Therapeutic response to Cognitive Processing Therapy in White and Black female veterans with military sexual trauma-related PTSD

Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD. Reductions in PTSD symptom severity, number of sessions attended, and early termination rates were compared between Black (n = 20) and White (n = 16) female veterans. A hierarchical linear modeling approach was used, with PTSD symptom severity over the course of treatment and follow-up entered as a level-1 variable and race (Black or White) entered as a level-2 predictor. Piecewise growth curves analyses revealed that both Black and White female veterans experienced significant reductions in PTSD symptom severity over the course of treatment and gains were maintained up to 6 months post-treatment. Race was not found to be a significant predictor of change in the slope of PTSD symptom severity over the course of CPT treatment. Additionally, number of sessions attended and rates of early termination did not significantly differ based on race. Results suggest that CPT was a well-tolerated and effective psychotherapeutic treatment for this sample regardless of racial self-identification.     

The Primacy of Discourse in the Study of Gender in Family Therapy

Family therapists and scholars increasingly adopt poststructural and postmodern conceptions of social reality, challenging the notion of stable, universal dynamics within family members and families and favoring a view of reality as produced through social interaction. In the study of gender and diversity, many envision differences as social constructed rather than as “residing” in people or groups. There is a growing interest in discourse or people's everyday use of language and how it may reflect and advance interests of dominant groups in a society. Despite this shift from structures to discourse, therapists struggle to locate the dynamics of power in concrete actions and interactions. By leaving undisturbed the social processes through which gendered and other subjectivities and relations of power are produced, therapists may inadvertently become complicit in the very dynamics of power they seek to undermine. In this article, we argue that discourse analysis can help family therapy scholars and practitioners clarify the link between language and power. We present published examples of discourse analytic studies of gender and sexism and examine the relevance of these ideas for family therapy practice and research.     

The Experience in Personal Social Systems Questionnaire (EXIS.pers): Development and Psychometric Properties

This study presents the theoretical background, development, and psychometric properties of the German and English versions of the Experience in Personal Social Systems Questionnaire (EXIS.pers). It assesses how the members of a personal social system experience their situation within that system. It is designed as a research tool for interventions in which only one member of the system participates (e.g., Family Constellation Seminars). The EXIS.pers was created to measure change on the individual level relating to one's own important personal social system. In Study 1, we used exploratory factor analysis (EFA) for latent variable identification of the original German EXIS.pers (n = 179). In Studies 2 and 3, we used confirmatory factor analysis (CFA) to examine the dimensionality of the German (n = 634) and English (n = 310) EXIS.pers. Internal consistencies and cross‐cultural structural equivalence were assessed. EFA indicated that a four‐factor model provided best fit for the German EXIS.pers. For both the German and English EXIS.pers, CFA provided the best fit for a five‐factor bi‐level model that included a general factor (Experience In Personal Social Systems) and four dimensions (Belonging, Autonomy, Accord, Confidence). Good internal consistencies, external associations, and cross‐cultural structural equivalence were demonstrated. This study provides first evidence for the German and English EXIS.pers as an economical and reliable measure of an individual's experience within his or her personal social systems.     

Effects of Group Functional Behavior-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Behavior in a Youth With Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) often present with comorbid Obsessive Compulsive Behaviors (OCBs), but little research exists on effective intervention for OCBs. Using a single-case experimental design, this study highlights the efficacy of a Group Functional Behavior-based Cognitive-Behavior Therapy (Fb-CBT) to reduce OCBs in an 11-year-old youth with ASD. Tailored to the individual needs of this youth, Fb-CBT included traditional CBT components (e.g., psychoeducation, cognitive-behavioral skills training, and exposure and response prevention) coupled with functional behavior assessment and intervention. Time-series parent report data and standardized measures showed clinically significant decreases in OCBs, an increase in psychosocial functioning, and high consumer satisfaction.     

Does Parent-Child Interaction Therapy Reduce Maternal Stress,Anxiety, and Depression Among Mothers of Children with Autism Spectrum Disorder?

Maternal stress, anxiety, and depression are associated with ineffective parenting strategies for families of children with Autism Spectrum Disorders (ASD). We present the use of Parent-Child Interaction Therapy (PCIT) with three mother-child dyads to reduce maternal stress, anxiety, and depression and child disruptive behavior in children with ASD. Results included increases in positive parenting skills, and decreases in maternal anxiety, depression, and stress, as well as child behavior problems. PCIT is a promising alternative to more intensive and costly interventions, both at reducing disruptive behaviors and improving maternal health. Implications of PCIT for dyads affected by ASD are discussed.     

Stability and Change in Cognitive Behavior Therapy: Considering the Implications of ACT and RFT

Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT) are part of the new wave of treatments and analyses that seem to be emerging in cognitive behavior therapy. In this article, data in support of these new approaches are provided, and evidence that ACT works through different processes than traditional CBT are presented. The integrative proposals of Ciarrochi and Robb, and Ciarrochi, Robb, and Godsell are then considered. In the long run, whether such integrations are useful is an empirical matter, but concerns are raised about the effects of focusing on the content of beliefs, and the role of logical–empirical challenges to belief. Address correspondence to Steven C. Hayes, Department of Psychology/298, University of Nevada, Reno, NV 89557-0062, USA.     

Acceptance and commitment therapy versus tinnitus retraining therapy in the treatment of tinnitus: a randomised controlled trial

The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60 min sessions. The TRT treatment consisted of one 150 min session, one 30 min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8 h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen’s d = 1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen’s d = 0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.     

A feasibility study of Acceptance and Commitment Therapy for emotional dysfunction following psychosis

The experience of psychosis can lead to depression, anxiety and fear. Acceptance and Commitment Therapy (ACT) facilitates individuals to accept difficult mental experiences and behave in ways that are consistent with personally held values. This study was a single (rater) blind pilot randomised controlled trial of ACT for emotional dysfunction following psychosis. Twenty-seven participants with psychosis were randomised to either: ten sessions of ACT plus treatment as usual (TAU) or TAU alone. The Hospital Anxiety and Depression Scale, Positive and Negative Syndrome Scale, Acceptance and Action Questionnaire, Kentucky Inventory of Mindfulness Skills and Working Alliance Inventory were used. Individuals were assessed at baseline and 3 months post-baseline. The individuals randomised to receive ACT found the intervention acceptable. A significantly greater proportion of the ACT group changed from being depressed at time of entry into the study to not being depressed at follow-up. The ACT group showed a significantly greater increase in mindfulness skills and reduction in negative symptoms. Results indicated that individuals randomised to ACT had significantly fewer crisis contacts over the study. Changes in mindfulness skills correlated positively with changes in depression. ACT appears to offer promise in reducing negative symptoms, depression and crisis contacts in psychosis.     

正念认知疗法对手机依赖大学生的干预效果*

使用SAS和MPAI量表从820名被试中筛选出60名被试随机分配到实验组和对照组进行实验研究。预期通过正念认知疗法对手机依赖进行干预以降低大学生手机依赖程度。结果发现:实验组被试在接受正念认知疗法为期4周8次的团体辅导训练后,手机依赖总分、失控性、戒断性和逃避性因子得分与对照组相比显著降低,正念水平显著提高。结果表明正念认知疗法对个体的手机依赖的干预效果明显。     

Building Communities, Bridging Gaps: Alexander George's Contributions to Research Methods

This article assesses Alexander L. George's seminal contributions in six areas of political psychology and qualitative case study methods. These include George's work on psychological inputs in political processes, the intersection of history and political science, methods of within-case analysis such as process tracing, the use of structured, focused case comparisons (SFCC), the development of typological theories, and the connections among theory, empirical research, teaching, and policy. The article concludes with an analysis of four ongoing dimensions of George's research agenda: the need to integrate theories on purposive, cognitive, social, and motivational dynamics of decision making; the importance of methodological safeguards against our own cognitive biases as researchers; ways of integrating qualitative, quantitative, formal, and experimental research methods; and ways of modeling and testing theories on causal complexity.