Aggressive adolescents in residential care: a selective review of treatment requirements and models

This article presents a selective inventory of treatment methods of aggressive behavior. Special attention is paid to types of intervention that, according to research, are frequently used in Dutch residential youth care. These methods are based on (1) principles of (cognitive) behavior management and control, (2) the social competence model, and (3) influencing the peer culture. Suggestions are made as to how the treatment of aggressive adolescents may be realized in residential settings. The article concludes that more attention should be paid to the involvement of parents and to the part played by the peer group in the treatment of aggressive behavior.     

Rumination-focused cognitive behaviour therapy for residual depression: a case series

The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression.     

Implicit attitudes towards meat and vegetables in vegetarians and nonvegetarians

Previous research, in which self‐report measures were used, showed that vegetarians have more negative beliefs about meat than nonvegetarians. An important limitation of this research is that it did not examine differences in spontaneous affective reactions (i.e., implicit attitudes) towards meat and other types of food. We therefore conducted a new study in which not only self‐report measures were used, but also two tasks that have been developed to measure implicit attitudes: The Implicit Association Test (IAT) and a pictorial version of the Extrinsic Affective Simon Task (EAST). Both the IAT and EAST revealed that implicit attitudes towards vegetables (as compared to implicit attitudes towards meat) were more positive in vegetarians than in nonvegetarians. In line with previous findings, the self‐report measures showed that, compared to nonvegetarians, vegetarians had more positive attitudes towards vegetables and more negative attitudes towards meat. The IAT and EAST measures both correlated in the expected manner with self‐reported attitudes. A logistic regression showed that self‐reported attitudes were an almost perfect predictor of group status (vegetarian or nonvegetarian), and that adding the IAT and EAST measures as predictors did not improve prediction of group status. The results suggest that vegetarians and nonvegetarians differ in their spontaneous affective reaction towards vegetables or meat, and provide further evidence for the validity of the IAT and EAST as measures of inter‐individual differences in attitudes. Implicit attitudes could influence eating behaviour indirectly by biasing the decision to become a vegetarian or by determining how difficult it is for someone to maintain a vegetarian diet.     

The absence of an auditory-visual attentional blink is not due to echoic memory

The second of two targets is often missed when presented shortly after the first target--a phenomenon referred to as the attentional blink (AB). Whereas the AB is a robust phenomenon within sensory modalities, the evidence for cross-modal ABs is rather mixed. Here, we test the possibility that the absence of an auditory-visual AB for visual letter recognition when streams of tones are used is due to the efficient use of echoic memory, allowing for the postponement of auditory processing. However, forcing participants to immediately process the auditory target, either by presenting interfering sounds during retrieval or by making the first target directly relevant for a speeded response to the second target, did not result in a return of a cross-modal AB. Thefindings argue against echoic memory as an explanation for efficient cross-modal processing. Instead, we hypothesized that a cross-modal AB may be observed when the different modalities use common representations, such as semantic representations. In support of this, a deficit for visual letter recognition returned when the auditory task required a distinction between spoken digits and letters.     

The facilitation of important personal goals through exercise

In a sample of 1287 adolescents, it appeared that weekly exercise facilitates a variety of goals; particularly those related to being or remaining healthy, feeling relaxed, not being bored, feeling physically good, not being stressed, and attaining high achievements were endorsed. Sedentary and active adolescents reported a similar order of 10 specific goals with respect to the likelihood of being positively influenced by exercise. The frequency of reported facilitation for each of the goals, however, was higher among the active adolescernts. This suggests that the more exercise is incorporated in daily life, the more it can be regarded as an integral part of the personal goal structure.     

Retrospective ratings of ADHD symptoms made at young adulthood by clinic-referred boys with ADHD-related problems, their brothers without ADHD, and control participants

Retrospective childhood attention-deficit/hyperactivity disorder (ADHD) symptoms are required to diagnosis adult ADHD, but the validity of self-rated symptoms across time is questionable. Here, boys with ADHD-related problems, their brothers without ADHD, and former schoolmates rated themselves during young adulthood for ages 9, 14, and 19. Brothers rated probands retrospectively at the same ages. The young adults referred as children for ADHD (a) acknowledged childhood symptoms; (b) described improvement over time; (c) did not differ from brothers or controls on most self-ratings of young adult symptoms; (d) rated themselves as more symptomatic at age 9, but less symptomatic at age 19, than their brothers rated them; and (e) agreed only to some degree with brothers' ratings of probands' aggression (median correlation = .22). Probands' ratings showed limited agreement with judges' symptom ratings (median correlation = .16) and young adult follow-up examiners' ratings (median correlation = .14). These findings are not accounted for solely by changes in informants, nor by the course of ADHD psychopathology. They suggest some stability but limited internal consistency and validity for retrospective ADHD ratings by probands and brothers.     

Performing well in an evaluative situation: the roles of perceived competence and task-irrelevant interfering thoughts

This research expands on previous research by arguing and demonstrating that high perceived competence buffers the detrimental effects of an evaluative situation. In Study 1 (n=75, 38.7% male), the situation (evaluative vs. non-evaluative) and perceived competence (high vs. low) were manipulated, whereas in Study 2 (n=42, 33.3% male), perceived competence relied on naturally occurring differences in perceived competence. The results of Study 1 indicate that people may underachieve in an evaluative situation. More importantly, in Study 2 it was demonstrated that such an evaluative situation had only a negative effect on test performance among individuals low in perceived competence. The occurrence of task-irrelevant interfering thoughts during task completion accounted for this inimical effect of an evaluative situation on test performance among these individuals.     

Using the Millon Behavioral Medicine Diagnostic to Delineate Treatment Outcomes in Rehabilitation

Patients undergoing rehabilitation have been evidenced to improve in different ways depending on their coping styles. Amplifiers, Repressors, and Social Copers are examples of patients who present differently in rehabilitation settings and tend to have differing levels of success in their response to treatment. The current study examined the differential treatment outcomes of three coping style groups undergoing multidisciplinary rehabilitation. A sample of 59 patients suffering from injuries associated with chronic pain were assessed using the Multidimensional Pain Inventory, Beck Depression Inventory, and Beck Anxiety Inventory before, during, and after multidisciplinary pain management treatment. Coping style groups derived from the Millon Behavioral Medicine Diagnostic consisting of Amplifiers, Repressors, and Social Copers were compared with regard to reductions in depression, anxiety, pain, functional impairment, and associated outcomes. Repeated measures ANOVA revealed that Amplifiers, Repressors, and Social Copers had varying levels of success in the treatment program. Hierarchical linear modeling analyses revealed the coping style groups to have significantly different change curves from pre to post-treatment in depression, anxiety, pain severity, functional impairment, affective distress, life control, social support, and soliciting help from others. These findings support prior research emphasizing the value of tailoring treatments in rehabilitation settings toward patients’ coping styles in order to maximize outcomes. A program (provided in either SAS or SPSS syntax) that will compute MBMD coping style group membership will be provided upon request. Request by e-mail to: dcipher@hsc.unt.edu or by fax to: +1-817-7352270.     

Cognitive Coping Tool Kit for Psychosis: Development of a Group-Based Curriculum

This article outlines an 8-week curriculum that was created to help outpatients develop cognitive and behavioral skills for coping with delusions and hallucinations as well as to reduce patients’ comorbid subjective levels of distress (e.g., depression, anxiety). The manualized protocol consisted of psychoeducation and training in a variety of CBT skills that have shown promise in treating individuals with residual psychosis, using recovery-oriented “naturalistic” methods and culminating in the creation of an individualized “tool kit” of cognitive coping resources. A preliminary study of the effectiveness of this brief group-based CBT program for outpatients with chronic, residual symptoms of schizophrenia was conducted. Participants were 24 outpatients diagnosed with schizophrenia spectrum disorders who were stable on medications and connected to case management community follow-up. The Positive and Negative Syndrome Scale for Schizophrenia interview and the Symptom Checklist-90 self-report symptom scales were administered pre- and post-intervention. The results suggest that there were significant improvements in psychotic symptoms and self-reported distress from pre- to posttreatment.     

Development and validation of the cognitive style indicator

The authors describe the development and validation of the Cognitive Style Indicator (CoSI) using 3 diverse samples (N = 5,924; N = 1,580; and N = 635). Reliability, item, and factor analyses demonstrated the internal consistency and homogeneity of 3 cognitive styles: knowing, planning, and creating. The authors also found substantial support for the instrument's convergent and discriminant validity by including other cognitive style instruments and personality and academic performance measures in the validation process. Criterion-related validity was confirmed by examination of the relation between these cognitive styles and work-related characteristics. The main contributions of this study are (a) the further refinement of the analytic-intuitive cognitive style dimension by splitting the analytic pole in a knowing and a planning style and (b) the development of a valid and reliable cognitive style instrument for use in organizations.