Effectiveness of Open-Ended Psychotherapy Under Clinically Representative Conditions.

OBJECTIVE: This study investigates the effectiveness of open-ended psychotherapy in a large, naturalistic, and diverse patient cohort using rigorous and multifaceted assessments. METHOD: Patients (N = 370) in open-ended psychotherapy completed an extensive set of self-report measures and diagnostic interviews, including long-term follow-up in order to assess stability of outcomes. About half of the patients qualified for a personality disorder at the onset of treatment. Treatments were open-ended, and on average therapists provided substantially larger treatment doses than common in the literature. RESULTS: A substantial majority recovered from their respective Axis I (58%) and/or Axis II (55%) disorders during treatment. Patients also experienced large positive changes in self-report measures of overall psychiatric symptoms and moderate positive changes in self-reported interpersonal problems, while very few (< 3%) demonstrated negative development. The patients maintained their diagnostic and self-assessed changes at a two-and-a-half-year follow-up. In contrast, self-reported occupational functioning showed minimal improvement throughout the treatment and follow-up phase. CONCLUSION: A naturalistic patient cohort undergoing open-ended psychotherapy demonstrates substantial and stable improvements.

Effect of Self-Efficacy on Quality of Life in People With Mild Cognitive Impairment and Mild Dementia: The Mediating Roles of Depression and Anxiety.

OBJECTIVES: To examine the mediating effects of depression and anxiety in the relationship between self-efficacy and quality of life among people with mild cognitive impairment (MCI) or mild dementia. METHOD: A total of 196 patients diagnosed with MCI or dementia due to Alzheimer disease completed structured measures of self-efficacy, quality of life, and depressive and anxiety symptoms. We examined direct and mediated effects by fitting structural equation models to data. RESULTS: Our analyses supported that the effects of self-efficacy on quality of life may be partially mediated by depression and anxiety. Both anxiety and depression had significant mediating effects, with depression showing a stronger effect. CONCLUSION: These results suggest that increased self-efficacy may have a positive effect on quality of life in people with MCI or dementia-partly by reducing depression and anxiety. These findings may have important practical implications for tailoring therapeutic interventions.

Framing unauthorized immigrants: the effects of labels on evaluations.

In the U.S. media, unauthorized immigrants are often interchangeably referred to as "illegal aliens," "illegal immigrants," and undocumented immigrants." In spite of formal equivalence, these terms carry different connotations, but the effects of these labels on people's attitudes toward immigrants are not well documented. In this replication study, 274 undergraduate students in psychology responded to one of three randomly distributed versions of a 20-item scale measuring attitudes toward unauthorized immigration. The items in the three scale versions varyingly referred to immigrants using the three terms. Results showed differences in attitudes toward unauthorized immigration between all experimental conditions. The label "illegal immigrants" yielded significantly less positive attitudes compared to the label "undocumented immigrants," and respondents exposed to the label "illegal aliens" showed the most positive attitudes. Furthermore, the effects of the experimental conditions were not moderated by the respondents' patriotism, sex, or own immigrant background.

Prevalence, comorbidity and stability of post-traumatic stress disorder and anxiety and depression symptoms after exposure to physical assault: an 8-year prospective longitudinal study.

BACKGROUND: There is a lack of prospective longitudinal studies focusing specifically on the victims exposed to physical violence by a perpetrator other than a family member. AIMS: To assess the prevalence and comorbidity of post-traumatic stress disorder (PTSD) and anxiety and depression symptoms and the stability of symptoms, in a population of victims of non-domestic physical violence through 8 years. METHOD: This study had a single group longitudinal design with four repeated measures-the first as soon as possible after the exposure (n = 143 at T1), the second 3 months later (n = 94 at T2), the third after 1 year (n = 73 at T3) and the fourth after 8 years (n = 47 at T4). Questionnaires used were Impact of Event Scale-15 and 22 (IES-15 and 22), Post Traumatic Symptom Scale-10 (PTSS-10) and the Hopkins Symptoms Check List (HSCL-25). RESULTS: Probable PTSD cases measured with IES-15 were 33.6% at T1, 30.9 at T2, 30.1% at T3 (12 months) and 19.1% at T4 (8 years), while probable anxiety and depression cases measured with HSCL-25 were 42.3% at T1, 35.5% at T2, 35.6% at T3 and 23.4% at T4. The estimated probability of recovery from PTSD symptoms during the 8 years is 52%, whereas the corresponding finding concerning anxiety and depression is 43%. CONCLUSION: The consequences of exposure to physical assault by strangers need to be given more attention as a severe risk of chronic mental health problems.

Integrating immigrant minorities: developing a scale to measure majority members' attitudes toward their own proactive efforts.

The present study is based on the premise that the integration of ethnic minorities may involve more than the majority's expression of tolerance. In order to promote inclusion, the majority may have to play a more active role in the integration process. We describe the development and validation of a new psychometric scale which assesses majority members' attitudes toward their own proactive contribution to the integration of immigrants within three domains: cultural and structural efforts, and openness to diversity. The scale is investigated by analyses of internal structure and exploration of construct validity in relation to relevant social psychological and personality constructs in a sample of 486 Norwegian university students (28% male, mean age = 26.5, SD = 6.08). Factor analyses supported a unidimensional structure and the estimated reliability of an additive scale was satisfactory (Cronbach's α = 0.91). The scale correlated negatively with measures of right-wing authoritarianism and social dominance orientation, and positively with global identity. It was weakly related to the personality traits agreeableness, intellect, extraversion, and conscientiousness. The potential utility of the scale in both applied and experimental social psychological studies are discussed.

The role of maternal attachment in children's attachment and cognitive executive functioning: a preliminary study.

The influence of maternal attachment on children's attachment and executive functioning skills through maternal sensitivity and decentered tutoring were studied in 40 middle-class mother-child dyads. Infant attachment security in the Strange Situation Procedure was related to maternal attachment security, evaluated with the Adult Attachment Interview. When the children were six-seven months of age, maternal sensitivity was evaluated. When the child was six years old, maternal decentered tutoring and the children's executive functioning were evaluated. Regression analyses indicated that maternal tutoring accounted for the association between maternal attachment and child cognitive functioning, whereas maternal sensitivity accounted for the association between maternal and child attachment.

Effectiveness in top management group meetings: the role of goal clarity, focused communication, and learning behavior.

To explore the relationship between goal clarity, focused communication, learning behavior, and team effectiveness (i.e., task performance, relationship quality, and member satisfaction), self-report and observer data from eight top management groups that processed 56 agenda items during meetings were analyzed. We found that goal clarity and focused communication was positively related to team effectiveness. The effect of goal clarity on team effectiveness was partially mediated by focused communication. Speaking up when a goal was unclear increased focused communication, task performance and relationship quality. Speaking up when the discussion was off track was not related to task performance and member satisfaction, and was negatively related to relationship quality. These findings have implications for how to conduct an effective management meeting.

Treatment failure in psychotherapy: the pull of hostility.

Client-therapist interactions were studied in 14 positive-change (PC) and 14 negative-change or nonchange (NC) therapies with the same therapists and similar clients. Aggregated structural analysis of social behavior (SASB) scores showed increasingly dissimilar interaction styles between client and therapist in NC therapies. First-lag transition analyses of SASB codings of Sessions 3, 12, and 20 showed the following differences: Stable hostile complementarity characterized NC within and across sessions. Hostile complementarity was nevertheless relatively rare. Therapists met clients' invitations to hostile responses most frequently in nonhostile ways, yet they initiated more belittling and ignoring interactions with NC clients, pointing to the subtly hostile therapeutic climate created. Rejection of therapists' interventions predicted negative outcome most strongly and escalated with time. Clients' skepticism may make therapists vulnerable to feelings of inadequacy and, if not dealt with therapeutically, may easily release the therapists' own hostility.

Prevalence and predictors of post-traumatic stress disorder (PTSD) in physically injured victims of non-domestic violence. A longitudinal study.

BACKGROUND: Victims of violent assault experience diverse post-event emotional problems such as post-traumatic stress disorder (PTSD), and they may have multiple emotional problems. The aim of the present study was to evaluate the prevalence and predictors of PTSD in a longitudinal design. METHODS: The levels of physical injury, perceived life threat, prior experience of violence, peritraumatic dissociation (PD), acute PTSD, perceived self-efficacy and perceived social support are considered possible predictors. This study had a single group (N = 70), longitudinal design with three repeated measures over a period of 12 months. Questionnaires used were: Impact of Event Scale-15 and 22 (IES-15 and 22), Post-Traumatic Symptom Scale-10 (PTSS-10), Peritraumatic Dissociation (PD) 7-item self-report measure, Social Provisions Scale (SPS) and Generalized Self-Efficacy scale (GSE). RESULTS: Results showed a high prevalence and severity of PTSD on all outcomes, for instance 31% scored as probable PTSD-cases and 14% as risk level cases by IES-15 at T3. Either injury severity or prior experience of being a victim of violence predicted PTSD in this study. Early PTSD predicted subsequent PTSD, and perceived life threat was a predictor of PD. Furthermore, lack of perceived social support was a predictor of PTSD symptoms at T3. In addition, low perceived self-efficacy was a predictor of PTSD and influenced perceived social support at T1. CONCLUSIONS: Our results showed that experience of non-domestic violence may cause serious chronic emotional problems, and therefore it is important to be aware of early symptoms indicating needs for special follow-ups.

The predictive value of post-traumatic stress disorder symptoms for quality of life: a longitudinal study of physically injured victims of non-domestic violence.

BACKGROUND: Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months. METHODS: A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM). RESULTS: For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3. CONCLUSION: The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his/her QoL in addition to the illness may increase the treatment priorities and efforts.

Acute psychological reactions in assault victims of non-domestic violence: peritraumatic dissociation, post-traumatic stress disorder, anxiety and depression.

The aims of this study were to investigate acute and subacute post-traumatic reactions in victims of physical non-domestic violence. A Norwegian sample of 138 physically assaulted victims was interviewed and a questionnaire was completed. The following areas were examined: the frequency and intensity of acute and subacute psychological reactions such as peritraumatic dissociation (PD), post-traumatic stress disorder (PTSD) and anxiety and depression; the relationship between several psychological reactions; the relationship between psychological reactions and level of physical injury, perceived life threat, and potential of severe physical injury, and the relationship between psychological reactions and socio-demographic variables. The following distress reactions were measured retrospectively: PD, PTSD, and anxiety and depression. Thirty-three per cent of the victims scored as probable PTSD cases according to the Post Traumatic Symptoms Scale 10 (PTSS-10); the corresponding Impact of Event Scale-15 (IES-15) score identified prevalence of 34% respectively. Forty-four per cent scored as cases with probable anxiety and depression, according to the Hopkins Symptom Check List 25 (HSCL-25). Severity of perceived threat predicted higher scores on all measures of psychological reactions. There were no statistically significant differences between acute and subacute groups on PD, PTSS-10, IES-15, IES-22 and HSCL-25 according to measured means (and standard deviations) and occurrence of probable cases and risk level cases. The results showed no connection between severity of physical injury and caseness. The acute psychological impairment that results from assault violence may have a deleterious effect on the mental health of victims.

Credibility of the emotional witness: a study of ratings by court judges.

Previous studies have shown that the emotional behavior displayed during testimony may affect the perceived credibility of the witness. The present study compares credibility ratings by Norwegian court judges with those made by lay people. The participants viewed one of three video-recorded versions of a rape victim's statement, role played by a professional actress. The statement was given in a free-recall manner with one of three kinds of emotions displayed, termed congruent, neutral, and incongruent emotional expression. The results show that, in contrast to lay people, the credibility ratings of court judges and their votes for a guilty verdict were not influenced by the emotions displayed by the witness. Results are discussed in terms of professional expertise.

Memory for a staged criminal event witnessed live and on video.

Memory for a staged robbery was tested in two groups of participants witnessing the event either live (n = 62) or on video (n = 64). Immediately after the event participants filled out a questionnaire probing memory with emphasis on the timing of the event and robber characteristics. The results showed that participants who watched a video recording of the event reported more details and with a higher accuracy than participants who were present on the scene, but the pattern of memory errors were similar in the two conditions. It is concluded that laboratory experiments may overestimate the memory of eyewitnesses but are otherwise able to simulate essential aspects of memory performance in naturalistic contexts.