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CONTENTS
ORIGINAL RESEARCH
CASE STUDY AND CLINICAL REPLICATION SERIES
ABSTRACTS
Using a randomized wait-list controlled design, this study evaluated the effects of a novel intervention, mindfulness-based relationship enhancement, designed to enrich the relationships of relatively happy, nondistressed couples. Results suggested the intervention was efficacious in (a) favorably affecting couples’ levels of relationship satisfaction, autonomy, relatedness, closeness, acceptance of one another, and relationship distress; (b) beneficially affecting individuals’ optimism, spirituality, relaxation, and psychological distress; and (c) maintaining benefits at 3-month follow-up. Those who practiced mindfulness more had better outcomes, and within-person analyses of diary measures showed greater mindfulness practice on a given day was associated on several consecutive days with improved levels of relationship happiness, relationship stress, stress coping efficacy, and overall stress.
The present study examined the impact of the Child’s Game parenting intervention (Forehand & McMahon, 1981; McMahon & Forehand, 2003) on child compliance, noncompliance, and aversive behavior in 3 groups of 20 nonreferred preschool children identified as high on dimensions of anxiety/withdrawal, anger/aggression, or social competence. The impact of the intervention on subtypes of compliance and noncompliance and on maternal behavior was also investigated. Child behavior was assessed using the command task, a structured observational procedure, at both pretest and posttest. Pretest and posttest (1 week later) maternal behavior was evaluated during a free-play period. Pretest group differences were evident in both maternal and child behavior. Pretest-posttest changes were observed in child behavior such that anxious/withdrawn and angry/aggressive children generally showed increases in compliance and decreases in noncompliance and aversive behavior while socially competent children showed no improvement on most behavioral measures. Pretest-posttest changes on subtypes of compliance and noncompliance were also evident and moderated by group membership.
Ninety-eight parents experiencing significant difficulties in managing their own anger in their interactions with their preschool-aged children were randomly assigned either an enhanced group-administered behavioral family intervention program based on the Triple P–Positive Parenting Program that incorporated attributional retraining and anger management (EBFI) or a standard behavioral family intervention program (SBFI) that provided training in parenting skills alone. At post-intervention, both conditions were associated with lower levels of observed and parent-reported disruptive child behavior, lower levels of parent-reported dysfunctional parenting, greater parental self-efficacy, less parental distress, relationship conflict and similarly high levels of consumer satisfaction. EBFI showed a significantly greater short-term improvement on measures of negative parental attributions for children’s misbehavior, potential for child abuse and unrealistic parental expectations than SBFI. At 6-month follow-up both conditions showed similarly positive outcomes on all measures of child abuse potential, parent practices, parental adjustment, and child behavior and adjustment; however, EBFI continued to show greater change in negative parental attributions. Implications for tailoring early-intervention programs to the needs of parents at risk of child maltreatment are discussed.
Cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) has received considerable empirical support for its efficacy. However, few investigators have examined the mechanisms proposed to account for the reduction of BN symptoms during CBT. The current study examined the associations between therapist interventions, client mechanisms, and symptoms during treatment in a sample of 56 clients undergoing CBT for BN. Results suggested that behavioral interventions were most associated with symptom change during treatment whereas relational interventions were most associated with change in client mechanisms such as client engagement. Additionally, some changes in BN symptoms were mediated by changes in proposed client mechanisms whereas others were directly associated with therapist interventions. Implications of these findings for CBT theory of BN treatment and CBT treatment process research methodology are discussed.
The summer treatment program (STP) is a comprehensive intervention for attention-deficit/hyperactivity disorder (ADHD) that combines several empirically validated, behavioral treatment components in order to address multiple areas of impairment. The current study utilized a BAB treatment withdrawal design to evaluate the effectiveness of the STP. Participants included 44 children diagnosed with ADHD and comorbid disruptive behavior disorders who were enrolled in the STP. During the 6th week of the STP, behavior was measured during a planned period where all behavioral treatment components were withdrawn. Treatment was then reinstated in its entirety. Across measures of behavior, academic functioning, and teacher, counselor, and child ratings, substantial behavioral deterioration occurred during the withdrawal period, and behavior returned to previous levels upon the reinstatement of the STP treatment components. Results support the efficacy of the STP as an intervention for ADHD across multiple domains of impairment, including classroom and peer functioning.
A model of parental monitoring behaviors, comprising rule setting and supervision, was proposed. The hypothesized relationship between rules, supervision, conflict, and adolescent problem behavior was tested using structured equation modeling on self-report data from 1,285 adolescents aged 14 to 15 years. The model was an adequate fit of the data, accounting for 40% of the variance in problem behavior. Specifically, lax rules predicted poor supervision and high conflict. High conflict and low supervision were predictors of the adolescent problem behavior construct, which encompassed conduct problems, rebelliousness, and sensation seeking. Adequate rules appear to form the foundation for better supervision and less conflict, and hence lower levels of adolescent problem behaviors.
A multiple-baseline across participants design was used to examine effects of a verbal self-regulatory procedure on direct measures of impulsivity associated with frontal lobe brain damage. Four young men participated in socially interactive group sessions with a therapist who (a) assisted the participants in selecting individualized instructions on how to behave, (b) provided participants with feedback on their correspondence between instructions and nonverbal behavior, and (c) gradually reduced assistance while participants maintained self-monitoring. Results show that the verbal self-regulation was efficacious in reducing impulsive behavior to clinically significant levels during the group sessions, although effects with 1 participant were variable.
A multiple baseline across-subjects design was used to examine the efficacy of virtual reality exposure therapy (VRET) to treat driving phobia. The treatment consisted of 8 weekly graded VRET sessions. Using self-monitoring and interview measures, treatment efficacy was examined across 5 participants. Three participants had reductions in driving phobia symptoms, while there was little change in the remaining individuals. VRET did not result in an increase of actual driving frequency for any of the participants. Some gains were lost at the 1- and 3-month follow-up, particularly for the participants who showed weaker treatment responses. Four individuals completed the 1-year follow-up and their symptoms remained largely unchanged. Given the modest treatment outcome and lack of generalization to actual driving behavior, VRET may be most useful as a supplement or preparatory intervention for in vivo exposure, rather than a stand-alone intervention. |
GREGORY A. FABIANO, WILLIAM E. PELHAM, JR., MICHAEL J. MANOS, ELIZABETH M. GNAGY, ANDREA M. CHRONIS, ADIA N. ONYANGO, ANDY LOPEZ-WILLIAMS, LISA BURROWS-MACLEAN, ERIKA K. COLES, DAVID L. MEICHENBAUM, DONALD A. CASERTA, AND SARA SWAIN. An Evaluation of Three Time-Out Procedures for Children With Attention-Deficit/Hyperactivity Disorder