Clinical significance methods: a comparison of statistical techniques

Clinically significant change refers to meaningful change in individual patient functioning during psychotherapy. Following the operational definition of clinically significant change offered by Jacobson, Follette, and Revenstorf (1984), several alternatives have been proposed because they were thought to be either more accurate or more sensitive to detecting meaningful change. In this study, we compared five methods using a sample of 386 outpatients who underwent treatment in routine clinical practice. Differences were found between methods, suggesting that the statistical method used to calculate clinical significance has an effect on estimates of meaningful change. The Jacobson method (Jacobson & Truax, 1991) provided a moderate estimate of treatment effects and was recommended for use in outcome studies and research on clinically significant change, but future research is needed to validate this statistical method.     

Exposure to violence, quality of life, and health status in a group of farm workers in South Africa: a preliminary report

Farm workers (N=52), ages 18 to 60 years (M=34.1, SD=11.1), completed the Survey of Exposure to Community Violence, General Health Questionnaire-28, and the Quality of Life Inventory. Farm workers reported average Exposure to Violence, very low Quality of Life, and subaverage Health Status. No significant correlation was found between scores on Exposure to Violence and Quality of Life. Exposure to Violence was significantly correlated with poor Health Status in women but not in men. The implication of these results is discussed.     

Is it prudent to administer all items for each Child Behavior Checklist cross-informant syndrome? Evaluating the psychometric properties of the Youth Self-Report dimensions with confirmatory factor analysis and item response theory

Through surveying of children in 10 nations with parent, teacher, and Youth Self-Report (YSR) forms of the Child Behavior Checklist (CBCL), cross-informant syndromes (CISs) were derived and cross-validated by sample-dependent methodology. Generalizing CBCL syndromes and norms to nations excluded from its normative sample is problematic. This study used confirmatory factor analyses (CFAs) to test factor model fit for CISs on the YSR responses of 625 Jamaican children ages 11 to 18 years. Item response theory (IRT), a sample-independent methodology, was used to estimate the psychometric properties of individual items on each dimension. CFAs indicated poor to moderate model-to-data fit. Across all syndromes, IRT analyses revealed that more than 3/4 of the cross-informant items yielded little information. Eliminating such items could be cost effective in terms of administration time yet improve the measures discrimination across syndrome severity levels.     

Stereotypes as dominant responses: on the "social facilitation" of prejudice in anticipated public contexts

This article challenges the highly intuitive assumption that prejudice should be less likely in public compared with private settings. It proposes that stereotypes may be conceptualized as a type of dominant response (C. L. Hull, 1943; R. B. Zajonc, 1965) whose expression may be enhanced in public settings, especially among individuals high in social anxiety. Support was found for this framework in an impression formation paradigm (Experiment 1) and in a speeded task designed to measure stereotypic errors in perceptual identification (Experiment 2). Use of the process dissociation procedure (B. K. Payne, L. L. Jacoby, & A. J. Lambert, in press) demonstrated that these effects were due to decreases in cognitive control rather than increases in stereotype accessibility. The findings highlight a heretofore unknown and ironic consequence of anticipated public settings: Warning people that others may be privy to their responses may actually increase prejudice among the very people who are most worried about doing the wrong thing in public.     

Book reviews

Women in the Footsteps of the Buddha. Struggle for Liberation in the Therigāthā . Katheryn R. Blackstone, 1998, London, Curzon Press xiv + 186 pp., ISBN 0 7007 0962 2

The Supreme Wisdom of the Upanisads. An Introduction. Klaus G. Witz, 1998, Delhi, Motilal Banarsidass xxv + 558 pp., hb Rs 700, ISBN 81 208 1573 4

The Original Analects: Sayings of Confucius and his Successors. E. Bruce Brooks & A. Takeo Brooks (Trans.), 1998 New York, Columbia University Press 368 pp., ISBN 0 2311 0430 8     

A qualitative examination of borderline personality disordered (BPD) patients: interpersonal dynamics and underlying paradoxes.

Theoretical conceptualizations of symptomatology in patients with borderline personality disorder (BPD) have noted an inability to integrate contradictory perceptions (splitting, or dichotomous thinking) as a hallmark of the disorder. This study investigated contradictions manifest in the thinking and behavior of BPD patients, using the concept of paradox. A paradox occurs when an apparent contradiction contains an underlying logic which makes the contradiction comprehensible. Using qualitative methods of analysis, this study explored paradoxes evident in 10 BPD patient narratives about relationship events. Specific paradoxes relating to interpersonal conflicts and self-destructiveness are presented, along with the underlying logic of each paradox as described by patients. Implications for treatment are discussed.     

Book reviews

Confucian Traditions in East Asian Modernity: moral education and economic culture in Japan and the four mini‐dragons Tu Wei‐Ming (Ed.), 1996 Cambridge, MA, Harvard University Press ii + 418pp., hb £28.50, pb £12.50, ISBN 0 674 16086 X (hb)

The Recluse of Loyang: Shao Yung and the moral evolution of early Sung thought Don J. Wyatt, 1996 Honolulu, University of Hawaii Press xii + 340 pp., hb (price not given), ISBN 0 8248 1755 9

Rude Awakenings: Zen, the Kyoto School and questions of nationalism James W. Heisig & John C. Maraludo (Eds), 1995 Honolulu, University of Hawaii Press hb $40.00, pb $19.95

Untying the Knots in Buddhism. Selected essays Buddhist Tradition Series Volume 28, 1997 Alex Wayman 1997 Delhi, Motilal Banarsidass x + 618 pp, hb Rs. 495; ISBN 81 208 1321 9

Historical Dictionary of Hinduism Historical Dictionaries of Religions, Philosophies, and Movements, No. 13 Bruce M. Sullivan 1997 Lanham, MD & London, The Scarecrow Press xviii, 346 pp, pb £46.55, ISBN 0 8108 3327 1

Dictionary of Philosophy and Religion. Eastern and Western thought (New and enlarged edition; first 1980) William L. Reese, 1996 New York, Humanities Press xiv + 856 pp., pb, ISBN 0 391 03864 8     

Predictors of Psychosocial and Cognitive Adaptation in Children with Sickle Cell Syndromes

Examined the role of socioecological factors (family functioning and socioeconomic variables) in predicting behavioral and cognitive adaptation in children with sickle cell syndromes (SCD). Participants included 74 African American children and adolescents with SCD and their primary caretakers. Outcomes included internalizing and externalizing behavior symptoms, as rated by caretakers, as well as intellectual abilities and academic achievement, as assessed by individually administered standardized instruments. Family functioning consisted of both caretaker adjustment and family environment (i.e., family adaptability and cohesion). Hierarchical multiple regression analyses revealed that caretaker psychological adjustment predicted externalizing behaviors, while family environment (i.e., adaptability and cohesion) predicted neither behavioral nor cognitive functioning. Socioeconomic variables alone predicted intellectual abilities and academic achievement and also contributed to the prediction of child behavioral adaptation. Results are discussed in terms of relevant sociocultural issues and implications for family-level prevention and intervention.     

Reviews

G ordon , R osemary . Dying and creating: a search for meaning.
K ubie , L awrence S. Symbol and neurosis. Selected papers of Lawrence S. Kubie.
K atz , S teven T., Ed. Mysticism and philosophical analysis.
P incus , L ily and D are , C hristopher . Secrets in the family.     

Reviews

F raser , M orris . The death of Narcissus .
Z' ev B en S himon H alevi . The way of Kabbalah .