Predicting treatment outcome on three measures for post-traumatic stress disorder.

The aim of the present study was to investigate predictors of treatment outcome for Posttraumatic Stress Disorder (PTSD) after treatment completion and at 15-months follow-up (n = 48), in a trial of Eye Movement Desensitisation and Reprocessing (EMDR) versus Imaginal Exposure and Cognitive Restructuring (E+CR). Factors associated with treatment outcome were investigated using regression analyses with the mean change scores in three assessor and self-rated PTSD symptomatology measures, including the Clinician-Administered PTSD Scale (CAPS), the Impact of Events Scale (IES) and the PTSD Symptom Checklist (PCL) from pre- to post-treatment and pre-treatment to follow-up as the dependent variables and demographics, trauma, clinical and personality measures as independent variables. Irrespective to outcome measures and assessment points it was found that four variables were able to predict significantly treatment outcome. These included baseline PTSD symptomatology, number of sessions, gender and therapy type. Overall, our results showed that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome, as significant predictors were found to be sample-specific and outcome measure-specific. Clinical relevance of the present results and directions for future research are discussed.

Earning and learning: role congruence, state/trait factors and adjustment to university life.

BACKGROUND: Undertaking term-time employment is increasingly commonplace for university students. Much research suggests that combining 'earning and learning' may be detrimental to university life, generating role conflicts, increasing stress and reducing academic success, participation and overall adjustment to university. Potential positive effects of term-time employment on well-being are often neglected. AIMS: This study adopted a balanced perspective, investigating the relationship between role congruence in academic, social and career domains and adjustment, with state and trait psychological factors as mediators/moderators. METHODS: A questionnaire measuring perceived role congruence, adjustment to university life and psychological state and trait characteristics was mailed to all undergraduates at a Scottish university during term-time. SAMPLE: Results for a subsample of 625 university students currently in term-time employment were included in this paper. RESULTS: Findings suggested that students generally perceived employment and university roles to be in balance, and there was no difference in adjustment for students whether currently in term-time employment or not. However, psychological factors, particularly positive affectivity and stress were important mediators of the relationship between role congruence and adjustment. CONCLUSIONS: Since promoting role congruence may enhance students' adjustment and well-being, the study has implications for universities, student welfare organizations and employers offering term-time employment.

Predicting general well-being from self-esteem and affectivity: an exploratory study with Scottish adolescents.

The present study investigated the association between the personality constructs of self-esteem/affectivity and General Well-Being (GWB) in Scottish adolescents. A total of 425 secondary school pupils completed the P.G.I. General Well-Being Scale [Verma et al. Ind J. Clin. Psychol. 10 (1983) 299], the Hare Self-esteem Scale (HSES) [Hare, The Hare General and Area-Specific (School, Peer, and Home) Self-esteem Scale. Unpublished manuscript, Department of Sociology, SUNY Stony Brook, New York, mineo, 1985] and the Positive and Negative Affect Schedule (PANAS) [Watson et al. J Personal Soc Psychol 54 (1988a) 1063]. Combined self-esteem, positive and negative affectivity, age and gender accounted for 49.7% of the total GWB variance, 24.9% of the physical well-being variance, 41.6% of the mood/affect well-being variance, 33.3% of the anxiety well-being variance and 44.3% of the self/others well-being variance. Home self-esteem was found the strongest predictor of mood/affect and self/others well-being domains as well as well-being total. It was also the second best predictor of anxiety well-being domain. School self-esteem was the strongest predictor of physical well-being, whereas negative affectivity was the strongest predictor of anxiety well-being domain. However age and gender were not significantly associated with GWB, total or domain specific. The study adds to previous evidence regarding the high association between GWB and personality factors in adult and adolescent populations. Directions for future research are discussed.

Early intervention for relapse in schizophrenia: impact of cognitive behavioural therapy on negative beliefs about psychosis and self-esteem.

OBJECTIVES: The study aimed to test two hypotheses. Firstly, that participants who relapsed during the 12-month follow-up period of our randomized controlled trial, would show increased negative beliefs about their illness and reduced self-esteem, in comparison to the non-relapsed participants. Secondly, that cognitive behavioural therapy (CBT) for early signs of relapse would result in a reduction in negative beliefs about psychosis and an improvement in self-esteem at 12 months. DESIGN AND METHODS: A total of 144 participants with schizophrenia or a related disorder were randomized to receive either treatment as usual (TAU; N=72) or CBT (N=72). Participants completed the Personal Beliefs about Illness Questionnaire (PBIQ; Birchwood, Mason, MacMillan, & Healy, 1993) and the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965) at entry, 3 months, 6 months, and 12 months. RESULTS: At 12 months, relapsers showed greater increase in scores for PBIQ entrapment compared with non-relapsers. In addition, after controlling for baseline covariates (treatment group and PBIQ self versus illness), relapsers also showed greater increase in scores for PBIQ self versus illness at 12 months. Furthermore, in comparison to treatment as usual, participants who received CBT showed greater improvement in PBIQ loss and in Rosenberg self-esteem. CONCLUSIONS: The study provides evidence that relapse is associated with the development of negative appraisals of entrapment and self-blame (self vs. illness). In addition, this is the first study to show that CBT reduces negative appraisals of loss arising from psychosis and improvements in self-esteem. Implications for future research and treatment are discussed.