Practice-based evidence: patients who did not respond to group analysis

Evidence-based psychotherapy is typically based on treatment outcome for the "average" patient in aggregate designs; reports on individual non-responders are rarely published. In this observational study, we explored factors that might have contributed to non-response in long-term dynamic group psychotherapy. Eight patients (14%) who did not change were compared with 48 treatment responders on clinical variables, and their case stories were retrospectively scrutinized for explanatory factors. The non-responders had less initial distress, stayed for shorter durations in therapy, and were more dissatisfied with their group and therapists. Based on detailed case stories, attempts are made to tease out idiographic hypotheses why each patient did not change during group analysis.     

All at once or one at a time? A randomized controlled trial comparing two ways to deliver bibliotherapy for panic disorder

Bibliotherapy is potentially effective in the treatment of panic disorder (PD). A still unanswered question is whether pacing is important. This study was designed to test whether there is a difference between being assigned a full book as therapy and receiving one individual chapter every week (i.e. pacing). A total of 28 participants were randomized to either 10 paced chapters or one book with 10 chapters. To maximize compliance, short weekly telephone calls were added in both conditions (M = 17.8 min, SD = 4.2). Both treatments showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen's d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both posttest and 2-year follow-up for three panic measures. Pacing of text material in bibliotherapy for PD is not needed, and all material can be provided at once when the treatment is guided by a therapist.     

DSM-IV Attention Deficit Hyperactivity Disorder Symptoms: Agreement Between Informants in Prevalence and Factor Structure at Different Ages

The agreement between teachers’ and parents’ ratings of the prevalence of DSM-IV attention deficit hyperactivity disorder (ADHD) symptoms and the concordance of the factor structure of ADHD symptoms was analyzed in a sample of 653 Spanish schoolchildren aged 4 to 12 divided into two age groups. The prevalence of ADHD symptoms ranged between 0.66 and 16.73% and was higher when the rater was the teacher. Agreement between parents and teachers was low. Confirmatory factor analysis (CFA) shows a slightly better fit for the three-factor model (Inattention, Hyperactivity and Impulsivity) than for the two-factor model (Inattention and Hyperactivity–impulsivity), except for parents’ ratings in the sample of children under six. CFA using a multitrait–multimethod model (CFA-MTMM) shows similar results.     

Toward a Responsibility-Catering Prioritarian Ethical Theory of Risk

Science and Engineering Ethics - Standard tools used in societal risk management such as probabilistic risk analysis or cost–benefit analysis typically define risks in terms of only...     

Interrater agreement on behavioral executive function measures in adolescents with Attention Deficit Hyperactivity Disorder

Background/ObjectiveThough most children with Attention Deficit Hyperactivity Disorder (ADHD) show difficulties in behavioral measures of executive functions (EF), few studies have examined interrater agreement in these measures.Objective: To analyze the agreement between parents, teachers and self-reports of behavioral EF in adolescents with ADHD and controls. Method: A sample of 118 adolescents (75 with ADHD and 43 controls) was rated by parents, teachers and the adolescents themselves using the Comprehensive Executive Function Inventory. The intraclass correlation coefficient (ICC) and Bland and Altman methods were used to evaluate agreement. Results: The ICC between parents, teachers and self-report was poor or moderate in the group with ADHD; in the control group the agreement was fair to good. The Bland and Altman graphs show that, in the control group, most of the scores are below to the clinical cut-off point, while in the group with ADHD they are above. Conclusions: Agreement between all raters was low. Parents, teachers and adolescents agreed on the absence of deficits in behavioral EF in the control group, and on the presence of deficits in the group with ADHD, although they did not agree on the frequency of these deficits.     

Changing views: the effect of explicit perception-focus instructions on perspective-taking

In two experiments, we examined whether explicit attention to another’s perspective fosters perspective-taking. In the first experiment, we attempted to replicate previous findings showing that a mind-set focusing on self-other differences incites speakers to adopt another’s viewpoint in a subsequent task. However, our results showed that speakers focusing on self-other differences were just as likely to describe an object’s location from their egocentric perspective as speakers focusing on self-other similarities. In the second experiment, we intensified speakers’ awareness of perspectives by explicitly instructing them to regard their own (self-focus) or another’s (other-focus) viewpoint during the perspective-taking task. Participants allocated to the baseline did not receive explicit focus instructions. Findings revealed that other-focused speakers were more likely to adopt another’s perspective than self-focused speakers. However, compared to the baseline, an explicit other-focus did not foster perspective-taking. We conclude that an explicit awareness of perspective differences does not attenuate speakers’ egocentricity bias.     

Impaired auditory attention skills following middle-ear infections.

The present study investigated auditory attention skills in a sample of children with non-chronic otitis media with effusion (OME). Twenty children with repeated episodes of OME but not found in the need for myringotomy and insertion of ventilating tubes were compared to 20 control children with no known episodes of OME based on parental reports and medical records. Mean age during assessment was 9 years, and none of the children showed signs of impaired language functions and with normal general cognitive abilities. They were assessed with dichotic listening CV-syllables (DLCV-108) free recall and directed attention tasks. The control children showed the expected right ear advantage during free recall and the directed right condition, and demonstrated a shift toward a left ear advantage during the directed left. The children with a history of OME showed a predominant right ear advantage across all three tasks. Although some change in ear accuracy occurred across tasks, impaired auditory attention skills were found following a history of middle ear infections. These results replicate those reported earlier from a sample of children with persistent otitis media with effusion, and suggest that treatment with ventilating tubes does not appear to make any difference in the development of auditory attention skills, whereas occurrence of OME must be considered when testing auditory attentional skills as a part of a neuropsychological assessment.     

Personality characteristics associated with romantic attachment: a comparison of interview and self-report methodologies

This study compared the personality attributes associated with self-report versus interview assessment of romantic attachment. Twenty-three-year-olds (N = 83) completed the Romantic Attachment Interview, the Experiences in Close Relationship Inventory, and measures of response bias, self-enhancement, and self-insight. Five psychologists evaluated the participants' personality. Although both self-report and interview assessment were related to attachment-relevant personality attributes, interview assessment was slightly more likely to explain unique variance in personality, especially regarding intrapsychic attributes. Self-enhancement was negatively related to secure attachment and positively related to dismissing attachment. The opposite pattern emerged for self-insight. A subgroup of 12 vulnerable individuals who described themselves as securely attached on self-report was judged as dismissing according to interview assessment. These individuals scored low on self-insight and high on self-enhancement and psychological vulnerability. The results are discussed with reference to the relative strengths of different measures of romantic attachment and relations among dismissing attachment, self-enhancement, and narcissism.