Introduction According to Control-Mastery Theory (CMT)—a cognitive-dynamic relational theory of m... more Introduction According to Control-Mastery Theory (CMT)—a cognitive-dynamic relational theory of mental functioning, psychopathology, and psychotherapy—patients come to therapy with an unconscious plan to disprove their pathogenic beliefs and achieve adaptive goals. One of the primary ways patients work to disconfirm their pathogenic beliefs is by testing them within the therapeutic relationship. Objectives: The present study aimed to replicate and expand the results of previous studies suggesting that therapists’ responses that disconfirmed patient’s pathogenic beliefs were predictive of patients’ within-session progress. Moreover, we wanted to investigate whether these interventions correlated with the therapeutic alliance. Methods: Transcriptions of 81 sessions from five brief psychodynamic psychotherapies were assessed by 11 independent raters. For each case, the patient’s plan was formulated and tests identified, the accuracy of the therapist’s responses to these tests was rated, and the impact of the therapist’s interventions on the patient’s subsequent communications and their relationship with the therapeutic alliance was measured. Results: The results supported the central hypothesis of the CMT that when the therapist’s interventions passed the patient’s tests, the patient showed signs of improvement. Moreover, the ability of the therapist to pass the patient’s tests correlated with the therapeutic alliance. Conclusions: The clinical implications and the limitations of these findings are discussed, together with the relevance of a good case formulation for clinicians’ optimal responsiveness.
Abstract: With survey data collected primarily from peer support group participants, we compared ... more Abstract: With survey data collected primarily from peer support group participants, we compared stigmatization responses of 462 parents losing children to suicide with 54 other traumatic death survivors and 24 child natural death survivors. Parents who encountered harmful responses and strained relations with family members and non-kin reported heightened grief difficulties. After controlling for time since the death and whether a child’s death was traumatic or not, stigmatization continued to be associated with grief difficulties, depression and suicidal thinking. Suicide survivors reported little differences in stigmatization from other-traumatic-death survivors, a result consistent with other recent studies, suggesting more convergence between these two populations than divergence. 2Stigmatization and Suicide Bereavement The literature on suicide bereavement identifies survivors as highly stigmatized
This analysis explores associations between differing death circumstances and the course of berea... more This analysis explores associations between differing death circumstances and the course of bereavement among a sample of 540 bereaved parents. Comparisons were made between parents whose children died by suicide (n = 462), those losing children from other traumatic death circumstances (n = 54), and others whose children died from natural causes (n = 24). Results were mixed, showing suicide survivors with more grief difficulties and other mental health problems on some criteria, though most findings showed no substantive differences between these subgroups. Results also showed, in the first years after loss, repeated suicide attempts and prior negative relationships with the decedent were associated with greater grief difficulties. However, as more time passed, all death circumstance differences were overshadowed by the importance of the time span since loss. This data also suggested that between 3 and 5 years usually marks the turning point, when acute grief difficulties accompanyi...
Background: Expressive Writing Intervention (EWI) asks people to write about a difficult experien... more Background: Expressive Writing Intervention (EWI) asks people to write about a difficult experience, such as infertility, to help them to elaborate and cope with the emotional impact of the stressful event. Through the application of Bucci’s referential process (RP) linguistic measures to infertile women’s narratives, the general aim of the present study was to explore possible differences in linguistic aspects of RP relative to assisted reproductive technology (ART) treatment outcomes. Method: Thirty-five women underwent three sessions of EWI during ART treatment, writing for each time about their thoughts and feelings related to the event that they were experiencing. Afterwards, women were divided into two groups: ART positive outcome (n=10) and ART negative outcome (n=25). Results: Differences within groups were evaluated, and in the negative outcome group a significant reduction in Italian Weighted Reflection and Reorganization List scores during writing sessions emerged, thus i...
Recent studies introduced the suicide crisis syndrome (SCS), a condition associated with imminent... more Recent studies introduced the suicide crisis syndrome (SCS), a condition associated with imminent suicidal behavior and characterized by (a) a pervasive feeling of entrapment in which the escape from an unbearable life situation is perceived as both urgent and impossible (Criterion A) and (b) affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal (Criterion B). The goal of the present study was to use some of the analytic tools provided by network analyses to further the understanding of the psychological, emotional, cognitive, behavioral, and physiological processes involved in the SCS by testing (a) whether the different symptoms of the proposed syndrome are related to each other, (b) whether symptoms form meaningful clusters, and (c) whether certain symptoms are more central than others. The study included 500 outpatient and 223 inpatient participants. A network analysis of the participants' scores on the various symptoms of the SCS was conducted. The network analysis suggested that most SCS symptoms are linked by strong connections and that entrapment and ruminative flooding are highly correlated with the other SCS symptoms. Three clusters of symptoms were identified, suggesting the existence of several interdependent psychological processes potentially involved in SCS phenomenology. Our findings support both the suggested symptoms of the SCS and the central role of entrapment in the proposed criteria for the syndrome. Emotional pain appears to be closely linked to entrapment and may belong in Criterion A. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Our research examined patterns of interpersonal problems in patients with a primary diagnosis of ... more Our research examined patterns of interpersonal problems in patients with a primary diagnosis of cocaine dependence (CD), comparing them with those in a normative sample. We hypothesized that the patterns of individuals with CD would reveal constellations of interpersonal problems distinct from those of the sample, not only at baseline, but also at termination of treatment. Analysis was conducted on 402 CD patients from the training and the main trial phases of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Responses to the Inventory for Interpersonal Problems were analyzed-from baseline, from month one, and at treatment termination-according to the Interpersonal Circumplex Model and were compared to the normative sample. The CD sample was described using four distinct subtypes, named according to their relative angular displacement at baseline and highest two subscale means: Cold and Socially Avoidant, Vindictive and Domineering, Overly Nurturant and Intrusive, Nonassertive and Exploitable. Each subtype remained distinct across treatment and consistently reported different types of interpersonal difficulties than the normative population at termination, consistent with the interpersonal pathoplasticity model. In all subtypes, overall interpersonal distress decreased over the course of treatment, to the extent that by treatment termination they were no more or less distressed than the normative sample. These findings have important clinical implications. The interpersonal challenges of patients struggling with addiction to cocaine warrant clinical attention, beyond mediating levels of distress.
Objective: To investigate whether (a) baseline levels of panic-specific reflection function (PSRF... more Objective: To investigate whether (a) baseline levels of panic-specific reflection function (PSRF; i.e. patients' capacity to reflect on their panic symptoms) and improvement in this capacity over treatment; (b) baseline borderline personality disorder (BPD) traits and pre-post treatment improvement in BPD traits predict change in patients' quality of object relations. Method: A subsample of 102 patients diagnosed with panic disorder from a larger randomized controlled trial received either Cognitive-Behavioral Therapy or Panic-Focused Psychodynamic Psychotherapy. We investigated whether baseline levels and change in both PSRF and BPD traits (as measured by the SCID-II) predicted pre-post change in quality of object relations (QOR), while controlling for pre-post treatment change in panic symptoms assessed by the Panic Disorder Severity Scale. Results: In both treatments, higher baseline levels of PSRF and lower levels of BPD traits, as well as pre-post decrease in BPD traits, predicted improvement in QOR when controlling for symptomatic change. Conclusions: The findings suggest that reduction in comorbid BPD traits can facilitate improvement in patients' quality of object relations even in brief symptom-focused psychotherapies. Additionally, patients with higher baseline levels of symptom-focused reflective function and lower BPD traits are more likely to demonstrate interpersonal change over the course of psychotherapy for panic disorder. Finally, our study highlights the importance of examining Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1
Background: Mental health professionals have a pivotal role in suicide prevention. However, they ... more Background: Mental health professionals have a pivotal role in suicide prevention. However, they also often have intense emotional responses, or countertransference, during encounters with suicidal patients. Previous studies of the Therapist Response Questionnaire-Suicide Form (TRQ-SF), a brief novel measure aimed at probing a distinct set of suicide-related emotional responses to patients found it to be predictive of nearterm suicidal behavior among high suicide-risk inpatients. The purpose of this study was to validate the TRQ-SF in a general outpatient clinic setting. Methods: Adult psychiatric outpatients (N = 346) and their treating mental health professionals (N = 48) completed self-report assessments following their first clinic meeting. Clinician measures included the TRQ-SF, general emotional states and traits, therapeutic alliance, and assessment of patient suicide risk. Patient suicidal outcomes and symptom severity were assessed at intake and one-month follow-up. Following confirmatory factor analysis of the TRQ-SF, factor scores were examined for relationships with clinician and patient measures and suicidal outcomes. results: Factor analysis of the TRQ-SF confirmed three dimensions: (1) affiliation, (2) distress, and (3) hope. The three factors also loaded onto a single general factor of negative emotional response toward the patient that demonstrated good internal reliability. The TRQ-SF scores were associated with measures of clinician state anger and anxiety and therapeutic alliance, independently of clinician personality traits after controlling for the state-and patient-specific measures. The total score and three subscales were associated in both concurrent and predictive ways with patient suicidal outcomes, depression severity, and clinicians' judgment of patient suicide risk, but not with global symptom severity, thus indicating specifically suicide-related responses.
Journal of Rational-Emotive & Cognitive-Behavior Therapy, 2017
The Attitudes and Belief Scale-2 (ABS-2) developed in the late 1980s, is a measure of Ellis' irra... more The Attitudes and Belief Scale-2 (ABS-2) developed in the late 1980s, is a measure of Ellis' irrational and rational beliefs. Although no publication has described the instrument and it has only appeared in conference presentations, many researchers have used the ABS-2 to test REBT. This article describes the development of the ABS-2 and the original research on its psychometric properties. The scale has three factors that represent 24 different cells in a 4 9 2 9 3 factorial model. The first factor, Cognitive Processes, reflects Ellis' concepts of Demandingness, Awfulizing, Frustration Intolerance, and Self-Downing. The second factor covers irrationally worded items versus rationally worded items. The rationally worded items were written to counter the irrational beliefs. The third factor includes content or life themes about which the person could be concerned, and includes Achievement, Affiliation, and Comfort. The ABS-2 generates a Total Score, a Total Irrationality Score, a Total Rationality score, and Scales scores representing each of the four Cognitive Processes domains and each of the three Content domains. The ABS-2 scores demonstrate adequate to excellent internal consistency, and correlate significantly with measures of depression, anxiety, life satisfaction, selfcontrol, well-being, and measures of internalizing personality disorders. The ABS-2 did not Russell Leaf: Deceased.
International Journal of High Risk Behaviors and Addiction, 2016
Background: Risk-taking behaviors are common and, unabated, can lead to serious consequences, suc... more Background: Risk-taking behaviors are common and, unabated, can lead to serious consequences, such as unintended pregnancies, sexually transmitted infections, drug and alcohol abuse, injuries, and death. Despite their prevalence and consequences, the psychological determinants underlying these behaviors are not well understood. Objectives: The study aimed to evaluated the role of Sex, Parent Attachment, Emotional Adjustment on Risk-Taking Behaviors. Patients and Methods: To test the role of close relationships on risk-taking behaviors,we used a correctional field design and examined the influence of parent attachment on these behaviors while accounting for participants' sex and emotional adjustment, measured in the form of self-esteem and level of depression. A total of 269 participants from Amazon's MTurk website completed our survey. Results: Results revealed differences between men and women on all six scales that assessed for risk-taking behavior; however no differences were evident by sex on levels of attachment to mother or attachment to father or on levels of adjustment. Our results also indicate that attachment to mother is directly and inversely associated with risk taking behavior, and that adjustment is a mediator between attachment to father and risk-taking behavior. Conclusions: These results and others are presented and discussed in the context of the literature along with implications for counseling and for future research in this area.
Objectives: Literature on outcome assessment suggests that 35-40% of patients in randomized contr... more Objectives: Literature on outcome assessment suggests that 35-40% of patients in randomized control trials terminate treatment with unchanged or higher levels of symptomatology. The goal of the present study was to shed light on this phenomenon and the factors accounting for it using a single case study design that investigates the process and outcome of a treatment conducted within a non-randomized clinical trial comparing a cognitive behavioral and a brief relational treatment. Method: The condition of L., a Caucasian man undergoing cognitive-behavioral therapy in a large metropolitan research program, was classified as deteriorating using the Reliable Change Index for the Inventory of Interpersonal Problems (IIP) and the Symptom Checklist-90 (SCL-90). Therapeutic process and outcome were examined using quantitative and qualitative methods rated by several sources. Results: Analysis showed that the treatment was delivered skillfully, and that despite initial difficulties, a strong alliance eventually developed between the patient and the therapist whose perspectives on the outcome of therapy nevertheless diverged. The patient's satisfaction with treatment was high, and he believed his deterioration was caused by its termination. Discussion: Results suggest that the deterioration was not caused by a negative process or a faulty delivery of the therapy. Several explanations were discussed in the context of the literature.
This study aimed to determine how control charts - a form of time-series line graphs - can be imp... more This study aimed to determine how control charts - a form of time-series line graphs - can be implemented in psychotherapy research to indirectly identify probable rupture-repair episodes that are associated with psychotherapy outcome. There is no current standard in psychotherapy research with regard to how to use control charts to identify rupture-repair events. Control charts were generated for each patient (N = 73) using patient-rated Working Alliance Inventory (WAI) scores obtained at the end of every session in a 30-session therapy protocol of either brief relational therapy (BRT) or cognitive behavioral therapy (CBT). Empirically-derived cutoff points were used to identify rupture and repair based on each dyad's control chart. Coded rupture-repair episodes were correlated with outcome measures to assess for their relationships. The results of these analyses provide preliminary support for the utility of control charts in psychotherapy research for the indirect identification of probable rupture repair events that are associated with psychotherapy outcome.
In October 2017, Northern California experienced devastating and historic wildfires leaving the c... more In October 2017, Northern California experienced devastating and historic wildfires leaving the community in need of support to foster emotional resilience during the recovery process. Adolescents represent a particularly vulnerable population in the wake of disaster, and digital mental health interventions may hold promise for reaching teens at scale. The present study examined the feasibility and efficacy of a mobile mental health app for disaster, Sonoma Rises. A multiple-baseline single-case experimental design (SCED) utilizing a research-enabled version of the app was employed with seven adolescents who experienced significant damage to their homes and schools in the wildfires. Participants completed daily mood ratings, weekly measures of posttraumatic stress symptoms, internalizing and externalizing symptoms, psychosocial functioning, and then pre-post-measures of anxiety, depression, wellbeing, sleep, academic engagement, and perceived social support as well as quantitative and qualitative measures of intervention satisfaction and feasibility. Sonoma Rises was found to be feasible in terms of engagement, satisfaction, and likelihood of recommending to a friend. During the study, another wildfire occurred and all participants underwent a prolonged mandated evacuation and were subject to a series of extended power outages. Uptake of the publicly available version of the Sonoma Rises app among the general population was modest but engagement among users was sustained. Lessons learned are offered to contribute to the science and practice of building, disseminating, and implementing digital tools to conduct more equitable disaster mental health outreach and research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Introduction According to Control-Mastery Theory (CMT)—a cognitive-dynamic relational theory of m... more Introduction According to Control-Mastery Theory (CMT)—a cognitive-dynamic relational theory of mental functioning, psychopathology, and psychotherapy—patients come to therapy with an unconscious plan to disprove their pathogenic beliefs and achieve adaptive goals. One of the primary ways patients work to disconfirm their pathogenic beliefs is by testing them within the therapeutic relationship. Objectives: The present study aimed to replicate and expand the results of previous studies suggesting that therapists’ responses that disconfirmed patient’s pathogenic beliefs were predictive of patients’ within-session progress. Moreover, we wanted to investigate whether these interventions correlated with the therapeutic alliance. Methods: Transcriptions of 81 sessions from five brief psychodynamic psychotherapies were assessed by 11 independent raters. For each case, the patient’s plan was formulated and tests identified, the accuracy of the therapist’s responses to these tests was rated, and the impact of the therapist’s interventions on the patient’s subsequent communications and their relationship with the therapeutic alliance was measured. Results: The results supported the central hypothesis of the CMT that when the therapist’s interventions passed the patient’s tests, the patient showed signs of improvement. Moreover, the ability of the therapist to pass the patient’s tests correlated with the therapeutic alliance. Conclusions: The clinical implications and the limitations of these findings are discussed, together with the relevance of a good case formulation for clinicians’ optimal responsiveness.
Abstract: With survey data collected primarily from peer support group participants, we compared ... more Abstract: With survey data collected primarily from peer support group participants, we compared stigmatization responses of 462 parents losing children to suicide with 54 other traumatic death survivors and 24 child natural death survivors. Parents who encountered harmful responses and strained relations with family members and non-kin reported heightened grief difficulties. After controlling for time since the death and whether a child’s death was traumatic or not, stigmatization continued to be associated with grief difficulties, depression and suicidal thinking. Suicide survivors reported little differences in stigmatization from other-traumatic-death survivors, a result consistent with other recent studies, suggesting more convergence between these two populations than divergence. 2Stigmatization and Suicide Bereavement The literature on suicide bereavement identifies survivors as highly stigmatized
This analysis explores associations between differing death circumstances and the course of berea... more This analysis explores associations between differing death circumstances and the course of bereavement among a sample of 540 bereaved parents. Comparisons were made between parents whose children died by suicide (n = 462), those losing children from other traumatic death circumstances (n = 54), and others whose children died from natural causes (n = 24). Results were mixed, showing suicide survivors with more grief difficulties and other mental health problems on some criteria, though most findings showed no substantive differences between these subgroups. Results also showed, in the first years after loss, repeated suicide attempts and prior negative relationships with the decedent were associated with greater grief difficulties. However, as more time passed, all death circumstance differences were overshadowed by the importance of the time span since loss. This data also suggested that between 3 and 5 years usually marks the turning point, when acute grief difficulties accompanyi...
Background: Expressive Writing Intervention (EWI) asks people to write about a difficult experien... more Background: Expressive Writing Intervention (EWI) asks people to write about a difficult experience, such as infertility, to help them to elaborate and cope with the emotional impact of the stressful event. Through the application of Bucci’s referential process (RP) linguistic measures to infertile women’s narratives, the general aim of the present study was to explore possible differences in linguistic aspects of RP relative to assisted reproductive technology (ART) treatment outcomes. Method: Thirty-five women underwent three sessions of EWI during ART treatment, writing for each time about their thoughts and feelings related to the event that they were experiencing. Afterwards, women were divided into two groups: ART positive outcome (n=10) and ART negative outcome (n=25). Results: Differences within groups were evaluated, and in the negative outcome group a significant reduction in Italian Weighted Reflection and Reorganization List scores during writing sessions emerged, thus i...
Recent studies introduced the suicide crisis syndrome (SCS), a condition associated with imminent... more Recent studies introduced the suicide crisis syndrome (SCS), a condition associated with imminent suicidal behavior and characterized by (a) a pervasive feeling of entrapment in which the escape from an unbearable life situation is perceived as both urgent and impossible (Criterion A) and (b) affective disturbance, loss of cognitive control, hyperarousal, and social withdrawal (Criterion B). The goal of the present study was to use some of the analytic tools provided by network analyses to further the understanding of the psychological, emotional, cognitive, behavioral, and physiological processes involved in the SCS by testing (a) whether the different symptoms of the proposed syndrome are related to each other, (b) whether symptoms form meaningful clusters, and (c) whether certain symptoms are more central than others. The study included 500 outpatient and 223 inpatient participants. A network analysis of the participants' scores on the various symptoms of the SCS was conducted. The network analysis suggested that most SCS symptoms are linked by strong connections and that entrapment and ruminative flooding are highly correlated with the other SCS symptoms. Three clusters of symptoms were identified, suggesting the existence of several interdependent psychological processes potentially involved in SCS phenomenology. Our findings support both the suggested symptoms of the SCS and the central role of entrapment in the proposed criteria for the syndrome. Emotional pain appears to be closely linked to entrapment and may belong in Criterion A. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Our research examined patterns of interpersonal problems in patients with a primary diagnosis of ... more Our research examined patterns of interpersonal problems in patients with a primary diagnosis of cocaine dependence (CD), comparing them with those in a normative sample. We hypothesized that the patterns of individuals with CD would reveal constellations of interpersonal problems distinct from those of the sample, not only at baseline, but also at termination of treatment. Analysis was conducted on 402 CD patients from the training and the main trial phases of the National Institute on Drug Abuse Collaborative Cocaine Treatment Study. Responses to the Inventory for Interpersonal Problems were analyzed-from baseline, from month one, and at treatment termination-according to the Interpersonal Circumplex Model and were compared to the normative sample. The CD sample was described using four distinct subtypes, named according to their relative angular displacement at baseline and highest two subscale means: Cold and Socially Avoidant, Vindictive and Domineering, Overly Nurturant and Intrusive, Nonassertive and Exploitable. Each subtype remained distinct across treatment and consistently reported different types of interpersonal difficulties than the normative population at termination, consistent with the interpersonal pathoplasticity model. In all subtypes, overall interpersonal distress decreased over the course of treatment, to the extent that by treatment termination they were no more or less distressed than the normative sample. These findings have important clinical implications. The interpersonal challenges of patients struggling with addiction to cocaine warrant clinical attention, beyond mediating levels of distress.
Objective: To investigate whether (a) baseline levels of panic-specific reflection function (PSRF... more Objective: To investigate whether (a) baseline levels of panic-specific reflection function (PSRF; i.e. patients' capacity to reflect on their panic symptoms) and improvement in this capacity over treatment; (b) baseline borderline personality disorder (BPD) traits and pre-post treatment improvement in BPD traits predict change in patients' quality of object relations. Method: A subsample of 102 patients diagnosed with panic disorder from a larger randomized controlled trial received either Cognitive-Behavioral Therapy or Panic-Focused Psychodynamic Psychotherapy. We investigated whether baseline levels and change in both PSRF and BPD traits (as measured by the SCID-II) predicted pre-post change in quality of object relations (QOR), while controlling for pre-post treatment change in panic symptoms assessed by the Panic Disorder Severity Scale. Results: In both treatments, higher baseline levels of PSRF and lower levels of BPD traits, as well as pre-post decrease in BPD traits, predicted improvement in QOR when controlling for symptomatic change. Conclusions: The findings suggest that reduction in comorbid BPD traits can facilitate improvement in patients' quality of object relations even in brief symptom-focused psychotherapies. Additionally, patients with higher baseline levels of symptom-focused reflective function and lower BPD traits are more likely to demonstrate interpersonal change over the course of psychotherapy for panic disorder. Finally, our study highlights the importance of examining Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1
Background: Mental health professionals have a pivotal role in suicide prevention. However, they ... more Background: Mental health professionals have a pivotal role in suicide prevention. However, they also often have intense emotional responses, or countertransference, during encounters with suicidal patients. Previous studies of the Therapist Response Questionnaire-Suicide Form (TRQ-SF), a brief novel measure aimed at probing a distinct set of suicide-related emotional responses to patients found it to be predictive of nearterm suicidal behavior among high suicide-risk inpatients. The purpose of this study was to validate the TRQ-SF in a general outpatient clinic setting. Methods: Adult psychiatric outpatients (N = 346) and their treating mental health professionals (N = 48) completed self-report assessments following their first clinic meeting. Clinician measures included the TRQ-SF, general emotional states and traits, therapeutic alliance, and assessment of patient suicide risk. Patient suicidal outcomes and symptom severity were assessed at intake and one-month follow-up. Following confirmatory factor analysis of the TRQ-SF, factor scores were examined for relationships with clinician and patient measures and suicidal outcomes. results: Factor analysis of the TRQ-SF confirmed three dimensions: (1) affiliation, (2) distress, and (3) hope. The three factors also loaded onto a single general factor of negative emotional response toward the patient that demonstrated good internal reliability. The TRQ-SF scores were associated with measures of clinician state anger and anxiety and therapeutic alliance, independently of clinician personality traits after controlling for the state-and patient-specific measures. The total score and three subscales were associated in both concurrent and predictive ways with patient suicidal outcomes, depression severity, and clinicians' judgment of patient suicide risk, but not with global symptom severity, thus indicating specifically suicide-related responses.
Journal of Rational-Emotive & Cognitive-Behavior Therapy, 2017
The Attitudes and Belief Scale-2 (ABS-2) developed in the late 1980s, is a measure of Ellis' irra... more The Attitudes and Belief Scale-2 (ABS-2) developed in the late 1980s, is a measure of Ellis' irrational and rational beliefs. Although no publication has described the instrument and it has only appeared in conference presentations, many researchers have used the ABS-2 to test REBT. This article describes the development of the ABS-2 and the original research on its psychometric properties. The scale has three factors that represent 24 different cells in a 4 9 2 9 3 factorial model. The first factor, Cognitive Processes, reflects Ellis' concepts of Demandingness, Awfulizing, Frustration Intolerance, and Self-Downing. The second factor covers irrationally worded items versus rationally worded items. The rationally worded items were written to counter the irrational beliefs. The third factor includes content or life themes about which the person could be concerned, and includes Achievement, Affiliation, and Comfort. The ABS-2 generates a Total Score, a Total Irrationality Score, a Total Rationality score, and Scales scores representing each of the four Cognitive Processes domains and each of the three Content domains. The ABS-2 scores demonstrate adequate to excellent internal consistency, and correlate significantly with measures of depression, anxiety, life satisfaction, selfcontrol, well-being, and measures of internalizing personality disorders. The ABS-2 did not Russell Leaf: Deceased.
International Journal of High Risk Behaviors and Addiction, 2016
Background: Risk-taking behaviors are common and, unabated, can lead to serious consequences, suc... more Background: Risk-taking behaviors are common and, unabated, can lead to serious consequences, such as unintended pregnancies, sexually transmitted infections, drug and alcohol abuse, injuries, and death. Despite their prevalence and consequences, the psychological determinants underlying these behaviors are not well understood. Objectives: The study aimed to evaluated the role of Sex, Parent Attachment, Emotional Adjustment on Risk-Taking Behaviors. Patients and Methods: To test the role of close relationships on risk-taking behaviors,we used a correctional field design and examined the influence of parent attachment on these behaviors while accounting for participants' sex and emotional adjustment, measured in the form of self-esteem and level of depression. A total of 269 participants from Amazon's MTurk website completed our survey. Results: Results revealed differences between men and women on all six scales that assessed for risk-taking behavior; however no differences were evident by sex on levels of attachment to mother or attachment to father or on levels of adjustment. Our results also indicate that attachment to mother is directly and inversely associated with risk taking behavior, and that adjustment is a mediator between attachment to father and risk-taking behavior. Conclusions: These results and others are presented and discussed in the context of the literature along with implications for counseling and for future research in this area.
Objectives: Literature on outcome assessment suggests that 35-40% of patients in randomized contr... more Objectives: Literature on outcome assessment suggests that 35-40% of patients in randomized control trials terminate treatment with unchanged or higher levels of symptomatology. The goal of the present study was to shed light on this phenomenon and the factors accounting for it using a single case study design that investigates the process and outcome of a treatment conducted within a non-randomized clinical trial comparing a cognitive behavioral and a brief relational treatment. Method: The condition of L., a Caucasian man undergoing cognitive-behavioral therapy in a large metropolitan research program, was classified as deteriorating using the Reliable Change Index for the Inventory of Interpersonal Problems (IIP) and the Symptom Checklist-90 (SCL-90). Therapeutic process and outcome were examined using quantitative and qualitative methods rated by several sources. Results: Analysis showed that the treatment was delivered skillfully, and that despite initial difficulties, a strong alliance eventually developed between the patient and the therapist whose perspectives on the outcome of therapy nevertheless diverged. The patient's satisfaction with treatment was high, and he believed his deterioration was caused by its termination. Discussion: Results suggest that the deterioration was not caused by a negative process or a faulty delivery of the therapy. Several explanations were discussed in the context of the literature.
This study aimed to determine how control charts - a form of time-series line graphs - can be imp... more This study aimed to determine how control charts - a form of time-series line graphs - can be implemented in psychotherapy research to indirectly identify probable rupture-repair episodes that are associated with psychotherapy outcome. There is no current standard in psychotherapy research with regard to how to use control charts to identify rupture-repair events. Control charts were generated for each patient (N = 73) using patient-rated Working Alliance Inventory (WAI) scores obtained at the end of every session in a 30-session therapy protocol of either brief relational therapy (BRT) or cognitive behavioral therapy (CBT). Empirically-derived cutoff points were used to identify rupture and repair based on each dyad's control chart. Coded rupture-repair episodes were correlated with outcome measures to assess for their relationships. The results of these analyses provide preliminary support for the utility of control charts in psychotherapy research for the indirect identification of probable rupture repair events that are associated with psychotherapy outcome.
In October 2017, Northern California experienced devastating and historic wildfires leaving the c... more In October 2017, Northern California experienced devastating and historic wildfires leaving the community in need of support to foster emotional resilience during the recovery process. Adolescents represent a particularly vulnerable population in the wake of disaster, and digital mental health interventions may hold promise for reaching teens at scale. The present study examined the feasibility and efficacy of a mobile mental health app for disaster, Sonoma Rises. A multiple-baseline single-case experimental design (SCED) utilizing a research-enabled version of the app was employed with seven adolescents who experienced significant damage to their homes and schools in the wildfires. Participants completed daily mood ratings, weekly measures of posttraumatic stress symptoms, internalizing and externalizing symptoms, psychosocial functioning, and then pre-post-measures of anxiety, depression, wellbeing, sleep, academic engagement, and perceived social support as well as quantitative and qualitative measures of intervention satisfaction and feasibility. Sonoma Rises was found to be feasible in terms of engagement, satisfaction, and likelihood of recommending to a friend. During the study, another wildfire occurred and all participants underwent a prolonged mandated evacuation and were subject to a series of extended power outages. Uptake of the publicly available version of the Sonoma Rises app among the general population was modest but engagement among users was sustained. Lessons learned are offered to contribute to the science and practice of building, disseminating, and implementing digital tools to conduct more equitable disaster mental health outreach and research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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