Multiple-family group treatment of outpatients with schizophrenia: impact on service utilization

The impact of multiple-family group treatment (MFGT) on outpatient and inpatient mental health service utilization of 97 persons with schizophrenia was investigated. Participants were randomly assigned to standard care (n = 44) or standard care plus MFGT (n = 53). Service use for a year prior to randomization, the 2-year study period, and a 1-year follow-up were examined. Relative to standard care participants, the MFGT group had reduced community hospitalization during year 1 of the intervention and reduced state hospitalization at follow-up. During the intervention period, MFGT participants demonstrated a significant increase in outpatient utilization as a direct consequence of the intervention. However, when service use was summed across 3 years post-randomization, no group differences were observed. Results suggest that implementation of MFGT in a community mental health setting reduces inpatient service at specific time periods, without significantly increasing outpatient service utilization. These findings add to other outcomes from this study that demonstrate decreased psychiatric symptoms and caregiver distress.     

Modeling the Bullying Prevention Program Preferences of Educators: A Discrete Choice Conjoint Experiment

We used discrete choice conjoint analysis to model the bullying prevention program preferences of educators. Using themes from computerized decision support lab focus groups (n = 45 educators), we composed 20 three-level bullying prevention program design attributes. Each of 1,176 educators completed 25 choice tasks presenting experimentally varied combinations of the study’s attribute levels. Latent class analysis yielded three segments with different preferences. Decision Sensitive educators (31%) preferred that individual schools select bullying prevention programs. In contrast, Support Sensitive educators (51%) preferred that local school boards chose bullying prevention programs. This segment preferred more logistical and social support at every stage of the adoption, training, implementation, and long term maintenance processes. Cost Sensitive educators (16%) showed a stronger preference for programs minimizing costs, training, and implementation time demands. They felt prevention programs were less effective and that the time and space in the curriculum for bullying prevention was less adequate. They were less likely to believe that bullying prevention was their responsibility and more likely to agree that prevention was the responsibility of parents. All segments preferred programs supported by the anecdotal reports of colleagues from other schools rather than those based on scientific evidence. To ensure that the bullying prevention options available reflect the complex combination of attributes influencing real world adoption decisions, program developers need to accommodate the differing views of the Decision, Support, and Cost Sensitive segments while maximizing the support of parents and students.     

Evaluation of a preventive intervention for a self-selected subpopulation of children

Evaluated an experimental preventive intervention developed for children who perceived their parents as problem drinkers. The 8-session program was designed to improve children's coping, self-esteem, and social competence, and modify alcohol expectancies which were specified as mediators of the effects of parental alcohol abuse on child mental health. Participants were 271 self-selected 4th-, 5th-, and 6th-grade students in 13 schools. The children were randomly assigned to treatment or delayed treatment conditions and the program was given to three successive cohorts of students. A meta-analysis across three different cohorts indicated significant program effects to improve knowledge of the program content and the use of support- and emotion-focused coping behaviors for the full sample. A slightly stronger range of effects was found for a high-risk subsample. This research was funded by the National Institute of Mental Health Grant P50-MH39246 to support a Preventive Intervention Research Center and Prevention Training Grant T32-MH18387-02.     

A Multimethod Examination of the Effect of Insomnia Symptoms on Anxious Responding to a Social Stressor

A growing number of studies identify insomnia symptoms as a potential risk factor for the development of anxiety disorders. However, little research has examined potential mechanisms through which insomnia could confer increased risk for anxiety. A separate line of literature suggests sleep is necessary for adaptive emotional and behavioral responding to stressors, a potential mechanism linking insomnia symptoms to anxiety risk. To test whether insomnia symptoms affect emotional and behavioral responding to an anxiety-relevant stressor, the current study recruited a sample of 99 undergraduates with varying levels of insomnia symptoms. Participants completed self-report and psychophysiological measures before, during, and after an impromptu speech task. Results indicated that, after covarying for negative affectivity, increased insomnia symptoms were significantly associated with elevated anticipatory anxiety and skin conductance response prior to the speech, and increased skin conductance response, emotion regulation difficulties, and safety aid use during the speech. Taken together, results provide evidence for the notion that insomnia symptoms are associated with maladaptive emotional and behavioral responding to an anxiety-relevant stressor.     

Confronting the Holocaust in Religious Education

Studies of Holocaust education in secondary schools have tended to focus on how the subject is taught as part of the history curriculum. Comparatively little work of either a theoretical or an empirical nature has looked at how the subject is handled in other curricular areas. Religious education is a case in point, for the field is marked both by a dearth of literature on appropriate content and by a virtual absence of research on teachers' practices. The need to address these lacunae provides the rationale for the article. In relation to content, two concerns dominate the discussion. The first is that the Holocaust may be portrayed as an act of religious intolerance; the second is that students may be offered a diluted or distorted account of the part played by Christianity. The empirical core of the article surveys the practices of 28 teachers of religious education in connection with both concerns. It also contains a content analysis of how textbooks used by the teachers treat the attempted annihilation of European Jewry. The article concludes with a discussion of the policy implications of the findings.