Predicting Outcome of Military Basic Training for Individuals Referred for Psychological Evaluation

We examined outcome data for 632 U.S. Air Force personnel who were referred for psychological evaluation during Basic Military Training (BMT) but who were subsequently returned to BMT to determine what proportion graduated. We analyzed motivational, biographical, and psychological testing variables, using logistic regression to develop a model predictive of training outcome. The results demonstrated that a relatively small number of variables could predict outcome with close to 70% accuracy. Level of optimism regarding training, history of physical abuse, and frequency of visits to the trainee health clinic were major contributors to the model. MMPI-2 (Hathaway & McKinley, 1989) Scales D and Sc also remained in the model but added little to its power. The findings are generally consistent with prior research on normal military populations, except that some factors previously linked to adjustment, such as sex and ethnicity, were found to be unrelated to training outcome in this population.     

Both early and late changes in psychological variables relate to treatment outcome for musculoskeletal pain patients at risk for disability

We know little about why some people get better after psychological treatments for pain disability, whereas other people do not. In order to understand differences in treatment response, we need to explore processes of change during treatment. It has been suggested that people with pain complaints who change early in treatment have better outcomes. Therefore, we aimed to investigate whether changes in psychological variables at different time points are related to outcome, and whether early or late changes are better predictors of outcome. We used the fear avoidance model as a theoretical framework. We followed 64 patients weekly over 6–7 weeks and then determined outcome. Our findings indicate that people who decrease in catastrophizing and function early in treatment as well as in depressive symptoms, worry, fear avoidance beliefs and function late in treatment have better outcomes. Early decreases in function, and late decreases in depressive symptoms and worry uniquely predict improvements in disability. While early and late changes covaried concurrently, there were no significant sequential relationships between early and late changes. Changes in the proposed process variables in the fear avoidance model, early as well as late in treatment, thus add valuable information to the explanation of outcome.     

Training Appraisees to Participate in Appraisal: Effects on Appraisers and Appraisees

This study examined the role of behavior modeling training (BMT) in enhancing appraisee participation during a performance appraisal discussion. In addition, the study examined the effects of enhanced participation on appraisee and appraiser perceptions toward several appraisal outcome variables; in particular, the fairness and accuracy of performance appraisal were of interest. The experimental design was a 2 × 3 completely crossed factorial design consisting of two levels of training (behavior modeling vs. lecture/discussion) and three levels of bogus evaluation feedback (low, neutral, and high). A series of multivariate and univariate comparisons were used to test the hypothesized outcomes. The findings suggest that appraisers exposed to the BMT group perceived appraisees as more proactive and better performers and, in addition, reported liking the appraisees more, and perceiving the appraisal process as more fair. The study also found support for the egocentric bias in perceived outcome fairness: appraisees in both training conditions who received a high evaluation perceived the appraisal evaluation as more fair than appraisees who received a low evaluation. In addition, the study found that favorable evaluations were also perceived as being more accurate. The results of the study are discussed in terms of procedural justice theory and related research examining the role of performance feedback on both the appraisee and the appraiser. Suggestions for future research in the areas of behavior modeling, voice-giving (high-input) procedures, and procedural justice are discussed.     

A controlled trial of mindfulness training in schools: The importance of practice for an impact on well-being

We report the results of a short programme of mindfulness training administered to adolescent boys in a classroom setting. Intervention and control groups (N = 155) were compared on measures of mindfulness, resilience and psychological well-being. Although the overall differences between the two groups failed to reach significance, we found that within the mindfulness group, there was a significant positive association between the amount of individual practice outside the classroom and improvement in psychological well-being and mindfulness. We also found that the improvement in well-being was related to personality variables (agreeableness and emotional stability). Most students reported enjoying and benefiting from the mindfulness training, and 74% said they would like to continue with it in the future. The results of this preliminary study are encouraging. Further work is needed to refine the training programme and undertake a definitive randomised controlled trial, using both subjective and objective outcome measures, with long-term follow-up.     

The Adaptation of Patients During the Hospitalization Period of Bone Marrow Transplantation

A longitudinally study was conducted among 42 bone marrow transplantation (BMT) patients to investigate the association between pretransplant psychosocial variables and psychophysiological outcomes during the immediate convalescence period. Family relationships (cohesion, expressiveness, and conflict) and coping resources (cognitive, social, emotional, spiritual/philosophical, and physical resources) were assessed on the admission day (Day –7 Time 1). Data on psychological distress and pain intensity were obtained on Day +7 (Time 2) and Day +14 (Time 3). The average scores at Times 2 and 3 were computed to indicate the overall adjustments of the patients during the hospitalization period after the day of actual transplant (Day 0). It was shown that higher expressiveness family relationships and higher resources to cope effectively with stressful situations were associated with less psychological distress during the above period. Both pretransplant psychosocial variables were not associated with pain intensity during hospitalization. Allogeneic transplant patients reported higher pain intensity than did autologous transplant patients. Psychological distress and pain intensity were positively correlated with each other. Our findings show that pretransplant family relationships and coping resources associate moderately with psychological distress during the immediate convalescent period of BMT. The present findings support the family-centered approach to BMT care and provide a scientific basis for pretransplant psychosocial interventions.     

The Chemical and Biological Warfare Environment: Psychological Responses and Social Supports in a High-Stress Environment

In order to better understand psychological responses to high-stress environments and the contributions of social supports to mediating the effects of this stress, we conducted a preliminary investigation of a health care delivery team in a simulated chemical and biological warfare (CBW) environment. Our data suggest that state anxiety prior to the exercise, perceived social support from family and friends, and active training stand out as predictors of psychological outcome, even after trait and pre-exercise psychological variables are considered. Interventions directed at state anxiety and active training may offer mechanisms to decrease the psychological distress of the high-stress environment. Future research should examine variables which are amenable to intervention to determine if they are causally related to health outcome in high-stress environments.     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

OBJECTIVE: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. DESIGN: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. MAIN OUTCOME MEASURES: The primary outcome measures for this study were psychological distress and psychological well-being. RESULTS: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. CONCLUSION: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.     

Coping strategies and psychological distress in cancer patients before autologous bone marrow transplant

The increased use of bone marrow transplantation (BMT) to treat a variety of cancers has led researchers to study psychological functioning of BMT patients. The majority of studies conducted, however, has focused on adjustment after transplantation. Cancer patients' use of coping strategies before undergoing this procedure may also relate to levels of psychological distress. Our aims were (1) to provide normative coping data, controlling for situation-specific variables with a homogeneous sample, targeted stressor, and fixed time point, using the Ways of Coping Questionnaire; and (2) to identify coping strategies associated with distress before high-dose chemotherapy. Subjects were 49 patients scheduled to receive high-dose chemotherapy and an autologous bone marrow transplant. Consistent with previous coping research, we found that escape-avoidance was related to psychological distress on several measures. Item endorsement analyses of the escape-avoidance subscale suggest that patients may have used more passive than active avoidance strategies. Subsequent participation in a longitudinal study was not affected by initial levels of avoidant coping.     

Forensic sexual abuse evaluations of older children: Disclosures and symptomatology

This study examines the results of forensic evaluations of 399 children between the ages of 8 and 15 who were seen at an urban evaluation center regarding allegations of sexual abuse. Data collected included demographic, family environment, and abuse variables, outcome of a multidisciplinary forensic evaluation, and psychological distress as measured by the Trauma Symptom Checklist for Children (TSCC Briere, in press). Children were grouped according to the outcome of the evaluation: nonabused, abused-disclosing, and abused-nondisclosing (composed of children for whom there was external evidence of abuse but who denied being abused). A number of variables predicted group membership, including subject race, sex, cognitive delays, mother's belief or disbelief in the allegation, and psychological distress. Sexually abused children who disclosed abuse reported particularly high levels of distress, abused but nondisclosing children reported the lowest levels, and nonabused children reported intermediate symptom levels. The data are discussed in terms of the role of denial, maternal support, and symptomatology in forensic evaluations.     

The role of problem-solving appraisal in the process and outcome of career counseling

Because problem-solving appraisal has been demonstrated to be a critical variable in psychological adjustment, this study examined its potential role as both a static and dynamic client attribute influencing the process and outcome of career counseling. Participants were 151 adults who received an average of five sessions of naturally occurring career counseling; data were collected before, during, and after counseling. The results indicated that: (a) in line with a static attribute model, clients' pre-counseling problem-solving appraisal scores predicted post-counseling career and psychological outcomes as well as career decidedness even after partialling out clients' pre-decidedness scores; (b) in line with a dynamic attribute model, clients who experienced positive changes in problem-solving appraisal in counseling were more likely to have more positive career resources to use in their career transitions as well greater goal directedness; (c) participation in career counseling related to positive change in problem-solving appraisal scores at a level similar to problem-solving training workshops; and (d) clients' changes in problem-solving appraisal related to changes in the working alliance over time.     

Psychological Distress Reported by Patients Undergoing Limb Reconstruction Surgery: Implications for Psychological Interventions

Limb reconstruction is an orthopaedic surgical technique designed to restore or improve functioning and appearance. The aims of the present study were to investigate levels of psychological distress in adults undergoing limb reconstruction as a result of traumatic injury, to examine which variables could account for any variations in distress during and after treatment, and to ascertain the potential relevance of psychological interventions. A cross-sectional sample of patients completed measures of psychological distress, posttraumatic symptomatology, coping, social support, pain, and disability. Self-reported levels of psychological distress and posttraumatic symptoms were high but did not tend to vary across stage of treatment, suggesting that distress is not solely attributable to limb reconstruction treatment per se but to other factors. Both medical variables (pain and mobility) and psychological variables (symptoms of trauma and coping strategies) accounted for a significant percentage of the variance in HAD scores. These results suggest that both medical and psychological interventions have potential for reducing distress and increasing well-being in an orthopaedic population who are experiencing high levels of emotional distress.     

Follow-up of children identified with and treated for a motor delay of nonspecifiable etiology

Forty-eight 7- to 8-year-old children who had been diagnosed prior to 48 months of age as being developmentally motor delayed and had received therapy for their delay were followed up and assessed for motor, intellectual, and psychological development as well as for self-perceived competence and school achievement. These children were found to be significantly inferior on all of these variables, except for self-competence, when compared with matched nondelayed controls. Those delayed children who had begun treatment prior to 24 months of age demonstrated significantly greater gains in motor function at follow-up, had significantly higher IQs, performed better at school, and participated in more peer-related activities than did the delayed children who began treatment after 24 months. This study supports the hypotheses that (1) young children diagnosed as being developmentally motor delayed demonstrate subsequent intellectual and psychological problems when in the primary grades and (2) that the age at onset of intervention therapy for the delay is significantly related to outcome (benefit of therapy).     

The Impact of Brief Mindfulness Training on Postevent Processing Among Individuals With Clinically Elevated Social Anxiety

Postevent processing (PEP), the engagement in detailed and repetitive self-focused review of one’s performance in social situations, is theorized to maintain pathological social anxiety. However, little is known about interventions that may impact this maintenance factor. The current study examined the impact of brief mindfulness training (BMT) on PEP among socially anxious individuals. There were 77 participants (75.32% female, 63.64% non-Hispanic/Latinx White) with clinically elevated social anxiety who attended one appointment in the laboratory during which they were randomized to receive a brief mindfulness-based training (n = 37) or no training (i.e., thinking as usual control group; n = 40). After the training period, participants underwent a 3-minute social anxiety induction task, after which they were instructed to apply their thinking strategy. Participants were then asked to complete 2 weeks of daily online surveys that included a PEP induction task, instructions to use their thinking strategy following PEP induction, and a measure of state PEP. Individuals in the BMT condition reported a significant reduction in state anxiety posttraining compared to individuals in the control condition. Conditions did not differ on state PEP after the social anxiety induction task. However, compared to those in the control condition, participants in the BMT condition reported significantly greater decreases in state PEP over the 14-day follow-up period. Thus, this brief mindfulness-based strategy may be useful for individuals with clinically elevated social anxiety who engage in PEP, a cognitive vulnerability factor implicated in the maintenance of social anxiety.     

Posttraumatic stress disorder in breast cancer patients following autologous bone marrow transplantation or conventional cancer treatments

We assessed 17 women who had undergone autologous bone marrow transplants (BMT) for their breast cancer and 20 other women who had been treated for breast cancer (but not with BMT) by structured clinical interviews examining each stage of the breast cancer experience (e.g. initial diagnosis, initial treatment, recurrence of cancer (if applicable) and BMT (if applicable)) and at follow-up points; 3, 6 and 12 months (if applicable) posttreatment. The two groups did not differ on incidence of posttraumatic stress disorder (PTSD), major depressive disorder (MDD) or generalized anxiety disorder at any stage. We found a high rate of PTSD over the cancer experience, 35% for the combined sample, with cancer diagnosis being the most likely point for developing PTSD, 27% for the combined sample. None of the 17 women who had undergone BMT developed PTSD as a result of the treatment.     

Testing between-family associations in within-family comparisons

Using behaviorally discordant siblings to test for gene-behavior associations is a common tool in molecular genetics, because the within-family contrast offers a research design that avoids confounds inevitable in all between-family comparisons of unrelated individuals. We propose a similar strategy to assess the behavior-behavior associations on which much of psychological science is built. Between-family correlations of personality test scores (e.g., sensation seeking) and behavioral outcomes (e.g., substance use) may be mediated by variables that differ between families (e.g., social class or religiosity) and correlate with both personality and outcome. Contrasting twin and nontwin siblings who were highly discordant for behavioral correlates of substance use, we tested whether between-family behavioral correlations replicated within families. Some, but not all, did. Within-family analyses of behaviorally discordant siblings may find wide application in efforts to clarify the meaning of correlational research data.     

The effectiveness of psychological skills training and behavioral interventions in sport using single-case designs: A meta regression analysis of the peer-reviewed studies

We used a novel meta regression analysis approach to examine the effectiveness of psychological skills training and behavioral interventions in sport assessed using single-case experimental designs (SCEDs). One hundred and twenty-one papers met the inclusion criteria applied to eight database searches and key sport psychology journals. Seventy-one studies reported sufficient detail for effect sizes to be calculated for the effects of psychological skills training on psychological, behavioral, and performance variables. The unconditional mean effect size for weighted (Δ = 2.40) and unweighted (Δ = 2.83) models suggested large improvements in psychological, behavioral, and performance outcomes associated with implementing cognitive-behavioral psychological skills training and behavioral interventions with a SCED. However, meta-regression analysis revealed important heterogeneities and sources of bias within this literature. First, studies using a group-based approach reported lower effect sizes compared to studies using single-case approaches. Second, the single-case studies, (over 90 per cent the effect sizes), revealed upwardly biased effect sizes arising from: (i) positive publication bias such that studies using lower numbers of baseline observations reported larger effects, while studies using larger numbers of baseline observations reported smaller – but still substantial – effects; (ii) not adopting a multiple baseline design; and (iii) not establishing procedural reliability. We recommend that future researchers using SCED’s should consider these methodological issues.     

Moderators of Parent Training for Disruptive Behaviors in Young Children with Autism Spectrum Disorder

We conducted a 6 month, randomized trial of parent training (PT) versus a parent education program (PEP) in 180 young children (158 boys, 22 girls), ages 3–7 years, with autism spectrum disorder (ASD). PT was superior to PEP in decreasing disruptive and noncompliant behaviors. In the current study, we assess moderators of treatment response in this trial. Thirteen clinical and demographic variables were evaluated as potential moderators of three outcome variables: the Aberrant Behavior Checklist-Irritability subscale (ABC-I), Home Situations Questionnaire (HSQ), and Clinical Global Impressions-Improvement Scale (CGI-I). We used an intent-to-treat model and random effects regression. Neither IQ nor ASD severity moderated outcome on the selected outcome measures. Severity of Attention Deficit Hyperactivity Disorder (ADHD) and anxiety moderated outcomes on the ABC-I and HSQ. For instance, there was a 6.6 point difference on the ABC-I between high and low ADHD groups (p?=?.05) and a 5.3 point difference between high and low Anxiety groups (p?=?.04). Oppositional defiant disorder symptoms and household income moderated outcomes on the HSQ. None of the baseline variables moderated outcome on the CGI-I. That IQ and ASD symptom severity did not moderate outcome suggests that PT is likely to benefit a wide range of children with ASD and disruptive behavior.     

Differential outcomes of skill training,group counseling,and individual cognitive therapy for persons with acquired visual impairment

As part of the Living Skills Training Program, group counseling and individual cognitive therapy were implemented to decrease psychological distress for adults with acquired visual impairment. This quasi‐experimental design study compared the outcomes of a 6‐month skill training program combined with a group counseling program (n = 37), with (n = 9) or without (n = 10) individual cognitive therapy, and with a control group (n = 42). The outcome measures were the Profile of Mood States and the Nottingham Adjustment Scale Japanese Version. The results showed that participants with low psychological distress decreased anxiety and increased acceptance of disability, even when they did not participate in group counseling. However, among the participants with high distress, they did not show any improvement without group counseling or individual therapy. The participants with high distress who engaged in group counseling showed an improving trend in attitudes toward others. Moreover, the participants who chose to engage in individual therapy in addition to group counseling showed decreased tension‐anxiety, depression, and fatigue, and significantly improved acceptance of disability. These results suggest that group counseling, combined with individual cognitive therapy, can be an effective part of rehabilitation treatment for clients who have high psychological distress.     

Analysis of the association between marital relationships and health problems: an interactional perspective.

This article reviews the evidence for a relationship between 3 types of marital variables (marital status, marital adjustment, and marital interaction) and health problems (etiology, course/outcome/treatment) as well as the effect that health problems have on marriage. The mechanisms responsible for these associations also are evaluated. The evidence suggest that marital variables affect health status but that the effect is indirect and nonspecific. The major explanatory model, the stress/social support hypothesis, has provided a broad conceptual framework rather than testable hypotheses. The results of the review suggest, however, that sufficient evidence exists for researchers to focus on exploring specific explanations. A hypothetical model is presented that includes interpersonal, intrapersonal, psychological, and physiological variables. This model is intended as a blueprint for exploration as well as a summary of available evidence.     

Therapists’ and clients’ perceptions of routine outcome measurement in the NHS: A qualitative study

Primary objective: This is the first qualitative study that elicited the perceptions of both psychological therapists and their clients in the use of Clinical Outcomes in Routine Evaluation with computer software (CORE‐Net), where instant visual feedback for session tracking was given on a computer screen in the therapy room at each therapy session. The study also examined how therapists viewed its potential value in supervision and provides suggestions for improving training. Research design: The study adopted a convenience sample of four therapists in a primary care counselling setting (PCC – General Practitioner referrals) who were experienced in using CORE‐Net, and five therapists in an NHS employee/occupational support counselling service (OH) who had just begun to use CORE‐Net for session tracking with 10 of their clients. Method: A qualitative methodology was used and interview data were collected from the therapists via focus groups; the clients were interviewed individually face to face. All data was analysed inductively. Findings: The study identified six overarching themes: (i) therapists were initially anxious and resistant; (ii) therapists adapt ‘creatively’; (iii) outcome measures help the client/therapist relationship; (iv) clients perceive visual measures as helpful; (v) CORE scores inform supervision; and (vi) proper and ongoing training/support of therapists is necessary. The main limitations are comparability of data and the generalisabilty of results. Conclusions: The implementation of routine outcome measurement (ROM) is a challenge but can be made easier with proper training and supervision. Clients appear happier than their therapists when routine outcome measurement is used.