Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

Mental health systems need scalable solutions that can reduce the efficacy–effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers’ fidelity to evidence-based treatment models and children’s and caregivers’ engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families.     

A Model of Threatening Academic Environments Predicts Women STEM Majors’ Self-Esteem and Engagement in STEM

Sex Roles - The present study tested a model of threatening academic environments among a vulnerable population: women in science, technology, engineering, and mathematics (STEM) fields. Women in...     

Diverting multi-problem youth from juvenile justice: investigating the importance of community influence on placement and recidivism

In the U.S., diversion has increasingly become one of the most utilized alternatives to detention of delinquent youth. Programs providing diversion can vary greatly. Variations in program design make it difficult to evaluate the effectiveness of program outcomes. Utilizing hierarchical linear modeling, this study examines variations in outcome for ten program sites of the New York State MH/JJ Diversion Project. Program and youth predictors were evaluated on two outcomes: out-of- community placement and recidivism. At the individual level, significant mental health and substance abuse problems, age, prior placements, and use of wraparound funds were predictive of youth placements, while significant substance abuse problems were predictive of recidivism. Program variations were found to have a significant impact on youth outcomes. Specifically, sites providing direct (or "in house") care had significantly reduced rates of placement. Study results and implications for future research are discussed.     

A mediational model of trait negative affectivity, dispositional thought suppression, and intrusive thoughts following laboratory stressors

Two studies examined the relationships among trait negative affectivity, dispositional thought suppression, and intrusions in non-clinical samples. In Study 1 (N=87), participants were presented with a series of emotionally evocative images and intrusions were examined 48 h after presentation via self-report. In Study 2 (N=118), intrusions were examined using a behavioral Key-press and self-report at two time points (5 and 20 min) following exposure to a series of emotionally evocative images. In each study, participants were assessed for trait negative affectivity and the tendency to engage in thought suppression in response to unpleasant cognitions. Results from both studies support a model in which chronic thought suppression fully mediates the relationship between negative affectivity and the frequency of intrusions.     

Reducing hopelessness: the interation of enhancing and depressogenic attributional styles for positive and negative life events among youth psychiatric inpatients

A recovery model of depression (Needles & Abramson, 1990 Journal of Abnormal Psychology, 99, 156-165) proposes that depressed individuals who exhibit an enhancing attributional style for positive events (i.e. make stable, global attributions) will be more likely to regain hopefulness and, thereby, recover from depression when positive events occur. While only a few studies have directly tested this model among clinical and nonclinical adult samples, none have tested a clinical sample of children and adolescents. Furthermore, prior studies testing this model have failed to examine the interactive role of an 'enhancing attributional style' for positive events with a 'depressogenic attributional style' for negative events, as prescribed by the hopelessness theory of depression (Abramson, Metalsky, & Alloy, 1989 Psychological Review, 96, 358-372). The current study presents data demonstrating that depressogenic and enhancing attributional styles interact to predict differential decreases in hopelessness. Implications of these findings and suggestions for future research also are presented.     

Factor structure and interpretation of the K10

The Kessler 10 Psychological Distress Scale (K10) is a brief 10-item questionnaire designed to measure the level of distress and severity associated with psychological symptoms in population surveys. It is being used widely, including in the World Health Organization World Mental Health Survey, and as a clinical outcome measure, although little information is available about the structure of the measure. The factorial composition of the K10 was examined in a prospective community survey and cross-validated in a separate large community survey. The K10 was found to consist of 4 factors and a 2-factor second-order factor structure. This was stable across the 2 waves of the prospective study and the Australian National Survey of Mental Health and Well-Being. The 4 factors, labeled Nervous, Negative Affect, Fatigue, and Agitation, were consistent with the original scales from which the items were taken. The 2 second-order factors represent Depression and Anxiety.     

Self‐Harm Focus Leads to Greater Collective Guilt: The Case of the U.S.‐Iraq Conflict

Collective guilt from harm one's group has caused an out‐group is often undermined because people minimize or legitimize the harm done (i.e., they generate exonerating cognitions). When a group action has harmed both the in‐group and an out‐group, focusing people on “self‐harm”—ways in which the in‐group has harmed itself—may elicit more collective guilt because self‐harm is less likely to be exonerated. In Study 1, American participants who focused on how the invasion of Iraq had harmed the United States expressed greater collective guilt over harm inflicted on the people of Iraq than those who focused on Iraqi suffering. Study 2 showed that this effect is due to reductions in exonerating cognitions among people focused on self‐harm. We consider the implications of these findings for intergroup reconciliation, particularly in situations where two groups have been involved in open conflict.     

A New Method for Analyzing Data From Visual Artwork

ABSTRACT

This article presents a novel data analytic approach to collect detailed information from visual artworks. This new method provides researchers with a framework to compare, analyze, and review in a systematic way large quantities of data from visual productions. Drawing on principles of art historical criticism, our research team devised a comprehensive coding scheme that captures both technical and content attributes. The coding scheme is configured to record specific, fundamental features for each artwork, providing an instrument for collecting data and cross-examining codes to reveal content in a unique and unbiased manner. For example, detailed data collected through individual codes can reveal clear patterns in the artistic treatment of composition and medium, providing evidence that the method could be adapted and applied for use in a variety of settings. To illustrate the method, this article presents examples from an empirical research study that was conducted at Harvard University's Project Zero. In this study, the coding scheme was applied to 414 pieces of artwork published in a teen art and literary magazine between 1990 and 2011. The coding scheme is defined and applied to 2 sample artworks, allowing readers to understand how this method can be used to record nuanced information about each work. Applying this analytic approach to visual art created in museums and informal learning settings can yield insights into artworks, their creators, and nuanced changes in creative production over time.