School programs targeting stress management in children and adolescents: A meta-analysis

Introduction

This meta-analysis evaluates the effect of school programs targeting stress management or coping skills in school children.

Methods

Articles were selected through a systematic literature search. Only randomized controlled trials or quasi-experimental studies were included. The standardized mean differences (SMDs) between baseline and final measures were computed for experimental and control groups. Experimental groups were groups that either received an intervention of (a) relaxation training, (b) social problem solving, (c) social adjustment and emotional self-control, or (d) a combination of these interventions. If no baseline measurement was available, SMDs were calculated between final measures of the groups. The overall pooled effect size was calculated and the pooled effect sizes of improvement on stress, coping, (social) behavior, and self-efficacy by random effects meta-analysis. The dependence of the results on study characteristics (i.e. methodological quality and type of intervention) was evaluated using meta-regression analysis.

Results

Nineteen publications met the inclusion criteria of controlled trials for class programs, teaching coping skills or stress management. Overall effect size for the programs was − 1.51 [95% confidence interval (CI) − 2.29, − 0.73], indicating a positive effect. However, heterogeneity was significant (p < .001). Sensitivity analyses showed that study quality and type of intervention were sources of heterogeneity influencing the overall result (p values < .001). The heterogeneity in quality may be associated with methodological diversity and differences in outcome assessments, rather than variety in treatment effect. Effect was calculated per intervention type, and positive effects were found for stress symptoms with a pooled effect size of − 0.865 (95% CI: − 1.229, − 0.502) and for coping with a pooled effect size of − 3.493 (95% CI: − 6.711, − 0.275).

Conclusion

It is tentatively concluded that school programs targeting stress management or coping skills are effective in reducing stress symptoms and enhancing coping skills. Future research should use clear quality criteria and strive for less diversity in methodology and outcome assessment.     

Eine Schlafstörung kommt selten allein

Eine Schlafst?rung kommt selten allein: 67 Prozent der Patienten mit nichtorganischen Schlafst?rungen haben organische Zusatzdiagnosen und 77 Prozent der Patienten mit organischen Schlafst?rungen haben psychiatrische Zusatzdiagnosen (1). Deshalb ist es bei der medikament?sen Behandlung von Schlafst?rungen wichtig, nicht nur den Einfluss verschiedener Medikamente auf die Schlafqualit?t und -architektur zu kennen, sondern auch ihren Einfluss auf die peripheren Schlaf-Variablen hinsichtlich schlafbezogenen Atmungsst?rungen und n?chtlichen Bewegungsst?rungen zu beachten, um nicht mit der Behandlung der einen Schlafst?rung eine andere - koexistente - Schlafst?rung zu verschlechtern und eine Besserung zu verhindern.     

Health psychology in international perspective: A summary and some thoughts for the future

This article reviews the progress made by the field in its short history and attempts to look at developments which seem likely to occur as the field matures.

Recommendations are made for training of health psychologists in the future and a plea is made for international standardisation of health psychology training programmes at the Ph.D. level which incorporate research and clinical training. Health psychologists are further encouraged to take a more active public and political role in order to provide needed visibility for their work.     

Thoughts of an Old Therapist About the Impact of Age on Her Clinical Work

This article deals with the impact of old age on the clinician as well as on the patients and families. The factors which seem to play an important role are: (a) The personal events in the clinician's life; (b) The changes which took place in the profession; (c) The life histories of the individuals and families which influenced the author's work as well as how her age affected families and the individuals. Several case illustrations are given to demonstrate the author's ideas. It is the author's hope that her experiences will encourage older therapists to continue in their practice.     

Short-Term Psychoanalytic Supportive Psychotherapy for Depressed Patients

Short-Term Psychoanalytic Supportive Psychotherapy (SPSP) is a face-to-face, individual psychotherapy, consisting of sixteen sessions in six months (first eight weekly, then eight fortnightly sessions). It is rooted in psychoanalytic theory. Its primary aim is to cure depression. A secondary goal is to reduce a patient's vulnerability to depression. The emphasis is on supportive techniques that counter regression and foster psychological growth. The putative process consists in experiencing a relational dissonance, i.e., feeling two contradictory relationships in the therapeutic situation simultaneously, one determined by the past, the other by the present. We assume an important curative factor is to experience, mostly unconsciously, an adequate gratification of developmental needs inadequately met in early infancy and, therefore, manifesting themselves in the archaic aspects of the therapeutic relationship. SPSP unfolds as a discourse in which we distinguish nine levels. Each regards a specific subject, which at that level is the focus of the interaction between patient and therapist. The efficacy of SPSP in ambulatory patients presenting a DSM-IV defined, mild to moderate major depressive disorder has been tested in five randomized clinical trials. The results have been aggregated in a mega-analysis. They suggest that, in the treatment of outpatients with mild to moderate major depressive disorder, SPSP and pharmacotherapy are equally efficacious and that the combination of SPSP and pharmacotherapy is more efficacious than pharmacotherapy alone but not than SPSP alone. We, therefore, consider SPSP a valuable extension to the existing options for the treatment of depressed patients.     

Marital discord and psychiatric disorder in children and adolescents

The relationship between marital discord and any DISC-2.1/DSM-III-R child psychiatric diagnosis was explored. Interview data from a community sample of 90 parent/child pairs and a clinic sample of 37 parent/child pairs were analysed. The data were collected at Columbia University/the New York State Psychiatric Institute as part of the pilot project of a multi-site methodological study. Rates of marital discord and DISC diagnoses were found higher in the clinic sample than in the community sample. The association between marital discord and any diagnosis remained significant when other risk and protective factors were controlled. Policy implications and recommendations for future research strategies suggested by the current exploratory study were discussed.     

Talking about subject choice at secondary school and career aspirations: conversations with students of Chinese background

Interviews with 15 boys and 12 girls from Chinese backgrounds are reported. The interviews, which centred on option/subject choices and career aspirations, were based on the results of a survey of 794 secondary-school students. This survey had indicated that the Chinese students included were more similar in their responses to ethnic-majority than to other ethnic-minority students. Conversation analysis of the interviews revealed three themes: students attributed their choices to (i) their liking for the subject/teacher; (ii) the link between school subjects and careers; and (iii) institutional frameworks. There was a marked omission of reference to issues related to ethnicity or gender. These findings are discussed in the context of other studies of Chinese ethnicity.     

The changing American family: For better or worse

This article deals with the viability of the American family. The family as a socio-biological phenomenon has existed throughout history. While it has frequently altered its constellation and membership it has preserved its basic function of the rearing and the socialization of the young. Since as other living organisms its survival depends on a certain balance between forces maintaining stability and others promoting change, the rapid changes occurring in the outside world have had profound effects on today's family. These technological and political changes have especially affected the power structure and the role distributions within the family (e.g., the women's movement, sexual revolution, greater egalitarianism) leaving it more vulnerable and unsettled, while at the same time opening new areas which it is hoped will lead to a new consciousness and growth.     

College students' memory for vocabulary in their majors: evidence for a nonlinear relation between knowledge and memory.

The effect of domain knowledge on students' memory for vocabulary terms was investigated. Participants were 142 college students (94 education majors and 48 business majors). The measure of domain knowledge was the number of courses completed in the major. Students recalled three different lists (control, education, and business) of 20 words. Knowledge effects were estimated controlling for academic aptitude, academic achievement, and general memory ability. Domain-specific knowledge consistently predicted recall, above and beyond the effect of these control variables. Moreover, nonlinear models better represented the relation between knowledge and memory, with very similar functions predicting recall in both knowledge domains. Specifically, early in the majors more classes corresponded with increased memory performance, but a plateau period, when more classes did not result in higher recall, was evident for both majors. Longitudinal research is needed to explore at what point in learning novices' performance begins to resemble experts' performance.