in their home context.     

Pyramidal parent training using behavioral skills training: Training caregivers in the use of a differential reinforcement procedure

Six caregivers participated in a research study in which behavioral skills training (BST) was used within a pyramidal training model to train a differential reinforcement of an alternative behavior (DRA) procedure. Physical prompting was utilized to obtain correct responses across the identified alternative behavior. The caregivers were split into two tiers, comprised of three caregivers each. The experimenter trained tier‐one caregivers, who then trained tier‐two caregivers after meeting a predetermined mastery criterion. A multiple baseline design across participants research design was used to evaluate the effectiveness of correct implementation of the DRA procedure, demonstrating experimental control across participants. During baseline, caregivers did not implement DRA correctly. Following training, tier‐one and tier‐two caregivers demonstrated correct implementation of the DRA and prompting procedure. Intervention score was (M = 96%), from a baseline score of (M = 34.6%), for tier‐one participants. Intervention score was (M = 96.6%), from a baseline score of (M = 33%), for tier‐two participants. A follow‐up maintenance probe demonstrated correct implementation of the DRA procedure with prompting across both tiers of trained caregivers.     

Body language reading of emotion in schizophrenia: Associations with symptoms and functional outcome

Our aim was to explore how body language reading of emotion relates to neurocognition, symptoms and functional outcome in schizophrenia. Fifty‐four individuals with schizophrenia and eighty‐four healthy controls participated in the study. Emotion perception was assessed with a point‐light display (PLD) task, the Emotion in Biological Motion (EmoBio) test, neurocognition was measured with the MATRICS Consensus Cognitive Battery (MCCB), and functioning was indexed by one measure of functional capacity and by one self‐report questionnaire. Clinical symptoms were assessed with a five factor Positive and Negative Syndrome Scale (PANSS) symptoms model. Participants with schizophrenia had impaired body language reading of emotions compared to healthy controls (Cohen's d = 0.69). In participants with schizophrenia, emotion perception was associated with neurocognition (r = 0.42), functional capacity (r = 0.27) and disorganization symptoms (r = –0.27). Mediation analyses showed that disorganization symptoms mediated the effects of emotion perception and neurocognition, respectively, on social functional capacity. These results suggest that in individuals with schizophrenia, reduced emotion perception from body movements has negative consequences for functional outcome, but that the effect is mediated through disorganization symptoms.