Links between physical fitness and cardiovascular reactivity and recovery to psychological stressors: A meta-analysis.

A meta-analysis of published studies with adult human participants was conducted to evaluate whether physical fitness attenuates cardiovascular reactivity and improves recovery from acute psychological stressors. Thirty-three studies met selection criteria; 18 were included in recovery analyses. Effect sizes and moderator influences were calculated by using meta-analysis software. A fixed effects model was fit initially; however, between-studies heterogeneity could not be explained even after inclusion of moderators. Therefore, to account for residual heterogeneity, a random effects model was estimated. Under this model, fit individuals showed significantly attenuated heart rate and systolic blood pressure reactivity and a trend toward attenuated diastolic blood pressure reactivity. Fit individuals also showed faster heart rate recovery, but there were no significant differences in systolic blood pressure or diastolic blood pressure recovery. No significant moderators emerged. Results have important implications for elucidating mechanisms underlying effects of fitness on cardiovascular disease and suggest that fitness may be an important confound in studies of stress reactivity.     

Utilizing Benchmarking to Study the Effectiveness of Parent–Child Interaction Therapy Implemented in a Community Setting

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of Parent–Child Interaction Therapy (CI-PCIT) utilized as a child maltreatment prevention effort. Data were collected from 83 parent–child dyads. Change scores were compared to treatment and control effect sizes aggregated from the PCIT literature. Pre-post results indicated significant positive changes in child behavior for CI-PCIT completers. Benchmarking analyses revealed that parents who completed CI-PCIT reported significantly greater positive child outcomes than the aggregate control group benchmark, and significantly less than observed in the treatment benchmark. A summary of decision points and implications for utilizing this methodology in the child maltreatment field are postulated.     

Therapeutic immediacy across long-term psychodynamic psychotherapy: an evidence-based case study

C. E. Hill (2004) recently developed the concept of therapist immediacy to capture discussion by the therapist about the therapeutic relationship that occurs in the here-and-now of a therapy session. This concept has been expanded to include discussion about the therapeutic relationship by both the client and therapist, captured by the term therapeutic immediacy (K. Kuutmann & M. Hilsenroth, 2011). Although prior research has examined the use of therapeutic immediacy across short-term treatment, the present study is the first to examine the use of immediacy across a long-term (4 years) psychotherapy. Also, this is the first study to assess the interrater reliability of therapeutic immediacy, which was found to achieve good to excellent levels across raters. The most frequently used categories of client and therapist immediacy are presented. Finally, the authors provide an in-depth qualitative examination of 5 therapeutic immediacy segments across the treatment judged by the raters to have high levels of depth/intensity (4.5 or higher out of 5) to examine the role of therapeutic immediacy in exploring meaningful treatment issues. Clinical utility, potential limitations, and future research on therapeutic immediacy are discussed.     

Exploring the construct validity of the social cognition and object relations scale in a clinical sample

The Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) measures the quality of object relations in narrative material. This study employed a multimethod approach to explore the structure and construct validity of the SCORS-G. The Thematic Apperception Test (TAT; Murray, 1943) was administered to 59 patients referred for psychological assessment at a large Northeastern U.S. hospital. The resulting 301 TAT narratives were rated using the SCORS-G method. The 8 SCORS variables were found to have high interrater reliability and good internal consistency. Principal components analysis revealed a 3-component solution with components tapping emotions/affect regulation in relationships, self-image, and aspects of cognition. Next, the construct validity of the SCORS-G components was explored using measures of intellectual and executive functioning, psychopathology, and normal personality. The 3 SCORS-G components showed unique and theoretically meaningful relationships across these broad and diverse psychological measures. This study demonstrates the value of using a standardized scoring method, like the SCORS-G, to reveal the rich and complex nature of narrative material.     

Do Parent and Teacher Report of ADHD Symptoms in Children Differ by SES and Racial Status?

Parent and teacher reports of symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in children often differ from each other. These informant report differences may occur in systematic ways that vary by child socioeconomic status (SES) and race, but little is known about how SES and race together relate to parent and teacher report of ADHD symptoms in school-aged children. We examined the relationship between child SES, child race and parent and teacher reports of ADHD symptoms in two samples of school-aged Caucasian and African American children being evaluated for ADHD (N = 1056; N = 317). Multivariate regression was used to predict parent and teacher reports of ADHD symptoms from child SES, race, age, gender and interaction terms. The Wald test of parameter constraints was used to test the contrast between the predictors of interest and parent and teacher report of symptoms. In the second sample, we also examined observer report measures of ADHD symptoms during one-to-one testing and in the classroom. In both samples, lower SES was associated with higher levels of inattention symptoms, as reported by teachers, but not by parents. Lower SES was also associated with higher levels of hyperactivity/impulsivity symptoms, as reported by both teachers and parents. African American race was associated with higher levels of inattention and hyperactivity/impulsivity symptoms reported by teachers than reported by parents. Observer report measures showed a different pattern of associations with SES and race. Investigating how children’s SES and race influence cross-informant agreement on ratings of children’s behavior might lead to the development of better assessment practices and more accurate diagnoses for diverse child populations.     

Experiences related to expert supervisors' views of ideal therapeutic practice

Aims: This study examines the relationship between expert supervisors' professional experiences and their views about the importance of different psychotherapy techniques. Method: Thirty psychodynamic‐interpersonal (PI) supervisors and 13 cognitive‐behavioural (CB) supervisors (N=43) were instructed to rate 20 therapeutic techniques according to how characteristic each technique is of an ideally‐conducted session within their theoretical orientation. The measure used for this assessment was the Comparative Psychotherapy Process Scale. Results: Findings demonstrated that supervisors' beliefs about ideal therapeutic techniques are related to their number of years in post‐graduate clinical practice, training, and supervising trainees, as well as to the number of publications they have authored. Further, experience within a given orientation tends to lead to a greater endorsement of techniques within that orientation, although this finding is more uniform for CB supervisors than PI supervisors. Finally, differential types of experience lead to differential focusing on specific techniques. Discussion: The clinical importance of these findings is explored.     

Exploring the Factor Structure of the Social Cognition and Object Relations–Global Rating Method: Support for Two- and Three-Factor Models

The Social Cognition and Object Relations Scales–Global Rating Method (SCORS–G) contains 8 scales for coding narrative content. This study explores the factor structure of this measure using college (n = 171), outpatient (n = 239), and inpatient (n = 78) samples. Participants told stories to the Thematic Apperception Test (TAT; Murray, 1943) cards. Stories were transcribed and coded by blind raters using the SCORS–G. Cases were randomly assigned to an exploratory or validation group. Exploratory factor analysis with the exploratory group suggested 2- and 3-factor models. The Emotional Investment in Relationships (EIR) scale did not obtain a primary loading on any factor and was not included in subsequentmodels. After modifications, confirmatory factor analysis indicated good-to-adequate fit for 2- and 3-factor models. Both models showed good fit in the validation group and met criteria for invariance across models. Findings indicated that some SCORS–G scales tap cognitive-structural elements, whereas others assess affective-relational components of narratives. We found mild support separating the affective-relational scales in terms of internal representations for the self and others and relationships. The results reported here indicate that clinicians and researchers can calculate a separate cognitive-structural composite score and an affective-relational composite score when using the SCORS–G to rate TAT stories.     

The Suicide (SPI) and Violence Potential Indices (VPI) from the Personality Assessment Inventory: A Preliminary Exploration of Validity in an Outpatient Psychiatric Sample

Assessing risk of harm to self and others is an important component of psychological assessment, although methods for risk assessment vary considerably. The Personality Assessment Inventory (PAI) is frequently administered to evaluate general psychological functioning, as well as to provide information about suicide and violence risk. The purpose of this study was to evaluate the construct validity of the PAI Suicide (SPI) and Violence Potential (VPI) indices in a sample of 158 psychiatric outpatients referred for psychological and neuropsychological assessment within a large northeastern academic medical center between 2007 and 2011. Results generally supported the convergent and divergent validity of both SPI and VPI when evaluating groups with and without a history of suicide and violence risk, and effect sizes were moderate to large even after controlling for other covariates. SPI and VPI scores were also found to vary significantly across different psychiatric groups in ways that would be expected. Finally, we explored the relationship between SPI and VPI, and executive functioning impairment??a neuropsychological variable found to be associated with impulsive self and other-harming behaviors. Consistent with prior research, SPI and VPI were found to be significantly elevated in groups demonstrating executive dysfunction. The implications of these findings and specifically the utility of using SPI and VPI in the assessment of risk are discussed.     

External Correlates of the Personality Assessment Inventory Higher Order Structures

This brief report explores the external correlates of 2 higher order structures of the Personality Assessment Inventory (PAI; Morey, 1991, 2007); Hoelzle and Meyer's (2009a, 2009b) PAI Components and Hopwood and Moser's (2011) Internalizing and Externalizing Dimensions. Scores from these higher order structures were correlated with life-event data including education, marital status, employment, suicide attempts, psychiatric hospitalizations, trauma, medical problems, hallucinations, paranoid ideation, drug abuse, alcohol abuse, and arrest. Although some differences were noted, the results showed that both Hoelzle and Meyer's Components and Hopwood and Moser's Dimensions were meaningfully correlated with a wide range of life outcomes in a conceptually consistent manner. Overall, these findings provide support for the utility of these higher order variables.