Characteristics of Clients Judged to Require Long-Term Counseling

This study examines one subgroup of clients seen at a university counseling center, namely, 72 clients who were expected by their counselor to remain in counseling for 10 or more interviews. Ratings were available on psychological characteristics for this sample and for the Counseling Center's total client population. In addition, the total university population could be compared with both of these groups on demographic characteristics. On the basis of pre- and post-counseling ratings of severity of problem, the sample being investigated was divided into Improved and Unimproved groups. Comparative data are examined with regard to class, college, sex, type of residence, type of problem, severity level at onset and termination, number of counseling interviews, motivation for counseling, defensiveness, and counselor's feelings toward client. Long-term counseling and improvement status are found to be a function of most of these variables.     

Positive psychotherapy for smoking cessation: Treatment development,feasibility, and preliminary results

Low positive and high negative affect (NA) predict low rates of smoking abstinence among smokers making a quit attempt. Positive psychotherapy can both increase positive affect (PA) and decrease NA and, therefore, may be a useful adjunct to behavioral smoking counseling. The purpose of the present study was to assess the feasibility and acceptability of a positive psychotherapy for smoking cessation (PPT-S) intervention that integrates standard smoking cessation counseling with nicotine patch and a package of positive psychology interventions. We delivered PPT-S to 19 smokers who were low in PA at baseline. Rates of session attendance and satisfaction with treatment were high, and most participants reported using and benefiting from the positive psychology interventions. Almost one-third of the participants (31.6%) sustained smoking abstinence for six months after their quit date. Future studies to assess the relative efficacy of PPT-S compared to standard smoking cessation treatment are warranted.     

Current issues and new directions in Psychology and Health : Theory,translation, and evidence-based practice

Health psychology has at least two masters; cognitive behavioral theory and clinical and public health practice. We are expected to contribute to theory by creating new models and adding to existent models of human behavior, and to contribute to improvements in health outcomes for the public. In this brief note, we propose that translating concepts from practice into theory to create interventions that meet the standards of evidence-based practice will satisfy both masters. However, the integration will require a re-examination of our current understanding of how to use theory, the process of translation, and the development of pragmatic evidence-based practice.     

The rejection-rage contingency in borderline personality disorder

Though long-standing clinical observation reflected in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) suggests that the rage characteristic of borderline personality disorder (BPD) often appears in response to perceived rejection, the role of perceived rejection in triggering rage in BPD has never been empirically tested. Extending basic personality research on rejection sensitivity to a clinical sample, a priming-pronunciation experiment and a 21-day experience-sampling diary examined the contingent relationship between perceived rejection and rage in participants diagnosed with BPD compared with healthy controls. Despite the differences in these 2 assessment methods, the indices of rejection-contingent rage that they both produced were elevated in the BPD group and were strongly interrelated. They provide corroborating evidence that reactions to perceived rejection significantly explain the rage seen in BPD.     

Observer ratings of health and sickness: can other people tell us anything about our health that we don't already know?

After administering interviews covering health conditions, physical limitations, optimism, and affect to 851 older adults, interviewers rated the health and sickness of the interviewees. Observers' ratings of health and sickness were more highly correlated with the severity of participants' self-reported health conditions than were participants' self-ratings of health. This finding is likely attributable to participants' self-ratings of health being more highly correlated with their optimism and positive affect than the observers' ratings. Participants rated as sicker and less healthy at baseline were at a 3 times greater risk for mortality over 114 months. This association was independent of participants' self-rated health as well as demographics, self-reported health conditions, years of smoking, physical limitations, body mass index, optimism, and affect.     

Just How Effective are Antidepressant Medications? Results of a Major New Study

The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) project was the largest and most extensive trial of antidepressants ever conducted. The study used state of- the-art methods to treat real patients coming to a hospital or psychiatric clinic for relief from depression. Because the first antidepressant is often ineffective for most patients, a sequence of drug treatments targeting various brain neurochemicals was carefully planned. This article will review the complex treatments and the various outcomes, including the frequency of relapse during twelve months of follow-up care.     

Impact of symptoms and aging attribution on emotions and coping

Two experimental studies and a large field study were designed to examine how symptom severity, symptom duration, symptom ambiguity, and the association of symptoms with aging affected emotional responses and coping with illness threats. In Study 1, 280 respondents from the surrounding community reported the emotional and coping responses they would manifest to scenarios that varied the severity, duration, and ambiguity (i.e., labeled vs. unlabeled) of a common set of symptoms. Severity had more of an impact on coping strategies than did duration or illness label; severe symptoms elicited stronger emotional upset and a higher incidence of both self-care behaviors and seeking of medical care. Symptoms of longer duration also resulted in increased seeking of medical care. Responses of the 334 adults participating in Study 2 replicated and extended these findings: A closed-ended item asking participants whether the symptoms could be attributed to aging showed that attribution of symptoms to aging increased with age, was more frequent for mild symptoms, and was associated with reduced emotional response to symptoms and a tendency to delay seeking treatment. Participants in the field study (168 patients seeking medical care for a variety of symptoms) completed interviews tracing symptom processing and emotional and coping reactions. The results provided evidence for the external validity of the scenario studies, as the attribution of symptoms to aging was greater for older than younger patients and resulted in a significant tendency to delay seeking medical care. Results of these studies suggest that symptom experience and symptom interpretation must be considered in the study of coping responses to illness threats.     

Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress.

Pain experience is conceptualized as a combination of stimulus sensations (e.g., aching) and emotional distress. In Experiment 1, less distress was reported to cold pressor stimulation by subjects first told about stimulus sensations than by subjects who were uninformed or were told about symptoms of bodily arousal (e.g., tension). Adding a pain warning to sensation information blocked distress reduction, presumably by eliciting an emotional interpretation of the stimulus. In Experiment 2, subjects attending only to hand sensations reported less distress than subjects attending to their bodies. This decrease in the power of the stimulus to provoke emotion is presumably mediated by a schema of hand sensations formed by attention. In Experiment 3, subjects attending to hand sensations early in the immersion and distracting themselves later reported the same low levels of distress as did subjects who attended to hand sensations throughout. Subjects distracted throughout and subjects attending to hand sensations later showed no distress reduction. Therefore, stimulus schematization must precede distress reduction. Implications for distress control are discussed.     

Neighborhood poverty and public policy: a 5-year follow-up of children's educational outcomes in the New York City moving to opportunity demonstration

Data from the Moving to Opportunity Program, a randomized mobility experiment in which a subset of low-income minority families living in public housing in high-poverty neighborhoods were given vouchers to move to low-poverty neighborhoods, were used to evaluate 1 policy approach for improving children's educational outcomes. Four hundred twenty-five New York City children were seen 2 1/2 and 5 years following relocation (mean age=14.64 years, SD=3.21 years). Analyses examining program effects on 5-year educational outcomes, accounting for 2 1/2-year outcomes, revealed that program effects on adolescent boys' achievement found at 2 1/2 years were not sustained at 5 years. Rather, male and female youths 14-20 years of age in low-poverty neighborhoods reported lower school grades and engagement relative to youths in high-poverty neighborhoods. From a policy standpoint, the complexity of enhancing low-income minority children's educational outcomes is underscored by the multiple dynamics involved--family, neighborhood, housing, and school.