The efficacy of systemic therapy with adult patients: a meta-content analysis of 38 randomized controlled trials

Systemic therapy is a widely used psychotherapy approach. Yet there exist few systematic reviews on its efficacy. A meta-content analysis was performed to analyze the efficacy of systemic therapy for the treatment of mental disorders in adulthood. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems oriented therapy in various settings (family, couple, individual, group, multifamily group therapy) with adult index patients suffering from mental disorders were identified by database searches and cross-references in other reviews. Inclusion criteria were: index patient diagnosed with a DSM or ICD listed mental disorder, trial published in any language up to the end of 2008. The RCTs were content analyzed according to their research methodology, interventions applied, and results. Thirty-eight trials published in English, German, Spanish, and Chinese were identified, 34 of them showing systemic therapy to be efficacious for the treatment of mood disorders, eating disorders, substance use disorders, mental and social factors related to medical conditions and physical disorders, and schizophrenia. Systemic therapy may also be efficacious for anxiety disorders. Results were stable across follow-up periods of up to 5 years. There is a sound evidence-base for the efficacy of systemic therapy for adult index patients with mental disorders in at least five diagnostic groups.     

Changing Me,Changing Us: Relationship Quality and Collective Efficacy as Major Outcomes in Systemic Couple Therapy

We examine the sensitivity to change in the Evaluation of Social Systems (EVOS) scale, which assesses relationship quality and collective efficacy. In Study 1 we conducted a waitlist‐control, short‐term couple therapy RCT study (N = 43 couples) with five systemic therapy sessions treating communication and partnership problems; our intent was to provide high external validity. Construct validity of EVOS was assessed by comparison with additionally applied scales (Family Scales; Outcome Questionnaire, OQ‐45.2). In Study 2, N = 332 individuals completed an experiment with high internal validity in order to verify sensitivity to change in three different social contexts. Results from Study 1 revealed a significant increase in relationship quality in the treatment group directly after treatment, as compared to the control group. Sensitivity to change was slightly better for EVOS than for other measures. While this positive change could not be fully sustained between posttreatment and a 4‐week follow‐up, EVOS score did not fall below baseline and pretreatment levels, supporting moderate‐to‐large sensitivity to change. Study 2 supported high sensitivity to change in EVOS for couple relations, family relations, and work‐team relationships. Therefore, EVOS can be used as an outcome measure to monitor the process of systemic interventions focusing on relationship quality and collective efficacy. Due to its sensitivity to change, EVOS can provide evidence for treatment success with regard to relationship aspects.     

Deficit in phonological processes: a characteristic of the neuropsychological profile of children with NF1

Learning disabilities are one of the most frequent complications of neurofibromatosis type 1 (NF1) in children. Studies of the effects of the neurocognitive deficit on academic performance are relatively rare, owing to the small size of the populations concerned. However, research is needed to develop effective rehabilitation programs. In the present study, we explored the impact of a possible phonological deficit on the reading abilities of children with NF1. A multicenter, cross-sectional study was conducted in France on two groups of 75 children with or without NF1 aged 8–12 years, matched for age, sex, handedness, and reading level. All participants underwent a neuropsychological evaluation to assess their general cognitive level, reading skills, phonological processes, visuoperceptual abilities, and attentional capacity. Phonological skills were assessed by means of two phonological awareness tasks and one short-term memory task. In the group of children with NF1, 41% had reading difficulties. Phonological processes were impaired in this group, compared with the children without NF1. Similar differences were found for a phoneme deletion task after adjustment for reading difficulties, IQ level, and visuoperceptual abilities. Phonological awareness, but not phonological short-term memory, was impaired in children with NF1, and not just those whose reading was impaired. Results suggest that children with NF1 have a phonological awareness deficit, whatever their reading level. Identification of reduced phonological skills may warrant the implementation of a specific rehabilitation program before early reading difficulties emerge.     

Effects of response preference on resistance to change

Treatments based on differential reinforcement of alternative behavior, such as functional communication training, are widely used. Research regarding the maintenance of related treatment effects is limited. Nevin and Wacker (2013) provided a conceptual framework, rooted in behavioral momentum theory, for the study of treatment maintenance that addressed two components: (a) reemergence of problem behavior, and (b) continued expression of appropriate behavior. In the few studies on this topic, focus has been on variables impacting the reemergence of problem behavior, with fewer studies evaluating the persistence of appropriate behavior. Given the findings from applied research related to functional communication training, variables related to response topography, such as response preference, may impact this aspect of maintenance. In the current study, the impact of response preference on persistence was evaluated in the context of functional communication training for individuals who did not exhibit problem behavior (Experiment 1) and for individuals with a history of reinforcement for problem behavior (Experiment 2). High‐preferred mands were more persistent than low‐preferred mands. These findings suggest that response related variables, such as response preference, impact response persistence and further suggest that response related variables should be considered when developing interventions such as functional communication training.     

Psychometric properties of the Highly Sensitive Child scale across developmental stage,gender, and country

Adolescents differ in their degree of Environmental Sensitivity, that is, the ability to perceive and process information about their environment. The present study aimed to investigate the psychometric properties of the Highly Sensitive Child scale (HSC), a self-report measure of Environmental Sensitivity, in two Belgian and UK samples with a total of 3056 adolescents. First, the factor structure, internal consistency, dimensionality, and construct validity of the HSC scale were examined. Second, measurement invariance of the HSC scale across developmental stage, gender, and country was tested. Results supported a bifactor model with a general sensitivity factor and three group factors: Ease of Excitation (EOE), Low Sensory Threshold (LST), and Aesthetic Sensitivity (AES). Cronbach’s alpha and McDonalds’s (hierarchical) omega indicated that the HSC scale is a reliable measure of Environmental Sensitivity, except for AES. Furthermore, AES was associated with different personality traits than EOE and LST. Second, the HSC scale was partially measurement invariant across developmental stage, gender, and country. The results provide important insights in the psychometrics of a first measurement of Environmental Sensitivity in early to late adolescents. Implications for further research are discussed.

     

Adolescents’ Conflict Resolution Styles Toward Mothers: The Role of Parenting and Personality

In the present research, we examined associations between contextual and individual factors and adolescents’ conflict resolution with mothers. In Study 1, we explored links between maternal responsiveness and psychological control and adolescent conflict resolution styles (positive problem solving, conflict engagement, withdrawal, and compliance) with two informants. In Study 2, we examined the unique contribution of adolescents’ personality above and beyond perceived parenting in the prediction of conflict resolution styles. Results of both studies indicated that responsiveness was related positively to problem solving and negatively to withdrawal. Psychological control was positively associated with destructive resolution styles. Study 2 indicated that extraversion predicted more problem solving and conflict engagement, and less withdrawal. Agreeableness predicted more problem solving and less conflict engagement. Finally, certain personality traits moderated associations between parenting and conflict resolution, indicating that some adolescents are more sensitive to these parenting dimensions than others.     

Children’s Implicit Leadership Theories in Middle Childhood: Christian Children's Perceptions in the Cavite Province

This mixed methods study explored the implicit leadership theories (ILTs) of children from Christian elementary schools in the Philippines, in response to the lack of importance attached to leadership ideas and leadership developmental experiences that occur in childhood. Jesus was the most frequently cited leader by the children who also showed a preference for the male stereotype for leadership. Among the nominated leader’s roles, religious figures, parents, teachers, and politicians received consideration from the children. The themes on leader’s attributes were categorized into four factors: (a) socioemotional, (b) spiritual–moral, (c) cognitive, and (d) physical. Males, older children, and non-Catholic participants were more likely to choose male leaders. Girls, Catholics, and young children were more likely to nominate a female leader.     

Cognitive factors in the development of sex-typed preferences

This study considered how children coordinate their understandings of gender identity and sex stereotypes to produce sex-typed preferences. Sex-typed preferences and gender constancy were assessed at ages 4 through 8 years on a cross section of urban black and white children (N=819). Findings verified that sex-stereotyped preferences are highly developed among young children prior to the period when gender constancy is fully developed. Additionally, by age 5, most children accurately attributed sex-stereotyped preferences to peers of the opposite sex. A distinction was made between a sex stereotype and a same-sex bias as a basis for a sex-typed preference. Gender constancy was shown to strengthen the same-sex bias as a determinant of a sex-typed preference, but this effect was context specific. Under certain conditions sex-stereotyped knowledge constrained the same-sex bias as a determinant of preferential choice.