Clin Psychol (clin + psychol)

Distribution by Scientific Domains

Selected Abstracts

The point prevalence of bulimic disorders from 1990 to 2004

Janis H. Crowther PhD
Abstract Objective: This study investigated the point prevalence of probable cases of bulimia nervosa (BN), eating disorder not otherwise specified (EDNOS), and specific eating disorder symptomatology among 6,844 undergraduate women at a single site, examining changes across five 3-year time periods and on a yearly basis from 1990 to 2004. Method: Participants completed a self-report checklist that assessed the diagnostic criteria for BN (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 1994) and the Bulimia Test (Smith and Thelen, J Consult Clin Psychol, 52, 863,872, 1984) (BULIT) or Bulimia Test-Revised (Thelen et al., Psychol Assess, 3, 119,124, 1991) (BULIT-R). Results: Chi-square analyses comparing the percentages of probable cases of BN and EDNOS and the percentages of women who reported frequent binge eating and most compensatory weight control strategies were nonsignificant. Only the percentages of women who endorsed overconcern with weight and shape and diuretic use and excessive exercise as compensatory weight control strategies changed over time. Conclusion: Consistent with Keel et al.'s (Keel et al., Psychol Med, 36, 119,127, 2006) findings regarding the point prevalence rates of BN from 1992 to 2002, results indicated that probable cases of eating disorders remained relatively stable. Methodologically, this research illustrates the importance of examining multiple data points when investigating stability or change in behavior. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source]

Combat experience and the acquired capability for suicide,

Craig J. Bryan
Abstract Rising suicide rates are an increasing concern among military personnel. The interpersonal-psychological theory of suicide proposes that three necessary factors are needed to die by suicide: feelings that one does not belong with other people, feelings that one is a burden on others or society, and an acquired capability to overcome the fear and pain associated with suicide. The current study tests the theory's proposal that acquired capability may be particularly influenced by military experience, because combat exposure may cause habituation to fear of painful experiences such as suicide. Utilizing clinical and nonclinical samples of military personnel deployed to Iraq, results of the current study indicate that a greater range of combat experiences predicts acquired capability above and beyond depression and post-traumatic stress disorder symptoms, previous suicidality, and other common risk factors for suicide. Combat experiences did not, however, predict perceived burdensomeness or thwarted belongingness. The authors discuss how combat experiences might serve as a mechanism for elevating suicide risk and implications for clinical interventions and suicide prevention efforts. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,13, 2010. [source]

Depression following open-heart surgery: A path model involving interleukin-6, spiritual struggle, and hope under preoperative distress

Amy L. Ai
Abstract Faith factors (i.e., factors pertaining to religion/spirituality) have been linked with well-being and adequate coping. Few studies have investigated negative aspects of religious coping, such as spiritual struggle. Based on the multidisciplinary literature and on previous findings, the study's analysis estimated parallel psychophysiological pathways from preoperative distress to postoperative depression in patients undergoing open heart surgery. Plasma samples for interleukin(IL)-6 were obtained before surgery. The results showed that a link between spiritual struggle and IL-6 mediated the indirect effects of preoperative anxiety on postoperative depression. Avoidant coping also mediated the influence of anxiety on postoperative maladjustment. Further, hope played a protective mediating role to moderate the undesirable influences of the spiritual struggle,IL-6 link and maladaptive coping on postoperative mental health attributes. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1,19, 2010. [source]

Alexithymia and posttraumatic stress: subscales and symptom clusters,

Frédéric Declercq
Abstract This study examined the relationship between the emotion-regulating factor alexithymia and the occurrence of posttraumatic stress disorder (PTSD) after critical incidents in a nonclinical sample of 136 nurses and ambulance personnel working in military facilities. The results showed that alexythima accounts for variance in PTSD symptoms. Breaking PTSD into its 4 symptom clusters, alexithymia was found to predict numbing and hyperarousal symptoms but not avoidance or reexperiencing symptoms. Finally, the rarely investigated, but clinically relevant, distinctive subdimensions of alexithymia were examined in relation to the 4 PTSD clusters. The difficulty identifying feelings subscale contributed most to the numbing and hyperarousal PTSD subscales. Clinical implications and future research directions are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1,14, 2010. [source]

Distinguishing anxiety and depression in self-report: purification of the beck anxiety inventory and beck depression inventory-II,

Niklaus Stulz
Abstract The overlap of symptoms associated with anxiety and depressive disorders hinders their differentiation using self-report scales. The aim of this study was to develop purified versions of the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II) that encompass only items highly specific to anxiety and depression, respectively. However, using these purified scales only increased the ability to differentiate anxiety and depressive disorders slightly. Anxiety and depression seem to be inherently linked and, thus, the high comorbidity of anxiety and depressive disorders seems to be not a function of the same types of symptoms being reported for each disorder. Nevertheless, purified BAI and BDI-II scales might be useful for separating the effects of interventions on anxiety and depressive symptoms. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,14, 2010. [source]

Assessing suicide risk among callers to crisis hotlines: A confirmatory factor analysis,

Tracy K. Witte
Abstract Our goal was to investigate the factor structure of a risk assessment tool utilized by suicide hotlines and to determine the predictive validity of the obtained factors in predicting subsequent suicidal behavior. We conducted an Exploratory Factor Analysis (EFA), an EFA in a Confirmatory Factor Analysis (EFA/CFA) framework, and a CFA on independent subsamples derived from a total sample of 1,085. Similar to previous studies, we found consistent evidence for a two-factor solution, with one factor representing a more pernicious form of suicide risk (i.e., Resolved Plans and Preparations; RPP) and one factor representing milder suicidal ideation (i.e., Suicidal Desire and Ideation; SDI). The RPP factor trended toward being more predictive of suicidal ideation at follow-up than the SDI factor. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1,24, 2010. [source]

Reasons for terminating psychotherapy: a general population study

Robin Westmacott
Abstract Clients' (N=693) reasons for ending psychotherapy and their associations with demographics, mental disorder caseness, and type of mental health care service provider were examined. The most frequently reported reason for termination was feeling better, however, a substantial minority of individuals reported terminating because of treatment dissatisfaction or wanting to solve problems independently. Lower income was associated with lower odds of termination because of feeling better and higher odds of termination because of a perception that therapy was not helping. Meeting criteria for an anxiety disorder, a mood disorder, or substance dependence decreased the odds of termination because of feeling better. These findings provide important information on the challenges to the successful completion of psychotherapy. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,13, 2010. [source]

Culturally relevant family-based treatment for adolescent delinquency and substance abuse: understanding within-session processes,

Phillippe B. Cunningham
Abstract Identifying psychotherapy processes that likely contribute to client outcome with ethnic minorities is a vital practice and research need, particularly within family-focused, evidence-based treatments (EBT) for youth with externalizing problems. Identifying process variables within a cross-cultural context may improve the efficacy of EBTs by informing psychotherapists how to modify their behavior when working with ethnically diverse clients. The authors described one approach to the development of culturally competent psychotherapy, using an observational coding system comprising Afrocentric codes to investigate culturally relevant therapist behaviors. Qualitative examples illustrated the quantitative findings relating to therapist in-session behavior that promote client engagement and positive responding during a midtreatment session of multisystemic therapy. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,17, 2010. [source]

Honoring children, mending the circle: cultural adaptation of trauma-focused cognitive-behavioral therapy for American Indian and Alaska Native children

Dolores Subia BigFoot
Abstract American Indians and Alaska Natives are vulnerable populations with significant levels of trauma exposure. The Indian Country Child Trauma Center developed an American Indian and Alaska Native (AI/AN) adaptation of the evidence-based child trauma treatment, trauma-focused cognitive-behavioral therapy. Honoring Children, Mending the Circle (HC-MC) guides the therapeutic process through a blending of AI/AN traditional teachings with cognitive-behavioral methods. The authors introduced the HC-MC treatment and illustrated its therapeutic tools by way of a case illustration. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,10, 2010. [source]

Advanced relationships between categories analysis as a qualitative research tool

Merav Rabinovich
Abstract The authors propose an advanced relationships between categories (RBC) model as an expansion of Tutty, Rothery, and Grinnell's (1996) qualitative tool for classifying RBC patterns as contained, temporal, and causal relationships. It is assumed that identification of the relationships obtained among categories of qualitative data paves the way for construction of a theory, even though few tools have been developed for this purpose to date. The advanced RBC model points to three additional relationship patterns: bilateral, trilateral, and quadrilateral relationships. These relationships reveal how the text itself links among its various components. The model serves as an innovative tool for systematic derivation of explanations based on the qualitative raw data, contributing to grounded theory and other interpretive studies. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,11, 2010. [source]

"Moved by the spirit": does spirituality moderate the interrelationships between subjective well-being subscales?

James Schuurmans-Stekhoven
Abstract Despite the recent escalation of research into the spirituality and well-being link, past efforts have been plagued by methodological problems. However, the potential for measurement error within psychometric instruments remains largely unexplored. After reviewing theory and evidence suggesting spirituality might represent an affective misattribution, moderation modeling,with each subjective well-being (SWB) subscale as a dependent variable as predicted by the remaining SWB subscales,is utilized to test the assumption of scale invariance. These interrelationships were shown to vary in conjunction with spirituality; that is the analysis revealed significant spirituality,×,subscale interactions. Importantly, in all models the spirituality main effect was either nonsignificant or accounted for by other predictors. In combination, the findings suggest the interrelationship between the subscales rather than the level of SWB varies systematically with spirituality and casts considerable doubt on the previously reported "belief-as-benefit" effect. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,17, 2010. [source]

Development and validation of brief content scales for the psychological screening inventory-2,

Richard I. Lanyon
Abstract This article describes the development of 21 brief content (BC) scales to supplement the existing scales of the Psychological Screening Inventory-2 (PSI-2), and three validity studies to support their use for both the PSI-2 and the original PSI. The BC scales comprise groups of four or more items that are statistically homogeneous in content and are replicated across three data sets: PSI and PSI-2 normative data and a PSI-based group of forensic respondents. Concurrent validity was shown in correlations with the following: (a) the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) basic clinical scales, Content scales, PSY-5 scales, and Restructured Clinical (RC) scales; (b) family/friend observer ratings; and (c) therapist ratings in an outpatient substance abuse treatment program. Consistent with the purpose of the PSI/PSI-2, the BC scales are intended to provide additional screening information and not a comprehensive representation of psychopathology. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,13, 2010. [source]

Ethnicity in trauma and psychiatric disorders: findings from the collaborative longitudinal study of personality disorders,,

Carlos I. Pérez Benítez
Abstract The study's aims are to explore ethnic differences in rates of adverse childhood experiences and lifetime traumatic events and in rates of psychiatric disorders for patients exposed to similar traumas. Rates of these events and rates of major depressive disorder, posttraumatic stress, substance use, and borderline personality disorders were compared among 506 non-Hispanic Whites (N-HW), 108 Latina(o)s, and 94 African Americans (AA) participating in the Collaborative Longitudinal Personality Disorder Study. We found that Whites reported higher rates of neglect than African Americans and Latina(o)s, higher rates of verbal/emotional abuse than African Americans, and higher rates of accidents and injuries/feared serious injury than Latina(o)s. African Americans had higher rates of seeing someone injured/killed than Whites. No significant interaction was observed between adverse events and ethnicity for mental disorders. © 2010 Wiley Periodicals, Inc. J Clin Psychol: 66:1,16, 2010. [source]

Emotional awareness in substance-dependent patients,

Solange Carton
Abstract We explored emotional awareness in substance-dependent patients and its relationships to self-reported alexithymia. Sixty-four outpatients with drug dependence or alcohol dependence were evaluated before the beginning of treatment with the Hamilton Depressive Scale and the Covi Anxiety Scale, and they completed the Toronto Alexithymia Scale (TAS-20) and the Levels of Emotional Awareness Scale (LEAS). Subjects exhibited low levels of emotional awareness and TAS-20 scores were high. Both measures were not related to depressive and anxious symptomatology. This research is the first to provide LEAS results with substance-dependent patients and highlights their deficits in emotions' differentiation and complexity. The lack of a relationship between LEAS and TAS-20 is discussed from the methodological and theoretical points of view. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1,12, 2010. [source]

Rural mental health and psychological treatment: a review for practitioners

K. Bryant Smalley
Abstract Practitioners in rural areas face particular challenges in providing psychological services, ranging from disparate rates of mental disorders to unique circumstances in treating special populations. In this article, we discuss the burden of mental disorders in rural areas, current trends in integration of mental health care and primary care, and unique concerns practitioners face in treating two special populations in rural areas (children and families, and older adults and their caregivers). Implications for practice are also discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,11, 2010. [source]

Rural telepsychology services for children and adolescents

Eve-Lynn Nelson
Abstract Because of the overwhelming maldistribution of mental health specialists in metropolitan areas and the many underserved families living in rural settings, rural areas are natural homes for the use of telemedicine or videoconferencing technology for clinical services. The authors describe telepsychology services for rural clients, placing best psychology practices within the context of broader telemental health services. The goal is to approximate evidence-based child psychotherapy from face-to-face practice using the videoconferencing technology. Telepsychology is illustrated with a case report of a rural Hispanic teen and her family presenting through the teen's primary care clinic. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,12, 2010. [source]

Treating the aged in rural communities: the application of cognitive-behavioral therapy for depression

Martha R. Crowther
Abstract Many rural communities are experiencing an increase in their older adult population. Older adults who live in rural areas typically have fewer resources and poorer mental and physical health status than do their urban counterparts. Depression is the most prevalent mental health problem among older adults, and 80% of the cases are treatable. Unfortunately, for many rural elders, depressive disorders are widely under-recognized and often untreated or undertreated. Psychotherapy is illustrated with the case of a 65-year-old rural married man whose presenting complaint was depressive symptoms after a myocardial infarction and loss of ability to work. The case illustrates that respect for rural elderly clients' deeply held beliefs about gender and therapy, coupled with an understanding of their limited resources, can be combined with psychoeducational and therapeutic interventions to offer new options. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66:1,11, 2010. [source]

Development and validation of the chinese rehearsal scale for preadolescent chinese children,,§

Fiona C.M. Ling
Abstract Roger (1997) defined rehearsal as "the tendency to rehearse or ruminate on emotionally upsetting events" (p. 71). The Rehearsal Scale for Children,Chinese (RSC-C) was developed from the original 14-item Rehearsal Scale of the Emotion Control Questionnaire (Roger & Nesshoever, 1987) after translation and modification for Hong Kong Chinese preadolescents (aged 6,12 years). Confirmatory factor analysis using structural equation modeling revealed that with 1 item deleted from the original scale, the RSC-C possessed good internal validity and satisfactory test-retest reliability within a 1-year period. The new 13-item RSC-C also showed good external validity and internal reliability (,=.76). Convergent and discriminant validity was evidenced against the Emotional Problem and the Prosocial Behavior Subscales of the Strengths and Difficulties Questionnaire (Goodman, 1997), respectively. No gender differences in rehearsal scores were found. It was concluded that the 13-item RSC-C could be useful for measuring rehearsal in Chinese preadolescents. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1,10, 2010. [source]

Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fear

Jamie L. Rhudy
Abstract Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1,18, 2010. [source]

Rumination fosters indecision in dysphoria,

Annette van Randenborgh
Abstract This study investigated the effects of rumination on indecision, assessed as high levels of perceived decision difficulty, low confidence in a decision, and decision latency. Dysphoric and nondysphoric participants were assigned to either a rumination or a distraction induction. Subsequently, they made four decisions with alleged real-life consequences. As predicted, rumination exhibited a negative effect on dysphoric participants' decision-making process. They experienced the decisions as more difficult and had less confidence in their choices. No effects emerged on the measure of decision time. Mediation analyses revealed that increased difficulty of the decisions was due to self-focused thinking as a cognitive consequence of rumination, while reduced confidence in the decisions was partly mediated by negative affect that resulted from rumination. The finding that rumination affects the important life domain of decision making by fostering indecision in dysphoric individuals is a central extension of previous studies on rumination's consequences. In addition, these results provide insight into the depressive symptom of indecisiveness by revealing its underlying mechanisms. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 229,248, 2010. [source]

Provision of social support to individuals with chronic fatigue syndrome,

Leonard A. Jason
The present study evaluated a buddy program designed to provide support for individuals with chronic fatigue syndrome (CFS). The intervention involved weekly visits by a student paraprofessional, who helped out with tasks that needed to be done in an effort to reduce some of the taxing demands and responsibilities that participants regularly encountered. This model of rehabilitation focused on avoiding overexertion in persons with CFS, aiming to avoid setbacks and relapses while increasing their tolerance for activity. Participants with CFS were randomly assigned to either a 4-month buddy intervention or a control condition. Posttest results showed that individuals who received a student buddy intervention had significantly greater reductions in fatigue severity and increases in vitality than individuals in the control condition. There were no significant changes between groups for physical functioning and stress. Buddy interventions that help patients with CFS reduce overexertion and possibly remain within their energy envelopes can be thought of as representing a different paradigm than nonpharmacologic interventions that focus only on increasing levels of activity through graded exercise. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 249,258, 2010. [source]

Psychometric evaluation of the body investment scale for use with adolescents

Augustine Osman
Abstract We conducted two studies to examine the psychometric properties of the Body Investment Scale (BIS; Orbach & Mikulincer, 1998) in U.S. adolescent samples. The BIS was designed to assess bodily experiences that are associated with suicide-related behaviors. In Study 1, confirmatory factor analysis (CFA) with data from a combined sample of 204 high school adolescents (83 boys, 121 girls) and 197 psychiatric inpatient (101 boys, 96 girls) adolescents provided moderate support for the oblique four-factor solution: Body Feelings (,=.86, 95% CI=.83,.89), Body Touch (,=.71, 95% CI=.65,.76), Body Care (,=.78, 95% CI=.71,.81), and Body Protection (,=.78, 95% CI=.73,.82); robust comparative fit index=.88 and the robust Tucker Lewis Index=.83. The second-order factor model also provided moderate fit to the data. In Study 2, results of the CFA with data from adolescent psychiatric inpatients (N=205; 101 boys, 104 girls) provided additional support for the four-factor solution. In addition, results of the receiver operating characteristic and logistic regression analyses showed that scores on the Body Feelings and Body Protection scales were most useful in differentiating the responses of suicidal and nonsuicidal adolescents, all Cohen's d values >.30. The study also examined associations between scores on the BIS scales and the validation self-report measures of hopelessness, suicide-related behavior, and reasons for living. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 259,276, 2010. [source]

Integrative harm reduction psychotherapy: a case of substance use, multiple trauma, and suicidality

Andrew Tatarsky
Abstract Harm reduction is a new paradigm that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence. This article discusses integrative harm reduction psychotherapy, one application of harm reduction principles to psychotherapy. Seven therapeutic tasks are described with attention to clinical process, skills, and strategies. A case is presented that illustrates the application of this approach with life-threatening substance use that was related to multiple trauma and suicidal depression. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66: 1,13, 2010. [source]

Partners in treatment: relational psychoanalysis and harm reduction therapy

Debra Rothschild
Abstract A relational psychoanalytic harm reduction orientation to the treatment of substance misusers is presented and illustrated with a clinical example. Both harm reduction therapy and relational psychoanalysis rely on a two-person model in which the therapist and client are collaborators in the treatment. In both, substance use is seen in the context of the user's internal psychodynamics and external environment, and there is an emphasis on treating the person as a whole individual whose substance use is one aspect of life, rather than focusing on the substance use itself as was often done in the past. Historically, psychoanalysis and substance abuse treatment were so different from each other that their paths rarely crossed. The introduction of harm reduction therapy to substance abuse and the relational orientation in psychoanalysis have brought the fields closer together such that the valuable contributions that each can make to the other can now be appreciated. © 2010 Wiley Periodicals, Inc. J Clin Psychol: In Session 66: 1,14, 2010. [source]

Mindfulness intervention for child abuse survivors,

Elizabeth Kimbrough
Abstract Twenty-seven adult survivors of childhood sexual abuse participated in a pilot study comprising an 8-week mindfulness meditation-based stress reduction (MBSR) program and daily home practice of mindfulness skills. Three refresher classes were provided through final follow-up at 24 weeks. Assessments of depressive symptoms, post-traumatic stress disorder (PTSD), anxiety, and mindfulness, were conducted at baseline, 4, 8, and 24 weeks. At 8 weeks, depressive symptoms were reduced by 65%. Statistically significant improvements were observed in all outcomes post-MBSR, with effect sizes above 1.0. Improvements were largely sustained until 24 weeks. Of three PTSD symptom criteria, symptoms of avoidance/numbing were most greatly reduced. Compliance to class attendance and home practice was high, with the intervention proving safe and acceptable to participants. These results warrant further investigation of the MBSR approach in a randomized, controlled trial in this patient population. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 1,18, 2010. [source]

Psychological mindedness in relation to personality and coping in a sample of young adult psychiatric patients

Ivan Nyklí
Abstract Psychological mindedness (PM) is a relevant but rarely studied construct in clinical psychology. The aim was to examine the relationships among PM, personality, and coping in young adults with psychological difficulties. Sixty-three young women and 32 young men who were admitted for intake at a Dutch mental health institute completed relevant questionnaires. PM showed positive associations with the putatively adaptive personality characteristics of extraversion, openness, agreeableness, and conscientiousness and a negative correlation with neuroticism. In addition, PM was associated with problem-focused coping independently of the effect of personality characteristics. PM seems to be related to adaptive person characteristics in young adults with psychological difficulties. Longitudinal studies are needed to examine the issue of causality. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66:1,12, 2010. [source]

Postpartum depression: what we know

Michael W. O'Hara
Abstract Postpartum depression (PPD) is a serious mental health problem. It is prevalent, and offspring are at risk for disturbances in development. Major risk factors include past depression, stressful life events, poor marital relationship, and social support. Public health efforts to detect PPD have been increasing. Standard treatments (e.g., Interpersonal Psychotherapy) and more tailored treatments have been found effective for PPD. Prevention efforts have been less consistently successful. Future research should include studies of epidemiological risk factors and prevalence, interventions aimed at the parenting of PPD mothers, specific diathesis for a subset of PPD, effectiveness trials of psychological interventions, and prevention interventions aimed at addressing mental health issues in pregnant women. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,12, 2009. [source]

Stability and individual change in depressive symptoms among mothers raising young children with ASD: maternal and child correlates,

Alice S. Carter
Abstract Mothers raising children with Autism Spectrum Disorders (ASD) evidence elevated depressive symptoms, but symptom stability has not been examined. Mothers (N=143) of toddlers with ASD (77% boys) were enrolled and assessed when their children were 18 to 33 months old and followed annually for 2 years. Multilevel modeling revealed no significant change in group depressive symptom level, which was in the moderately elevated range (Intercept=13.67; SE=.96). In contrast, there was significant individual variation in change over time. Child problem behaviors and delayed competence, maternal anxiety symptoms and angry/hostile mood, low parenting efficacy and social supports, and coping styles were associated with depression severity. Only maternal anxiety and parenting efficacy predicted individual change. Many mothers do not appear to adapt, supporting the need for early intervention for maternal well-being. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,11, 2009. [source]

Problem solving moderates the effects of life event stress and chronic stress on suicidal behaviors in adolescence

Kelly E. Grover
Abstract The present study examined the unique and interactive effects of stress and problem-solving skills on suicidal behaviors among 102 inpatient adolescents. As expected, life event stress and chronic stress each significantly predicted suicidal ideation and suicide attempt. Problem solving significantly predicted suicidal ideation, but not suicide attempt. Problem solving moderated the associations between life event stress and suicidal behaviors, as well as between chronic stress and suicidal ideation, but not chronic stress and suicide attempt. At high levels of stress, adolescents with poor problem-solving skills experienced elevated suicidal ideation and were at greater risk of making a nonfatal suicide attempt. The interactive effects decreased to non-significance after controlling for depressive symptoms and hopelessness. Clinical implications are discussed.© 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1,10, 2009. [source]

Therapist empathy and client anxiety reduction in motivational interviewing: "She carries with me, the experience"

Lynne E. Angus
Abstract In this article, we examine the use of motivational interviewing (MI) to treat generalized anxiety disorder (GAD) by means of case illustration that focuses on four categories drawn from the client's experience of the key ingredients in MI therapy. The case illustration, drawn from the York study on combining MI and cognitive behavior therapy in the treatment of GAD (uses the client's pre- and post-therapy narrative interviews) to arrive at categories representative of the client's experience of MI therapy. The results of the qualitative analysis highlight the key contributions to positive client outcomes and readiness for change in brief MI therapy for GAD. © 2009 Wiley Periodicals, Inc. J Clin Psychol: In Session 65: 1,12, 2009. [source]