Evaluating Outcome Domains Assessing Caregivers of Individuals with Mental Illness: A Review

In this article, we describe the properties and consider the outcome dimensions of a collection of self‐administered questionnaires that assess caregivers of offspring with mental illness. To this end, we searched the MEDLINE, Web of Science, and PsycINFO databases, as well as reference lists of studies published between 1980 and 2012. We reviewed 43 instruments, and found multiple outcome domains, associated with either objective burden or subjective burden, or both. A number of tools captured additional negative aspects of caregiving (e.g., strain, stress, and worrying) as well as positive aspects (e.g., personal growth, strength, support, rewards, and satisfaction), supplemented by measures assessing caregivers' perceptions and attitudes toward their offspring with SMI (e.g., insight, stigma, and efficacy). This current review of existing measures and their specific domains contributes to a more comprehensive understanding of the caregiving experience and allows both clinicians and researchers to select the most appropriate measurement tools for their purposes.     

Treatment-resistant depression: A systematic review of systematic reviews

The objective of this research study was to assess pharmacological, somatic and/or psychological treatments in adults with a diagnosis of major depressive disorder who have not responded to at least one course of antidepressant medication. We conducted a systematic review to identify systematic scientific reviews and meta-analyses on treatment-resistant depression (TRD) published until February 2012. Of the sixty studies selected, sixteen met the inclusion criteria and were therefore included in the review. We considered eight main themes, including the definition of TRD, long-term results, and different treatment strategies, including so-called somatic therapies. Based on the review, the definition of TRD should be standardized in order to achieve a shared conceptualization of this disorder. This would allow a better understanding among clinicians and researchers in the field, promoting a homogeneous research methodology and thus leading to more reliable and comparable results. This essential conceptual clarification would also have a positive impact on patients with TRD, their families, and social and health systems.     

Language Anxiety and Counseling Self‐Efficacy

A total of 120 master's‐level counseling students were given the Foreign Language Classroom Anxiety Scale and the Counselor Self‐Estimate Inventory. Significance was found for all 3 hypotheses: (a) nonnative English‐speaking students have significantly more language anxiety than native English‐speaking students, (b) nonnative English‐speaking students’ language anxiety was negatively correlated with counseling self‐efficacy, and (c) native English‐ and nonnative English‐speaking students significantly differed in their perceptions of counseling self‐efficacy. Se administraron la Escala de Ansiedad en Clase de Lengua Extranjera y el Inventario de Autoestimación de Consejeros a un total de 120 estudiantes de máster en consejería. Se encontró significación para las 3 hipótesis siguientes: (a) los estudiantes cuya lengua nativa no es el inglés sufren un nivel considerablemente más alto de ansiedad a causa del idioma que los hablantes nativos de inglés, (b) la ansiedad a causa del idioma de los estudiantes cuya lengua nativa no es el inglés mostró una correlación negativa con la autoeficacia en consejería y (c) los grupos de estudiantes nativos y no nativos en inglés mostraron diferencias significativas en sus percepciones de autoeficacia en consejería.     

Predictors of Involvement and Warmth of Custodial Fathers in Israel: Comparison with Married and Noncustodial Divorced Fathers

This study compared the levels and predictors of paternal warmth and involvement of 218 custodial fathers to 222 married fathers and 105 noncustodial (NC) divorced fathers in Israel. The examined predictors were fathers' perceptions of their own fathers; their own caregiving behaviors and parental self‐efficacy; and child characteristics and coparental coordination. Results indicated that being a custodial father was associated with more involvement than being a married or NC divorced father. Regression analyses revealed that experience of care with own father predicted fathers' involvement, whereas own father control was related to lower paternal warmth. Lower avoidant caregiving and high paternal self‐efficacy predicted both paternal involvement and warmth, whereas perceiving the child as more difficult predicted lower paternal warmth. Higher levels of coparental coordination were associated with more paternal involvement, whereas low coparental coordination was associated with less involvement, primarily among NC divorced fathers. These interactions highlight the distinct paternal behavior of custodial fathers. Unlike married and NC divorced fathers, they showed more warmth, regardless of their avoidant caregiving. Results are discussed in light of the different roles played by fathers in the three groups.     

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta‐analysis

Parental reflective functioning (PRF) is an important predictor of infant attachment, and interventions that target parent–infant/toddler dyads who are experiencing significant problems have the potential to improve PRF. A range of dyadic interventions have been developed over the past two decades, some of which explicitly target PRF as part of their theory of change, and some that do not explicitly target PRF, but that have measured it as an outcome. However, no meta‐analytic review of the impact of these interventions has been carried out to date. The aim of this review was to evaluate the effectiveness of dyadic interventions targeting parents of infant and toddlers, in improving PRF and a number of secondary outcomes. A systematic review and meta‐analysis was conducted in which key electronic databases were searched up to October 2018. Eligible studies were identified and data extracted. Data were synthesised using meta‐analysis and expressed as both effect sizes and risk ratios. Six studies were identified providing a total of 521 participants. The results of six meta‐analyses showed a nonsignificant moderate improvement in PRF in the intervention group (standardised mean difference [SMD]: –0.46; 95% confidence interval [CI] [–0.97, 0.04]) and a significant reduction in disorganised attachment (risk ratio: 0.50; 95% CI [0.27, 0.90]). There was no evidence for intervention effects on attachment security (odds ratio: 0.71; 95% CI [0.19, 2.64]), parent–infant interaction (SMD: –0.10; 95% CI [–0.46, 0.26]), parental depression (SMD: –1.55; 95% CI [–3.74, 0.64]) or parental global distress (SMD: –0.19, 95% CI [–3.04, 22.65]). There were insufficient data to conduct subgroup analysis (i.e. to compare the effectiveness of mentalisation‐based treatment with non‐mentalization‐based treatment interventions). Relational early interventions may have important benefits in improving PRF and reducing the prevalence of attachment disorganisation. The implications for future research are discussed.