Parent management training for conduct problems in children: Enhancing treatment to improve therapeutic changeCapacitación en entrenamiento de padres para problemas de conducta en niños: mejorar el tratamiento para mejorar el cambio terapéutico

Background/Objective: The study evaluated two variations of Parent Management Training (PMT) for children referred to treatment for oppositional, aggressive, and antisocial behavior. The goal was to evaluate the impact of multiple enhancements to optimize common and placebo factors to augment therapeutic change. Method: The families of all children (N=138, 39 girls and 99 boys, ages 6-13) received PMT. One half of the families were assigned to receive an enhanced version with multiple additions designed to increase bonding of the parent to the therapist, professionalism of treatment and setting, credibility of the intervention, and expectancies for therapeutic change. Assessment included multiple treatment outcome measures of the child (problem behaviors, psychiatric symptoms, social competence, and adaptive functioning) and parents (depression, stress, and family relations) showed marked improvements over the course of treatment, and several process measures (therapeutic alliance, credibility of the procedures, expectancy for change). Results: The results indicated that children and parents made marked improvement in all the treatment outcome measures. The vast majority of children fell within the normative range at posttreatment on problem and prosocial behaviors. The two treatment conditions were no different in outcomes for children or parents. Conclusion: PMT led to marked changes in treatment outcome.     

Reevaluating Cue Exposure and Response Prevention in a Pilot Study: An Updated Treatment for Binge Eating Disorder

Approximately half of individuals with binge eating disorder (BED) fail to improve when treated with cognitive behavioral therapy; thus, better treatments are needed. Cue exposure and response prevention (CERP) may be one option, but its full potential for reducing binge eating remains unknown because prior applications for binge eating have not utilized the broad range of strategies believed to optimize exposure therapy. The current single-subject AB design investigated the acceptability and effectiveness of a comprehensive CERP treatment among 8 women who met DSM-5 criteria for binge eating disorder. Changes in the number of binges were measured from baseline to the end of treatment, and desire to eat, salivation, and idiographic expectancies of aversive outcomes to food-cue exposure (idiographic CS-US expectancies), including expectancies about ability to tolerate distress when exposed to food cues were measured across the course of treatment. Statistical analysis revealed a significant reduction in the number of binges from baseline to the end of treatment. Across the course of treatment, desire to eat and idiographic CS-US expectancies reduced, and distress tolerance expectancies increased. No participants dropped out and all reported being maximally satisfied with the treatment. Based on these findings, future randomized-control trials with larger samples should examine the efficacy of CERP and mechanisms underlying change with the aim of establishing a more effective treatment for binge eating disorder.     

The Empirical Status of Cue Exposure and Response Prevention Treatment for Binge Eating: A Systematic Review

Approximately 50% of individuals fail to obtain treatment benefits when undergoing cognitive-behavioral therapy (CBT) for binge-eating behaviors, making it necessary to evaluate additional approaches. Cue exposure and response prevention (CERP) is one such approach, although its effectiveness across studies has been inconsistent. This may be due to inconsistent implementation of theoretically based CERP strategies. This possibility has not yet been systematically investigated. To address this gap, this review investigated which CERP strategies have been incorporated into treatment protocols for binge eating, and if the use of certain strategies improves treatment effectiveness. Relevant studies were identified through reference lists, grey literature, and searches of electronic databases using multiple search terms related to CERP and binge eating, which resulted in 18 eligible studies. Most studies were underpowered, many were of low methodological quality, and none of the included studies utilized all of the strategies that have been recommended to optimize CERP. Despite these weaknesses, CERP appeared to reduce the frequency of binge eating in the short and long term. This review underscores the need for higher quality research that utilizes larger samples and uniform outcome measures that are more strongly grounded in theory. Such research would help improve treatment outcomes for binge eating.     

A meta-analysis of support variables and well-being in ethnic minority populations

Aims: The importance of social support as a predictor of well-being has been documented in the literature for decades. The extent to which social support may be uniquely relevant to the well-being of ethnic minority populations has not yet been empirically supported with meta-analytic techniques. The current meta-analytic study attempted to clarify the nuances of the relationship between support and well-being in ethnic minority populations and to identify what moderators may be relevant to understanding such relationships. Method: Data from 111 articles were included in the analyses that examined both the main effects and moderators of the relationship between social support and well-being. Results: Overall findings revealed a greater effect size (ES) between support and positive well-being (r = .38) than between support and negative well-being (r = −.27). Significant moderators included the proportion of females in the sample, age of the participants, and nature of support. Several ES differences were found in support type and ethnic group interactions as well. Conclusions: Implications of these data include the importance of social support enhancement in efforts to increase the positive well-being and attending to gender and other cultural modifiers in future studies of social support with racial and ethnic minorities.     

Evaluation of early relational disturbance in high-risk populations: Borderline personality disorder features,maternal mental state,and observed interaction

Despite the longstanding theoretical association in the attachment literature between maternal trauma history and disturbances in the mother–infant interaction, few studies have investigated mechanisms of transmission of traumatogenic relational patterns in high-risk mother–infant dyads. This study investigated interrelationships among maternal trauma history, distorted maternal representations (DMRs, i.e. disturbed thoughts and feelings about the infant and self-as-parent), maternal mentalisation (i.e. capacity to conceive of self and other's intentions in terms of mental states including thoughts, feelings, and desires), and quality of interaction in a clinical sample of mothers with Borderline Personality Disorder (BPD) features and their infants (N = 61). Measures used included the Childhood Trauma Questionnaire, Parent Development Interview, Mother–Infant Relationship Scale, Borderline Symptom Checklist-23, and the Emotional Availability Scales. The results indicated BPD features mediated the relationship between maternal trauma history and DMRs predicting disturbance in interaction. In addition, analyses showed that maternal mentalisation had a buffering effect between DMRs and maternal non-hostility and yet the severity of BPD features moderated the relationship between mentalisation and DMRs. The findings suggest postpartum borderline pathology may adversely impact the experience of being a parent for women with a relational trauma history including deficits in mentalisation (i.e. hypermentalising) and disturbances in the mother–infant interaction. Implications for research and clinical practice are discussed.     

Parent-early adolescent relationship quality and problem behavior in Hungary,the Netherlands,India, and Iceland

Higher parent-child relationship quality has been associated with less internalizing and externalizing problem behavior. However, it remained less clear whether these associations are universal or depend on the country under investigation. Furthermore, fathers are still understudied, even though there is increasing evidence of their important role in early adolescent development. Our study compared the association of mother-child as well as father-child relationship quality with early adolescents’ problem behavior in four culturally different countries, namely Hungary (N = 293; M_age = 11.22; 53% boys), the Netherlands (N = 242; M_age = 11.20; 48% boys), India (N = 230; M_age = 10.68; 61% boys), and Iceland (N = 261; M_age = 10.90; 53% boys). Early adolescents filled out questionnaires in their classroom, assessing warmth and conflict with fathers and mothers and internalizing and externalizing problem behavior. Stepwise multi-group path analysis demonstrated no cross-cultural differences in associations between quality of the parent-child relationship and problem behavior. We did not find any effects of maternal or paternal warmth. However, across samples conflict with mothers was associated with more internalizing and externalizing problem behavior, and conflict with fathers was associated with more externalizing problem behavior. Our findings highlight the need to target conflict with both fathers and mothers in interventions across different countries, especially when addressing externalizing problem behavior.     

Social anxiety and perceptions of likeability by peers in children

The current study aimed to investigate the discrepancy between self-reported and peer-reported likeability among children, and the relation with social anxiety, depression, and social support. In total, 532 children between 7 and 12 years completed questionnaires about social anxiety symptoms, depressive symptoms, and social support, estimated their own likeability, and indicated how much they liked their classmates. Children with higher levels of social anxiety or depression overestimated their likeability less or even underestimated their likeability. Social anxiety symptoms, but not depressive symptoms, were significant predictors of the discrepancy. Social support was positively related to likeability and negatively related to social anxiety, but did not moderate the association between social anxiety symptoms and perception accuracy of likeability. These results are in line with cognitive theories of childhood social anxiety, and they stress the importance of using multi-informant measures when studying the relation between social anxiety and social functioning in children.     

Functional Dependencies between Variables

We consider a predicate logic L_fd where not all assignments of values to individual variables are possible. Some variables are functionally dependent on other variables. This makes sense if the models of logic are assumed to correspond to databases or states. We show that L_fd is undecidable but has a complete and sound sequent calculus formalisation.