Outcome evaluation in brief mother-infant psychotherapies: Report on 75 cases

The effects of brief mother–infant psychotherapies (maximum of 10 sessions) were examined in cases of functional and behavioral disturbances in children less than 30 months old. Seventy-five mother-infant dyads were assessed prior to treatment, at 1 week, and 6 months after therapy ended. The outcome measures were changes in the infant's symptoms, the behavioral interactions between mother and infant, and maternal representations. The effect of two forms of intervention—Psychodynamic Therapy and Interaction Guidance Therapy—were compared. Results indicated a significant symptom reduction; dyadic interactions became more harmonious (mothers became less intrusive and infants more cooperative). Maternal self-esteem grew significantly and negative affects decreased. Improvements lasted as least several months, with some positive improvement detected at the 6-month follow-up. No major difference in outcome was found between the effects of the two forms of intervention. Within the limitations of research in a clinical context, this study suggests that brief mother–infant psychotherapies are a cost-effective method of early intervention.     

The speed and accuracy of material recognition in natural images

We studied the time course of material categorization in natural images relative to superordinate and basic-level object categorization, using a backward-masking paradigm. We manipulated several low-level features of the images—including luminance, contrast, and color—to assess their potential contributions. The results showed that the speed of material categorization was roughly comparable to the speed of basic-level object categorization, but slower than that of superordinate object categorization. The performance seemed to be crucially mediated by low-level factors, with color leading to a solid increase in performance for material categorization. At longer presentation durations, material categorization was less accurate than both types of object categorization. Taken together, our results show that material categorization can be as fast as basic-level object categorization, but is less accurate.     

Entstehung und Aufrechterhaltung von chronischen Schmerzen

Chronic pain has previously been defined as lasting longer than 3 or 6 months. This criterion, however, does not adequately describe the process of pain becoming chronic. Consequently, pain chronicity is not only assessed by pain duration but by consideration of other factors, such as disability or intensity. A number of learning processes affect pain chronicity as they mediate changes in neural networks involved in pain processing. Furthermore, a number of psychosocial risk factors have been identified that affect not only the transition from acute to chronic pain but also the maintenance of chronic pain. The fear-avoidance model takes into account many of these risk factors to explain the development and maintenance of chronic musculoskeletal pain.     

Internet als Ratgeber bei psychischen Problemen

Communication serves as an integral part of every psychotherapeutic treatment. Consequently, in the last decade modern information and communication technologies in the therapeutic context gained in importance. How important are Internet-based therapeutic information and intervention sources for potential patients and how are they appraised when already known or used? In the course of a representative study the health-related Internet use behavior of 2,411 Germans was examined. There was a focus on the usage of health-related websites and counseling services in the past and (potentially) in the future. More than one third (37.3%) of the German population and almost two thirds (63.5%) of German Internet users search for medical information on Internet. However, physicians, psychologists, pharmacists, family members and friends have a greater impact on health behavior than the Internet. Of German Internet users 54.1% are not informed about the possibilities of psychosocial online counseling. Nevertheless, they would maybe use the Internet in the future. The 2.2% who already used Internet in case of psychosocial problems are content with the service. In fact new media have not yet found their way into psychotherapy and counseling as much as in our daily lives. With regard to manifest mental disorders, Germans would prefer the conventional psychotherapeutic milieu to media-assisted kinds of treatment.     

Goals and Everyday Problem Solving: Examining the Link between Age-Related Goals and Problem-Solving Strategy Use

ABSTRACT

Qualitative interviews on family and financial problems from 332 adolescents, young, middle-aged, and older adults, demonstrated that developmentally relevant goals predicted problem-solving strategy use over and above problem domain. Four focal goals concerned autonomy, generativity, maintaining good relationships with others, and changing another person. We examined both self- and other-focused problem-solving strategies. Autonomy goals were associated with self-focused instrumental problem solving and generative goals were related to other-focused instrumental problem solving in family and financial problems. Goals of changing another person were related to other-focused instrumental problem solving in the family domain only. The match between goals and strategies, an indicator of problem-solving adaptiveness, showed that young individuals displayed the greatest match between autonomy goals and self-focused problem solving, whereas older adults showed a greater match between generative goals and other-focused problem solving. Findings speak to the importance of considering goals in investigations of age-related differences in everyday problem solving.     

Problem-solving variability in older spouses: how is it linked to problem-, person-, and couple-characteristics?

Problem-solving does not take place in isolation and often involves social others such as spouses. Using repeated daily life assessments from 98 older spouses (M age = 72 years; M marriage length = 42 years), the present study examined theoretical notions from social-contextual models of coping regarding (a) the origins of problem-solving variability and (b) associations between problem-solving and specific problem-, person-, and couple- characteristics. Multilevel models indicate that the lion's share of variability in everyday problem-solving is located at the level of the problem situation. Importantly, participants reported more proactive emotion regulation and collaborative problem-solving for social than nonsocial problems. We also found person-specific consistencies in problem-solving. That is, older spouses high in Neuroticism reported more problems across the study period as well as less instrumental problem-solving and more passive emotion regulation than older spouses low in Neuroticism. Contrary to expectations, relationship satisfaction was unrelated to problem-solving in the present sample. Results are in line with the stress and coping literature in demonstrating that everyday problem-solving is a dynamic process that has to be viewed in the broader context in which it occurs. Our findings also complement previous laboratory-based work on everyday problem-solving by underscoring the benefits of examining everyday problem-solving as it unfolds in spouses' own environment.     

Daily management of work and family goals in employed parents

This study uses one-week time-sampling information from 104 employed parents with pre-school children to examine the association between daily workloads, control strategies, and goal progress. In addition, it examines relationships between work- and family-goal progress and important stress indices such as positive/negative affect and cortisol levels. Multilevel models indicate that family-specific control strategies fostered daily family-goal progress whereas work-specific control strategies were unrelated to daily work-goal progress. Furthermore, employed parents who successfully pursued their work and family goals as part of their daily life routines reported concurrent higher positive and lower negative affect. Only family-goal progress was associated with reduced cortisol secretion whereas work-goal progress was not. Our findings illustrate the usefulness of examining the dynamic interplay between daily workloads, control strategies, goal progress, and stress in the daily lives of employed parents and suggest that the underlying mechanisms may be domain-specific.     

Treatment specific competence predicts outcome in cognitive therapy for social anxiety disorder

Several studies have demonstrated a positive relationship between competence and outcome in CBT for depression but studies of CBT for anxiety disorders are lacking. The present study explores the relationship between competence and outcome in cognitive therapy (CT) for social anxiety disorder, using hierarchical linear modeling analyses (HLM). Data were drawn from a multicenter randomized controlled trial. Five trained raters evaluated videotapes of two therapy sessions per patient using the Cognitive Therapy Competence Scale for Social Phobia (CTCS-SP). Overall adherence to the treatment manual and patient difficulty were also assessed. Patient outcome was rated by other assessors using the Clinical Global Impression Improvement Scale (CGI-I) and the Liebowitz Social Anxiety Scale (LSAS). Results indicated that competence significantly predicted patient outcome on the CGI-I (β = .79) and LSAS (β = .59). Patient difficulty and adherence did not further improve prediction. The findings support the view that competence influences outcome and should be a focus of training programs. Further research is needed to compare different ways of assessing competence and to understand the complex relationships between competence and other therapy factors that are likely to influence outcome.     

Klinisch-psychologische Intervention im Internet

Background

Currently a multitude of Internet-based intervention (IBI) programs exist for various disorders. These programs generally have the potential to reach a wide spectrum of the low threshold population and encourage them to play a more active role in managing individual healthcare. How effective are disorder and problem-specific IBI programs? This review aims to give a systematic overview of controlled evaluation studies available to date and contrast them with the state of research in 2003 (Ott 2003).

Method

References were analyzed in three steps: 1. Research in pertinent international scientific databases using specified keywords (result: more than 1,000 publications since 2003). 2. Selection: exclusion of publications which did not contain empirical evidence of effectiveness (with control group design) (result: 89 studies published between 2003 and 2009 as opposed to 30 up to 2003). 3. Systemization: classification of the analyzed studies based on two dimensions (type of syndrome, function of intervention).

Results

In most of the studies on hand (91.0%) the effectiveness of IBI could be confirmed. Among the methods used cognitive behavioral methods (cognitive, behavioral therapy, CBT) were used almost exclusively. In nearly three quarters of all studies (71.9%), IBI procedures were used for treatment. The remaining studies were on prevention (19.1%) and rehabilitation (9.0%).

Conclusion

Evaluation studies of IBIs are now available, particularly for anxiety disorders, depression, posttraumatic stress disorder, eating disorders including adiposity, substance-related and behavioral medical disorders, psychological problems related to physical illnesses, compulsive gambling and burnout. For each type of disorder, exemplary programs are described. Subsequently the methodical limitations of several of the studies are pointed out.     

The lost postcard technique: Formal aspects of the message as legibility indices of social perception

The return rate of lost postcards was hypothesized to depend upon the precision of the image that the finder can form of the relationship sender-recipient, Signature and length of the message were taken as indices and confirmed this role in two studies using a representative design.