Outcomes for Children and Adolescents After Residential Treatment: A Review of Research from 1993 to 2003

The focus of this research review is to determine what factors increase the likelihood that positive individual and systemic changes occur for children and adolescents following discharge from residential treatment. Residential treatment outcome studies from 1993 to 2003 that fulfilled predetermined criteria were located through 4 on-line databases using key word combinations. The research selected was: (a) 7 studies that measured outcome immediately upon completion of treatment and discharge, and (b) 11 studies where outcome progress was assessed at one or more follow-up dates after discharge. Results showed that children and adolescents with severe emotional and behaviour disorders can benefit and sustain positive outcomes from residential treatment that is multi-modal, holistic and ecological in its approach. Similar to the clinical child psychotherapy research, conclusions must be tempered due to the limited number of studies and methodological weaknesses. Future considerations highlight how research results can more realistically reflect intervention effectiveness when elements of the ecological and systemic landscape of care are addressed.     

Parenting Competency Across Pregnancy and Postpartum Among Urban Minority Women

Taking a life-course perspective, we explored the sense of parenting efficacy during the pregnancy-postpartum transition among a group under-represented in much of adult developmental research, minority women. Our intent was to describe the women's report of parenting competency in a major life transition occurring within the context of an impoverished urban environment. We also explored associations with depression, social support, and life events. One hundred and eighty-two African-American and Hispanic mothers at community health centers in low-income urban areas completed measures early in the third trimester and again at 3 months postpartum. Across time, the levels of reported parental efficacy and satisfaction increased while depressive symptoms decreased. Negative life events and levels of depressive symptomatology differentially influenced women's experience of parenting satisfaction and efficacy feelings before and after their babies were born.     

Tracking Substance Abusers in Longitudinal Research: Understanding Follow-Up Contact Difficulty

Studies examining follow-up contact difficulty provide useful information for planning longitudinal studies and for assessing the validity of follow-up data. Contact difficulty was examined among 96 substance abusers following substance abuse treatment. Interview completion rates at the 3-month and 6-month follow-ups were 93 and 97%, respectively. The extent of contact efforts required to complete follow-up interviews varied substantially but tended to be greater at the 3-month follow-up than at the 6-month follow-up. Contact difficulty was related to reuse of substances at the 3-month and at the 6-month follow-ups with reusers requiring greater contact efforts than abstainers. None of the baseline individual and contextual variables examined significantly predicted level of contact effort at follow-ups. Attrition-related validity implications are discussed along with practical suggestions for planning tracking efforts.     

Mandated Interventions with Drug-Dependent, Pregnant Women

Increased concern about the influence of pregnant women's substance use on fetal health has prompted a variety of actions, including calls for legal interventions against some pregnant women with chronic substance abuse problems. In this paper I examine the legal and social science arguments used to support and oppose these interventions. Several assumptions about the behaviors of pregnant women that are used to support the arguments are described. The types of social science research that could inform the ongoing debate about interventions with pregnant women are explored.     

Social cognition and real-life functioning in patient samples with 22q11.2 deletion syndrome with or without psychosis,compared to a large sample of patients with schizophrenia only and healthy controls

Patients with the 22q11.2 deletion syndrome (DS) show an increased risk of developing a psychotic illness lifetime. 22q11.2DS may represent a reliable model for studying the neurobiological underpinnings of schizophrenia. The study of social inference abilities in a genetic condition at high risk for psychosis, like 22q11.2DS, may shed light on the relationships between neurocognitive processes and patients' daily general functioning. The study sample consisted of 1736 participants, divided into four groups: 22q11.2DS patients with diagnosis of psychotic disorder (DEL SCZ, N = 20); 22q11.2DS subjects with no diagnosis of psychosis (DEL, N = 43); patients diagnosed with schizophrenia without 22q11.2DS (SCZ, N = 893); and healthy controls (HC, N = 780). Social cognition was assessed through The Awareness of Social Inference Test (TASIT) and general functioning through the Specific Levels of Functioning (SLoF) scale. We analysed data through regression analysis. The SCZ and DEL groups had similar levels of global functioning; they both had significantly lower SLoF Total scores than HC (p < .001); the DEL SCZ group showed significantly lower scores compared to the other groups (SCZ, p = .004; DEL, p = .003; HC, p < .001). A significant deficit in social cognition was observed in the three clinical groups. In the DEL SCZ and SCZ groups, TASIT scores significantly predicted global functioning (p < .05). Our findings of social cognition deficit in psychosis-prone patients point to the possible future adoption of rehabilitation programmes, like Social Skills Training and Cognitive Remediation, during premorbid stages of psychosis.     

Relationship between maternal aggression and maternal care in the rat

Aggression among female rats is almost entirely confined to the period of late pregnancy and lactation. Behaviorally it is similar to the aggression of males including piloerection and lateral attacks, but it differs in its function. Unlike male aggression which serves to establish a social hierarchy and a territory, i. e., is competitive, maternal aggression is protective, i. e., it serves to prevent predation of the mother's offspring. In this respect it is closely related temporally and causally to maternal care; if the offspring are removed maternal aggression wanes almost immediately–its function no longer exists! Studies on aggression by mothers, among rats, from the author's laboratory are reviewed and comparisons made with maternal care. As noted, maternal aggression and maternal care are closely related during the cycle of maternal behavior and they share a similar hormonal basis and possibly the effect of uterine stimulation, but maternal care requires prolactin and the decline of progesterone while maternal aggression appears independent of pituitary hormones and does not require a decline in progesterone. Maternal aggression like maternal care appears to be organized into a hormonal phase, during pregnancy, parturition, and for about a week postpartum and a nonhormonal phase thereafter. Bilateral radiofrequency lesions of the lateral midbrain peripeduncular nucleus (PPN) produce deficits in maternal aggression if made on lactation day 7 (L7), but not earlier, without producing significant deficits in maternal behavior. Experiments showed that the PPN does not mediate hormonally stimulated maternal aggression; it appears to mediate only nonhormonally stimulated maternal aggression. Studies on the role of pregnancy hormones on long-term retention of maternal aggression and the role of olfaction in maternal aggression are also reviewed. © 1994 Wiley-Liss, Inc.     

Single Session Treatment of Test Anxiety with Eye Movement Desensitization and Reprocessing (EMDR)

One session of Eye Movement Desensitization and Reprocessing (EMDR) appeared to be an effective treatment for test anxiety, reducing reported physiological distress, worry, and fears of negative evaluation. The research design included two components: a comparison study, comparing Immediate Treatment and Wait List groups, and a replication study, comparing the treatment response of Immediate and Delayed (Treated Wait List) groups. Seventeen test anxious university students were randomly assigned to one session of EMDR or Wait List. At post-test, the Immediate group demonstrated significant improvement, compared to the Wait List group, on the Test Anxiety Inventory (TAI) and Fear of Negative Evaluation Scale. Treatment effects were maintained at follow-up. The Wait List group received treatment after post-measures were taken. Treatment of the Delayed group replicated effects. Improvement was reflected by large treatment effect sizes and a decrease in percentile ranking on the TAI from the 90th to the 50th percentile.     

The longitudinal association between social status insecurity and relational aggression: Moderation effects of social cognition about relational aggression

Previous research has shown that adolescents’ insecurity about their social status is related to their use of relational aggression. However, little is known about how adolescents’ social cognition may moderate this association. Employing a mixed-method approach and a short-term longitudinal design, this study addresses this issue by examining the moderation effects of attribution and outcome expectancies regarding relational aggression on the associations between social status insecurity and relational aggression among 476 Chinese adolescents (238 girls). The main results showed that self-serving attributions and instrumental outcome expectancies strengthened the positive and longitudinal association between social status insecurity and self-reported relational aggression. The findings of this study enrich our knowledge about the social cognitive processes pertinent to peer status and relational aggression among adolescents.     

Intensive Transactional Analysis Psychotherapy (ITAP): A case series study

Intensive Transactional Analysis Psychotherapy (ITAP) is a new therapeutic approach based on the integration of Transactional Analysis and brief psychodynamic approaches. ITAP is based on two key therapeutic tools—the intrapsychic triangle and the interpersonal triangle—which the therapist uses to focus patients’ attention on moment‐by‐moment therapy processes. The aim of the present study was to provide early empirical documentation of ITAP effectiveness. To this aim, six patients (four females, two males) were longitudinally evaluated using an A‐B‐A mixed quantitative and qualitative design, with evaluations at Baseline, Treatment and Follow‐up phases. Each patient received 16 50‐min weekly sessions of ITAP therapy over 4 months. For quantitative evaluations, patients filled out the Clinical Outcome in Routine Evaluation‐Outcome Measure (CORE‐OM) at each evaluation. Effects size values were estimated to evaluate quantitative changes comparing mean scores of Baseline, Treatment and Follow‐up phases. At the first follow‐up, the Change Interview was used to qualitatively evaluate patients’ perceived changes. In the quantitative data, four of the six patients reported a very good outcome, with large to very large effect sizes in Baseline versus Treatment and/or Baseline versus Follow‐up scores comparisons, whereas two patients reported variable fluctuations within the non‐clinical range of outcome scores. In the qualitative evaluations, all patients reported several moderately to extremely important perceived changes attributed to psychotherapy.