Cognitive-behavioral treatment of childhood obsessive-compulsive disorder in community-based clinical practice: clinical significance and benchmarking against efficacy

Objective

To evaluate the feasibility and outcomes of evidence-based (EB) manualized, cognitive-behavioral treatment (CBT) for childhood obsessive-compulsive disorder (OCD), when delivered in an outpatient community-based specialist clinic.

Method

This study, conducted in an outpatient private clinic in South-East Queensland Australia, involved thirty-three children and adolescents with OCD. Children were assessed at pre- and post-treatment, by means of diagnostic interviews, symptom severity interviews, and self-report. Treatment involved 12 sessions CBT delivered either individually or in small groups and included parental involvement.

Results

Manualized CBT could be transported to the community setting effectively, with 63% of the current sample responding positively, based on post-treatment diagnosis. Significant change was evident across a wide-range of outcomes; including, diagnostic severity, symptom severity, child reported depression and anxiety, and both child and parent reported OCD functional impairment.

Conclusions

This study provides evidence for the transportability of manualized CBT in clinical community practice for pediatric OCD. The next important step is larger community based dissemination and effectiveness studies to advance both research and clinical practice outcomes.     

Telling perfectionists about their perfectionism: Effects of providing feedback on emotional reactivity and psychological symptoms

A randomized, controlled clinical trial was conducted to determine the efficacy of receiving feedback in a sample of maladaptive perfectionists. A total of 60 young adults were randomly assigned to a feedback intervention or control group. Hierarchical Linear Modeling was utilized to analyze the effects of perfectionism over time, as well as the effects of treatment condition on the relationship between perfectionism and outcomes. Measures of interest included emotional reactivity, self-esteem, and psychological distress. Findings revealed that providing feedback to maladaptive perfectionists reduced self-reported global symptomatic distress as well as emotional reactivity. The results are discussed in light of treatment implications, especially with regard to the manner in which perfectionists respond to therapeutic interventions. Overall, study findings suggest that a brief, low-cost feedback intervention is effective at decreasing psychological distress in maladaptive perfectionists and may serve as a beneficial precursor to individual therapy or counseling.     

Spirituality,Anger, and Stress in Early Adolescents

The purpose of this study was to explore the relationship of spiritual beliefs and involvement with anger and stress in early adolescents. Early adolescents (n = 53) completed the Spiritual Involvement and Beliefs Scale (Hatch et al. 1998), the State-Trait Anger Expression Inventory (Spielberger 1999), and the Perceived Stress Scale (Cohen and Williamson 1988). Contrary to expectations, spirituality was significantly and positively related to anger and stress. Implications and possible explanations for the unanticipated findings in this study are discussed.     

Leader power and leader self-serving behavior: The role of effective leadership beliefs and performance information

In this research we investigated the role played by leader power in determining leader self-serving behavior. Based on an integration of insights from research on the determinants of leader behavior and the power-approach theory, we hypothesized that with higher leader power leader self-serving behavior is determined more by internal states like effective leadership beliefs and less by external cues like performance information. We found support for this prediction across two experiments and one organizational survey assessing leader behavior along a self-serving–group-serving continuum. Overall, these results suggest that whether leaders benefit the collective or act self-servingly is not a function of their power per se but rather that leader power determines the extent to which internal belief states or external cues influence leader self- versus group-serving behavior.     

When Sibling Becomes Competitor: A Qualitative Investigation of Same-Sex Sibling Competition in Elite Sport

Abstract

The effects of performance strategies, goal setting, and self-evaluative recording on the acquisition of a novel motoric skill were studied with 90 high school girls. It was hypothesized that greater acquisition would occur when (a) an analytic strategy was used instead of imaginal strategy, (b) practice goals were shifted dynamically during learning instead of remaining unchanging or fixed, and (c) self-evaluative recording of strategic performance processes was present rather than absent. Support for all three hypotheses was found. In addition to improving motoric skill acquisition, these same self-regulatory processes significantly enhanced three sources of learners' motivation: self-efficacy beliefs, self-satisfaction, and intrinsic interest. Additional analyses revealed that self-evaluative recording enhanced strategy attributions during learning which were predictive of improved self-efficacy, self-satisfaction, and intrinsic interest during posttesting. Self-efficacy was highly predictive of subsequent dart-skill performance. The results were discussed in terms of a strategic cycle view of self-regulation of motoric learning.     

Response Speed and Accuracy During Anticipatory Stress

Response speed and accuracy of 48 general aviation pilots were determined under condition of anticipatory physical threat stress (APTS). Variables included unpleasantness of the event (electrical shock), proximity of the event, and relationship of Ss’ performance to the occurrence of the event. The data support inclusion of these variables in Wherry’s model of APTS. Ss who believed they could avoid the shock by an adequate performance were able to maintain or improve that performance while the performance of Ss who perceived the shock as inevitable was deteriorating. Two possible modifications of the APTS model were discussed: (1) weighting APTS determiners according to their effectiveness in generating anticipatory stress, (2) recognizing the interaction of the APTS variables with S’s personality structure.     

Transfer of Motor Learning Engages Specific Neural Substrates During Motor Memory Consolidation Dependent on the Practice Structure

The authors investigated how brain activity during motor-memory consolidation contributes to transfer of learning to novel versions of a motor skill following distinct practice structures. They used 1 Hz repetitive Transcranial Magnetic Stimulation (rTMS) immediately after constant or variable practice of an arm movement skill to interfere with primary motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). The effect of interference was assessed through skill performance on two transfer targets: one within and one outside the range of practiced movement parameters for the variable practice group. For the control (no rTMS) group, variable practice benefited delayed transfer performance more than constant practice. The rTMS effect on delayed transfer performance differed for the two transfer targets. For the within-range target, rTMS interference had no significant affect on the delayed transfer after either practice structure. However, for the outside-range target, rTMS interference to DLPFC but not M1 attenuated delayed transfer benefit following variable practice. Additionally, for the outside-range target, rTMS interference to M1 but not DLPFC attenuated delayed transfer following constant practice. This suggests that variable practice may promote reliance on DLPFC for memory consolidation associated with outside-range transfer of learning, whereas constant practice may promote reliance on M1 for consolidation and long-term transfer.     

An Approach to Use of Color on the Rorschach through Individual Color Preferences

More must be learned of color and its possible relationships with the Rorschach before its interpretation may be taken with assurance. Twenty Ss were administered the Rorschach and a Color Battery of four tasks chosen to tap color preference. Preferences were analyzed for use of the color on the Rorschach plates; color response scores and form-level scores; relationship with color meaning for the subject. Significances were found between: (1) preference and use of color; (2) preference and CF and C scores; (3) plus form-level and preferences. Color meanings varied with each subject. Color preference may influence the subject's use of color on the Rorschach, as well as scores, regardless of what the preferred color may be or the amount available. Generalizations are not warranted on the basis of color or color use, especially as regards differential diagnosis.     

Factor Structure of the Center for Epidemiological Studies Depression Scale in Hong Kong Adolescents

E. A. Southwell &; M. Merbaum (Eds.). Personality: Readings in Theory and Research. (2nd ed.) Belmont, Calif.: Brooks/Cole, 1971, 422 pages. Reviewed by Benjamin Beit-Hallahmi