Guidelines for classifying evidence-based treatments in couple and family therapy

Guidelines for Evidence-Based Treatments in Family Therapy are intended to help guide clinicians, researchers, and policy makers in identifying specific clinical interventions and treatment programs for couples and families that have scientifically based evidence to support their efficacy. In contrast to criteria, which simply identify treatments that "work" and have been employed in the evaluation of other psychotherapies, these guidelines propose a three-tiered levels-of-evidence-based model that moves from "evidence-informed," to "evidence-based," to "evidence-based and ready for dissemination and transportation within diverse community settings." Each level reflects an interaction between the specificity of the intervention, the strength and readth of the outcomes, and the quality of the studies that form the evidence. These guidelines uniquely promote a clinically based "matrix" approach in which the empirical support is evaluated according to various dimensions including strength of the outcomes, the applicability across cultural contexts, and demonstration of specific change mechanisms. The guidelines are offered not only as a basis for understanding the evidence for diverse clinical approaches in couple and family therapy within the systemic tradition of the field, but also as an alternative aspirational model for evaluating all psychotherapies.     

Alcohol use trajectories and the ubiquitous cat's cradle: cause for concern?

In recent years, trajectory approaches to characterizing individual differences in the onset and course of substance involvement have gained popularity. Previous studies have sometimes reported 4 prototypic courses: (a) a consistently "low" group, (b) an "increase" group, (c) a "decrease" group, and (d) a consistently "high" group. Although not always recovered, these trajectories are often found, despite these studies varying in the ages of the samples studied and the duration of the observation periods employed. Here, the authors examined the consistency with which these longitudinal patterns of heavy drinking were recovered in a series of latent class growth analyses that systematically varied the age of the sample at baseline, the duration of observation, and the number and frequency of measurement occasions. Data were drawn from a 4-year, 8-wave panel study of college student drinking (N = 3,720). Despite some variability across analyses, there was a strong tendency for these prototypes to emerge regardless of the participants' age at baseline and the duration of observation. These findings highlight potential problems with commonly employed trajectory-based approaches and the need to not over-reify these constructs.     

The importance of a visual horizon for distance judgments under severely degraded vision

In two experiments we examined the role of visual horizon information on absolute egocentric distance judgments to on-ground targets. Sedgwick [1983, in Human and Machine Vision (New York: Academic Press) pp 425-458] suggested that the visual system may utilize the angle of declination from a horizontal line of sight to the target location (horizon distance relation) to determine absolute distances on infinite ground surfaces. While studies have supported this hypothesis, less is known about the specific cues (vestibular, visual) used to determine horizontal line of sight. We investigated this question by requiring observers to judge distances under degraded vision given an unaltered or raised visual horizon. The results suggest that visual horizon information does influence perception of absolute distances as evident through two different action-based measures: walking or throwing without vision to previously viewed targets. Distances were judged as shorter in the presence of a raised visual horizon. The results are discussed with respect to how the visual system accurately determines absolute distance to objects on a finite ground plane and for their implications for understanding space perception in low-vision individuals.     

Training kindergarten students lockdown drill procedures using behavioral skills training

During situations in which a gunman is present on a school campus, lockdowns are initiated until the threat is removed. However, there are no data demonstrating an effective teaching strategy to increase students’ correct responding during a lockdown. We evaluated the effectiveness of behavioral skills training (BST) to teach three groups of kindergarten students how to respond during lockdown drills. Results showed that participant groups displayed increases in correct steps and decreases in noise levels after BST was implemented; these effects maintained following training.     

Working memory and attention are still impaired after three years in patients with stress‐related exhaustion

Cognitive impairment is one of the most pronounced symptoms reported by patients with stress‐related mental health problems. Impairments related to executive function and to some extent speed and attention are therefore common in patients with stress‐related burnout/exhaustion. In this paper we present a follow‐up of cognitive performance in patients with stress‐related exhaustion several years after they initially sought medical care. Thirty patients and 27 healthy controls, mean age 49 years (SD 6.5) and 55 years (SD 6.7) respectively, were included, all of whom had undergone baseline measurements of neuropsychological functioning. The mean follow‐up time was three years. Half of the patients still reported mental health problems at follow‐up and over time no major changes in cognitive performance were noted. The patients still performed significantly poorer than controls with regard to cognitive functions, mainly related to speed, attention and memory function. Long‐lasting impairment of cognitive functions related to speed, attention and memory function noted in patients with stress‐related exhaustion should be acknowledged and taken into consideration during treatment and when discussing a return to work. Follow‐up periods longer than three years are needed to explore the persistence of the cognitive impairment.     

Swedish women's perceptions of and conformity to feminine norms

The relatively high gender equality in the Swedish society is likely to exert an influence on gender role construction. Hence, the present research aimed to investigate Swedish women's perceptions of and conformity to feminine norms. A mixed methods approach with two studies was used. In Study 1, young Swedish women’s gender role conformity, as measured by the Conformity to Feminine Norms Inventory 45 (CFNI‐45), was compared to the results from previously published studies in Canada, the United States, and Slovakia. Overall, Swedish women displayed less conformity than their foreign counterparts, with the largest difference on the subscale Sexual fidelity. In Study 2, focus group interviews with young Swedish women added a more complex picture of feminine norms in the Swedish society. For instance the results indicated that Swedish women, while living in a society with a strong gender equality discourse, are torn between the perceived need to invest in their appearances and the risk of being viewed as non‐equal when doing so. In sum, despite the fact that traditional gender roles are less pronounced in Sweden, gender role conformity is still a pressing issue. Since attending to the potential roles of feminine norms in women’s lives previously has been proposed to be useful in counseling and therapeutic work, the present research also offers valuable information for both researchers and practitioners. [Correction added on 5 May 2017, after first online publication in April 2017: An incorrect Abstract was inadvertently captured in the published article and has been corrected in this current version.]     

Physical, Sociocultural, and Behavioral Factors Associated with Body-Esteem in 16-Year-Old Swedish Boys and Girls

Body Mass Index (BMI), weight loss attempts, pubertal timing, body ideal internalization, and peer appearance teasing were examined in relation to three dimensions of body-esteem; weight-based body-esteem (Weight), appearance-based body-esteem (Appearance), and beliefs about how others view one’s body and appearance (Attribution). Participants were 758 Swedish 16-year-olds. Results showed that the factors examined varied in importance depending on gender and body-esteem dimension. Whereas a majority of the factors examined were related to the Weight dimension, fewer were related to the Appearance dimension, and almost none were related to the Attribution dimension. Furthermore, the factors examined were generally able to explain a much greater amount of variance in girls’ body-esteem than boys’.     

Extending the the behavioral immune system to political psychology: Are political conservatism and disgust sensitivity really related?

Previous research suggests that several individual and cultural level attitudes, cognitions, and societal structures may have evolved to mitigate the pathogen threats posed by intergroup interactions. It has been suggested that these anti-pathogen defenses are at the root of conservative political ideology. Here, we test a hypothesis that political conservatism functions as a pathogen-avoidance strategy. Across three studies, we consistently find no relationship between sensitivity to pathogen disgust and multiple measures of political conservatism. These results are contrasted with theoretical perspectives suggesting a relationship between conservatism and pathogen avoidance, and with previous findings of a relationship between conservatism and disgust sensitivity.     

Influence of Attachment Style on Sexual Abuse Survivors' Posttraumatic Growth

This study investigated the directional relationship between adults' (N = 292) attachment styles and perceived impact of child sexual abuse with their experience of posttraumatic growth (PTG). Structural equation modeling results identified that attachment style served as a partial mediator between trauma and PTG scores, with the mediating effect contributing to 8% of the variance in the presence of PTG (p < .05; standardized coefficient = ?.31).     

Comparison of longitudinal phenotypes based on alternate heavy drinking cut scores: a systematic comparison of trajectory approaches III.

The goal of the present study was to empirically determine the effect of employing different cut scores for frequency of heavy episodic drinking (HED; an often-used indicator of problematic alcohol involvement) within a longitudinal framework. Using data from a large prospective (9-wave) college student sample, the authors used latent class growth analyses to characterize developmental trajectories of HED based on alternate cut scores that varied in frequency of HED (defined by 5+ drinks per occasion), as well as to measure very heavy episodic drinking (12+ drinks per occasion). As cut score severity increased and base rates for HED correspondingly decreased, individuals were increasingly categorized into less severe classes. Concordance between trajectories ranged from small to moderate, with concordance using highly discrepant definitions of frequent HED being particularly low. HED trajectories based upon different cut scores were validated against a range of etiological and consequential correlates. No single cut score was superior to others in explaining variance in external validity indicators, suggesting that the choice of cut score should be based upon theoretical and clinical considerations. This study further extends the authors' prior work examining the effects of methodological factors that are critical to characterizing the developmental course of alcohol involvement.