Group CBT for early psychosis--are there still benefits one year later?

Our team recently conducted a randomized controlled trial comparing group cognitive behavior therapy for psychosis (CBTp) to group social skills training for symptom management and a wait-list control group, for early psychosis. The results at post-therapy and six months provided considerable empirical support for the efficacy of the group CBTp. The results of the one-year follow-up are described here. Given the high attrition rates, mostly in the comparison and control conditions, imputations were not possible, so that only the results of those having completed more than 50% of the group CBTp are presented. Significant improvements at 12 months were found for social support and insight. Negative symptoms remained low, whereas positive symptoms went back to pre-therapy levels. Challenges regarding attrition with this clientele are discussed.     

What Does the Alliance Predict in Group Interventions for Early Psychosis?

The therapeutic alliance is considered an essential component of any clinical or psychological intervention. The therapeutic alliance can however change over time, and therefore it is relevant to determine if the alliance and its variations are related to clinical outcomes. The present study had three objectives: (1) determine the impact of the alliance measured by the client and the therapist, on clinical and psychosocial outcomes of individuals with early psychosis receiving group interventions; (2) measure the concordance between the client and the therapists’ ratings of the alliance; and (3) determine the best predictor of the client’s alliance in our sample. A total of 36 individuals with early psychosis who participated in group interventions for symptom management answered the WAI three times, and so did the group therapists. Outcomes included measures of insight, symptoms (total, positive and negative), and self-esteem. Attendance and group participation were also measured. Results suggest that the overall client’s alliance predicted total symptoms and self-esteem at post-therapy, whereas both clients’ and therapists’ ratings predicted group attendance and participation. Greater variations in the alliance overtime for the clients were somewhat linked to worse negative symptoms at post-therapy. Alliance ratings were generally high and fairly concordant between therapists and clients. Only the baseline measure of capacity for attachment, predicted the client’s overall alliance scores. Clinical implications are discussed.     

Accounting for Movement between Childcare Classrooms: Does it Change Teacher Effects Interpretations?

Child care studies that have examined links between teachers' qualifications and children's outcomes often ignore teachers' and children's transitions between classrooms at a center throughout the day and only take into account head teacher qualifications. The objective of this investigation was to examine these traditional assumptions and to compare inferences made from these traditional models to methods accounting for transitions between classrooms and multiple teachers in a classroom. The study examined the receptive language, letter-word identification, and passage comprehension skills of 307 children enrolled in 49 community-based childcare centers serving primarily low-income families in Colorado. Results suggest that nearly one-third of children and over 80% of teachers moved daily between classrooms. Findings also reveal that failure to account for daily transitions between classrooms can affect interpretations of the relationship between teacher qualifications and child outcomes, with the model accounting for movement providing significant improvements in model fit and inference.     

Confusion of Wills: Otto Rank’s Contribution to an Understanding of Childism

Drawing from Elisabeth Young-Bruehl's psychological and psychodynamic study of prejudice as a starting point, this paper explores the phenomenon of childism—namely, the prejudice again children—from a Rankian psychodynamic perspective. Young-Bruehl argues that childism is comparable to prejudices such as anti-Semitism, sexism, and racism, and serves such purposes as the elimination of an individual's personhood, sexual exploitation, and the erasure of identity. Adding to Young-Bruehl's analysis of the social and psychological causes and effects of prejudice against children, this paper will examine the nature and dangers of childism explicit and implicit in the writings of Otto Rank. We will examine the development of creative will in child maturation—a development that childist forms of prejudice may obstruct, inhibit, and compromise. We will see that Young-Bruehl's foundational writing on childism echoes many of the observations and writings of Otto Rank in regard to the prejudice against children, and how such prejudice deeply diminishes, undermines, and fractures our unfolding lives and creative will in a shared world.     

Integration of visual information for saccade production

To foveate a visual target, subjects usually execute a primary hypometric saccade (S1) bringing the target in perifoveal vision, followed by a corrective saccade (S2) or by more than one S2. It is still debated to what extent these S2 are pre-programmed or dependent only on post-saccadic retinal error. To answer this question, we used a visually-triggered saccade task in which target position and target visibility were manipulated. In one-third of the trials, the target was slightly displaced at S1 onset (so-called double step paradigm) and was maintained until the end of S1, until the start of the first S2 or until the end of the trial. Experiments took place in two visual environments: in the dark and in a dimly lit room with a visible random square background. The results showed that S2 were less accurate for shortest target durations. The duration of post-saccadic visual integration thus appears as the main factor responsible for corrective saccade accuracy. We also found that the visual context modulates primary saccade accuracy, especially for the most hypometric subjects. These findings suggest that the saccadic system is sensitive to the visual properties of the environment and uses different strategies to maintain final gaze accuracy.     

Validity and Reliability of the French Versions of the Body Shape Questionnaire

The validity of the 34-item and shortened versions of the Body Shape Questionnaire (BSQ) has been evaluated in various languages. To date, only the validity of the 34-item French BSQ scale has been tested in a nonclinical sample. This study assessed the reliability and validity of the 34-item French BSQ and 7 shortened versions in clinical and nonclinical samples. The 34-item French BSQ was administered to 159 obese women with and without binge eating disorders and to 1,169 female undergraduate students. The results suggested that the BSQ–8B was the best French BSQ to use in nonclinical and clinical samples.