Guidelines for classifying evidence-based treatments in couple and family therapy

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.     

Personality and obesity across the adult life span

Personality traits contribute to health outcomes, in part through their association with major controllable risk factors, such as obesity. Body weight, in turn, reflects our behaviors and lifestyle and contributes to the way we perceive ourselves and others. In this study, the authors use data from a large (N = 1,988) longitudinal study that spanned more than 50 years to examine how personality traits are associated with multiple measures of adiposity and with fluctuations in body mass index (BMI). Using 14,531 anthropometric assessments, the authors modeled the trajectory of BMI across adulthood and tested whether personality predicted its rate of change. Measured concurrently, participants higher on Neuroticism or Extraversion or lower on Conscientiousness had higher BMI; these associations replicated across body fat, waist, and hip circumference. The strongest association was found for the impulsivity facet: Participants who scored in the top 10% of impulsivity weighed, on average, 11Kg more than those in the bottom 10%. Longitudinally, high Neuroticism and low Conscientiousness, and the facets of these traits related to difficulty with impulse control, were associated with weight fluctuations, measured as the variability in weight over time. Finally, low Agreeableness and impulsivity-related traits predicted a greater increase in BMI across the adult life span. BMI was mostly unrelated to change in personality traits. Personality traits are defined by cognitive, emotional, and behavioral patterns that likely contribute to unhealthy weight and difficulties with weight management. Such associations may elucidate the role of personality traits in disease progression and may help to design more effective interventions.     

The Association Between Church Attendance and Psychological Health in Northern Ireland: A National Representative Survey Among Adults Allowing for Sex Differences and Denominational Difference

This study extends previous research concerning the association between religion and psychological health in six ways: (1) by focusing clearly on religious attendance (church attendance); (2) by employing a robust measure of psychological distress (GHQ-12); (3) by studying a highly religious culture (Northern Ireland); (4) by taking sex differences into account (male or female); (5) by taking denominational differences into account (Catholic or Protestant); (6) and by obtaining a national representative sample (N = 4,281 adults aged 16 and above). Results from a 2 (sex) by 2 (denomination) ANCOVA demonstrated that Catholics recorded significantly lower levels of psychological health compared to Protestants, and that females showed significantly lower levels of psychological health compared to males. In addition, females reported higher frequency of religious service attendance than males, and Catholics reported higher attendance rates than Protestants. A significant positive association was found between frequency of religious attendance and GHQ-12 scores, and this association was moderated by sex and denomination. In conclusion, the results suggest that there may be sex and denominational differences in further understanding the relationship between frequency of religious attendance and psychological health.     

A Stairway to Heaven? Structure of the Religious Involvement Inventory and Spiritual Well-Being Scale

Being religious or having spiritual beliefs has been linked to improved health and well-being in several empirical studies. Potential underlying mechanisms can be suggested by psychometrically reliable and valid indices. Two self-report measures of religiosity/spirituality were completed by a cohort of older adults: the Religious Involvement Inventory and the Spiritual Well-being Scale. Both were analyzed using principal components analysis and the Mokken scaling procedure. The latter technique examines whether items can be described as having a hierarchical structure. The results across techniques were comparable and hierarchical structures were discovered in the scales. Analysis of the hierarchy in the RII items suggested the latent trait assesses the extent to which an individual’s belief in God influences their life. Examining scales with a range of psychometric techniques may give a better indication of the latent construct being assessed, particularly the hierarchies within these which may be of interest to those investigating religiosity-health associations.     

Behavior-Based Assessment of the Auditory Abilities of Brushtail Possums

Brushtail possums (Trichosurus vulpecula) were trained to press a right lever when a tone was presented (a tone‐on trial) and a left lever when a tone was not presented (a tone‐off trial) to gain access to food. During training the tone was set at 80 dB(A), with a frequency of 0.88 kH for 3 possums and of 4 kH for the other 2. Once accuracy was over 90% correct across five consecutive sessions, a test session was conducted where the intensity of the tone was reduced by 8 dB(A) over blocks of 20 trials until accuracy over a block fell below 60%. After each test session, training sessions were reintroduced and continued until accuracy was again over 90%, when another test session was conducted. This process continued until there were at least five test sessions at that tone frequency. The same procedure was then used with frequencies of 0.20, 0.88, 2, 4, 10, 12.5, 15, 20, 30, and 35 kHz. Percentage correct and d' decreased approximately linearly for all possums as tone intensity reduced. Both sets of lines were shallowest at the higher frequencies and steepest at the lower frequencies. Hit and false alarm rates mirrored each other at high frequencies but were asymmetric at lower frequencies. Equal d' contours showed that sensitivity increased from 2 to 15 kHz and continued to be high over 20 to 35 kHz. The possums remained sensitive to the 20 to 35 kHz tones even at low intensities. The present study is the first to report the abilities of possum to detect tones over this range of frequencies and its results support the findings of a microelectrode mapping survey of possums' auditory cortex.     

Dual-task processing in younger and older adults: similarities and differences revealed by fMRI

fMRI was used to explore age differences in the neural substrate of dual-task processing. Brain activations when there was a 100 ms SOA between tasks, and task overlap was high, were contrasted with activations when there was a 1000 ms SOA, and first task processing was largely complete before the second task began. Younger adults (M=21 yrs) showed activation in dorsolateral prefrontal cortex and in parietal areas as well as in ventral medial frontal cortex and sub-lobar areas. Activations in older adults (M=71 yrs) did not differ significantly from younger adults except for higher activations in occipital and polar prefrontal cortex. The results were well fit by a model with two networks managing dual-task interference, a medial prefrontal network that detects changes in the stimulus situation and maps them to associated changes in the valence of response mappings and a lateral frontal-parietal network that initiates and carries out the shift from one task to the other. The additional activations in older adults as a group and the correlations of individual differences in activation with performance were consistent with recruitment within each of these networks. Alternative explanations such as hemispheric asymmetry reduction and reactive rather than proactive processing in older adults were not supported.     

Estimating the population of survivors of suicide: seeking an evidence base

Shneidman (1973) derived an estimate of six survivors for every suicide that, in the ensuing years, has become an assumed fact underlying public health messaging campaigns in support of suicide prevention and postvention programs worldwide, in spite of it lacking either empirical testing or validation. This report offers a first test designed to derive estimates of suicide survivors and raises an array of empirical questions needing further study to reasonably address the impact of suicide on others.     

A demonstration of dual-task performance without interference in some older adults

Highly efficient dual-task processing is demonstrated when reaction time to each of two tasks does not differ between the dual-task situation and the single-task situation. This has been demonstrated reliably in younger adults; nevertheless, the two extant studies of extensive dual-task training did not find evidence for it in any elderly adult. The origins of age-related differences after training were explored in a study in which the stimuli for the two tasks were perfectly redundant although two distinct responses were required. The dual-task situation thus greatly reduced the demands of stimulus categorization while still requiring two response selections and two response executions. After only limited training 8 of 8 younger adults and 5 of 8 older adults showed performance consistent with highly efficient processing. Three older adults failed to show this even after 12 training sessions. The results implicate stimulus categorization more than response selection as an important locus of inefficient dual-task processing, particularly for older adults.