Choosing Assessment Instruments for Posttraumatic Stress Disorder Screening and Outcome Research

Effect‐size results from Erford et al.'s ( 2016 ) meta‐analysis for the treatment of posttraumatic stress disorder (PTSD) were used to compare 6 instruments' usefulness in measuring counseling treatment outcomes. Effect‐size comparisons indicated equivalent overall effect sizes using the Clinician‐Administered PTSD Scale, the Impact of Event Scale–Revised, the Posttraumatic Stress Diagnostic Scale, the PTSD Checklist, and the Structured Interview for PTSD. The Mississippi Scale for Combat‐Related PTSD yielded significantly more conservative (i.e., lower) effect‐size comparisons.     

Physical Abuse and Childhood Disability

SUMMARY

Several authors have hypothesized that children with disabilities are at increased risk for physical abuse. Such a finding would be consistent with current ecological models, which posit that certain child characteristics (e.g., behavior problems) in combination with other risk factors can lead to abuse. The paucity of research in this area makes it difficult to draw firm conclusions at this time. However, the few studies conducted suggest that child characteristics play a minor role in the etiology of abuse. Despite the lack of evidence indicating that children with disabilities are at significantly greater risk for abuse than their nondisabled peers, the presence of a disability raises some unique issues in the identification, assessment, and treatment of special needs children. This article reviews the literature linking abuse and disability as a risk factor. In addition, impediments encountered in the assessment and treatment of abused children with disabilities and their families are discussed and guidelines for practice are presented.     

Psychological MaltreatmentL

SUMMARY

Current issues regarding the definition of psychological maltreatment and its impact on children are discussed. The argument is made that psychological maltreatment can be understood as parenting and socialization practices that leave a child's basic psychological needs unmet, and that children exposed to interparental violence should be viewed as victims of psychological maltreatment. A needs analysis based on developmental theory and research is presented as a context within which to view psychological maltreatment. Using that conceptualization, research findings concerning the behavioral, cognitive, and social-emotional difficulties of children exposed to marital violence are examined. Based on this developmental analysis, recommendations are made regarding research that is needed in the areas of these children and psychological maltreatment.     

On wisdom

This article explores some of the features involved in making wise decisions in couples and family therapy. Delineating what qualities are involved in making wise decisions in life--so as to live the "good life" in the polis, and the necessary contributions of life experiences in this task--was first discussed by Aristotle. A major problem that therapists face today is that our society offers many different ways of living well--or for that matter, badly--and our theories do the same. Family therapy theories are not value free. I clarify that different family theories embody different values: clear boundaries, good attachments, the ability to communicate, and so on. If our theories foster certain values, then, as Isaiah Berlin has made clear, seeking to achieve a particular value leads to placing less value on another. The article concludes with some thoughts about values that therapists could appropriately follow in their work.     

The family check-up: a pilot study of a brief intervention to improve family functioning in adults

Many barriers exist for families seeking appropriate treatment for family problems. In an effort to minimize some of these barriers, we developed the Family Check-Up, a brief two-session family intervention. The Family Check-Up is based on the Drinker's Check-Up and consists of assessment, feedback, discussion, and goal setting. The purpose of the intervention is to help families identify and become motivated to make needed changes in any aspect of their family functioning. We conducted an open pilot trial of the Family Check-Up with 32 families. Our data suggest that the Family Check-Up (1) is sought out by the target audience, namely those with family problems; (2) is sought out by people with elevated depression symptoms or a history of treatment for depression or anxiety; (3) is feasible to conduct; (4) is acceptable to families; and (5) may be associated with changes in family functioning and depression symptoms over time. These results suggest that further research, particularly a randomized clinical trial, is warranted.     

II. Genotype-environment interaction in the schizophrenia spectrum: qualitative observations

Previous reports from the Finnish Adoptive Family Study of Schizophrenia have documented significant interplay between genetics (G) and family rearing (E), leading to adoptee outcomes of schizophrenia spectrum disorders. Quantitative evidence for this interplay is significantly enhanced when both high genetic liability and severe environmental dysfunction are present. However, when either genetic liability is low or the rearing environment is healthy, the adoptees appear to be resiliently protected against a pathologic outcome. Nevertheless, exceptions to this pattern do occur. Six qualitative vignettes, together with quantitative measures and categorical diagnoses from the same families, illustrate how multiple methods partially confirm one another and also suggest where further exploration of gene-environment interaction is needed.     

An evaluation of the value of choice with preschool children

The current study examined the reinforcing effects of choosing among alternatives in a four-part evaluation. In the first study, initial-link responses in a concurrent-chains arrangement resulted in access to terminal links in which the completion of an academic task resulted in (a) the choice of a reinforcer (choice), (b) the delivery of an identical reinforcer (no choice), or (c) no material reinforcer (control). Three patterns of responding emerged: persistent preference for choice (3 participants); initial preference for choice, which did not persist (2 participants); and preference for no choice (1 participant). Additional evaluations determined if preference for choice could be enhanced (Study 2) or established (Study 3) by including more stimuli from which to choose. Choice-link selections systematically increased for all participants when more items were available from which to choose. Study 4 identified the precise value of the opportunity to choose by progressively increasing the response requirement during the choice terminal links for 3 children and determining the point at which these children stopped selecting the choice link. All children continued to select the choice link even when the work required in the choice link was much greater than that arranged in the no-choice link.     

The effectiveness of and preschoolers' preferences for variations of multiple-schedule arrangements

Multiple schedules of reinforcement have been used to teach children to recruit attention only when it is available, thereby minimizing disruptive requesting during instructional activities. This procedure involves alternating periods of continuous reinforcement (CRF) with periods of extinction and correlating each period with a distinct and continuous discriminative stimulus. The present study evaluated the effectiveness of and children's preferences for multiple schedules in which (a) two different stimuli, one correlated with reinforcement (S+) and another correlated with extinction (S-), were presented; (b) only an S+ was presented (i.e., no stimulus was correlated with extinction), and (c) neither an S+ nor an S- was presented (i.e., a mixed schedule). S+/S- and S+ arrangements were similarly effective for 7 children, but 3 preferred the S+/S- condition and 4 preferred the S+ condition. Correlational analyses suggested that children who responded more effectively given the S- (discrimination indexes were relatively high) preferred the S+/S- condition, whereas children who responded less effectively given the S- preferred the S+ condition. The implications of these findings for arranging multiple schedules for social responses are discussed.