Two-Year Findings from a National Effectiveness Trial: Effectiveness of Behavioral and Non-Behavioral Parenting Programs

Long-term follow-up studies of selective parent training (PT) programs are scarce, particularly in the case of effectiveness trials conducted within regular care settings. This study evaluated the 2-year effects of 4 programs: Comet, Incredible Years, Cope, and Connect and differences in the rate of change among programs were investigated using Latent Growth Modeling (LGM). Participants were parents who had sought help at 30 local service sector units (e.g., child psychiatric clinics and social services centers) for major problems in managing their children’s externalizing behavior. Parents of 749 children (63 % boys) with moderate levels of externalizing behavior, aged 3–12, were randomized to one of the 4 PT programs. Assessments included parent-reported measures of child externalizing, hyperactivity and inattention, as well as parenting practices, sense of competence, and parents’ stress and depressive symptoms. At 2-year follow-up, there were no differences in any of the child outcomes among the programs. All programs had reduced externalizing behaviors with large effect sizes (d = 1.21 to d = 1.32), and negative parenting practices with moderate to large effect sizes (d = 0.49 to d = 0.83). LGM analyses showed that the 2 behavioral programs, Comet and Incredible Years, produced more rapid reductions in externalizing behavior during the course of the intervention than the non-behavioral program, Connect. Connect, however, was the only program where children continued to improve after the intervention. Overall, the results indicate that the 4 programs were equally effective in a clinical setting, despite differences in their theoretical origin.     

Gender differences on the Five to Fifteen questionnaire in a non‐referred sample with inattention and hyperactivity‐impulsivity and a clinic‐referred sample with hyperkinetic disorder

Lambek, R., Trillingsgaard, A., Kadesjö, B., Damm, D. & Thomsen, P. H. (2010). Gender differences on the Five to Fifteen questionnaire in a non‐referred sample with inattention and hyperactivity‐impulsivity and a clinic‐referred sample with hyperkinetic disorder. Scandinavian Journal of Psychology 51, 540–447. The aim of the present study was to examine gender differences in children with inattention, hyperactivity, and impulsivity on the Five to Fifteen (FTF) parent questionnaire. First, non‐referred girls (n = 43) and boys (n = 51) with problems of attention and hyperactivity‐impulsivity and then clinic‐referred girls (n = 35) and boys (n = 66) with hyperkinetic disorder (HKD) were compared on the FTF. Results suggested that non‐referred boys were more hyperactive‐impulsive than non‐referred girls, whereas clinic‐referred boys and girl with HKD were more similar than dissimilar on the FTF questionnaire. Secondly, it was examined whether the application of gender mixed norms versus gender specific norms would result in varying proportions of clinic‐referred children with HKD being identified as impaired on the subdomains of the FTF questionnaire. Based on results it was concluded that the use of a gender mixed normative sample may lead to overestimation of impairment in boys with HKD, but the type of sample applied to define impairment on the FTF should depend on the purpose for applying the questionnaire.     

Sex differences in parking are affected by biological and social factors

The stereotype of women’s limited parking skills is deeply anchored in modern culture. Although laboratory tests prove men’s average superiority in visuospatial tasks and parking requires complex, spatial skills, underlying mechanisms remain unexplored. Here, we investigated performance of beginners (nine women, eight men) and more experienced drivers (21 women, 27 men) at different parking manoeuvres. Furthermore, subjects conducted the mental rotation test and self-assessed their parking skills. We show that men park more accurately and especially faster than women. Performance is related to mental rotation skills and self-assessment in beginners, but only to self-assessment in more experienced drivers. We assume that, due to differential feedback, self-assessment incrementally replaces the controlling influence of mental rotation, as parking is trained with increasing experience. Results suggest that sex differences in spatial cognition persist in real-life situations, but that socio-psychological factors modulate the biological causes of sex differences.     

Narrative skill in children with early unilateral brain injury: a possible limit to functional plasticity

Children with pre‐ or perinatal brain injury (PL) exhibit marked plasticity for language learning. Previous work has focused mostly on the emergence of earlier‐developing skills, such as vocabulary and syntax. Here we ask whether this plasticity for earlier‐developing aspects of language extends to more complex, later‐developing language functions by examining the narrative production of children with PL. Using an elicitation technique that involves asking children to create stories de novo in response to a story stem, we collected narratives from 11 children with PL and 20 typically developing (TD) children. Narratives were analysed for length, diversity of the vocabulary used, use of complex syntax, complexity of the macro‐level narrative structure and use of narrative evaluation. Children’s language performance on vocabulary and syntax tasks outside the narrative context was also measured. Findings show that children with PL produced shorter stories, used less diverse vocabulary, produced structurally less complex stories at the macro‐level, and made fewer inferences regarding the cognitive states of the story characters. These differences in the narrative task emerged even though children with PL did not differ from TD children on vocabulary and syntax tasks outside the narrative context. Thus, findings suggest that there may be limitations to the plasticity for language functions displayed by children with PL, and that these limitations may be most apparent in complex, decontextualized language tasks such as narrative production.     

Friendship,Need Satisfaction and Happiness

Friendship quality is an important predictor of happiness, however, what might account for the association between the two? Two studies investigated satisfaction of basic psychological needs as a mediator of the relationship between friendship quality and happiness. Study 1 (n = 424) found support for the model for best friendship. Second study (n = 176) replicated the first study and showed that needs satisfaction in best and two closest friendships mediated the relationship between the quality of all friendships and happiness. The findings suggest that one reason why the quality of friendships is related to happiness is because friendship experiences provide a context where basic needs are satisfied.     

Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout

Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017, 95% CI_asymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CI_asymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.     

Inventing the wheel once more or learning from the history of psychotherapy research methodology: Reply to Gaudiano's comments on review

Gaudiano's criticism of one part of my review of ACT outcome research (Öst, 2008) is refuted on all issues but one. It is clear that the average amount of grant support for the ACT-studies was smaller than that of CBT-studies, even if the proportion of studies having grant support was not lower. However, that fact should only influence 25% (2 out of 8) of the methodology variables on which ACT-studies had lower mean scores than CBT-studies. It is not acceptable that a relatively new treatment, such as ACT, should be evaluated by more lenient criteria than already established therapies like CBT. If proponents of a new treatment wish to claim that their therapy is empirically supported then they have to accept to be evaluated by the APA Task Force criteria. It is time that ACT researchers start using the current psychotherapy research methodology.     

Early life origins of psychological development and mental health

According to the Developmental Origins of Health and Disease (DOHaD)‐hypothesis, conditions early in life may have life‐long consequences. In a series of epidemiological birth cohort and clinical studies and natural experiments, we have had the chance to test the extent to which this hypothesis is useful in understanding individual differences in psychological development and mental health. Our findings have provided evidence that individual differences in cognitive, social and emotional development and in mental health may lie in early life circumstances, and add significantly to the literature by pointing out which periods of early growth are the most critical. These findings are also important in translating pre‐clinical evidence to humans. What remains less clear, however, is what the mechanisms of programming are. Thus, further research is needed to elucidate these mechanisms before information on the early life origins of health and disease can be used in designing prevention and intervention programs.     

The AMQ: A Four‐Factor Inventory of Absentmindedness and Memory

The Absentmindedness and Memory Questionnaire (AMQ) is a new self‐rating scale designed to evaluate everyday memory problems related to absentmindedness. It includes 24 items and is based on studies of different samples (N= 623). Its test‐retest reliability is high and it has consistently shown similar factor structure. The AMQ thus measures four weakly correlated factors: Absentmindedness, Persons, Locations and Codes/Addresses. Factor analysis further indicates that Absentmindedness may include two subfactors: momentary attention deficit and prospective forgetfulness or impaired agenda memory. Gender differences were found in Persons (Female+) and Locations (Male+) but not in Absentmindedness or Codes/Addresses. The current version of AMQ has seven interindividually comparable response alternatives for each item in the questionnaire. This makes it useful as a measure of subjective absentmindedness or forgetfulness as well as a complementary measure of subjective memory for persons, locations, and codes/addresses/stories, especially at follow‐up examinations.     

Physiological responses in blood phobics

Eighteen patients with blood phobia were shown a film of thoracic operations containing large amounts of blood. Their heart rate (HR) and blood pressure (BP) were measured continuously before, during and after the watching of the film. The group data showed a diphasic response; an increase in HR and BP from baseline to the beginning of the film, and then a sharp drop in these parameters with the lowest values 4 min after the film was turned off. Individual data from 5 patients who fainted or were on the edge of doing so, showed massive bradycardia or drop in BP or both. In all of these patients at least one (range 1–33) 5-sec period of asystole was recorded. Possible theoretical explanations for this characteristic response pattern are discussed.