Studying psychotherapy change in narrative terms: The innovative moments method

This paper aims to describe the Innovative Moments (IM) Coding System (IMCS), an idiographic and transtheoretical methodology that allows the identification of IMs—markers of changes in the client's initial maladaptive framework of meaning—throughout psychotherapy. The present study introduces the theoretical background underlying this methodology, along with the main empirical findings resulting from former studies that have applied this tool to clinical data. The IMCS application is also detailed: the coding phases, the training steps and inter‐rater agreement measures. In order to illustrate the application of IM coding, a case study is presented. Although a partial coding was used, the results are in line with previous research. Discussion is centred on the usefulness of the IMCS for the advance of process research in psychotherapy, and the potential use of this methodology in group format.     

Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa

Few of the limited randomized controlled trails (RCTs) for adolescent anorexia nervosa (AN) have explored the effects of moderators and mediators on outcome. This study aimed to identify treatment moderators and mediators of remission at end of treatment (EOT) and 6- and 12-month follow-up (FU) for adolescents with AN (N = 121) who participated in a multi-center RCT of family-based treatment (FBT) and individual adolescent focused therapy (AFT). Mixed effects modeling were utilized and included all available outcome data at all time points. Remission was defined as ≥ 95% IBW plus within 1 SD of the Eating Disorder Examination (EDE) norms. Eating related obsessionality (Yale-Brown-Cornell Eating Disorder Total Scale) and eating disorder specific psychopathology (EDE-Global) emerged as moderators at EOT. Subjects with higher baseline scores on these measures benefited more from FBT than AFT. AN type emerged as a moderator at FU with binge-eating/purging type responding less well than restricting type. No mediators of treatment outcome were identified. Prior hospitalization, older age and duration of illness were identified as non-specific predictors of outcome. Taken together, these results indicate that patients with more severe eating related psychopathology have better outcomes in a behaviorally targeted family treatment (FBT) than an individually focused approach (AFT).     

The coherence of critical event narratives and adolescents' psychological functioning

The present study examined the coherence of low- and high-point life-event narratives among adolescents (aged between 12 and 21 years) and their psychological functioning in terms of well-being and prosocial behaviour. The results showed robust age-related increases in narrative coherence. Age and gender significantly moderated the associations between narrative coherence and psychological functioning. Specifically, higher levels of coherence were significantly associated with prosocial behaviour only for older adolescents. Higher levels of narrative coherence were also associated with lower levels of well-being among adolescent boys, but not among adolescent girls. Results are discussed in terms of why coherent life-event narratives may not be linked to benefits for younger adolescents and for boys, and how low- and high-point life events both contribute to identity construction.     

Refinement and Psychometric Properties of the Eight-Item Brazilian Positive and Negative Affective Schedule for Children (PANAS-C8)

This study aimed to refine the Brazilian Positive and Negative Affect Scale for Children (PANAS-C34). A total of 1,160 children, between seven and 16 years of age (M = 11.2; SD = 1.92), from public elementary schools in eight Brazilian southern cities participated in the study. Four studies were conducted for this project. Study I (n = 370) evaluated the factorial structure of the PANAS-C34 (the original 34-item version). Ten potential items were selected for the instrument’s refined version. Employing an independent sample (n = 340), Study II assessed the utility of this ten-item version. Exploratory factor analysis, parallel analysis, and confirmatory factor analysis supported a bi-factorial solution. However, significant modification indices emerged for two items (happy and sad) regarding their respective factors and thus they were excluded. In Study III, using another independent sample (n = 450), it was demonstrated that the eight-item version (PANAS-C8) had better fit indices than the ten-item version. In Study IV (N = 1,160) a multigroup confirmatory factor analysis was conducted to evaluate the measurement invariance of the factorial solution across gender. Moreover, convergent validity was also evaluated using the Child Depression Inventory (CDI) and the General Life Satisfaction Scale for Children (GLSS-C). Measurement invariance was obtained for the PANAS-C8 across all the investigated model parameters. The correlations between the PANAS-C8 and both the CDI and the GLSS-C were of similar magnitude to those obtained using the PANAS-C34. The PANAS-C8 had adequate validity indices, demonstrating its usefulness in evaluating positive and negative affect in children.     

A comparison between elemental and compound training of cues in retrospective revaluation

Associative learning theories assume that cue interaction and, specifically, retrospective revaluation occur only when the target cue is previously trained in compound with the to-be-revalued cue. However, there are recent demonstrations of retrospective revaluation in the absence of compound training (e.g., Matute & Pine?o, 1998a, 1998b). Nevertheless, it seems reasonable to assume that cue interaction should be stronger when the cues are trained together than when they are trained apart. In two experiments with humans, we directly compared compound and elemental training of cues. The results showed that retrospective revaluation in the elemental condition can be as strong as and, sometimes, stronger than that in the compound condition. This suggests that within-compound associations are not necessary for retrospective revaluation to occur and that these effects can possibly be best understood in the framework of general interference theory.     

Motivational Interviewing Promotes Adherence and Improves Wellbeing in Pre-Dialysis Patients with Advanced Chronic Kidney Disease

Low rates of adherence to medical treatments and adverse emotional states are a widespread problem in advanced chronic kidney disease (ACKD). Motivational interviewing using the stages of change model is an effective combination in promoting behavior modifications. The objective of the present study was to determine the effectiveness of an individual, pre-dialysis intervention program (monthly sessions of 90 min over a 6-month period) in terms of adherence, emotional state and health-related quality of life (HRQL). Forty-two patients were evaluated for adherence, depression, anxiety and HRQL with standardized self-report questionnaires. Biochemical markers were also registered. The results show that after the intervention, patients reported significantly higher levels of adherence, lower depression and anxiety levels, and better HRQL (i.e., general health and emotional role domains). Biochemical parameters were controlled significantly better after the intervention, except for iPTH. These findings highlight the potential benefit of applying individual psycho-educational intervention programs based on motivational interviewing and using the stages of change model to promote adherence and wellbeing in ACKD patients.