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121.
Hinshaw SP Owens EB Wells KC Kraemer HC Abikoff HB Arnold LE Conners CK Elliott G Greenhill LL Hechtman L Hoza B Jensen PS March JS Newcorn JH Pelham WE Swanson JM Vitiello B Wigal T 《Journal of abnormal child psychology》2000,28(6):555-568
To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting. 相似文献
122.
Wells KC Epstein JN Hinshaw SP Conners CK Klaric J Abikoff HB Abramowitz A Arnold LE Elliott G Greenhill LL Hechtman L Hoza B Jensen PS March JS Pelham W Pfiffner L Severe J Swanson JM Vitiello B Wigal T 《Journal of abnormal child psychology》2000,28(6):543-553
Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD. 相似文献
123.
We examined the differential impact of chronic versus acute economic stress on depressive mood among a sample of 1241 low-income, single, European and African American women. Based on Hobfoll's (1988, 1989) conservation of resources (COR) theory, we predicted that acute resource loss would be more distressing than chronic economic lack. That is, although chronically impoverished conditions are stressful, the attendant resource losses created will be more distressing. We further predicted that mastery and social support would be more beneficial in offsetting the negative consequences of acute resource loss than the negative consequences of chronic economic lack, because acute loss creates identifiable demands that resources may address. Hence, we hypothesized that mastery and social support would show stress buffering effects only for material loss, not chronic lack. The findings generally supported the hypotheses, but mastery buffered only European American women's resource loss and social support buffered only African American women's resource loss. The findings are discussed in light of implications for prevention within theoretical and cultural contexts. 相似文献
124.
Willi Butollo 《Journal of Psychotherapy Integration》2000,10(4):357-374
Out of the many aspects of posttraumatic adaptation the role of self-process is emphasized, where self is conceptualized as the representation of social interaction: Not only the messages conveyed by others, but also a person's inner response to that messages, forms ongoing self-processes. Traumatic experiences lead to distorted self-processes, to a great extent due to posttraumatic inner dialogues. Therapeutic implications and experiences from Bosnia are discussed, where this model has been applied. 相似文献
125.
Luo Lu Shu-Fang Kao Cary L. Cooper Paul E. Spector 《International journal of stress management》2000,7(3):209-226
This study investigated managerial stress in Taiwan and UK using the Occupational Stress Indicator-2 (OSI-2) and the Work Locus of Control (WLCS) scale. Results showed that the reliability and validity of the measures used were acceptable and comparable in the two samples. There were similarities as well as differences in managerial stress in the two countries. Recognition and Managerial role were important predictors of strain for the Chinese managers, whereas Relationships, Organizational climate, and Personal responsibility were important predictors of strain for UK managers. There were consistent moderating (vulnerability) effects of internal control for the Taiwanese managers. Results corroborated some previous studies conducted in the West. However, caution was also suggested for generalizing Western-originated concepts and theories across cultural boundaries. 相似文献
126.
Family-based therapy is one of the most thoroughly studied treatments for adolescent drug abuse. Considerable empirical support exists for the efficacy of family-based therapy in curtailing adolescent drug use and cooccurring behavior problems. This article extends knowledge of the effects of family-based therapy for adolescent drug abuse by reviewing 16 controlled trials and 4 therapy process studies from a treatment development perspective. We articulate knowns and unknowns regarding the outcomes of treatment as well as the components, processes, mechanisms, moderators, and boundaries of effective family-based therapy for adolescent drug abuse. The review highlights areas of progress and future research needs within the specialty of family-based therapy for adolescent drug abuse. 相似文献
127.
While obsessive–compulsive disorder is widely recognized to have a strong genetic component, psychosocial factors are also acknowledged to be important. The primary focus of this paper is on familial factors associated with OCD in children and adolescents. It explores the family context as a possible risk factor in the development and maintenance of the disorder, including parental modeling, expressed emotion, parenting style, and family accommodation of the child's symptoms. The involvement of the family in the treatment of the disorder is also reviewed. Finally, future directions for research investigating familial factors in childhood OCD are presented. 相似文献
128.
Switankowsky I 《Theoretical medicine and bioethics》2000,21(6):567-580
Cartesian dualism has been viewed by medical theorists to be oneof the chief causes of a reductionist/mechanistic treatment ofthe patient. Although I aver that Cartesian dualism is one culprit for the misapprehension of the genuine treatment of patients in termsof both mind and body, I argue that interactive dualism whichstresses the interaction of mind and body is essential to treatpatients with dignity and compassion. Thus, adequate medical carethat is humanistic in nature is difficult (if not impossible)to achieve without physicians adhering to a dualistic frameworkin which the body and person is treated during illness. 相似文献
129.
The concept of acceptance is receiving increased attention as an alternate approach to the suffering that is often associated with persistent and disabling pain. This approach differs from established treatments in that it does not principally focus on reducing pain, but on reducing the distressing and disabling influences of pain as they concern important areas in patients' lives. The present analyses represent a preliminary evaluation of an acceptance-based approach to chronic pain within an interdisciplinary treatment program. One hundred and eight patients with complex chronic pain conditions completed treatment and provided data for the current study. Treatment was conducted in a 3- or 4-week residential or hospital-based format. It included a number of exposure-based, experiential, and other behavior change methods focused on increasing (a) engagement in daily activity regardless of pain and (b) willingness to have pain present without responding to it. Significant improvements in emotional, social, and physical functioning, and healthcare use were demonstrated following treatment. The majority of improvements continued at 3-months post-treatment. Improvements in most outcomes during treatment were correlated with increases in acceptance, supporting the proposed process of treatment. 相似文献
130.
Eva?M.?EpsteinEmail author Denise?M.?Sloan 《Journal of Contemporary Psychotherapy》2005,35(4):317-330
There is a wealth of data indicating the effectiveness of cognitive behavioral therapy in the treatment of bulimia nervosa.
However, the best evidence indicates a treatment success rate of 50%. The purpose of this paper is to briefly describe cognitive
behavioral treatment of bulimia nervosa and to offer suggestions on how this therapy approach may be tailored to best serve
the needs of individual clients. Such tailoring should ultimately lead to even greater treatment success. 相似文献