Establishing Treatment Fidelity in Evidence-Based Parent Training Programs for Externalizing Disorders in Children and Adolescents

The current review evaluates the use of treatment fidelity strategies in evidence-based parent training programs for treating externalizing disorders. We used a broad framework for evaluating treatment fidelity developed by the National Institutes of Health Treatment Fidelity Workgroup that includes the aspects of treatment design, treatment delivery, training providers, and assessment of participant receipt of treatment and enactment of treatment skills. Sixty-five articles reporting outcome trials of evidence-based parent training programs met inclusion criteria and were coded for treatment fidelity strategies. The mean adherence to fidelity strategies was .73, which was higher than two previous review studies employing this framework in the health literature. Strategies related to treatment design showed the highest mean adherence (.83), whereas training of providers and enactment of treatment skills had the lowest (.58). In light of an increasing emphasis on effectiveness and dissemination trials, the broader treatment fidelity framework as applied in this review focuses needed attention on areas often overlooked in fidelity practices, such as training providers and generalization of treatment skills. We discuss the strengths and limitations of fidelity practices in parent training studies, implications of these findings, and areas for future research.     

An atypical anxious‐impulsive pattern of social anxiety disorder in an adult clinical population

An atypical subgroup of Social Anxiety Disorder (SAD) with impulsive rather than inhibited traits has recently been reported. The current study examined whether such an atypical subgroup could be identified in a clinical population of 84 adults with SAD. The temperament dimensions harm avoidance and novelty seeking of the Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale were used in cluster analyses. The identified clusters were compared on depressive symptoms, the character dimension self‐directedness, and treatment outcome. Among the six identified clusters, 24% of the sample had atypical characteristics, demonstrating mainly generalized SAD in combination with coexisting traits of inhibition and impulsivity. As additional signs of severity, this group showed low self‐directedness and high levels of depressive symptoms. We also identified a typically inhibited subgroup comprising generalized SAD with high levels of harm avoidance and low levels of novelty seeking, with a similar clinical severity as the atypical subgroup. Thus, higher levels of harm avoidance and social anxiety in combination with higher or lower levels of novelty seeking and low self‐directedness seem to contribute to a more severe clinical picture. Post hoc examination of the treatment outcome in these subgroups showed that only 20 to 30% achieved clinically significant change.     

Longitudinal Analysis of Adolescent NSSI: The Role of Intrapersonal and Interpersonal Factors

Non-suicidal self-injury (NSSI) occurs in approximately 10 % of adolescents. To establish effective prevention and intervention initiatives, it is important to understand onset, maintenance and cessation of NSSI. We explored whether the relationships between interpersonal factors (i.e. attachment, social support) and NSSI were mediated by intrapersonal factors (i.e. emotion regulation, self-esteem, self-efficacy). Participants were 1973 students (1414 female and 559 male) aged between 12 and 18 years (M?=?13.89, SD?=?0.97) recruited from 40 Australian high schools. Participants completed a questionnaire at two time-points with a 12-month interval. At baseline, 8.3 % of adolescents engaged in NSSI, increasing to 11.9 % at follow-up. Family support was most salient in onset, maintenance and cessation of NSSI. Attachment anxiety was related to NSSI onset. Of the intrapersonal variables, self-esteem and self-efficacy were significant in predicting onset of NSSI. Self-esteem, self-efficacy and cognitive reappraisal mediated the relationship between attachment anxiety and NSSI onset. A combination of interpersonal and intrapersonal variables contributes to the onset, maintenance and cessation of NSSI in adolescence. Perceived family support appears to be an important safeguard against NSSI. Strategies targeting family functioning and teaching cognitive reappraisal techniques to adolescents may reduce the number engaging in NSSI.     

Happy babies,chatty toddlers: Infant positive affect facilitates early expressive,but not receptive language

Eighty-three mother–infant dyads participated in this study. Positive affect (PA) broadly, along with fine-grained aspects of PA, was measured at 10 months of age. Language was measured at 14 months. Infant PA predicted expressive, but not receptive, language. The implications of these findings are discussed.     

Trajectories of Adolescent Psychopathic Traits

There is growing evidence that psychopathic traits are stable across the adolescent developmental period. Yet, no previous studies have examined the longitudinal course of these traits across adolescence. In this study, we examined joint developmental trajectories of grandiose-manipulative traits, callous-unemotional traits, and impulsive-irresponsible behavior and how these trajectories were related to changes in parental behavior and delinquency over time. Participants were 1,068 adolescents from a community sample, who were followed annually over 4 years. Overall, our results showed that a four-class latent class growth model best represented the developmental pattern of adolescent psychopathic traits. Although the majority of adolescents showed low or moderate initial levels that also decreased over time, there was a small group of adolescents who, despite significant decreases in two out of three dimensions, still maintained relatively high levels on all three dimensions. We also found that parental behavior and delinquency developed differently for the groups over time, with the high-decreasing group engaging in more delinquent behavior over time and experiencing more negative parental behavior than any other group. In sum, our findings suggest that there is a group of adolescents at particular risk for negative development.     

Like Mike: Ability contagion through touched objects increases confidence and improves performance

Magical thinking refers to irrational peculiar beliefs, including those that conform to the laws of contagion. We propose that touching an object that was previously touched by a high performer increases confidence via magical thinking (ability contagion) and improves actual performance among individuals high in experiential processing. A series of studies provides support for this main proposition. Our results cast doubt on an alternative explanation based on priming, and are obtained controlling for participants’ level of rational processing, motivation, and affect.     

The Impact of a Digital Recorder Intervention in Pragmatic/Experiential Therapy for Couples: A Pilot Study to Assess Emotional Flooding

The present study explored the effectiveness of a unique intervention for couple therapy, the Canned Attitude Method (a technique developed by Brent Atkinson), which utilized a digital recorder in and between therapy sessions. Participant dyads were randomly assigned to the intervention group utilizing the digital recorders or the control group, in which Pragmatic/Experiential Therapy for Couples (Atkinson in J Syst Ther 17:18–35, 1998) was conducted without the use of digital recorders. Both the intervention and the control groups were composed of five couples each for a total of 20 participants. This study hypothesized that the use of the Canned Attitude Method in couple therapy would produce a significant change in marital satisfaction, emotional flooding, and positive psychological tendencies associated with intimate relationships. Findings approached significance, demonstrating decreases in the experience of emotional flooding, gains in relationship satisfaction, and a shift towards positive attributes within the couples’ relationships.     

Survivor mission: Do those who survive have a drive to thrive at work?

Are helping professionals who have experienced the same types of struggles as their clients more engaged at work? In the current investigation, we examine this question in samples of police detectives (with and without a history of violent victimization) and mental health workers (with and without a history of mental illness). Our results indicate that police detectives who have experienced violent victimization and mental health professionals who have experienced the same mental illness as their clients do indeed exhibit greater work engagement than their colleagues who lack these parallel life experiences. The link between a professional’s firsthand experience of his/her client’s hardships and work engagement appears to be partially explained by higher levels of grit among police detectives and by a greater sense of life-narrative continuity among mental health professionals.