Child and adolescent psychotherapy outcomes in experiments versus clinics: Why the disparity?

In a recent article, Weisz, Weiss, and Donenberg (1992) compared the effects of child and adolescent psychotherapy in experimental studies and in studies of clinic practice. Here we update that report with new information and we explore 10 possible reasons why, to date, therapy in experiments appears to have shown larger effect sizes than therapy in clinics. We find that beneficial therapy effects are associated with three factors which are more common in research therapy than in clinic therapy: (a) the use of behavioral (including cognitive-behavioral) methods, (b) reliance on specific, focused therapy methods rather than mixed and eclectic approaches, and (c) provision of structure (e.g., through treatment manuals) and monitoring (e.g., through review of therapy tapes) to foster adherence to treatment plans. These three factors all involve dimensions along which clinic procedures could be altered.     

Health-protective effects of attachment among African American girls in psychiatric care

African American girls in psychiatric care are at increased risk for HIV and sexually transmitted infection (STI) through sexual risk taking. Adolescent sexual behavior often reflects peer norms and behavior. Secure attachment patterns with mothers and peers might lessen the effects of negative peer influences and reduce sexual risk taking among African American girls. This study examined the relationships among mother-daughter and peer attachment, peer norms, and sexual-risk behaviors in African American girls seeking outpatient psychiatric care. A group of 12-16-year-old African American girls (N = 262; M age = 14.45 years) reported on their attachment to their mothers and peers, peer risk-taking and dating behaviors, peer pressure, and sexual-risk behaviors (e.g., number of partners, high-risk partners, and condom use). Structural equation modeling examined whether peer attachment and peer norms mediated the relationship between mother attachment and sexual risk. Findings supported peer norms, but not peer attachment, as a mediator of mother attachment and girls' sexual-risk behaviors. Findings revealed important family and peer factors for African American girls in psychiatric care. HIV prevention programs may be strengthened by improving mother-daughter relationships, addressing the importance of peer relationships, and emphasizing how secure mother-daughter relationships can temper the impact of peer norms.     

被遗忘的《古兰经》文化

文化是否能够改变文明,就像人类一样,个人或家族经历中曾被抑制的因素会留下印记,甚至会在当今引发混乱？对上述两种情况,我们是否可以提出假设：以往未解决的冲突和“被遗忘的”,即被抑制的渊源会在当下以不满、冲突和激情的方式重现显现出来？     

Dating Violence Victimization and Unprotected Sex Acts Among Adolescents in Mental Health Treatment

The objective of this study was to explore the relationship between dating violence victimization and unprotected sex acts among youth in mental health treatment. Sexually-active adolescents (n?=?261; ages 13–18) enrolled in mental health treatment completed an audio-assisted computerized self-interview (ACASI) to assess recent dating violence victimization, unprotected sex acts, depression symptoms, and recent alcohol use. Path analysis revealed that dating violence victimization was related to unprotected sex acts both directly and indirectly via its association with depression and condom use self-efficacy. These findings suggest that in order to reduce HIV-related risk behaviors among dating violence victims, treatment providers should consider depressive symptomatology and associated affect around sexual situations.     

INTRAORGANIZATIONAL EMPLOYEE NAVIGATION AND SOCIALLY DERIVED OUTCOMES: CONCEPTUALIZATION,VALIDATION, AND EFFECTS ON OVERALL PERFORMANCE

Intraorganizational employee navigation (IEN) is conceptualized as a means of better understanding how the organizational actor proactively works across their firm's internal environment in the execution of their jobs. Navigation is argued to be a precursor to the employee's overall performance through a class of mediating variables labeled “socially derived outcomes,” which are variables inside the organization that are bestowed upon the employee as a result of them first engaging in proactive behavior (e.g., IEN). Two studies are reported. Study I sees IEN psychometrically validated versus a range of existing proactive behaviors and individual traits (discriminant, nomological, and criterion‐related validity) with a heterogeneous sample of 704 employees. Study II then tests a model relating IEN to performance through six mediating “socially derived outcomes” by leveraging data from 2 Fortune 500 firms. The results of Study II show that IEN significantly impacts multiple measures of the employee's overall performance through mediating effects brought about by key socially derived outcomes, such as the employee's “manager alignment.” The contributions, broader implications, and limitations of the research are then put into context.     

Neighborhood Environment, Sexual Risk Behaviors and Acquisition of Sexually Transmitted Infections Among Adolescents Diagnosed with Psychological Disorders

The association between neighborhood environment and prevalence of STIs, sexual partner variables and condom use among adolescents with psychological disorders was examined. Cross-sectional data in three urban areas of the US (Southeast, Northeast and Midwest) were obtained from 384 sexually active male and female participants who provided urine samples for laboratory-confirmed testing of Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. A total of 15.4% of participants tested positive for one of the three STIs. Results indicated that relative to adolescents living in low risk neighborhood environments, those living in high risk environments were significantly more likely to have a STI and to report having casual partners. Findings suggest that in high risk neighborhoods, STI acquisition may be less dependent on condom use and more dependent on other contextual factors. The importance of expanding public health research to include assessment of neighborhood context as a determinant of sexual risk-taking is emphasized.     

Sibling Teenage Pregnancy and Clinic-Referred Girls’ Condom Use: The Protective Role of Maternal Monitoring

Younger sisters of teenage parents have elevated rates of engaging in unprotected sex. This may result from changes in parenting behavior after a sibling becomes pregnant or impregnates a partner, and be particularly pronounced for girls seeking mental health treatment. The current study examines condom use over time in 211 African-American girls recruited from outpatient psychiatric clinics. Findings indicate that having a sibling with a teenage pregnancy history predicts less consistent condom use 2 years later. After accounting for earlier condom use and mental health problems, maternal monitoring moderates condom use such that for girls with a sibling with a pregnancy history, more vigilant maternal monitoring is associated with increased condom use, while for girls with no sibling pregnancy history, maternal monitoring is unrelated to adolescents’ condom use 2 years later. Findings suggest that targeted interventions to increase maternal monitoring of high-risk teens may be beneficial for girls with a sibling history of teenage pregnancy.     

The impact of young children with externalizing behaviors on their families

Compared the impact on families of young children with externalizing behaviors (e.g., hyperactive, aggressive; n=22), autism (n=20), or no significant problem behaviors (n=22) on several measures of family functioning. Previous studies have found heightened stress and parental maladjustment in families with externalizing children. The present study expanded upon that literature by (1) including a clinical control group to determine the specific impact of externalizing problems, (2) focusing on preschool aged children, and (3) using a new measure to directly ascertain parents' perception of impact. Compared to parents with normally developing children, parents with externalizing children reported more negative impact on social life, more negative and less positive feelings about parenting, and higher child-related stress. Moreover, parents of externalizing children reported levels of impact and stress as high as those reported by parents of children with autism. On broader measures of parental and marital wellbeing, however, the three groups of families of preschoolers did not differ. The implications of these findings for intervention are discussed.This research was conducted at the Fernald Child Study Center, University of California at Los Angeles. We wish to thank Jan Blacher, Doug Granger, Stephen Hinshaw, and Karen Rudolph for comments on an earlier version of this article, and Kenny Smith and Doug Granger for computer help. We also appreciate the assistance of our colleagues on the Preschool Project, Drew Erhardt, Tracy Heller, Barbara Henker, Alice Huber, Blair Paley, Karen Rudolph, and Jennifer Treuting.     

Experimental Task and Speaker Effects on Parent-Child Interactions of Aggressive and Depressed/Anxious Children

Parent-child interactions of aggressive and depressed/anxious clinic-referred children were observed during two different tasks: planning a vacation and discussing a conflict. Marked group differences were found as a function of the type of task, who was speaking (parent vs. child), and type of child psychopathology. Negative behaviors (e.g., Belittling and Blaming) were especially pronounced in the conflict task, whereas positive behaviors (e.g., Nurturing and Protecting) were more common in the planning task. Parents displayed other-directed behavior (e.g., Watching and Controlling), whereas children showed more self-directed behavior (e.g., Walling Off and Distancing), and patterns of child psychopathology interacted with task and speaker in theoretically important ways; for example, parents of aggressive children showed more Belittling and Blaming than their children in the conflict task, but not in the planning task. The findings highlight key factors that may need to be incorporated into models of parent-child interaction and child psychopathology.