Assessing Psychiatric Symptoms in Youth Affected by HIV: Comparing a Brief Self-Administered Rating Scale with a Structured Diagnostic Interview

Brief psychiatric assessment tools are needed for evaluating children affected by HIV for emotional and behavioral problems. We compared a self-administered symptom rating scale (CASI-4R) to a semi-structured diagnostic interview (DICA-P) in 136 U.S. children affected by HIV. Agreement and performance measures for the two instruments were computed for attention deficit hyperactivity disorder, depression, anxiety, and disruptive behavior. Correlations and regression analyses were conducted to compare the two instruments, and to evaluate their associations with social, academic, and global function. Higher CASI-4R symptom severity scores were associated with DICA diagnoses (p?<?0.02 for all disorders). Agreement (κ) between DICA diagnoses and CASI-4R Clinical Cutoffs (which incorporated symptoms and impairment) was low to moderate (0.19–0.40 for all disorders). Thirty-two percent of cases with a DICA diagnosis were identified by the CASI-4R Clinical Cutoff (sensitivity), yet over 90% of DICA-negative cases were negative by the CASI-4R (specificity). Sensitivity was higher using CASI-4R Severity Score thresholds based on median scores compared to the DICA diagnoses. The presence and severity of psychiatric symptoms and impairment were associated with poorer academic, social, and global function. The CASI-4R symptom checklist can be used to inexpensively screen youth affected by HIV for emotional and behavioral problems, although it is important that there be appropriate mental health evaluation follow-up.     

Therapiewechsler

At least 30% of the patients, currently in psychotherapy, have been in one or more psychotherapeutic treatments before the beginnig of the actual treatment. A great number of these patients decided as a consequence of their experiences with the former therapeutic treatments to change not only the therapist but also the form of the psychotherapy. The task was to find out the reasons for this. 25 patients who had changed from one of the Guideline Therapies into a client-centred therapy (CCT) were interviewed about their reasons for this change. It was assumed, that the failing of earlier therapies was caused by a lack of matching between patient and therapist, treatment and disorder in the sense of the Generic Model of Psychotherapy (GMP) conceptualized by Orlinsky and Howard. The results support this hypotheses: For most of these patients CCT turned out to be a necessary and successful alternative to the previous treatments. Most of the patients reported that they responded better to the therapeutic offer of CCT. The reasons mentioned for choosing another form of psychotherapy support the necessity of a differential indication for psychotherapy on the basis of the GMP.     

Teaching adolescents about changing bodies: Randomized controlled trial of an Internet puberty education and body dissatisfaction prevention program

This study tested the efficacy of an Internet-based prevention program, Trouble on the Tightrope: In Search of Skateboard Sam, on pubertal knowledge, body esteem, and self-esteem. One hundred and ninety participants (mean age 11.6 years) were randomized to either an intervention or attention placebo control condition and were assessed at baseline, after three Internet-based sessions, and at 3-month follow-up. Although the primary hypotheses were not supported, exploratory moderator analyses indicated that the intervention was beneficial for select students. Specifically, pubertal status moderated the effects on weight-related body esteem and several domains of self-esteem, resulting in positive effects for participants in the intervention group who had begun puberty. Gender differences were found on self-esteem subscales, indicating more robust effects for girls than boys. Tailored Internet programs based on personal characteristics such as gender and pubertal status may be a fruitful area for future research with adolescents.     

Counseling Intimate Partner Abuse Survivors: Effective and Ineffective Interventions

This study obtained feedback from intimate partner abuse survivors (N = 104) regarding helpful and unhelpful aspects of therapy. The survivors’ narrative accounts and answers to quantitative questions were subjected to quantitative and qualitative analysis. Results suggest that survivors sought therapy to understand themselves and the abuse they endured. Clinicians’ diagnoses of codependency or assertions that survivors chose the relationship weakened the therapeutic alliance and reduced the perceived helpfulness of therapy.     

Reviews: Books, Art

YOGA AND PSYCHOLOGY. By Howard Coward. 115 pp. Albany: State University of New York Press, 2002. $16.95. CASE STUDIES IN INFANT MENTAL HEALTH: RISK, RESILIENCY AND RELATIONSHIPS. Edited by Joan J. Shirilla and Deborah J. Weatherston. 203 pp. Washington, D.C.: Zero to Three, 2002. $32.95. JACOB'S SHADOW: CHRISTIAN PERSPECTIVES ON MASCULINITY. By Herbert Anderson. 173 pp. Louisville, KY: Bridge Resources, 2002. $18.95. LEONARDO DA VINCI. By Sherwin B. Nuland. 170 pp. New York: Viking, 2002. $19.95. FAITH AND THE PLACEBO EFFECT: AN ARGUMENT FOR SELF-HEALING. By Lolette Kuby. 323 pp. Novato, CA: Origin Press, 2001. $23.00. NOTHING PERSONAL, JUST BUSINESS: A GUIDED JOURNEY INTO ORGANIZATIONAL DARKNESS. By Howard F. Stein. Westport, CT: Quorum/Greenwood Publishing Group, 2001. FAITH BEYOND FAITH HEALING: FINDING HOPE AFTER SHATTERED DREAMS. By Kimberly Winston. 115 pp. Brewster, MA: Praraclete Press, 2002. A SHADOW OF GLORY: READING THE NEW TESTAMENT AFTER THE HOLOCAUST. Edited by Tod Linafelt. New York and London: Routledge, 2002. LOVE IS STRONGER THAN DEATH: THE MYSTICAL UNION OF TWO SOULS. By Cynthia Bourgeault. 222 pp. Great Barrington, MA: Lindisfarne Books, 2001. $14.95. Moving Pictures     

A parent intervention with a growth mindset approach improves children's early gesture and vocabulary development

Socioeconomic disparities in children's early vocabulary skills can be traced back to disparities in gesture use at age one and are due, in part, to the quantity and quality of communication children are exposed to by parents. Further, parents' mindsets about intelligence contribute to their interactions with their children. We implemented a parent gesture intervention with a growth mindset component with 47 parents of 10‐month‐olds to determine whether this approach would increase parents' use of the pointing gesture, infants' use of pointing, and child vocabulary growth. The intervention had an effect on parent gesture such that by child age 12‐months, parents who received the intervention increased in their pointing more than parents in the control condition. Importantly, the intervention also had a significant effect on child gesture use with parents. There was no main effect of the intervention on child vocabulary. Further, the effect of the intervention on pointing was stronger for parents who endorsed fixed mindsets at baseline, and had an added benefit of increased vocabulary growth from 10–18 months for children of those parents who endorsed fixed mindsets. Incorporating growth mindset approaches into parenting interventions is encouraged.     

Children's Emotional Security in the Interparental Relationship

ABSTRACT— In response to the societal premium placed on understanding the difficulties faced by children from high-conflict homes, emotional security theory aims to understand precisely how and why interparental discord is associated with children's psychological problems. One of its main premises is that interparental discord increases children's vulnerability to mental illness by undermining their sense of safety or security in the context of the interparental relationship. In this article, we highlight the main assumptions of a new ethological formulation of emotional security theory and its predictions and findings regarding the organization, precursors, and consequences of individual differences in children's emotional insecurity. We conclude with a synopsis of the value of the new formulation for future work.