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Behavioral Activation Treatments for Depression in Adults: A Meta-analysis and ReviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Behavioral activation (BA) treatments for depression require patients to increase overt behavior to bring them in contact with reinforcing environmental contingencies. This meta-analysis sought to identify all randomized controlled studies of BA, determine the effect of this approach, and examine the differential effectiveness of variants. Thirty-four studies with 2,055 participants reporting symptoms of depression were included. The pooled effect size indicating the difference between BA and control conditions at posttest was 0.78. For participants who satisfied the criteria for major depressive disorder, the overall effe...
Source: Clinical Psychology: Science and Practice - October 27, 2009 Category: Psychiatry & Psychology Authors: Trevor Mazzucchelli, Robert Kane, Clare Rees Tags: REVIEW Source Type: journals

Can the Behavioral Approach System (BAS) Dysregulation Theory Help Us to Understand Psychosocial Interventions in Bipolar Disorders?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The past decade has witnessed a proliferation of reports of beneficial effects of adding psychosocial interventions to medication for bipolar patients. These interventions have common pragmatic elements, which are not specific to the theory underpinning therapy. Nusslock, Abramson, Harmon-Jones, Alloy, and Coan (2009) attempted to further our understanding by linking psychosocial interventions specific to bipolar disorders with the Behavioral Approach System (BAS) Dysregulation Theory. The attempt is most successful for cognitive behavioral therapy. The cognitive model and the BAS complement each other. Goal-attainment dys...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Dominic Lam Tags: COMMENTARIES Source Type: journals

On the Role of Goal Dysregulation in the Treatment of Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nusslock, Abramson, Harmon-Jones, Alloy, and Coan (2009) propose that current psychosocial treatments for bipolar disorder be supplemented with interventions focused on altering goal dysregulation pathways. While innovations to existing treatment manuals are always welcome, there are several reasons why this suggestion may be premature. We highlight issues pertaining to the status of cognitive-behavioral therapy for bipolar disorder, the distinction between education and psychoeducation, the nature of familial expressed emotion, differences between clinical and analog samples, and the larger question of how to assess mecha...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: David J. Miklowitz, Sheri L. Johnson Tags: COMMENTARIES Source Type: journals

Psychosocial Interventions for Bipolar Disorder: Perspective From the Behavioral Approach System (BAS) Dysregulation TheoryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of the current article was to examine the extent to which findings from the BAS dysregulation theory can inform psychosocial interventions for bipolar disorder. Toward this end, we first provide an overview of the BAS dysregulation theory. Second, we review extant research on psychosocial interventions for bipolar disorder. And, third, we discuss means by which research and theory in line with the BAS dysregulation model can inform psychosocial interventions for bipolar disorder. Particular attention is given to the clinical implications of research, suggesting that bipolar disorder is characterized by high d...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Robin Nusslock, Lyn Abramson, Eddie Harmon-Jones, Lauren Alloy, James Coan Tags: REVIEW Source Type: journals

If We Build It, Will They Come? The Health Belief Model and Mental Health Care UtilizationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Application of the Health Belief Model (HBM) to the problem of underutilization of mental health services represents a creative and potentially quite useful conceptual innovation. Importantly, Henshaw and Freedman-Doan (2009) address several critical issues in this application, including the importance of considering the role of diversity in the HBM, the essential role of evidence regarding the benefits of the approach, evaluation of costs relative to those benefits, and the possible integration of the approach into primary care settings. Yet, there are also major challenges to be addressed in future research, including th...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Timothy W. Smith Tags: COMMENTARIES Source Type: journals

Commentary: Using Psychological Theory in Help-Seeking ResearchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In commenting on Henshaw and Freedman-Doan's (2009) article, we note that the topic is significant because treatment rates for mental health problems remain relatively low; we agree that theory-based research is needed to better understand and remediate this. We discuss dual-process models of health behavior, including heuristic-based as well as reasoned or rational information processing, and the role of informal networks and social comparison processes in symptom labeling and help seeking decisions. We suggest how social-cognitive theory may be useful for further research, and we note the low rates of help seeking for po...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Thomas A. Wills, Frederick X. Gibbons Tags: COMMENTARIES Source Type: journals

Conceptualizing Mental Health Care Utilization Using the Health Belief ModelEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article uses the Health Belief Model (HBM; Health Education Monographs, 1974, 2:409) as a framework for explaining what factors might encourage or inhibit an individual from utilizing mental health services. The HBM is a socio-cognitive approach that proposes that people are likely to engage in a given health-related behavior when they believe the problem could have serious consequences for daily living activities, when they believe the intervention will be effective, and when they perceive few barriers to taking action. When applied to mental health utilization, this model provides a structure for developing and eval...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Erin J. Henshaw, Carol R. Freedman-Doan Tags: REVIEW Source Type: journals

Reaffirmation of Behavioral Approaches to Depression TreatmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This meta-analytic review improved on the methods and scope of similar reviews but reached the same conclusion that behavioral activation (BA) therapies for adult depression are much more effective than control conditions and comparable with cognitive-behavioral interventions. Future research should strengthen our understanding of the mechanisms that account for the effectiveness of BA approaches and should provide more evidence on long-term maintenance. The resurgence of interest in BA was attributed to pioneering work of Lewinsohn and the components analysis research of Jacobson and colleagues, who demonstrated the effec...
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Manuel Barrera Jr Tags: COMMENTARIES Source Type: journals

Looking at the Components of Treatment for DepressionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This commentary reviews the Jacobson et al. (1996) article that is often cited as the basis for the current interest in behavioral activation (BA). It is argued that the results do not necessarily support the conclusion that BA is the essential component of cognitive therapy. Second, the commentary discusses the potential value of isolating components of complex treatment packages for depression and evaluating them for their match to the lives of individual depressed persons. (Source: Clinical Psychology: Science and Practice)
Source: Clinical Psychology: Science and Practice - October 26, 2009 Category: Psychiatry & Psychology Authors: Lynn P. Rehm Tags: COMMENTARIES Source Type: journals

Making Science Matter in Clinical Practice: Redefining PsychotherapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Evidence suggests that the well-known chasm that exists between science and practice may be maintained less by the intransigence of practitioners than by the failure of scientists to (a) offer a workable model of how to integrate science to clinicians and (b) recognize how weak the evidence is for certain widely held beliefs about the nature of empirically supported treatments (ESTs). A rational weighing of the status of current evidence behooves scientists to take another, more careful look at why ESTs have failed to distinguish themselves from other treatments and to use this information in framing a broader approach to ...
Source: Clinical Psychology: Science and Practice - August 22, 2009 Category: Psychiatry & Psychology Authors: Larry E. Beutler Tags: REVIEW AND COMMENTARY Source Type: journals

Treatment Integrity and Differential Treatment EffectsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bhar and Beck (2009) examined the extent to which treatment integrity procedures were implemented in studies comparing psychoanalytic psychotherapies and cognitive-behavioral therapies. Consistent with other reports on attention to treatment integrity in psychotherapy research, the authors noted that most of the evaluated studies did not adequately implement treatment integrity procedures. This highlights methodological neglect of treatment integrity and a need to amend errors in monitoring the independent variables under investigation. This commentary considers how Bhar and Beck's investigation affects the dodo bird verdi...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Francheska Perepletchikova, Tags: REVIEW AND COMMENTARY Source Type: journals

Treatment Integrity of Studies That Compare Short-Term Psychodynamic Psychotherapy With Cognitive-Behavior TherapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In their meta-analysis, Leichsenring, Rabung, and Leibing (2004) found that short-term psychoanalytic psychotherapy (STPP) and cognitive-behavior therapy (CBT) were equally efficacious. However, they did not examine whether the treatments were delivered as intended. In our review of nine studies comparing STPP and CBT, we found that most did not adequately implement treatment integrity procedures. Leichsenring and colleagues' contention that CBT and STPP are equally efficacious is therefore based on studies without adequate procedures to monitor treatment adherence or therapist competence. The neglect of treatment integrit...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Sunil S. Bhar, Aaron T. Beck Tags: REVIEW AND COMMENTARY Source Type: journals

Balancing Breadth and Specialized Training in Doctoral Education: (How) Can We Do It Effectively?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The existence and role of focused or specialized training experiences in doctoral training programs is an ongoing debate. Although accreditation guidelines specify that at the predoctoral level, training is broad and general, there is a diversity of opinion about the feasibility and wisdom of limiting predoctoral training to a broad and general level. Perry and Boccaccini (2009) present a study that documents the majority of accredited clinical psychology graduate programs self-identify on their websites as providing specialized training experiences and discusses several issues that this raises for the training community. ...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Debora J. Bell Tags: REVIEW AND COMMENTARIES Source Type: journals

Problems With Nomenclature of Specialty Training and Practice and Disclosure of Information Within Clinical PsychologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This commentary responds to Perry and Boccaccini (2009) by extending implications of the findings to nomenclature about specialties and specialty training, standardizing website information, and truth in advertising about clinical training programs. (Source: Clinical Psychology: Science and Practice)
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Michael C. Roberts, Jade A. Bender, Brandon S. Aylward Tags: REVIEW AND COMMENTARIES Source Type: journals

Specialized Training in APA-Accredited Clinical Psychology Doctoral Programs: Findings From a Review of Program WebsitesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The current study examined the websites of the 231 clinical psychology doctoral programs accredited by the American Psychological Association (APA) in 2007 and found that more than half described themselves as offering a track, emphasis, certificate, or degree in a specialized training area. About 18% of programs required students to enroll in a specialized training stream. The most common areas of specialized training were clinical child, clinical health, forensic, family, and clinical neuropsychology. The most common format for specialized training was a track within a general clinical training program. A greater percent...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Kevin M. Perry, Marcus T. Boccaccini Tags: REVIEW AND COMMENTARIES Source Type: journals

Telemental Health: Reflections on How to Move the Field ForwardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Richardson, Frueh, Grubaugh, Egede, and Elhai (2009) review recent literature on providing mental health care via videoconferencing. Videoconferencing is one of a growing number of telecommunications technologies used to provide telemental health care. This commentary places videoconferencing in the broader field of telemental health care and discusses some of the areas that are crucial to the advancement of the field. To this end, the assumption that telemental health intervention improves access to care is explored. The notion that different telemental health telecommunications media, including the telephone and Internet...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: David C. Mohr Tags: REVIEW AND COMMENTARIES Source Type: journals

Any Minute Now but Far Far Away: Electronically Mediated Mental HealthEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Rapidly expanding access to a wide array of electronically mediated modes of human communication has and will continue to change society. Why should we not expect mental health services to change accordingly? Just as we contemplate and evaluate other advances in psychological assessment and intervention activities, we must consider the changes brought about by technology, including the good, the bad, and the risky. The Richardson, Frueh, Grubaugh, Egede, and Elhai (2009) article on current directions in videoconferencing and tele-mental health research provides a wonderful context to scratch a bit more beneath the surface ...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Gerald P. Koocher Tags: REVIEW AND COMMENTARIES Source Type: journals

Current Directions in Videoconferencing Tele-Mental Health ResearchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The provision of mental health services via videoconferencing tele-mental health has become an increasingly routine component of mental health service delivery throughout the world. Emphasizing the research literature since 2003, we examine (a) the extent to which the field of tele-mental health has advanced the research agenda previously suggested and (b) implications for tele-mental healthcare delivery for special clinical populations. Previous findings have demonstrated that tele-mental health services are satisfactory to patients, improve outcomes, and are probably cost effective. In the very small number of randomized...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: Lisa K. Richardson, B. Christopher Frueh, Anouk L. Grubaugh, Leonard Egede, Jon D. Elhai Tags: REVIEW AND COMMENTARIES Source Type: journals

Research Psychotherapy: Aspirin or Music?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Beutler's call for an expanded psychotherapy agenda is appropriate but does not require downgrading the role of randomized clinical trials (RCTs). Large-scale RCTs are necessary to address questions of general public health importance. Within RCTs, psychotherapy can be conducted in a flexible, creative manner, similar to the practice of good clinicians. The aspirin analogy drawn from Klerman is not illustrative of how psychotherapy is actually conducted in contemporary clinical trials. A better analogy is that of music, which not only involves known ingredients and trainable, replicable skills, but also permits tailoring a...
Source: Clinical Psychology: Science and Practice - August 20, 2009 Category: Psychiatry & Psychology Authors: John F. Curry Tags: REVIEW AND COMMENTARY Source Type: journals

Psychosocial Research on the Course of Bipolar Disorder: Appreciating Its Past and Encouraging Its FutureEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Miklowitz and Johnson (2009) review the accumulating accomplishments of studies of psychosocial contributors to and treatments of bipolar disorder. Much of the initial work was influenced by paradigms that addressed predictors and treatments of unipolar depression. That personality, stress, and family factors also play an important role in the course and outcomes of bipolar disorders has now been well established, but because depression appears to be especially debilitating and difficult to manage in bipolar disorder, further challenges remain to understand and treat it. At the same time the predictors of mania, and switch...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Constance Hammen Tags: REVIEW AND COMMENTARY Source Type: journals

Social and Familial Factors in the Course of Bipolar Disorder: Basic Processes and Relevant InterventionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the role of social factors, notably life events and family relationships, in the course of bipolar illness in adults and youth. We also discuss psychological variables that help explain the vulnerability of bipolar patients to social environments, including personality factors (e.g., neuroticism), reward sensitivity, and difficulty with the accurate perception of facial emotions. Bipolar patients are highly sensitive to reward, and excessive goal pursuit after goal-attainment events may be one pathway to mania. Negative life events predict depressive symptoms, as do levels of familial expressed emotion...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: David J. Miklowitz, Boulder Sheri L. Johnson Tags: REVIEW AND COMMENTARY Source Type: journals

A Commentary on "Sleep Disturbance in Bipolar Disorder"Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sleep disturbances are among the most common clinical features of bipolar affective disorder and are typically present in manic, hypomanic, mixed, and depressive episodes. The processes that regulate sleep are relevant to the pathophysiology of bipolar illness and further study of these processes may help to elucidate fundamental associations with central nervous system arousal and cerebral metabolism. Among the various therapeutic interventions that are used to treat insomnia associated with bipolar affective disorder, the strategies and approaches of behavioral sleep medicine warrant greater attention. [Clin Psychol Sci ...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Michael E. Thase Tags: REVIEW AND COMMENTARY Source Type: journals

Sleep Disturbance in Bipolar Disorder Across the LifespanEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The aim of this article is to highlight the importance of the sleep[ndash]wake cycle in children, adolescents, and adults with bipolar disorder. After reviewing the evidence that has accrued to date on the nature and severity of the sleep disturbance experienced, we document the importance of sleep for quality of life, risk for relapse, affective functioning, cognitive functioning, health (sleep disturbance is implicated in obesity, poor diet, and inadequate exercise), impulsivity, and risk taking. We argue that sleep may be critically important in the complex multifactorial cause of interepisode dysfunction, adverse healt...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Allison G. Harvey, Lisa S. Talbot, Anda Gershon Tags: REVIEW AND COMMENTARY Source Type: journals

Parsing the Heterogeneity and Increasing Specificity: A Commentary on "Neurocognitive Functioning in Bipolar Disorder"Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
"Neurocognitive Functioning in Bipolar Disorder" is a comprehensive examination of the literatures examining neurocognitive and neuroimaging studies in pediatric and adult bipolar disorder. Based upon this review, the present commentary highlights four important areas of future investigation: increasing specificity of cognitive measures, evaluating the specificity of neurocognitive abnormalities to bipolar disorder, modeling heterogeneity of neurocognitive functioning within bipolar disorder, and searching for core neurocognitive processes more closely linked to the dysfunctional behavior seen in bipolar disorder. In addit...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Thomas W. Frazier Tags: REVIEW AND COMMENTARY Source Type: journals

Neurocognitive Functioning in Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Neuropsychological processes may have direct bearing on the emotional dysregulation and functional impairments characteristic of bipolar disorder. Neuropsychological deficits that have been identified in adults and children with bipolar disorder include impairments in executive functions, declarative memory, attentional processes, and possibly working memory. Structural and functional magnetic resonance imaging and magnetic resonance spectroscopy studies of adults and children with bipolar disorder also indicate abnormalities in regions thought to underlie these neuropsychological deficits, including the basal ganglia, amy...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Aude Henin, Jamie A. Micco, Janet Wozniak, Jacquelyn M. Briesch, Angela J. Narayan, Dina R. Hirshfeld-Becker Tags: REVIEW AND COMMENTARY Source Type: journals

Etiology of Bipolar Disorder Across the Lifespan: Essential Interplay With Diagnosis, Classification, and AssessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Bipolar disorder has garnered increasing attention as many argue that rates of bipolar disorder are skyrocketing and the definition of the classic bipolar disorder phenotype should be expanded, especially among children and adolescents. Understanding the psychosocial etiologies of bipolar disorder across the lifespan is critically important, and Alloy and colleagues' (2009) scholarly review makes an important contribution. Given the debate and controversy surrounding the description, diagnosis, and phenotype of bipolar disorder, having an accurate, reliable, and valid classification for definition, diagnosis, and assessmen...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Benjamin L. Hankin Tags: REVIEW AND COMMENTARY Source Type: journals

Longitudinal Predictors of Bipolar Spectrum Disorders: A Behavioral Approach System PerspectiveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We review longitudinal predictors, primarily psychosocial, of the onset, course, and expression of bipolar spectrum disorders. We organize our review along a proximal[ndash]distal continuum, discussing the most proximal (i.e., prodromes) predictors of bipolar episodes first, then recent environmental (i.e., life events) predictors of bipolar symptoms and episodes next, followed by more distal psychological (i.e., cognitive styles) predictors, and ending with the most distal temperament (i.e., Behavioral Approach System [BAS] sensitivity) predictors. We then present a theoretical model, the BAS dysregulation model, for unde...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Lauren B. Alloy, Rachel E. Bender, Clara A. Wagner, Lyn Y. Abramson, Snezana Urosevic Tags: REVIEW AND COMMENTARY Source Type: journals

Advancing the Role of Assessment in Evidence-Based Psychological PracticeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Miller, Johnson, and Eisner's (2009) thorough review of the assessment literature for bipolar disorders (BD) in adults provides valuable guidance to both clinicians and researchers. This commentary highlights the range of scientifically sound instruments available and the current limitations evident in the BD assessment literature. I discuss how these limitations are also evident in the assessment research on other disorders and how improvements in assessment instruments (including those used for the purposes of diagnosis, case formulation, and treatment monitoring and evaluation) are central to the promotion and implement...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: John Hunsley Tags: REVIEW AND COMMENTARY Source Type: journals

Assessment Tools for Adult Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the current state of the literature on the assessment of bipolar disorder in adults. Research on reliable and valid measures for bipolar disorder has unfortunately lagged behind assessment research for other disorders, such as major depression. We review diagnostic tools, self-report measures to facilitate screening for bipolar diagnoses, and symptom severity measures. We briefly review other assessment domains, including measures designed to facilitate self-monitoring of symptoms. We highlight particular gaps in the field, including an absence of research on the reliable diagnosis of bipolar II and mi...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Christopher J. Miller, Sheri L. Johnson, Lori Eisner Tags: REVIEW AND COMMENTARY Source Type: journals

Construct Validity of Childhood Bipolar Disorder: A Developmental PerspectiveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article highlights the components of a nomological network that can be applied to the validation of the construct of child-onset bipolar disorder, including phenomenology, course and prognosis, etiology, and treatment response. That is, if a particular set of symptoms coheres, has a similar time course and outcome, is explained by the same etiological mechanisms, and responds similarly to treatment, then it is reasonable to conclude that the construct is a valid representation of the disorder. Additionally, developmental issues relevant to each aspect of the network (e.g., continuity over time and between typical and ...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Judy Garber, Sarah A. Frankel, Brandyn M. Street Tags: REVIEW AND COMMENTARY Source Type: journals

Assessment of Childhood Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Barriers to the comprehensive clinical assessment of child-onset bipolar disorder (BPD) are numerous and include factors common to many pediatric diagnoses (e.g., disentangling comorbid conditions and overlapping symptoms; cross-situational variability in behavior; limited reliability of child report), as well as issues more specific to child-onset BPD (e.g., lack of empirically validated screening instruments; disagreement over age-specific symptom presentation and temporal discontinuity of symptoms). Thorough assessment includes careful consideration of differential diagnosis, investigation of familial history of affecti...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Benjamin W. Fields, Mary A. Fristad Tags: REVIEW AND COMMENTARY Source Type: journals

Diagnostic Concepts of Bipolar Disorders: A European PerspectiveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In adult psychiatry, bipolar disorders are underdiagnosed in favor of depression. In this commentary a diagnostic specifier for hidden bipolarity is proposed, and preliminary data on its validity, collected from independent community studies, are presented. Such a specifier identifies as many as 40% of major depressive disorders as hidden bipolar disorders. In addition, tools such as the 32-item Hypomania Checklist (HCL-32 R1) can help identify bipolarity; in Europe its factor structure has been shown to be the same in healthy subjects and in mood disorder patients and to be transculturally stable (European, South American...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Jules Angst Tags: REVIEW AND COMMENTARY Source Type: journals

Definitional Issues in Bipolar Disorder Across the Life CycleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the current diagnostic criteria for bipolar mood episodes and disorders, emphasizing gaps and limitations in the current definitions. The review also discusses terms that have been perceived as inconsistent between child versus adult presentations of bipolar disorders, such as "rapid cycling." The review links the DSM diagnoses to broader discussions of a bipolar spectrum, and to alternate definitions of "narrow,""intermediate," and "broad" phenotypes. Strengths and limitations of dimensional models of bipolar disorder are discussed. The bulk of the evidence suggests that research and clinical practice...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Eric A. Youngstrom Tags: REVIEW AND COMMENTARY Source Type: journals

The Boundaries of Bipolarity: Comments on the Epidemiology of Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The review of epidemiological studies of bipolar disorder (Merikangas & Pato, 2009) raises a challenging question: How subtle should be the approach to bipolar disorders? Research has accumulated clearly favoring the presence of "bipolarity" beyond the classical manic-depressive psychosis. Hypomanic and manic symptoms are increasingly documented in seemingly "unipolar" patients, and this is affecting the approach to the conceptualization of this disorder, its treatment, and the search for its etiologies. Refined instruments and longitudinal studies provide a fascinating database that will intensify the discussions about th...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Elie G. Karam, John A. Fayyad Tags: REVIEW AND COMMENTARY Source Type: journals

Recent Developments in the Epidemiology of Bipolar Disorder in Adults and Children: Magnitude, Correlates, and Future DirectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
During the past decade, there has been increasing recognition of the dramatic personal and societal impact of bipolar disorder I and II (DSM[ndash]IV). The estimated disability-adjusted life years of bipolar disorder outrank all cancers and primary neurologic disorders, such as epilepsy and Alzheimer's disease, primarily because of its early onset and chronicity across the lifespan (World Health Report, 2002). The results of numerous international epidemiologic surveys using contemporary diagnostic criteria have strengthened the evidence base on the magnitude, correlates, and consequences of bipolar disorder in representat...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Kathleen R. Merikangas, Michael Pato Tags: REVIEW AND COMMENTARY Source Type: journals

Emotion–Cognition Interplay in Motivating and Guiding Plans and Actions: Commentary on McClure-Tone's Socioemotional Functioning in Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
McClure-Tone (2009) focused on the role of two aspects of emotion knowledge (emotion expression recognition and labeling) and on emotion regulation in bipolar disorder (BD). We encourage further research on these and on other components of emotion knowledge that probably play equally significant roles in normal and abnormal development, and perhaps particularly in BD. Despite the author finding serious gaps in the literature, it was shown that we have learned a lot about differences in neural, cognitive, and behavioral processes in children and adolescents with BD and same-age normal individuals, and that much remains unkn...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Carroll E. Izard, E. Stephanie Krauthamer-Ewing, Elizabeth M. Woodburn, Kristy J. Finlon, Jeffrey Rosen Tags: REVIEW AND COMMENTARY Source Type: journals

Socioemotional Functioning in Bipolar Disorder Versus Typical Development: Behavioral and Neural DifferencesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article critically reviews the literature on two types of core socioemotional skills that may represent endophenotypes for BD, with a focus on differences between individuals with BD, both youth and adults, and their typically developing peers. First, it examines studies of social cue perception and interpretation, with an emphasis on behavioral and neural studies of facial expression processing. Second, it shifts to examine behavioral and neural differences in cognitive and behavioral flexibility. Finally, the article summarizes potential future directions for research in this area. [Clin Psychol Sci Prac 16: 98[ndas...
Source: Clinical Psychology: Science and Practice - June 10, 2009 Category: Psychiatry & Psychology Authors: Erin B. McClure-Tone Tags: REVIEW AND COMMENTARY Source Type: journals

Psychological Science and Bipolar DisorderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Knowledge about bipolar disorder is rapidly advancing. One consequence is that current evidence about the diagnostic definitions, prevalence, phenomenology, associated features and underlying processes, risk factors and predictors, and assessment or treatment strategies for bipolar disorder is often markedly different than the conventional wisdom reflected even in recent textbooks and clinical training. This Special Issue draws together a series of reviews discussing the evidence with emphasis on the contributions of psychological science and attention to the implications for evidence-based practice. International experts ...
Source: Clinical Psychology: Science and Practice - June 1, 2009 Category: Psychiatry & Psychology Authors: Eric A. Youngstrom, Philip C. Kendall Tags: INTRODUCTION TO THE SPECIAL ISSUE Source Type: journals

Psychologist Impairment: What Is It, How Can It Be Prevented, and What Can Be Done to Address It?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Research indicates that psychologists self-report a variety of problems related to their personal and professional functioning, such as depression, substance abuse, and burnout. These difficulties not only lead to psychologist distress, but can also result in impairment and have a negative effect on patient care. This review of the psychologist impairment literature provides information on the historical movement toward colleague assistance, rates of impairment, identifying distress and impairment, intervening with an impaired colleague, barriers to treatment, and preventing impairment. It is suggested that, through educat...
Source: Clinical Psychology: Science and Practice - February 20, 2009 Category: Psychiatry & Psychology Authors: Penni L. Smith, Shannon Burton Moss Tags: REVIEW AND COMMENTARIES Source Type: journals

Responsiveness as an Obstacle for Psychotherapy Outcome Research: It's Worse Than You ThinkEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Not only do treatment, therapist, client, and contextual variables depend partly on each other[mdash]confounding effects supposedly assessed in randomized clinical trials (RCTs) of psychotherapy, as Krause and Lutz (2009) explained[mdash]but the independent variables depend partly on the dependent variables. Therapists and clients can use emerging information about outcome to modify their activity in therapy and so optimize outcome, a phenomenon described as appropriate responsiveness. As a result of appropriate responsiveness, not only are RCTs uninterpretable in terms of experimental effects, but also the hypothesized ef...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: William B. Stiles Tags: REVIEW AND COMMENTARIES Source Type: journals

Some Observations on Studying Therapists Instead of Treatment PackagesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Some practical problems are highlighted with regard to studying the outcomes of individual therapists, including the long and inconsistent success in finding therapist variables that explain differential client treatment response. Research on the individual therapist makes it clear that considerable variability in outcome exists at the extreme ends of the normal distribution of therapist effects. Much less is known about the variability of client outcomes within specific therapists' clients. We encourage further research on therapist effects, but concede that such research is not likely to provide actionable information fo...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Michael J. Lambert, Scott A. Baldwin Tags: REVIEW AND COMMENTARIES Source Type: journals

Process Transforms Inputs to Determine Outcomes: Therapists Are Responsible for Managing ProcessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The variance in outcomes for psychotherapy patients is not partitionable into components that are independent contributions of treatments, therapists, and patients. If these inputs did not influence one another over the course of psychotherapy, they could be independent and so have additive main-effects or interaction-effects on outcomes. But that is impossible because they do influence one another and therapists are responsible for actively managing the psychotherapy process by repeatedly adjusting these inputs toward optimally influencing one another. The consequent interdependence of these inputs within the therapy proc...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Merton S. Krause, Wolfgang Lutz Tags: REVIEW AND COMMENTARIES Source Type: journals

Understanding Why Therapy Allegiance Is Linked to Clinical OutcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Researchers and practitioners have long debated the meaning and importance of the relation between therapy allegiance and clinical outcomes. Leykin and DeRubeis (2009) make a meaningful contribution to this discussion and their observations will help sharpen future discourse on the topic. This commentary builds upon their observations and argues that efforts to identify and understand the mechanisms underlying the relation between therapy allegiance and therapy outcome may inform the ongoing debate and benefit the field of psychological therapy. Two potential mechanisms[mdash]investigators (via training) and therapists (vi...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Bryce D. McLeod Tags: REVIEW AND COMMENTARIES Source Type: journals

A Timely Reminder on Research Design and InterpretationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article also extends the "adversarial collaboration" strategy recommended by Leykin and DeRubeis for reducing any potential allegiance biases by describing some benefits of "neutrality collaboration," studying the effects of treatments about which one has neither a positive nor a negative preconception. [Clin Psychol Sci Prac 16: 66[ndash]68, 2009] (Source: Clinical Psychology: Science and Practice)
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: David A. F. Haaga Tags: REVIEW AND COMMENTARIES Source Type: journals

Allegiance in Psychotherapy Outcome Research: Separating Association From BiasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present a new vocabulary with the aim of sharpening the allegiance discourse, and we propose that research strategies markedly different from the ones used to date are needed to address some of the more serious limitations of allegiance bias research. [Clin Psychol Sci Prac 16: 54[ndash]65, 2009] (Source: Clinical Psychology: Science and Practice)
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Yan Leykin, Robert J. DeRubeis Tags: REVIEW AND COMMENTARIES Source Type: journals

Some Needed Changes in DSM-V: But What About Children?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Maser et al. (2009) arguments for changes in DSM-V are extended by arguing for diagnostic quantification that includes, but is not limited to, dimensions. The following clinical and research realities require quantification of diagnostic criteria and adjustable diagnostic thresholds for children but are also desirable for adults: developmental and gender differences, differences between data from different sources, and cultural differences. Normative and ROC data should be used to provide empirical foundations for selecting diagnostic thresholds and for evaluating severity. Impairment should be separated from diagnosti...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Thomas M. Achenbach Tags: REVIEW AND COMMENTARIES Source Type: journals

Can a Developmental Psychopathology Perspective Facilitate a Paradigm Shift Toward a Mixed Categorical–Dimensional Classification System?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Maser et al. (2009) identify several problems with the categorical DSM, and suggest that a shift to a mixed categorical[ndash]dimensional system is warranted. Maser et al. support their argument by citing evidence related to mood and anxiety disorders, among other conditions. In this commentary, I consider the applicability of several issues raised by Maser et al. to two disruptive behavior disorders in youth, oppositional defiant disorder (ODD) and conduct disorder (CD). The issues include paradigm shifts concerning (a) the diagnostic threshold, (b) symptoms, and (c) distress/psychosocial impairment. Within each topic, se...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Deborah A. G. Drabick Tags: REVIEW AND COMMENTARIES Source Type: journals

Psychiatric Nosology Is Ready for a Paradigm Shift in DSM-VEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Data since 1980 demonstrate that the DSM-III model requires revisions in its assumptions and format. Problems inherent in the DSM-III model are considered and a paradigm shift toward a mixed categorical[ndash]dimensional classification system for DSM-V is recommended. This will reduce comorbidity, allow symptom weighting, introduce noncriterion symptoms, eliminate NOS categories, and provide new directions to biological researchers. We suggest reevaluating the threshold concept and use of quality-of-life assessment. A framework for such a revision is presented. Drawbacks to change include retraining of clinicians, administ...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Jack D. Maser, Sonya B. Norman, Sidney Zisook, Ian P. Everall, Murray B. Stein, Pamela J. Schettler, Lewis L. Judd Tags: REVIEW AND COMMENTARIES Source Type: journals

Wellness and Impairment: Moving Beyond Noble Us and Troubled ThemEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Psychologists tend to view wellness and impairment in dangerous dualities. In actuality, our level of functioning varies continuously due to multiple factors. We examine factors influencing psychologists' level of functioning, and offer recommendations for individuals and the profession. In addition, we explore topics too often considered taboo in discussions of psychologist impairment, such as depression and suicide, with the hope that such discussions can help prevent future problems. In sum, wellness and impairment should not be viewed as an "Us and Them" issue, but rather as an "Us and When" issue. [Clin Psychol Sci Pr...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Glenn E. Good, Taleb Khairallah, Laurie B. Mintz Tags: REVIEW AND COMMENTARIES Source Type: journals

Creating a Culture of Self-CareEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Psychologists are vulnerable to the effects of distress, which if left unchecked may lead to burnout, vicarious traumatization, and impaired professional competence. Smith and Moss (2009) provide a convincing call to action for the profession of psychology to give adequate attention to these important issues. This commentary adds to their excellent review and provides specific recommendations for individual psychologists for those who train graduate students, and for professional associations. A rationale is provided for the recommendations made and further guidance is provided for creating a culture of self-care in the pr...
Source: Clinical Psychology: Science and Practice - February 17, 2009 Category: Psychiatry & Psychology Authors: Jeffrey E. Barnett, Natalie Cooper Tags: REVIEW AND COMMENTARIES Source Type: journals