Emergent patterns in the development of young children's object play.

The present study set out to examine developments in object play in a contemporary sample of 289 typically developing children from 8- to 60-months of age. The value of object play centers on developments in object knowledge and mental representation, along with the developmental processes of decentration, substitution, and agency. The early play studies focused on one or another of these aspects of development, and generally for the age group 12-36 months. The present study sought to expand this age period and to examine these processes in relation to one another and how they build upon each other in development. Videorecorded observations of the children's play activities were collected in homes for children recruited at 8-, 12-, 18-, 24-, 30-, 36-, 42-, 48-, 54-, and 60-months of age. Children were White (70%); of mixed racial/cultural backgrounds (14%); Asian (7%); Black (6%); and Latinx (3%); 49% were boys; 51% were girls. Twenty-seven categories of object play were identified. Progress was analyzed in frequency of category occurrence and variety of examples expressed within a category. Some categories occurred with robust frequency and variety, and others did not. Within-subjects analyses of variance revealed significant interactions between age and categories. Exploratory factor analyses of variety suggested clusters of categories representing cognitive change. Discussion centers on the intersection of cognitive development with experience, the covariation of developments in play, and the usefulness of frequency and variety as measures of play.

A collaborative outcome resource network (ACORN): Tools for increasing the value of psychotherapy.

The authors describe a collaborative outcomes resource network (ACORN) and the suite of measurement and decision support tools (ACORN Toolkit) that have emerged from this collaboration for the purpose of providing clinical feedback to therapists. The ACORN Toolkit is most accurately described as a comprehensive clinical information system designed to increase the value of mental health services across large systems of care. It was built to integrate large datasets from multiple sources including outcome data, client demographics and diagnostic data, therapist credentialing information, pharmacy data, and service claims data. For the limited purposes of this article, the authors focus on the ACORN Toolkit for measuring and how it has contributed to improving outcomes in psychotherapy. Implications to current practice and future training are provided.

Yoga for military service personnel with PTSD: A single arm study.

This study evaluated the effects of yoga on posttraumatic stress disorder (PTSD) symptoms, resilience, and mindfulness in military personnel. Participants completing the yoga intervention were 12 current or former military personnel who met the Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition-Text Revision (DSM-IV-TR) diagnostic criteria for PTSD. Results were also benchmarked against other military intervention studies of PTSD using the Clinician Administered PTSD Scale (CAPS; Blake et al., 2000) as an outcome measure. Results of within-subject analyses supported the study's primary hypothesis that yoga would reduce PTSD symptoms (d = 0.768; t = 2.822; p = .009) but did not support the hypothesis that yoga would significantly increase mindfulness (d = 0.392; t = -0.9500; p = .181) and resilience (d = 0.270; t = -1.220; p = .124) in this population. Benchmarking results indicated that, as compared with the aggregated treatment benchmark (d = 1.074) obtained from published clinical trials, the current study's treatment effect (d = 0.768) was visibly lower, and compared with the waitlist control benchmark (d = 0.156), the treatment effect in the current study was visibly higher.

Cultural accommodation of group substance abuse treatment for Latino adolescents: Results of an RCT.

Comparative studies examining the difference between empirically supported substance abuse treatments versus their culturally accommodated counterparts with participants from a single ethnic minority group are frequently called for in the literature but infrequently conducted in practice. This randomized clinical trial was conducted to compare the efficacy of an empirically supported standard version of a group-based cognitive-behavioral treatment (S-CBT) to a culturally accommodated version (A-CBT) with a sample of Latino adolescents primarily recruited from the juvenile justice system. Development of the culturally accommodated treatment and testing was guided by the Cultural Accommodation Model for Substance Abuse Treatment (CAM-SAT). Seventy Latino adolescents (mean age = 15.2; 90% male) were randomly assigned to 1 of 2 group-based treatment conditions (S-CBT = 36; A-CBT = 34) with assessments conducted at pretreatment, posttreatment, and 3-month follow-up. Longitudinal Poisson mixed models for count data were used to conduct the major analyses. The primary outcome variable in the analytic models was the number of days any substance was used (including alcohol, except tobacco) in the past 90 days. In addition, the variables ethnic identity, familism, and acculturation were included as cultural moderators in the analysis. Although both conditions produced significant decreases in substance use, the results did not support a time by treatment condition interaction; however, outcomes were moderated by ethnic identity and familism. The findings are discussed with implications for research and practice within the context of providing culturally relevant treatment for Latino adolescents with substance use disorders.

Defining early positive response to psychotherapy: An empirical comparison between clinically significant change criteria and growth mixture modeling.

Several different approaches have been applied to identify early positive change in response to psychotherapy so as to predict later treatment outcome and length as well as use this information for outcome monitoring and treatment planning. In this study, simple methods based on clinically significant change criteria and computationally demanding growth mixture modeling (GMM) are compared with regard to their overlap and uniqueness as well as their characteristics in terms of initial impairment, therapy outcome, and treatment length. The GMM approach identified a highly specific subgroup of early improving patients. These patients were characterized by higher average intake impairments and higher pre- to-posttreatment score differences. Although being more specific for the prediction of treatment success, GMM was much less sensitive than clinically significant and reliable change criteria. There were no differences between the groups with regard to treatment length. Because each of the approaches had specific advantages, results suggest a combination of both methods for practical use in routine outcome monitoring and treatment planning.

Benchmarking outcomes in a public behavioral health setting: feedback as a quality improvement strategy.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of a large public behavioral health (PBH) agency serving only clients at or below the federal poverty level that had implemented continuous outcome feedback as a quality improvement strategy. METHOD: The authors investigated the post treatment outcomes of 5,168 individuals seeking treatment for a broad range of diagnoses who completed at least 2 psychotherapy sessions. The Outcome Rating Scale (ORS; Duncan, 2011; Miller & Duncan, 2004) was used to measure outcomes. Clients had a mean age of 36.7 years and were predominantly female (60.7%) and White (67.8%), with 17.7% being Hispanic, 9.3% being African American, and 2.8% being Native American. Forty-six percent were diagnosed with depression, mood, and anxiety disorders; 18.8% were diagnosed with substance abuse disorders; and 14.4% were diagnosed with bipolar disorder and schizophrenia. A subset of clients with a primary diagnosis of a depressive disorder was compared to treatment efficacy benchmarks derived from clinical trials of major depression. Given that the PBH agency had also implemented an outcome management system, the total sample was also compared to benchmarks derived from clinical trials of continuous outcome feedback. RESULTS: Treatment effect sizes of psychotherapy delivered at the PBH agency were comparable to effect size estimates of clinical trials of depression and feedback. Observed effect sizes were smaller, however, when compared to feedback benchmarks that used the ORS. CONCLUSIONS: Services to the poor and disabled can be effective, and continuous outcome feedback may be a viable means both to improve outcomes and to narrow the gap between research and practice.

Influence of social class perceptions on attributions among mental health practitioners.

OBJECTIVE: A vignette-based study assessed the influence of social class attributions toward a hypothetical client's difficulty. METHOD: 188 licensed mental health professionals who were recruited through professional listservs completed an online survey after reviewing one of two versions of a vignette describing a hypothetical client that varied based on social class cues. RESULTS: As expected, this sample of licensed mental health practitioners detected social class differences based on the descriptors of the hypothetical client across the two vignettes. These perceived social class differences, however, did not impact participants' attributions toward the client for causing or solving her problems, level of Global Assessment of Functioning score ascribed to the client, or willingness to work with the client. CONCLUSIONS: There was no evidence that participants differentially ascribed attributions based on social class. Implications and directions for future research are provided.

Dose-effect relationship in routine outpatient psychotherapy: does treatment duration matter?

OBJECTIVE: There is an ongoing debate concerning how outcome variables change during the course of psychotherapy. We compared the dose-effect model, which posits diminishing effects of additional sessions in later treatment phases, against a model that assumes a linear and steady treatment progress through termination. METHOD: Session-by-session outcome data of 6,375 outpatients were analyzed, and participants were categorized according to treatment length. Linear and log-linear (i.e., negatively accelerating) latent growth curve models (LGCMs) were estimated and compared for different treatment length categories. RESULTS: When comparing the fit of the various models, the log-linear LGCMs assuming negatively accelerating treatment progress consistently outperformed the linear models irrespective of treatment duration. The rate of change was found to be inversely related to the length of treatment. CONCLUSION: As proposed by the dose-effect model, the expected course of improvement in psychotherapy appears to follow a negatively accelerated pattern of change, irrespective of the duration of the treatment. However, our results also suggest that the rate of change is not constant across various treatment lengths. As proposed by the "good enough level" model, longer treatments are associated with less rapid rates of change.

Signature of singlet open-shell character on the optically allowed singlet excitation energy and singlet-triplet energy gap.

A signature of singlet open-shell character on the optically allowed singlet excitation energy and singlet-triplet energy gap is theoretically illuminated for open-shell singlet molecules. On the basis of a two-site diradical model with two electrons in two orbitals, the linear dependence of these excitation energies on the transfer integral, which is equivalent to the energy gap between the highest occupied (HOMO) and the lowest unoccupied (LUMO) molecular orbitals in the Hückel theory, is found to be broken down in the high diradical character region due to an increase in electron correlation in the open-shell singlet ground state. A series of polyacenes shows the similar behavior of the optically allowed singlet excitation energies obtained by time-dependent spin-flip density functional theory calculations and experiments, which bears testimony to the singlet open-shell character in long polyacenes.

Cognitive-behavioral therapy versus other therapies: redux.

Despite the evidence suggesting that all treatments intended to be therapeutic are equally efficacious, the conjecture that one form of treatment, namely cognitive-behavioral therapy (CBT), is superior to all other treatment persists. The purpose of the current study was to (a) reanalyze the clinical trials from an earlier meta-analysis that compared CBT to 'other therapies' for depression and anxiety (viz., Tolin, 2010) and (b) conduct a methodologically rigorous and comprehensive meta-analysis to determine the relative efficacy of CBT and bona fide non-CBT treatments for adult anxiety disorders. Although the reanalysis was consistent with the earlier meta-analysis' findings of small to medium effect sizes for disorder-specific symptom measures, the reanalysis revealed no evidence for the superiority of CBT for depression and anxiety for outcomes that were not disorder-specific. Following the reanalysis, a comprehensive anxiety meta-analysis that utilized a survey of 91 CBT experts from the Association of Behavioral and Cognitive Therapists (ABCT) to consensually identify CBT treatments was conducted. Thirteen clinical trials met the inclusion criteria. There were no differences between CBT treatments and bona fide non-CBT treatments across disorder-specific and non-disorder specific symptom measures. These analyses, in combination with previous meta-analytic findings, fail to provide corroborative evidence for the conjecture that CBT is superior to bona fide non-CBT treatments.

Uniformity of evidence-based treatments in practice? Therapist effects in the delivery of cognitive processing therapy for PTSD.

OBJECTIVE: Various factors contribute to the effective implementation of evidence-based treatments (EBTs). In this study, cognitive processing therapy (CPT) was administered in a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty clinic in which training and supervision were provided following VA implementation guidelines. The aim was to (a) estimate the proportion of variability in outcome attributable to therapists and (b) identify characteristics of those therapists who produced better outcomes. METHOD: We used an archival database of veterans (n = 192) who completed 12 sessions of CPT by therapists (n = 25) who were trained by 2 nationally recognized trainers, 1 of whom also provided weekly group supervision. Multilevel modeling was used to estimate therapist effects, with therapists treated as a random factor. The supervisor was asked to retrospectively rate each therapist in terms of perceived effectiveness based on supervision interactions. Using single case study design, the supervisor was interviewed to determine what criteria she used to rate the therapists and emerging themes were coded. RESULTS: When initial level of severity on the PTSD Checklist (PCL; McDonald & Calhoun, 2010; Weathers, Litz, Herman, Huska, & Keane, 1993) was taken into account, approximately 12% of the variability in the PCL at the end of treatment was due to therapists. The trainer, blind to the results, identified the following characteristics and actions of effective therapists: effectively addressing patient avoidance, language used in supervision, flexible interpersonal style, and ability to develop a strong therapeutic alliance. CONCLUSIONS: This study adds to the growing body of literature documenting the importance of the individual therapist as an important factor in the change process.

Differences among trainees in client outcomes associated with the phase model of change.

This study investigated psychotherapy trainees' ability to facilitate change in outcomes (e.g., well-being, symptom reduction, and life functioning) specifically related to the phase model. Four different psychotherapist experience levels (beginning practicum, advanced practicum, intern/postdoc, and psychologist) were compared to determine whether there are training differences related to significant change for psychotherapy outcomes according to the phase model. A total of 1,318 clients from a university counseling center, treated by 64 psychotherapists, were included in the analysis for this study. Results indicate that interns/postdocs' clients achieve more significant change than psychologists' and advanced practicum students' clients related to life functioning. In addition, interns/postdocs' clients achieve more significant change related to symptom reduction, when compared with the clients of psychologists. Implications for these results, given the hypotheses of both the phase model and competency models, are discussed.

Interplay between the diradical character and third-order nonlinear optical properties in fullerene systems.

To reveal new structure-property relationships in the nonlinear optical (NLO) properties of fullerenes that are associated with their open-shell character, we investigated the interplay between the diradical character (y(i)) and second hyperpolarizability (longitudinal component, γ(zzzz)) in several fullerenes, including C(20), C(26), C(30), C(36), C(40), C(42), C(48), C(60), and C(70), by using the broken-symmetry density functional theory (DFT; LC-UBLYP (µ=0.33)/6-31G*//UB3LYP/6-31G*). We found that the large differences between the geometry and topology of fullerenes have a significant effect on the diradical character of each fullerene. On the basis of their different diradical character, these fullerenes were categorized into three groups, that is, closed-shell (y(i)=0), intermediate open-shell (0

Young parenthood program: supporting positive paternal engagement through coparenting counseling.

OBJECTIVES: Because of their youth, adolescent parents often lack the interpersonal skills necessary to manage the relationship challenges involved in parenting, leaving them and their children vulnerable to the health risks associated with relational stress and conflict. The primary goal of this study was to test the efficacy of the Young Parenthood Program (YPP), a 10-week counseling program administered during pregnancy and designed to facilitate interpersonal skill development and positive parenting among adolescent parents. METHODS: Participants included 105 pregnant adolescents and their partners randomly assigned to YPP or treatment as usual. Assessments measured coparenting skills and parental functioning during the second trimester, 12 weeks after birth, and 18 months after birth. RESULTS: Results indicated that fathers completing YPP demonstrated more positive parenting than did fathers in the control group. Moreover, the positive outcomes in paternal functioning were mediated through changes in the mother's interpersonal skill development. CONCLUSIONS: Results supported the efficacy of this couples-focused, coparenting support program, particularly for facilitating positive paternal engagement. These findings underscored the relevance of including fathers in the delivery of maternal-child public health services.

Benefits of yoga for psychosocial well-being in a US high school curriculum: a preliminary randomized controlled trial.

OBJECTIVE: To test feasibility of yoga within a high school curriculum and evaluate preventive efficacy for psychosocial well-being. METHODS: Grade 11 or 12 students (N = 51) who registered for physical education (PE) were cluster-randomized by class 2:1 yoga:PE-as-usual. A Kripalu-based yoga program of physical postures, breathing exercises, relaxation, and meditation was taught 2 to 3 times a week for 10 weeks. Self-report questionnaires were administered to students 1 week before and after. Primary outcome measures of psychosocial well-being were Profile of Mood States-Short Form and Positive and Negative Affect Schedule for Children. Additional measures of psychosocial well-being included Perceived Stress Scale and Inventory of Positive Psychological Attitudes. Secondary measures of self-regulatory skills included Resilience Scale, State Trait Anger Expression Inventory-2™, and Child Acceptance Mindfulness Measure. To assess feasibility, yoga students completed a program evaluation. Analyses of covariance were conducted between groups with baseline as the covariate. RESULTS: Although PE-as-usual students showed decreases in primary outcomes, yoga students maintained or improved. Total mood disturbance improved in yoga students and worsened in controls (p = .015), as did Profile of Mood States-Short Form (POMS-SF) Tension-Anxiety subscale (p = .002). Although positive affect remained unchanged in both, negative affect significantly worsened in controls while improving in yoga students (p = .006). Secondary outcomes were not significant. Students rated yoga fairly high, despite moderate attendance. CONCLUSIONS: Implementation was feasible and students generally found it beneficial. Although not causal due to small, uneven sample size, this preliminary study suggests preventive benefits in psychosocial well-being from Kripalu yoga during high school PE. These results are consistent with previously published studies of yoga in school settings.

Halide ion complexes of decaborane (B10H14) and their derivatives: noncovalent charge transfer effect on second-order nonlinear optical properties.

Quantum molecular engineering has been performed to determine the second-order nonlinear optical (NLO) properties in different halo complexes of decaborane (B(10)H(14)) and their derivatives using the density functional theory (DFT) method. These decaborane halo complexes of X(-)@B(10)H(14) (X = F, Cl, Br, and I) are found to possess noncovalent charge transfer interactions. The static polarizability (α(0)) and first hyperpolarizability (ß(0)) among these complexes increase by moving down the group from F to I, partly due to the increase in size of their anionic radii and the decrease in their electron affinities. A two-level approximation has been employed to investigate the origin of ß(0) values in these halo complexes, which show very consistent results with those by the finite-field method. Furthermore, in the same line, two experimentally existing complexes, I(-)@B(10)H(14) and I(-)@2,4-I(2)B(10)H(12), are found to have considerably large ß(0) values of 2859 and 3092 a.u., respectively, which are about three times larger than a prototypical second-order NLO molecule of p-nitroaniline, as reported by Soscun et al. [Int. J. Quantum Chem.2006, 106, 1130-1137]. Besides this, the special effects of solvent, counterion, and bottom substitutions have also been investigated. Interestingly, 2,4-alkali metal-substituted decaborane iodide complexes show remarkably large second-order NLO response with ß(0) amplitude as large as 62436 a.u. for I(-)@2,4-K(2)B(10)H(12) complex, which are explained in terms of their transition energies, frontier molecular orbitals and electron density difference plots. Thus, the present investigation provides several new comparative insights into the second-order NLO properties of halo complexes of decaborane, which possess not only large first hyperpolarizabilities, but also high tunability to get a robustly large second-order NLO response by alkali metal substitution effects.

Full configuration interaction calculations of the second hyperpolarizabilities of the H4 model compound: summation-over-states analysis and interplay with diradical characters.

The second hyperpolarizability (γ) of the one-dimensional H(4) model compound has been calculated at the full configuration interaction level to describe its relationships with the diradical characters y(i) [the occupation numbers of the lowest unoccupied natural orbital (LUNO) + i] and the geometry. It is found that the system with intermediate y(0) ( = 0.527) and small y(1) ( = 0.178) exhibits the largest γ value [enhanced by a factor of 9 compared to that of a nearly closed-shell H(4) analog (y(0) = 0.099, y(1) = 0.029)], where both the outer H-H distances are slightly larger than the inner one. These results provide a molecular design guideline for enhancing and controlling the third-order nonlinear optical properties of singlet multiradical linear molecular systems such as multiradical organic aggregates, supermolecular systems, and extended metal atom chains.

Theoretical Study of Singlet Fission in Oligorylenes.

Using the time-dependent tuned long-range corrected density functional theory method, the feasibility for singlet fission in oligorylenes has been investigated within the scope of the diradical character based guideline and of the energy level matching conditions for the isolated monomers. It is found that the relatively small-size oligorylenes, that is, terrylene and quaterrylene, which present intermediate diradical character without significant tetraradical character, are possible candidates for energetically efficient singlet fission. In relation to this result, we also raise the possibility that the unsettled ultrafast dynamics previously observed on quaterrylene is evidence for singlet fission.

Evidence-based treatments for depression and anxiety versus treatment-as-usual: a meta-analysis of direct comparisons.

OBJECTIVE: The aim of this study was to examine the relative efficacy of evidence-based treatments (EBTs) versus treatment-as-usual (TAU) in routine care for anxiety and depression in adults. METHOD: A computerized search of studies that directly compared an EBT with a TAU was conducted. Meta-analytic methods were used to estimate effectiveness of EBTs relative to TAU and to model how various confounding variables impacted the results of this comparative research. RESULTS: A total of 14 studies were included in the final meta-analysis. There was significant heterogeneity in the TAU conditions, which ranged from unknown and/or minimal mental health treatment to psychotherapeutic interventions provided by trained professionals. Although the effect for EBT vs. TAU was significantly greater than zero, the effect for EBT vs. TAUs that were psychotherapeutic interventions was not statistically different from zero. CONCLUSIONS: Heterogeneity of TAU conditions in this meta-analysis highlight the importance of clarifying the research questions being asked when investigating and drawing conclusions from EBT-TAU comparisons. Researchers need to clarify if they are comparing an EBT to psychotherapeutic services in routine care or to minimal mental health services. Extant research on EBT versus TAU reveals that there is insufficient evidence to recommend the transportation of EBTs for anxiety and depression to routine care, particularly when the routine care involves psychotherapeutic services.

Open-shell characters and second hyperpolarizabilities of one-dimensional graphene nanoflakes composed of trigonal graphene units.

The impact of topology on the open-shell characters and the second hyperpolarizabilities (γ) has been addressed for one-dimensional graphene nanoflakes (GNFs) composed of the smallest trigonal graphene (phenalenyl) units. The main results are: 1) These GNFs show not only diradical but also multiradical characters when increasing the number of linked units. 2) GNFs composed of an equivalent number of units can exhibit a wide range of open-shell characters-from nearly closed-shell to pure multiradical characters-depending on the linking pattern of the trigonal units. 3) This wide variation in open-shell characters is explained by their resonance structures and/or by their (HOMO-i)-(LUMO+i) gaps deduced from the orbital correlations. 4) The change in the linking structure of the units can effectively control their open-shell characters as well as their γ values, of which the longitudinal components are significantly enhanced for the singlet GNFs having intermediate open-shell characters. 5) Singlet alternately linked (AL) systems present intermediate multiradical characters even in the case of a large number of units, which creates a significant enhancement of γ with increasing the size, whereas nonalternately linked (NAL) systems, which present pure multiradical characters, possess much smaller γ values. Finally 6) by switching from the singlet to the highest spin states, the γ values of NAL systems hardly change, whereas those of AL systems exhibit large reductions. These fascinating structure-property relationships between the topology of the GNFs, their open-shell characters, and their γ values not only deepen the understanding of open-shell characters of GNFs but aim also at stimulating further design studies to achieve giant NLO responses based on open-shell graphene-like materials.