Evidence-based practice: A challenge for European developmental psychology

In recent years the evidence-based practice movement has been seeing great gains in impact. Standards for research leading to evidence-based practice have been defined. So far, however, in the area of education standards of evidence are not extensively implemented and in most federal European policies an evidence-based reform has not been attained. The present paper advocates investing effort in evidence-based practice. In particular, the paper invites European developmental psychology and its representatives to transfer their knowledge and contribute to evidence-based practice which, in turn, will foster positive child and youth development. Incipiently, the paper discusses the new challenges facing universities and European scientific societies as contexts for scientific disciplines and their perspectives. Then, current directions in developmental psychology are described. The central section of the paper focuses on standards of evidence and the use of research for evidence-based practice and policy. It highlights the challenge facing European developmental psychology concerning active contribution to evidence-based practice. Two empirical examples are presented: (1) illustrating that kindergarten and school are the places where evidence-based practice preventions and interventions should take place; and (2) describing various steps of the transfer of basic research to evidence-based practice. Finally, the contribution that the European Society for Developmental Psychology can make to support the transfer of knowledge to evidence-based practice is outlined.     

Evidence-based mental health interventions for traumatized youth: a statewide dissemination project

Psychological trauma in childhood has been shown to increase a variety of psychological disturbances and psychiatric disorders. Although evidence-based treatments for children who have been traumatized exist, they are infrequently used by clinicians treating children. The present paper describes the creation of the Treatment Collaborative for Traumatized Youth (TCTY) which is a statewide partnership in North Dakota designed to disseminate efficacious treatments for traumatized children and monitor outcomes across a broad, rural, geographic expanse. The paper reviews the dissemination strategy developed by the TCTY, reports outcomes regarding both clinicians and child participants, and highlights problems identified in the project and solutions that were generated.     

循证医学发展对临床医学科研人员的启示

从临床医学科研工作的角度简要介绍了循证医学的发展情况,阐述了在循证医学发展对临床医学科研人员提出的新要求,即:具有良好的临床专业知识;具有良好的信息处理能力;具有良好的洞察力;具有终身教育观.并从选题范围的拓展、掌握资料的广泛、立项评价的健全、管理措施的更新等浅议了循证医学对临床医学科研人员的启示.     

正确理解和应用循证医学的思维方法

循证医学(Evidence-based Medicine,EBM)是遵循证据的医学,经验医学的特点则是凭个人经验或上级高年资医生的指导、教科书与医学刊物上零星的研究报告为依据来处理病人.为提高临床疗效,必须克服经验医学中存在的问题,科学地应用循证医学的思维方法来指导医学实践.     

A cross-cultural, long-term outcome evaluation of the ISTAR Comprehensive Stuttering Program across Dutch and Canadian adults who stutter

There is a need to evaluate the effectiveness of stuttering treatment programs delivered in domestic and international contexts and to determine if treatment delivered internationally is culturally sensitive. Evaluation of the effectiveness of the ISTAR Comprehensive Stuttering Program (CSP) within and across client groups from the Netherlands and Canada revealed generally positive results. At 2 years post-treatment both groups were maintaining statistically significant reductions in stuttering frequency and improvements in attitudes, confidence, and perceptions as measured by the Revised Communication Attitude Inventory (S24), Perceptions of Stuttering Inventory (PSI), and the approach scale of the Self-Efficacy Scaling by Adult Stutterers (SESAS). Data pooled across the groups on these measures gave evidence of a global treatment effect with standardized effect sizes ranging from typical to larger than typical in the behavioural sciences. Only two differences between the groups emerged: differences in speech rate and perception of self. Given that these groups represent two distinct cultures, differences were discussed in terms of whether they could be due to cultural, methodological, or other variables. Overall, results suggest that, the CSP appears to be similarly effective in both cultures and thus, sufficiently sensitive to the culture of Dutch adults who stutter.

Educational objectives: The reader will be able to (a) describe a methodology that can be used in a clinical setting to evaluate the long-term effectiveness of stuttering treatment with adults, (b) describe some of the challenges in developing a model of clinically meaningful outcome, (c) explain the rationale for the need for cross-cultural investigations of treatment outcome, and (d) summarize speech and self-report results of the cross-cultural evaluation of an integrated stuttering treatment program.     

Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment with Children and Adolescents with Severe Emotional and Behavioral Problems

Community mental health agencies are consistently challenged to provide realistic and effective home-based family-centered treatment that meets local needs and can realistically fit within available budget and resource capabilities. Integrated Family and Systems Treatment (I-FAST) is developed based on existing evidence-based approaches for working with at-risk children, adolescents, and families and a strengths perspective. I-FAST identified 3 evidence-based, core treatment components and integrated them into a coherent treatment protocol; this is done in a way that builds on and is integrated with mental health agencies' existing expertise in home-based treatment. This is an intervention development study in which we conducted an initial feasibility trial of I-FAST for treating families with children at risk of out-of-home placement. The outcomes of the study provide initial empirical evidence that supports the effectiveness of I-FAST. Findings indicate that there were significant improvements in child behavior, significant increases in parental competency, and significant increases in the level of cohesion and adaptability in these families. All observed changes were significant from pre- to posttreatment with the families able to maintain these positive changes at 6-month follow-up. A more rigorous and robust research design, however, will be needed to establish definitive evidence of the effectiveness of I-FAST.     

Behavioral case consultation with parents and teachers: An example using differential reinforcement to treat psychogenic cough

This study presents a demonstration of successful behavioral case consultation combined with case study methodology in the treatment of a 13-year-old female who presented with a brief history of psychogenic cough. Psychogenic cough is diagnosed when there is no organic or physiologic basis for the repeated, harsh coughing. We first present a brief review of treatments for psychogenic cough and then describe how we used differential reinforcement of low rate responding (DRL) and differential reinforcement of zero responding (DRO) within an A-B-C design. The DRL schedule produced significant decreases in coughing but plateaued at about one-third the baseline rate. Thereafter, a DRO schedule was employed which resulted in complete and lasting elimination of coughing. Discussion focuses on the limitations of case study methodology as well as its usefulness for conducting service related research in the schools, implications of some of the findings for practitioners, and other issues related to treatment.     

Family Intervention Effects on Co-occurring Early Childhood Behavioral and Emotional Problems: A Latent Transition Analysis Approach

This study used latent transition analysis (LTA) to examine changes in early emotional and behavioral problems in children age 2 to 4 years resulting from participation in a family-centered intervention. A sample of 731 economically disadvantaged families was recruited from among participants in a national food supplement and nutrition program. Families with toddlers between age 2 and 3 were randomized either to the Family Check-Up (FCU) or to a nonintervention control group. The FCU’s linked interventions were tailored to each family’s needs. Assessments occurred at age 2, 3, and 4. The FCU followed age 2 and age 3 assessments. Latent class analyses were conducted on mother reports of behavior and emotional problems from age 2 to 4 to study transitions among the following four groups: (a) externalizing only, (b) internalizing only, (c) comorbid internalizing and externalizing, and (d) normative. LTA results revealed that participation in the FCU increased the likelihood of transitioning from either the comorbid or the internalizing class into the normative class by age 4. These results suggest family interventions in early childhood can potentially disrupt the early emergence of both emotional and behavioral problems.     

SOA对Stroop启动效应的影响:行为和ERP研究

在Stroop启动范式中,启动刺激是灰色的色词,目标刺激是颜色块,被试的任务是命名颜色块的颜色。本研究通过行为实验和事件相关电位(ERP)实验的方法,研究SOA(Stimulus Onset Asynchrony)对Stroop启动效应的影响。当SOA为107ms时,在行为数据(反应时)和ERP数据(N300成分)上均表现出明显的启动效应;当SOA为1040ms时,行为上和ERP上的启动效应消失。该结果提示了在Stroop启动效应中,启动刺激对目标刺激的影响很可能是发生在对目标刺激的知觉加工晚期。     

School psychology: a public health framework: III. Managing disruptive behavior in schools: the value of a public health and evidence-based perspective

Schools typically adopt individualistic approaches to address disruptive behavior and meet the needs of students with disruptive behavior disorders (DBD) [i.e., Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD)]. These approaches are often not the most effective and have a limited impact on overall school climate. This article emphasizes the value of an evidence-based and public health perspective in managing disruptive behavior. Information about comprehensive school-based programs and classroom management techniques for disruptive behavior disorders is presented and the important role school psychologists can play in implementing these programs discussed.     

Condom Negotiation in Heterosexually Active Men and Women: Development and Validation of a Condom Influence Strategy Questionnaire

The ability to negotiate condom use with a partner is a skill that sexually active men and women must have in order to avoid sexually transmitted diseases including HIV. Despite this fact, there is no psychometrically valid instrument in the literature to measure condom influence strategies. This investigation reports on the development and initial validation of the condom influence strategy questionnaire (CISQ). Exploratory and confirmatory analyses revealed and confirmed six influence strategies used by heterosexually active men and women to negotiate condom use. These CISQ subscales accounted for variance in safer sexual variables including sexual assertiveness, self-efficacy, and partner communication. Further, those who endorsed CISQ subscales were more likely to have intentions to use condoms consistently and to use condoms. Gender differences in subscales favoring women as the ones most likely to use influence strategies also emerged. Implications of these results as well as future directions for research are discussed.     

Dissemination of effective mental health treatment procedures: Maximizing the return on a significant investment

While much is known about the efficacy of evidence-based practices, it is currently less clear how to implement these practices into the broader mental health system. Dissemination and implementation research will play a critical role in addressing this uncertainty. This commentary reviews the most recent and compelling research related to these topics while advocating a broader and more defined perspective of dissemination for future research. Three of the authors' most pressing questions are proposed and explored.     

Genetic Influence Helps Explain Variation in Human Fertility: Evidence From Recent Behavioral and Molecular Genetic Studies

To search for genetic influence on human fertility differentials appears inconsistent with past empirical research and prior interpretations of Fisher's fundamental theorem of natural selection. We discuss Fisher's theorem and give reasons why genetic influences may indeed account for individual differences in human fertility. We review recent empirical studies showing genetic influence on variance in fertility outcomes and precursors to fertility. Further, some of the genetic variance underlying fertility outcomes overlaps with that underlying fertility precursors. Findings from different cultures, different times, different levels of data, and both behavioral and molecular genetic designs lead to the same conclusion: Fertility differentials are genetically influenced, and at least part of the influence derives from behavioral precursors that are under volitional control, which are themselves genetically mediated.     

A randomized clinical trial of Behavioral Activation (BA) therapy for improving psychological and physical health in dementia caregivers: Results of the Pleasant Events Program (PEP)

Dementia caregiving is associated with elevations in depressive symptoms and increased risk for cardiovascular diseases (CVD). This study evaluated the efficacy of the Pleasant Events Program (PEP), a 6-week Behavioral Activation intervention designed to reduce CVD risk and depressive symptoms in caregivers. One hundred dementia family caregivers were randomized to either the 6-week PEP intervention (N = 49) or a time-equivalent Information-Support (IS) control condition (N = 51). Assessments were completed pre- and post-intervention and at 1-year follow-up. Biological assessments included CVD risk markers Interleukin-6 (IL-6) and D-dimer. Psychosocial outcomes included depressive symptoms, positive affect, and negative affect. Participants receiving the PEP intervention had significantly greater reductions in IL-6 (p = .040), depressive symptoms (p = .039), and negative affect (p = .021) from pre- to post-treatment. For IL-6, clinically significant improvement was observed in 20.0% of PEP participants and 6.5% of IS participants. For depressive symptoms, clinically significant improvement was found for 32.7% of PEP vs 11.8% of IS participants. Group differences in change from baseline to 1-year follow-up were non-significant for all outcomes. The PEP program decreased depression and improved a measure of physiological health in older dementia caregivers. Future research should examine the efficacy of PEP for improving other CVD biomarkers and seek to sustain the intervention's effects.     

Behavioral Gerontology: State of the Science

Baer, Wolf and Risley's (1968) dimensions of applied behavior analysis are used as an organizing framework to review and discuss current research on the application of behavioral principles to the solution of social problems faced by older adults. Implications for future research are discussed.     

Prevention of Anxiety Disorders: Results of a Universal Trial with Young Children

We examined a brief program aimed at preventing anxiety and other problems in early childhood. Participants (N = 734, age 3–6 years) were drawn from 25 preschools across Brisbane, Australia. Assessments occurred four times over 14 months, with a diagnostic interview at follow-up. Parent and teacher reports included information on child temperament, social behavior, inhibition, parent characteristics, and parent-child interactions. REACH for RESILIENCE, a universal prevention program developed for this study, consisted of a six-session training program for parents focusing on building positive expectations and social competency in children. Parents rated the program positively and attended well, especially highly stressed parents who thus became over-represented in the treatment group as time progressed. Despite this difficulty with interpreting results, the intervention resulted in decreases in child problems via teacher report for both internalizing and externalizing problems. However, the effect sizes were not impressive and no changes were noted in parent’s diagnostic ratings. Results, directions for further research, and refinement of methods are discussed.

The Influence of Distress on Mothers' and Fathers' Reports of Childhood Emotional and Behavioral Problems

This study examined the effect of parental distress on mothers' and fathers' reports of children's emotional and behavioral problems. The subjects were the parents of 696 children aged 10 to 11 or 14 to 15 years living in two-parent families in the community. The study utilized an extended version of the model previously employed by Fergusson, Lynskey, and Horwood (1993) to examine the impact of maternal depression on mothers' reports of children's behavior. In the present study, the extended model was used to assess the impact of distress on reports of childhood externalizing and internalizing problems obtained from both mothers and fathers. The results suggested that distress had little influence on mothers' or fathers' reports of childhood behavior problems. It is concluded that in community studies the size of any bias in mothers' and fathers' reports of childhood behavior problems due to parental distress is likely to be very small and of little clinical significance.