Links among theory, research, and practice: cornerstones of clinical scientific progress

Discusses how explicit links among clinical theory, research, and practice are necessary if a clinical discipline is to survive in the managed care marketplace of today. Robust links among theory, research, and practice enable the elaboration of a systematic body of clinical knowledge that is practical in its deployment, effective in its methods, and compelling in its rationale. Moreover, theoretical advances are increasingly necessary, in that they allow scientists to categorize and prioritize the growing amount of empirically derived information, determine how pieces of multilevel data fit together, identify knowledge gaps, and set priorities for future studies. As shown by some of the articles in this special section, evolving theories of behavior have several characteristics in common; namely that they are developmental, transactional, contextual, adaptational, multilevel, and multidetermined. Concerns may be raised, however, as to whether current research methods are fully adequate to test these newer, more complex, multilevel theories or the clinical phenomena they seek to characterize. To address these difficulties, as well as to increase the pace of scientific advances that may result from propitious links among theory, research, and practice, I offer several recommendations to clinical psychology in general and to clinical child psychological research in particular.     

Informant-Based Determinants of Symptom Attenuation in Structured Child Psychiatric Interviews

Informant-related determinants of item attenuation, that is, the drop-off in symptom endorsement rates at retest, were examined in an enriched community subsample of 245 parent–child pairs drawn from the National Institute of Mental Health Methods for Epidemiology of Child and Adolescent Mental Disorders Study. Youngsters and their parents were interviewed with the Diagnostic Interview Schedule for Children (Version 2.3; DISC-2.3) on two occasions with a mean test–retest interval of 12 days. Item attenuation rates were high for both informants, with adults failing to confirm 42% and children 58% of baseline responses at retest. Stepwise regressions revealed that item attenuation at DISC-P retest was higher for adult informants who were younger, and who reported on older and less impaired children. On the DISC-C, attenuation was higher for children who were less impaired, rated as doing worse in school, and who had a longer test–retest interval. These results are broadly consistent with past studies examining the determinants of attenuation and test–retest reliability and have implications for the design and use of structured diagnostic instruments.     

Criterion-related validity of self-report measures of female heterosocial functioning

Common measures of female heterosocial functioning, the Survey of Heterosocial Interactions for Females (SHI-F) and dating frequency questions, were validated against the criterion of male liking, i. e., how well men like a woman. The SHI-F was unrelated to the criterion and to the other measures of heterosocial activity. The dating frequency and satisfaction questions were moderately related to the criterion. It was concluded the self-reported ability to initiate contact with men (as measured by the SHI-F) may not be related to female heterosocial functioning. Self-reported dating frequency and satisfaction appear to be a valid measure of female heterosocial functioning.The data were collected while the first author was at Louisiana State University.     

Understanding movement control in infants through the analysis of limb intersegmental dynamics

One important component in the understanding of the control of limb movements is the way in which the central nervous system accounts for joint forces and torques that may be generated not only by muscle actions but by gravity and by passive reactions related to the movements of limb segments. In this study, we asked how the neuromotor system of young infants controls a range of active and passive forces to produce a stereotypic, nonintentional movement. We specifically analyzed limb intersegmental dynamics in spontaneous, cyclic leg movements (kicking) of varying intensity in supine 3-month-old human infants. Using inverse dynamics, we calculated the contributions of active (muscular) and passive (motion-dependent and gravitational) torque components at the hip, knee, and ankle joints from three-dimensional limb kinematics. To calculate joint torques, accurate estimates were needed of the limb's anthropometric parameters, which we determined using a model of the human body. Our analysis of limb intersegmental dynamics explicitly quantified the complex interplay of active and passive forces producing the simple, involuntary kicking movements commonly seen in 3-month-old infants. our results revealed that in nonvigorous kicks, hip joint reversal was the result of an extensor torque due to gravity, opposed by the combined flexor effect of the muscle torque and the total motion-dependent torque. The total motion-dependent torque increased as a hip flexor torque in more vigorous kicks; an extensor muscle torque was necessary to counteract the flexor influences of the total motion-dependent torque and, in the case of large ranges of motion, a flexor gravity torque as well. Thus, with changing passive torque influences due to motions of the linked segments, the muscle torques were adjusted to produce a net torque to reverse the kicking motion. As a consequence, despite considerable heterogeneity in the intensity, range of motion, coordination, and movement context of each kick, smooth trajectories resulted from the muscle torque, counteracting and complementing not only gravity but also the motion-dependent torques generated by movement of the linked segments.     

Depressive symptom patterns among older women

The structure of depressive symptom patterns was investigated in a community sample of 344 women between the ages of 51 and 92 who were administered the SCL-90-R Depression and Additional Symptoms Scales. Confirmatory factor analysis was used to test alternative measurement hypotheses implied by clinical formulations of depressive symptom patterns among elderly persons. The findings show support for the hypothesis that 2 somewhat different depressive syndromes, along with 4 more delimited forms of distress, underlie symptom-reporting patterns. Implications of these findings for future research on the relation between aging and depression are discussed.     

The effect of specific hypnotic suggestions on blood pressure in normotensive subjects

Twenty normotensive subjects participated on a voluntary basis in an experiment designed to study the effects of specific suggestions on blood pressure (BP). After an induction procedure, the experimental group received suggestions presumed to be relatively nonactivating, although capable of lowering or raising BP. A control group was used to record the BP changes over time. All subjects met for one session. Eight subjects from the experimental group met for a second session. Both adaptation and induction resulted in significant BP decreases. A specific suggestion to increase BP gave a significant result when compared to the induction point. There was no significant change from induction to the BP decrease suggestion. Both systolic and diastolic BP behaved in the same way. A second experimental session resulted in no significant change compared with the first session. Also, no significant difference was found in suggestibility scores from the first to the second session. The results are in line with previously published studies.     

Development and psychometric validation of the verbal affective memory test

We here present the development and validation of the Verbal Affective Memory Test-24 (VAMT-24). First, we ensured face validity by selecting 24 words reliably perceived as positive, negative or neutral, respectively, according to healthy Danish adults’ valence ratings of 210 common and non-taboo words. Second, we studied the test's psychometric properties in healthy adults. Finally, we investigated whether individuals diagnosed with Seasonal Affective Disorder (SAD) differed from healthy controls on seasonal changes in affective recall. Recall rates were internally consistent and reliable and converged satisfactorily with established non-affective verbal tests. Immediate recall (IMR) for positive words exceeded IMR for negative words in the healthy sample. Relatedly, individuals with SAD showed a significantly larger decrease in positive recall from summer to winter than healthy controls. Furthermore, larger seasonal decreases in positive recall significantly predicted larger increases in depressive symptoms. Retest reliability was satisfactory, rs?≥?.77. In conclusion, VAMT-24 is more thoroughly developed and validated than existing verbal affective memory tests and showed satisfactory psychometric properties. VAMT-24 seems especially sensitive to measuring positive verbal recall bias, perhaps due to the application of common, non-taboo words. Based on the psychometric and clinical results, we recommend VAMT-24 for international translations and studies of affective memory.     

A two wave cross‐lagged study of work‐role conflict,work‐family conflict and emotional exhaustion

By using a two‐wave panel design, the present study aimed to study causal, reversed, and reciprocal relations among work‐role conflict, work‐family conflict, and emotional exhaustion. The Conservation of Resources theory was applied as a theoretical framework. The study was conducted in a large Norwegian oil and gas company (n = 1703). The results demonstrated positive cross‐lagged effects of work‐role conflict and work‐family conflict on emotional exhaustion. In addition, emotional exhaustion predicted work‐family conflict over time, and work‐family conflict predicted work‐role conflict over time, indicating the presence of reciprocal effects. The current study adds new knowledge to the positioning of work‐family conflict in relation to perceived conflict in the workplace and emotional exhaustion.     

Evaluating the Utility of MFT Models in the Treatment of Trauma: Implications for Affect Regulation

The purpose of this paper is to discuss polyvagal theory as a theoretical foundation for helping clinicians more effectively treat clients who have experienced major trauma. More specifically, we emphasize that through the use of both modern and post-modern models, marriage and family therapists may use emotion regulation strategies to assist clients in overcoming the negative repercussions of traumatic events. We suggest that the nature of emotional arousal which accompanies trauma alters the physical process by which the body regulates future affective stimuli in ways that are potentially detrimental to human relationships. We then offer a discussion of how a selection of MFT models contain strategies that promote reconnection to self and others that should be utilized with greater precision, ultimately to target the physiological symptoms of trauma-altered emotion regulation processes. Finally, we discuss the need for more specific, process-oriented research that integrates cross-disciplinary theory to contribute to a more intricate and useful understanding of the treatment of trauma in the relational context.