Are Shunt Revisions Associated with IQ in Congenital Hydrocephalus? A Meta -Analysis

Although it is generally acknowledged that shunt revisions are associated with reductions in cognitive functions in individuals with congenital hydrocephalus, the literature yields mixed results and is inconclusive. The current study used meta-analytic methods to empirically synthesize studies addressing the association of shunt revisions and IQ in individuals with congenital hydrocephalus. Six studies and three in-house datasets yielded 11 independent samples for meta-analysis. Groups representing lower and higher numbers of shunt revisions were coded to generate effect sizes for differences in IQ scores. Mean effect size across studies was statistically significant, but small (Hedges’ g = 0.25, p < 0.001, 95 % CI [0.08, 0.43]) with more shunt revisions associated with lower IQ scores. Results show an association of lower IQ and more shunt revisions of about 3 IQ points, a small effect, but within the error of measurement associated with IQ tests. Although clinical significance of this effect is not clear, results suggest that repeated shunt revisions because of shunt failure is associated with a reduction in cognitive functions.     

A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.     

Eight-Year Latent Class Trajectories of Academic and Social Functioning in Children with Attention-Deficit/Hyperactivity Disorder

We examined trajectories of academic and social functioning in children with attention-deficit/hyperactivity disorder (ADHD) to identify those who might be at risk for especially severe levels of academic and social impairment over time. We estimated a series of growth mixture models using data from two subsamples of children participating in the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) including those with at least baseline and 96-month data for reading and mathematics achievement (n = 392; 77.3% male; M age = 7.7; SD = 0.8) or social skills ratings from teachers (n = 259; 74.9% male; M age = 7.6; SD = 0.8). We compared latent trajectories for children with ADHD to mean observed trajectories obtained from a local normative (i.e., non-ADHD) comparison group (n = 289; 80.6% male; M age = 9.9; SD = 1.1). Results indicated six latent trajectory classes for reading and mathematics and four classes for teacher social skills ratings. There was not only a relationship between trajectories of inattention symptoms and academic impairment, but also a similarly strong association between trajectory classes of hyperactive-impulsive symptoms and achievement. Trajectory class membership correlated with socio-demographic and diagnostic characteristics, inattention and hyperactive-impulsive symptom trajectories, externalizing behavior in school, and treatment receipt and dosage. Although children with ADHD display substantial heterogeneity in their reading, math, and social skills growth trajectories, those with behavioral and socio-demographic disadvantages are especially likely to display severe levels of academic and social impairment over time. Evidence-based early screening and intervention that directly address academic and social impairments in elementary school-aged children with ADHD are warranted. The ClinicalTrials.gov identifier is NCT00000388.     

Does Group CBT for Depression Do What It Says on the Tin? A Systemic Review and Meta-analysis of Group CBT for Depressed Adults (2000–2016)

The present study aimed to update previous meta-analyses of gCBT, and focus specifically on recent studies in which the Beck Depression Inventory (BDI) was used to assess outcome. PsycINFO, PubMed, EMBASE, and Cochrane were searched for eligible studies. Both randomized controlled trials (RTC, k = 9) and non-RTCs (k = 1) published since 2000 were included. On the BDI large significant effect sizes were found for gCBT compared with treatment as usual (TAU, d = 4.64), wailing list controls (WLC, d = 1.20), and both of these comparison conditions combined with studies of well-defined alternative treatments (ALT, d = 1.61). On the BDI a moderate effect size (d = 0.53) was found for comparisons of gCBT and ALT groups. gCBT also had large and significant effects on depressive cognition assessed with the Automatic Thoughts Questionnaire and the Dysfunctional Attitudes Scale compared with WLC and ALT comparison groups (d = 2.66). This meta-analysis shows that gCBT is a robust intervention for depression in adults.     

Clinical Utility of Expanded Carrier Screening: Reproductive Behaviors of At-Risk Couples

Expanded carrier screening (ECS) analyzes dozens or hundreds of recessive genes to determine reproductive risk. Data on the clinical utility of screening conditions beyond professional guidelines are scarce. Individuals underwent ECS for up to 110 genes. Five-hundred thirty-seven at-risk couples (ARC), those in which both partners carry the same recessive disease, were invited to participate in a retrospective IRB-approved survey of their reproductive decision making after receiving ECS results. Sixty-four eligible ARC completed the survey. Of 45 respondents screened preconceptionally, 62% (n = 28) planned IVF with PGD or prenatal diagnosis (PNDx) in future pregnancies. Twenty-nine percent (n = 13) were not planning to alter reproductive decisions. The remaining 9% (n = 4) of responses were unclear. Of 19 pregnant respondents, 42% (n = 8) elected PNDx, 11% (n = 2) planned amniocentesis but miscarried, and 47% (n = 9) considered the condition insufficiently severe to warrant invasive testing. Of the 8 pregnancies that underwent PNDx, 5 were unaffected and 3 were affected. Two of 3 affected pregnancies were terminated. Disease severity was found to have significant association (p = 0.000145) with changes in decision making, whereas guideline status of diseases, controlled for severity, was not (p = 0.284). Most ARC altered reproductive planning, demonstrating the clinical utility of ECS. Severity of conditions factored into decision making.     

Effectiveness of Two Cognitive Interventions Promoting Happiness with Video-Based Online Instructions

A 3-month experimental online study examined the short-term and 1 month follow-up effects of regularly practicing one of two cognitive interventions on subjective well-being. Participants were 435 self-selected adults (366 female, 69 male, aged 18–63) randomly assigned to one of three conditions: writing about best possible selves in the future (n = 135), making gratitude lists (n = 150) or writing to-do-lists as a control condition (n = 150). The study was fully self-administered and exercise instructions were given in online videos. Repeated-measures MANOVA revealed that both interventions significantly increased subjective well-being in comparison to the control condition. Effect sizes for the different components of subjective well-being ranged from r = .09–.13 (η² = .01–.02) for the 2 months intervention period. These effects were maintained until the 1-month follow-up. Enjoyment and interest regarding the exercise as indicators of perceived person-intervention-fit moderated the effect; participants of the happiness interventions who perceived a better fit showed greater increases in subjective well-being. These findings confirm previous research on these interventions and encourage further studies on online interventions, especially regarding possibilities to increase participants’ motivation and reduce dropout attrition.     

Therapeutic Identity among Clinical Psychology Professionals in India

This study explored the therapeutic identity among clinical psychology professionals in India with objectives of assessing therapeutic style, attitudes, orientation, values and its relationship with work experience, age and gender. Out of 79 clinical psychology professionals contacted, 50 gave written informed consent for participation in study. The data obtained from Psycho-Therapeutic Identity Questionnaire (ThIdQ). Cluster analysis of the responses on attitude scales revealed broad themes of therapeutic identity in the form of three cluster profiles: Vague psychodynamic assumptions with high self-doubt and low optimism about change (n = 9); Entangled in their own strong feelings of limitations and doubts as a therapist (n = 16); and Eclectic approach with low self-doubt and high optimism about change(n = 25). A lack of synchrony was seen between assessed and reported therapeutic orientation with overuse of the cognitive behavioural therapy (CBT) orientation. Correlation findings indicated that increased work experience in the field and higher age were associated with low self-doubt and high optimism about change in therapy. Findings on therapeutic identity provide mixed bag of results, positive as well as negative, with equal number of participants on each side.     

Emotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review

Anxiety is conceptualized as a state of negative emotional arousal that is accompanied by concern about future threat. The purpose of this meta-analytic review was to evaluate the evidence of associations between emotional competence and anxiety by examining how specific emotional competence domains (emotion recognition, emotion expression, emotion awareness, emotion understanding, acceptance of emotion, emotional self-efficacy, sympathetic/empathic responses to others’ emotions, recognition of how emotion communication and self-presentation affect relationships, and emotion regulatory processes) relate to anxiety in childhood and adolescence. A total of 185 studies were included in a series of meta-analyses (N’s ranged from 573 to 25,711). Results showed that anxious youth are less effective at expressing (r = ?0.15) and understanding emotions (r = ?0.20), less aware of (r = ?0.28) and less accepting of their own emotions (r = ?0.49), and report less emotional self-efficacy (r = ?0.36). More anxious children use more support-seeking coping strategies (r = 0.07) and are more likely to use less adaptive coping strategies including avoidant coping (r = 0.18), externalizing (r = 0.18), and maladaptive cognitive coping (r = 0.34). Emotion acceptance and awareness, emotional self-efficacy, and maladaptive cognitive coping yielded the largest effect sizes. Some effects varied with children’s age. The findings inform intervention and treatment programs of anxiety in youth and identify several areas for future research.     

Identifying Effective Components of Child Maltreatment Interventions: A Meta-analysis

There is a lack of knowledge about specific components that make interventions effective in preventing or reducing child maltreatment. The aim of the present meta-analysis was to increase this knowledge by summarizing findings on effects of interventions for child maltreatment and by examining potential moderators of this effect, such as intervention components and study characteristics. Identifying effective components is essential for developing or improving child maltreatment interventions. A literature search yielded 121 independent studies (N = 39,044) examining the effects of interventions for preventing or reducing child maltreatment. From these studies, 352 effect sizes were extracted. The overall effect size was significant and small in magnitude for both preventive interventions (d = 0.26, p < .001) and curative interventions (d = 0.36, p < .001). Cognitive behavioral therapy, home visitation, parent training, family-based/multisystemic, substance abuse, and combined interventions were effective in preventing and/or reducing child maltreatment. For preventive interventions, larger effect sizes were found for short-term interventions (0–6 months), interventions focusing on increasing self-confidence of parents, and interventions delivered by professionals only. Further, effect sizes of preventive interventions increased as follow-up duration increased, which may indicate a sleeper effect of preventive interventions. For curative interventions, larger effect sizes were found for interventions focusing on improving parenting skills and interventions providing social and/or emotional support. Interventions can be effective in preventing or reducing child maltreatment. Theoretical and practical implications are discussed.     

Seemingly anomalous full scale IQ scores on the WAIS-III and the WISC-III

The Canadian and American WISC-III and the American WAIS-III standardization data were used to investigate the prevalence of “seemingly anomalous” Full Scale IQ (FSIQ) scores for all possible Verbal and Performance sums of scale score combinations. It was found that 6% of FSIQ scores in these three samples were seemingly anomalous (i.e., fell outside of their associated VIQ/PIQ intervals). Interestingly, the anomalous FSIQ scores were more prevalent at the extremes of the FSIQ distribution, and did not occur when the VIQ/PIQ interval was greater than 12. Additionally, anomalous FSIQ scores were generally further from the center of the FSIQ distribution than were the associated VIQ and PIQ scores. Also, when the VIQ/PIQ interval contained FSIQ (the non-anomalous case), FSIQ tended to be located distally in the half-segment of the VIQ/PIQ interval furthest from the center of the FSIQ distribution. A statistical explanation for the findings is provided. Portions of this paper were presented March 3, 2000 at the 14th Annual Joseph R. Royce Research Conference, Department of Psychology, University of Alberta, Edmonton, Alberta. An erratum to this article is available at .     

Decisional Procrastination: Assessing Characterological and Contextual Variables around Indecision

University students (n = 75; M age = 21.4 years old) and community adults (n = 55: M age = 36.6 years old) completed self-reported measures of decisional procrastination (indecision), character (life satisfaction, meaningful life, and need for cognition), context (place attachment, sense of community, and psychological home) and “cross-over” factors relating character and context (self-identity with possessions, people/thing orientation, and clutter), to provide an ecological understanding of persons who claim indecision. Controlling for social desirability tendencies, indecision was negatively related to all character but none of the context variables. Indecision also was related to both person and thing orientation and clutter. Multiple regression analysis indicated that only need for cognition significantly predicted (negatively) indecision among character, context, and cross-over variable sets. Subjective well-being also predicted indecision with low need for cognition among cross-over variables. Taken together, decisional procrastinators reported too much clutter (stuff), interfering with a positive quality of life and related to character over context and cross-over, ecological variables.     

Distress Tolerance and Social Support in Adolescence: Predicting Risk for Internalizing and Externalizing Symptoms Following a Natural Disaster

The purpose of the multi-measure, multi-wave, longitudinal study was to examine the interactive relation between behavioral distress tolerance (DT) and perceived social support (PSS) in 352 tornado-exposed adolescents aged 12–17 years (M = 14.44; SD = 1.74). At baseline, adolescents completed a computer-based task for DT, and self-report measures of PSS, depressed mood, posttraumatic stress disorder (PTSD), substance use, and interpersonal conflict. Symptoms also were assessed 4 and 12 months after baseline. Findings showed that lower levels of DT together with lower levels of PSS conferred risk for elevated symptoms of prospective depression (t(262) = ?2.04, p = .04; r_{effect size} = 0.13) and PTSD (t(195) = ?2.08, p = .04; r_{effect size} = 0.15) following a tornado. However, only PSS was significant in substance use t(139) = 2.20, p = .03; r_{effect size=}0.18) and conflict (t(138) = ?4.05, p < .0001; r_{effect size=}0.33) in our sample. Implications regarding adolescent DT, the transdiagnostic nature of PSS, and the clinical applications of our findings in the aftermath of a natural disaster are discussed.     

Seemingly anomalous full scale IQ scores on the WAIS-III and the WISC-III

The Canadian and American WISC-III and the American WAIS-III standardization data were used to investigate the prevalence of “seemingly anomalous” Full Scale IQ (FSIQ) scores for all possible Verbal and Performance sums of scale score combinations. It was found that 6% of FSIQ scores in these three samples were seemingly anomalous (i.e., fell outside of their associated VIQ/PIQ intervals). Interestingly, the anomalous FSIQ scores were more prevalent at the extremes of the FSIQ distribution, and did not occur when the VIQ/PIQ interval was greater than 12. Additionally, anomalous FSIQ scores were generally further from the center of the FSIQ distribution than were the associated VIQ and PIQ scores. Also, when the VIQ/PIQ interval contained FSIQ (the non-anomalous case), FSIQ tended to be located distally in the half-segment of the VIQ/PIQ interval furthest from the center of the FSIQ distribution. A statistical explanation for the findings is provided. Portions of this paper were presented March 3, 2000 at the 14th Annual Joseph R. Royce Research Conference, Department of Psychology, University of Alberta, Edmonton, Alberta. An erratum to this article is available at .     

Performing and Declining PGD: Accounts of Jewish Israeli Women Who Carry a <Emphasis Type="Italic">BRCA1/2</Emphasis> Mutation or Partners of Male Mutation Carriers

To describe factors associated with preimplantation genetic diagnosis (PGD) decisions among Jewish Israeli BRCA1/2 carriers or spouses of a male carrier, we contacted all women who initiated PGD consultation for embryonic BRCA1/2 mutation detection at Sheba Medical Center, prior to March 2014. Applying a qualitative approach, we asked women to elaborate on the factors they considered in either opting for PGD or discontinuing the screening procedure. Participants were 18 Jewish Israeli women; 14 were carriers of one of the Ashkenazi founder mutations in BRCA1/2, and four were spouses of male mutation carriers, who underwent at least one cycle of PGD. Prior to seeking PGD, ten of the women had no children. At the time of the interview, all but three had at least one child. Three factors emerged as key motivators for PGD: having witnessed the disease in a close relative (n = 12); prior IVF treatment for infertility (n = 12); and having pre-existing frozen embryos (n = 6). Ten women withdrew from the PGD process due to clinical, logistical, and financial reasons. In conclusion, most women decided to withdraw from PGD instead of continuing until a successful conception was achieved. Those who opted for PGD attributed their discontinuation of further screening to the emotional burden that is greatly intensified by practical difficulties.     

Let’s be healthy together: Relational motivation for physical health is more effective for women

Four studies examined the role of relationally-autonomous reasons in health behavior (RARHs) and how gender moderates their association with health outcomes. Study 1 (n = 160) involved the development of a measure of RARHs. The results of a factor analysis distinguished RARHs from other types of health reasons. In Study 2, participants (n = 284) completed a survey assessing their relational reasons prior to taking assessments of their body composition and fitness level. In Study 3, participants (n = 577) completed an online survey assessing RARHs, self-construal and health behaviors. The results of Studies 2 and 3 showed that RARHs positively predicted healthy outcomes for females only. In Study 4, participants (n = 72) were asked to complete an online survey, attend an orientation session, keep track of their exercise and nutrition over the course of a week, and attend a follow-up session. The results revealed that having an exercise partner was positively associated with RARHs, and that this in turn predicted reported effort and progress outcomes at the follow-up session for females only. Implications for theories of motivation and gender differences are discussed.     

Psychoeducational Psychotherapy and Omega-3 Supplementation Improve Co-Occurring Behavioral Problems in Youth with Depression: Results from a Pilot RCT

This pilot randomized controlled trial (RCT) investigated benefits of omega-3 fatty acid supplementation and Individual-Family Psychoeducational Psychotherapy (PEP; a family-focused, cognitive-behavioral therapy) for behavior problems among youth with depression. Participants aged 7–14 with DSM-IV-TR depressive disorders (N = 72; 56.9 % male) were randomized to 1 of 4 treatment conditions: PEP + omega-3, PEP monotherapy (with pill placebo), omega-3 monotherapy, or placebo (without active intervention). At screen, baseline, and 2, 4, 6, 9, and 12 weeks post-baseline, parents completed the SNAP-IV, which assesses attention-deficit/hyperactivity disorder symptoms, oppositional defiant disorder symptoms, and overall behavior problems. At screen, baseline (randomization), 6 and 12 weeks, parents completed the Eyberg Child Behavior Inventory (ECBI), which includes Intensity and Problem scales for child behavior problems. Youth who had a completed SNAP-IV or ECBI for at least two assessments during treatment (n = 48 and 38, respectively) were included in analyses of the respective outcome. ClinicalTrials.gov.:NCT01341925. Linear mixed effects models indicated a significant effect of combined PEP + omega-3 on SNAP-IV Total (p = 0.022, d = 0.80) and Hyperactivity/Impulsivity trajectories (p = 0.008, d = 0.80), such that youth in the combined group saw greater behavioral improvement than those receiving only placebo. Similarly, youth in combined treatment had more favorable ECBI Intensity trajectories than youth who received no active treatment (p = 0.012, d = 1.07). Results from this pilot RCT suggest that combined PEP + omega-3 is a promising treatment for co-occurring behavior symptoms in youth with depression.     

Extending the Balloon Analogue Risk Task to Assess Naturalistic Risk Taking via a Mobile Platform

The Balloon Analogue Risk Task (BART) is a behavioral measure that is commonly used to assess risk taking propensity. The primary goal of the present study was to introduce a mobile version of the BART (mBART) that can be included within ambulatory assessment protocols to assess risk taking in daily life. Study 1 compared common BART indices (i.e., total money earned, adjusted average pumps, balloon explosions, and coefficient of variability [CV]) on a single administration of the laboratory BART on a computer and the mBART on a smartphone (n = 78). Results revealed generally consistent relationships between indices of risk taking propensity in both the laboratory BART and mBART. Study 2 administered the mBART as part of a 7-day ecological momentary assessment (EMA) protocol in a population of nondaily smokers (n = 51). Using multi-level models, results suggest that males have greater adjusted average pumps (p = .03), and that a participant’s average CV is negatively related to trait sensation seeking (p = .03) and positively associated with trait positive urgency (p = .04). There were within-person effects of study day (p = .05) and environment (p = .02) with respect to adjusted average pumps such that individuals took greater risks as the study progressed and were riskier when alone compared to with others. Inclusion of the mBART in EMA did not appear to significantly increase participant burden and demonstrated acceptable levels of compliance. These results offer initial evidence supporting the feasibility and utility of the mBART for ambulatory research designs.     

Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M _age  = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p < .001), generalized anxiety disorder (OR = .65, p < .001), social anxiety disorder (OR = .74, p < .001), panic disorder (OR = .65, p <. 001), and alcohol dependence (OR = .85, p < .001). Discrepancy between expected and observed PTSD symptom severity based on IP trauma load may represent a useful, quantitative measure of resilience.     

Scoring reliability on the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III)

Nineteen psychologists and 19 graduate students scored two Wechsler Adult Intelligence Scale-Third Edition patient protocols. Mean IQs and indexes were similar across groups, but the ranges for Verbal IQ (VIQ), Performance IQ (PIQ), and Full Scale IQ (FSIQ) on one protocol were 25, 22, and 11 points, respectively. For both protocols taken together, percentages of agreement with the "actual" IQs for psychologists were only 26.3 for VIQ, 36.8 for PIQ, and 42.1 for FSIQ. For students, percentages were 15.8 for VIQ, 23.7 for PIQ, and 31.6 for FSIQ. The percentages of FSIQs that fell within +/- 1 standard error of measurement of the actual IQs were 89.5 for psychologists and 76.3 for students. Scoring error also had a negative impact on index scores. Both groups were confident about their scoring accuracy.     

Parental Depressive Symptoms as a Predictor of Outcome in the Treatment of Child Depression

Child depression is an impairing condition for which psychotherapies have shown modest effects. Parental depression is a risk factor for development of child depression and might also be negatively associated with child depression treatment outcomes. To explore this possibility, we analyzed data from a study in which children were treated for depression after parental depressive symptoms had been assessed at baseline. Among children treated for depression in a randomized controlled trial, we identified 31 who had child- and parent-report pre- and post-treatment data on child symptoms and parent-report of pre-treatment parental depressive symptoms. Children were aged 8–13, 77% boys, and 52% Caucasian, 13% African-American, 6% Latino, and 29% multi-racial. Analyses focused on differences in trajectories of change (across weekly measurements), and post-treatment symptoms among children whose parents did (n = 12) versus did not (n = 19) have elevated depressive symptoms at baseline. Growth curve analyses showed markedly different trajectories of change for the two groups, by both child-report (p = 0.03) and parent-report (p = 0.03) measures: children of parents with less severe depression showed steep symptom declines, but children of parents with more severe depression showed flat trajectories with little change in symptoms over time. ANCOVAs showed lower post-treatment child symptoms for children of parents with less severe depression versus parents with more severe depression (p = 0.05 by child report, p = 0.01 by parent report). Parental depressive symptoms predict child symptom trajectories and poorer child treatment response, and may need to be addressed in treatment.