The psychological impact of wrongful convictions: Exploring retrospective trajectories of distress in exonerees

OBJECTIVE

Although an emerging body of research has examined the legal causes of wrongful convictions, there is little research that examines the psychological impact of wrongful convictions. This study aims to understand the psychological experiences of exonerees, with a focus on the role of meaning-making in individuals' reactions to trauma. The study also aims to examine exonerees' self-reported trajectories of distress throughout their experience of being wrongfully convicted and subsequently exonerated.

METHOD

A total of 46 exonerees completed an online survey. Measures included: Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, PTSD Checklist for DSM-5, Posttraumatic Growth Inventory, World Assumptions Questionnaire, Meaning in Life Questionnaire, Satisfaction with Life Scale, and a self-reported retrospective trajectory measure.

RESULTS

Cluster analysis suggested a four-factor solution: Chronic Distress, Relief and Readjustment, Recovery, and Intense Distress with Minimal Recovery. The Recovery cluster (n = 17; 37.0%) had significantly lower levels of PTSD and anxiety symptoms than the other three groups. The Recovery cluster had higher levels of positive world assumptions and lower levels of searching for meaning than the other three clusters, but there were no differences among clusters in level of meaning made, presence of meaning, depression symptoms, and satisfaction with life.

CONCLUSIONS

The results revealed that exonerees with more positive world beliefs (conceptualized as an outcome of meaning-making) have lower rates of PTSD and anxiety. Consistent with the literature, results also suggest that the search for meaning may be indicative of increased distress and less recovery. Clinical and policy implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of mindfulness in quality of life of persons with spinal cord injury: a cross-sectional study

BACKGROUND

Quality of life is considered the most overarching psychosocial adaptation outcome following the rehabilitation of persons with spinal cord injury. Literature suggests that the quality of life of persons with spinal cord injury is determined by many personal and psychological factors, including mindfulness. This study aimed to identify the direct and indirect effect of mindfulness on the quality of life of persons living with spinal cord injury.

METHODS

Participants consisted of 231 members of three spinal cord injury organizations in the United States: United Spinal Association, North American Spinal Cord Injury Consortium, and Paralyzed Veterans of America-Wisconsin Chapter. The participants completed a set of standardized self-report questionnaires in an online Qualtrics survey. A hierarchical regression analysis was performed to identify the contribution of mindfulness to quality of life, controlling for sociodemographic and injury-related factors. A serial mediation analysis was performed to examine the indirect effect of mindfulness on quality of life.

RESULTS

In the hierarchical regression analysis, sociodemographic and injury-related factors (i.e., age, gender, race, marital status, education, employment, level and completeness of injury, comorbidities, frequency of hospitalization, pain intensity, and functional limitation) and mindfulness explained 59% variance on quality of life of the participants with spinal cord injury. Mindfulness uniquely contributed to the higher quality of life above and beyond sociodemographic and injury-related variables. In the serial mediation analysis, pain and functional limitation did not significantly mediate the relationship between mindfulness and quality of life. However, the indirect effects of mindfulness on functional limitation and quality of life through pain were significant.

CONCLUSION

The findings underscore the vital role of mindfulness in improving the quality of life of persons with spinal cord injury. Implications of these findings for future research and clinical practice are discussed.

Evaluating psychotherapist competence: Testing the generalizability of clinical competence assessments of graduate trainees

Health service psychology (HSP) graduate programs are shifting from knowledge- to competency-based assessments of trainees' psychotherapy skills. This study used Generalizability Theory to test the dependability of psychotherapy competence assessments based on video observation of trainees. A 10-item rating form was developed from a collection of forms used by graduate programs (n = 102) in counseling and clinical psychology, and a review of the common factors research literature. This form was then used by 11 licensed psychologists to rate eight graduate trainees while viewing 129, approximately 5-min video clips from their psychotherapy sessions with clients (n = 22) at a graduate program's training clinic. Generalizability analyses were used to forecast how the number of raters and clients, and length of observation time impact the dependability of ratings in various rating designs. Raters were the primary source of error variance in ratings, with rater main effects (leniency bias) and dyadic effects (rater-target interactions) contributing 24% and 7% of variance, respectively. Variance due to segments (video clips) was also substantial, suggesting that therapist performance varies within the same counseling session. Generalizability coefficients (G) were highest for crossed rating designs and reached maximum levels (G > .50) after four raters watched each therapist working with three clients and observed 15 min per dyad. These findings suggest that expert raters show consensus in ratings even without rater training and only limited direct observation. Future research should investigate the validity of competence ratings as predictors of outcome. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cultural context matters: Testing the minority stress model among Chinese sexual minority men

Minority stress theory (e.g., Meyer, 2003b), a model for understanding mental health disparities affecting sexual minorities, has primarily been tested in Western samples yet has not been carefully applied to the experiences of sexual minorities in a global context, including in East Asian countries. Combining minority stress theory with considerations of Chinese culture, the current study tested the associations among norm conformity, distal minority stressor (enacted stigma), proximal minority stressors (sexual identity concerns and concealment), lesbian, gay, and bisexual (LGB) family support, and psychological distress among Chinese sexual minority men (n = 748). Structural equation modeling showed that sexual identity concerns mediated the associations of norm conformity, enacted stigma, and lower family support with concealment. Psychological distress was associated with enacted stigma and lower family support, but not with proximal stressors (sexual identity concerns and concealment). Alternative model testing found sexual identity acceptance concerns predicted psychological distress and mediated the associations of norm conformity and LGB family support with distress. Findings provide partial support for the minority stress model in a Chinese context and suggest the importance of incorporating cultural considerations into minority stress conceptualizations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Exploration of the Effects of Protective Person–Environment Factors Between Functional Impairments and Stress in Individuals With Multiple Sclerosis: Mediation and Moderation Analyses

Functional impairments can lead to stress in individuals with multiple sclerosis (MS). The study examined protective person and environment factors (i.e., positive cognitive stress appraisal, core self-evaluations [CSE], resilience, hope, spirituality, social support, and environmental supports) as both mediators and moderators of this association to guide understanding of the experience of stress in this population. The sample consisted of 373 participants with MS. In simple mediation analyses, positive cognitive stress appraisal, CSE, resilience, hope, social support, and environmental supports served as a partial mediator between functional impairments and stress. In a parallel mediation analysis, significant unique indirect effects were observed for two of the seven hypothesized mediator variables (CSE and environmental supports). Separate moderator tests provided support for the CSE variable as a protective factor. The positive association between functional impairments and stress was weaker for persons reporting high CSE compared with those reporting low CSE. The findings provide implications for rehabilitation counseling practices by promoting CSE and environmental supports in improving rehabilitation and psychosocial outcomes for individuals with MS.

Cultural context matters: Testing the minority stress model among Chinese sexual minority men

Minority stress theory (e.g., Meyer, 2003b), a model for understanding mental health disparities affecting sexual minorities, has primarily been tested in Western samples yet has not been carefully applied to the experiences of sexual minorities in a global context, including in East Asian countries. Combining minority stress theory with considerations of Chinese culture, the current study tested the associations among norm conformity, distal minority stressor (enacted stigma), proximal minority stressors (sexual identity concerns and concealment), lesbian, gay, and bisexual (LGB) family support, and psychological distress among Chinese sexual minority men (n = 748). Structural equation modeling showed that sexual identity concerns mediated the associations of norm conformity, enacted stigma, and lower family support with concealment. Psychological distress was associated with enacted stigma and lower family support, but not with proximal stressors (sexual identity concerns and concealment). Alternative model testing found sexual identity acceptance concerns predicted psychological distress and mediated the associations of norm conformity and LGB family support with distress. Findings provide partial support for the minority stress model in a Chinese context and suggest the importance of incorporating cultural considerations into minority stress conceptualizations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evaluation of Constructs Based on Self-Determination Theory and Self-Efficacy Theory as Predictors of Vocational Rehabilitation Engagement for People With Physical and Sensory Disabilities

Although gainful employment is associated with health and well-being, people with chronic illness and disability may be ambivalent about the prospects of working. As a result, those who might benefit from vocational rehabilitation (VR) services do not always fully engage in those services. Limited motivation toward participating may be due to factors related to self-determination and autonomous choice. Rehabilitation counseling researchers are beginning to test Deci and Ryan’s self-determination theory (SDT), along with Bandura’s self-efficacy theory (SET), as a work motivation model in VR. The purpose of the present study was to evaluate SDT and SET constructs as predictors of VR engagement in a sample of VR clients, using hierarchical regression analysis. After controlling for the effects of demographic variables and person–environment (P-E) contextual factors, SDT and SET predictors were found to account for an increase of 40% in the variance explained in VR engagement. Working alliance was the single strongest predictor of VR engagement, followed by job performance self-efficacy and autonomy supportive climate. Interventions to enhance counselor skills to promote working alliance, in addition to vocational training to increase job performance self-efficacy of rehabilitation clients, may strengthen motivation to engage in VR services, leading to better employment outcomes.

Longitudinal effects of psychotherapy with transgender and nonbinary clients: A randomized controlled pilot trial

Minority stress has been determined to contribute to some mental health concerns for transgender, nonbinary, and gender nonconforming individuals, yet little is known regarding interventions to decrease the effects of minority stress. The purpose of this pilot study was to assess the feasibility and relative effectiveness of two interventions developed for work with transgender clients. Transgender individuals (N = 20) were recruited to participate in a randomized controlled trial comparing two psychotherapy interventions for transgender adults seeking psychotherapy for a variety of concerns: (a) transgender affirmative psychotherapy (TA) and (b) Building Awareness of Minority Stressors + Transgender Affirmative psychotherapy. Gender-related stress and resilience were assessed before, immediately after, and 6 months following the intervention; psychological distress and working alliance were assessed at these three time points as well as weekly during the intervention. Feasibility and acceptability of the study and psychotherapy interventions were supported. Exploratory analyses indicate improvement in both groups based on general outcome measures; targeted outcome measures indicate a trend of improvement for internalized stigma and nonaffirmation experiences. Results from this study support further evaluation of both treatment arms in a larger randomized controlled trial. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Sexual risk behaviors in the internet age: the case of Chinese men who have sex with men

This cross-sectional study examined a sample of sexually active Chinese MSM recruited online (N = 403) to determine the associations of MSM social life (both online and in-person) and sexual identity stigma with three types of sexual risk behaviors in the past 12 months, including condom use %, number of anal intercourse partners, and number of partners engaged in condomless anal intercourse (CAI). Hierarchical regression analyses were conducted. More frequent use of social media was associated with higher numbers of anal intercourse partners as well as more condom use in past 12 months, but not number of CAI partners. More active in-person MSM social life was associated with higher numbers of partners in anal intercourse as well as CAI. Both perceived and enacted sexual identity stigma associated with higher numbers of CAI partners; perceived stigma was also linked to less condom use. In conclusion, social life and minority stress are relevant factors of sexual risk among MSM in China in the uptrend of internet use. The internet may be an important and promising platform for HIV prevention, and intervention efforts should consider online-based designs to promote safe sex and reduce sexual minority stigma.

What can we learn from randomized clinical trials about the construct validity of self-report measures of mindfulness? A meta-analysis

Because they provide data on responsiveness to experimental manipulation, clinical trials involving mindfulness-based interventions are a source of evidence for the construct validity of self-report measures of mindfulness. Within-group and between-group changes in mindfulness were examined from randomized clinical trials comparing mindfulness interventions to other bona fide treatment comparison conditions or waitlist control conditions. We also examined changes in clinical outcomes and the magnitude of these changes relative to changes in mindfulness. We included 69 published studies representing 55 unique samples (n = 4,743). Self-report mindfulness measures showed relatively larger gains in mindfulness intervention conditions vis-à-vis waitlist comparison conditions at both post-treatment (effect size [ES] = 0.52, 95% CI [0.40, 0.64]) and follow-up (ES = 0.52 [0.20, 0.84]), although the effect at follow-up diminished to non-significance in a trim-and-fill analysis intended to account for publication bias (ES = 0.35 [-0.03, 0.72]). Measures of mindfulness also showed relatively larger gains in mindfulness intervention conditions vis-à-vis bona fide comparison conditions, but only at post-treatment (ES = 0.25 [0.11, 0.38], 0.10 [-0.08, 0.28], at post-treatment and follow-up, respectively). All three conditions (mindfulness, bona fide, waitlist) showed relatively larger improvements on measures of clinical outcomes than measures of mindfulness, with the exception of waitlist conditions for which this effect was no longer significant at follow-up. Taken together, findings provide partial support for the unique responsiveness of mindfulness self-report measures to interventions that include promotion of mindfulness meditation practice.

Unique effects and moderators of effects of sources on self-efficacy: A model-based meta-analysis

Self-efficacy beliefs are strong predictors of academic pursuits, performance, and persistence, and in theory are developed and maintained by 4 classes of experiences Bandura (1986) referred to as sources: performance accomplishments (PA), vicarious learning (VL), social persuasion (SP), and affective arousal (AA). The effects of sources on self-efficacy vary by performance domain and individual difference factors. In this meta-analysis (k = 61 studies of academic self-efficacy; N = 8,965), we employed B. J. Becker's (2009) model-based approach to examine cumulative effects of the sources as a set and unique effects of each source, controlling for the others. Following Becker's recommendations, we used available data to create a correlation matrix for the 4 sources and self-efficacy, then used these meta-analytically derived correlations to test our path model. We further examined moderation of these associations by subject area (STEM vs. non-STEM), grade, sex, and ethnicity. PA showed by far the strongest unique association with self-efficacy beliefs. Subject area was a significant moderator, with sources collectively predicting self-efficacy more strongly in non-STEM (k = 14) compared with STEM (k = 47) subjects (R2 = .37 and .22, respectively). Within studies of STEM subjects, grade level was a significant moderator of the coefficients in our path model, as were 2 continuous study characteristics (percent non-White and percent female). Practical implications of the findings and future research directions are discussed. (PsycINFO Database Record

Effect size calculation in meta-analyses of psychotherapy outcome research

Meta-analysis of psychotherapy intervention research normally examines differences between treatment groups and some form of comparison group (e.g., wait list control; alternative treatment group). The effect of treatment is normally quantified as a standardized mean difference (SMD). We describe procedures for computing unbiased estimates of the population SMD from sample data (e.g., group Ms and SDs), and provide guidance about a number of complications that may arise related to effect size computation. These complications include (a) incomplete data in research reports; (b) use of baseline data in computing SMDs and estimating the population standard deviation (σ); (c) combining effect size data from studies using different research designs; and (d) appropriate techniques for analysis of data from studies providing multiple estimates of the effect of interest (i.e., dependent effect sizes). Clinical or Methodological Significance of this article: Meta-analysis is a set of techniques for producing valid summaries of existing research. The initial computational step for meta-analyses of research on intervention outcomes involves computing an effect size quantifying the change attributable to the intervention. We discuss common issues in the computation of effect sizes and provide recommended procedures to address them.

Eating disorder severity and functional impairment: moderating effects of illness duration in a clinical sample

PURPOSE

The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship.

METHODS

The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically.

RESULTS

Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment.

CONCLUSIONS

Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.

Creating a climate for therapist improvement: A case study of an agency focused on outcomes and deliberate practice

Recent evidence suggests that psychotherapists may not increase in effectiveness over accrued experience in naturalistic settings, even settings that provide access to patients' outcomes. The current study examined changes in psychotherapists' effectiveness within an agency making a concerted effort to improve outcomes through the use of routine outcome monitoring coupled with ongoing consultation and the planful application of feedback including the use of deliberate practice. Data were available for 7 years of implementation from 5,128 patients seen by 153 psychotherapists. Results indicate that outcomes indeed improved across time within the agency, with increases of d = 0.035 (p = .003) per year. In contrast with previous reports, psychotherapists in the current sample showed improvements within their own caseloads across time (d = 0.034, p = .042). It did not appear that the observed agency-level improvement was due to the agency simply hiring higher-performing psychotherapists or losing lower-performing psychotherapists. Implications of these findings are discussed in relation to routine outcome monitoring, expertise in psychotherapy, and quality improvement within mental health care. (PsycINFO Database Record

Unpacking the therapist effect: Impact of treatment length differs for high- and low-performing therapists

OBJECTIVE

Differences between therapists in their average outcomes (i.e., therapist effects) have become a topic of increasing interest in psychotherapy research in the past decade. Relatively little work, however, has moved beyond identifying the presence of significant between-therapist variability in patient outcomes. The current study sought to examine the ways in which therapist effects emerge over the course of time in psychotherapy.

METHOD

We used a large psychotherapy data set (n = 5828 patients seen by n = 158 therapists for 50,048 sessions of psychotherapy) and examined whether outcomes diverge for high-performing (HP) and low-performing (LP) therapists as treatment duration increases.

RESULTS

Therapists accounted for a small but significant proportion of variance in patient outcomes that was not explained by differences between therapists' caseload characteristics. The discrepancy in outcomes between HP and LP therapists increased as treatment duration increased (interaction coefficient = 0.071, p < .001). In addition, patients' trajectories of change were a function of their therapist's average outcome as well as the patient's duration of treatment (interaction coefficient = 0.060, p = .040).

CONCLUSIONS

Indeed, patterns of change previously described ignoring between-therapist differences (e.g., dose-effect, good-enough level model) may vary systematically when disaggregated by therapist effect.

Advanced Methods in Meta-Analytic Research

Over the past 25 years, meta-analysis has assumed a significant role in the synthesis of counseling and psychotherapy research through the evaluation and interpretation of the results of multiple studies. An examination of four widely recognized rehabilitation counseling journals, however, reveals that only one meta-analysis (Bolton & Akridge, 1995) has been published during the past 10 years. This article examines the meta-analysis process as a viable method to aggregate multiple studies, discusses common advantages and criticisms of meta-analysis, and provides suggestions specific to how meta-analyses may be applied to investigate rehabilitation outcomes. In addition, new applications of meta-analysis that have been discovered and refined in recent years are presented through a reanalysis of the Bolton and Akridge (1995) meta-analysis.

Analysis and Interpretation of Findings Using Multiple Regression Techniques

Multiple regression and correlation (MRC) methods form a flexible family of statistical techniques that can address a wide variety of different types of research questions of interest to rehabilitation professionals. In this article, we review basic concepts and terms, with an emphasis on interpretation of findings relevant to research questions of interest to rehabilitation researchers. To assist readers in using MRC effectively, we review common analytical models (e.g., mediator and moderator tests) and recent thinking on topics such as interpretation of effect sizes and power analysis.

Development and Awareness of Reputations in Newly Formed Groups: A Social Relations Analysis

Reputation formation was inferred from significant target variance in previously unacquainted group members' ratings of one another on dimensions of affiliation and control, indicating a consensus within the groups regarding each member's standing on these dimensions. These reputations were relatively stable over the four weekly meetings of the groups. Group members were able to predict the consensus about themselves, particularly during later sessions. Unexpected findings included differences in the patterns of consensus on the affiliation and control dimensions. As predicted, consensus increased over time on the affiliation dimension, although this increase was not statistically significant. On the control dimension, however, consensus was highest in the early sessions and decreased significantly over time, possibly reflecting the refinement of status hierarchies in the developing groups.

Transgression-Related Motivational Dispositions: Personality Substrates of Forgiveness and their Links to the Big Five

Generalizability analyses were used to evaluate the contribution of individual differences to people’s transgression-related interpersonal motivations (TRIMs). Individual differences accounted for 22% to 44% of the variance in participants’ TRIMs (i.e., avoidance, benevolence, and revenge). Although revenge motivation is apparently more cross-situationally consistent than either avoidance or benevolence, estimating people’s dispositions on the basis of their responses to single transgressions will lead to perilously undependable estimates for all three TRIMs. Agreeableness consistently predicted revenge, whereas both Neuroticism and Agreeableness predicted avoidance and benevolence. The association of Neuroticism, but not Agreeableness, with people’s TRIMs appeared to be mediated by appraisals of transgression severity. Differences in people’s responses to historical versus fictional transgressions suggest that transgression-related motivational dispositions should probably be estimated with responses to historical rather than fictional transgressions.

Dependability of Measurement in Counseling Psychology

Classical approaches to the assessment of reliability neglect to take into account multiple sources of error and to consider diverse measurement contexts. Generalizability theory (GT) offers a flexible framework for assessing dependability of measurement. With GT, investigators can estimate the total proportion of variance in ratings that is due to error rather than focusing on one source of error at a time. Simultaneous consideration of multiple sources of error allows investigators to assess the overall impact of measurement error in terms of attenuation of study findings and reduction of statistical power. Estimation of variance components allows for flexible application of findings to a variety of possible future research designs. Illustrative analyses demonstrate the special advantages of GT for planning studies in which observer ratings will be used.

Construct Validation in Counseling Psychology Research

Counseling psychology researchers devote little attention to theory-based measurement validation, as evidenced by cursory mention of validity issues in the method and discussion sections of published research reports. Especially, many researchers appear unaware of the limitations of correlations between pairs of self-report measures as evidence of construct validity. The authors provide an overview of the process of construct validation via user-friendly terminology and examples, with special attention to aspects often neglected in counseling psychology research, including specific recommendations for design and interpretation of multimethod validity investigations.

The secret ingredient in mindfulness interventions? A case for practice quality over quantity

As mindfulness-based interventions become increasingly widespread, interest has grown in better understanding which features of these treatments produce beneficial effects. The present study examined the relative contribution of mindfulness practice time and practice quality in predicting psychological functioning (negative affect, emotion regulation, quality of life, mindfulness). Data were drawn from a randomized clinical trial of mindfulness training for smokers and assessed outcomes at posttreatment (n = 43) and 5-month follow-up (n = 38). The intervention included instruction in mindfulness techniques targeted to smoking cessation and relapse prevention and was composed of 10 group meetings over 8 weeks. Data from 8 treatment groups were used. Mindfulness practice quality was measured weekly over the course of treatment, and multilevel modeling was used to estimate trajectories of change in practice quality. The measure of practice quality was shown to be valid and reliable, with change in practice quality predicting change in psychological functioning at both posttreatment (β = .31, 95% CI = [0.04, 0.56], p = .022) and follow-up (β = .45 [0.16, 0.73], p = .002), even when controlling for practice time. Practice time predicted outcomes at posttreatment (β = .31 [0.05, 0.57], p = .019) but not at follow-up (β = .16 [-0.14, 0.47], p = .293). Neither practice time nor change in practice quality predicted smoking abstinence at 1 month or 6 months postquit. Results support the importance of practice quality as a relevant aspect of mindfulness interventions.

The influence of multicultural counseling competence and anti-Black prejudice on therapists' outcome expectancies

The broad goal of this study was to examine multiple potential predictors of anti-Black bias among counselors. Specifically, in an online survey of 173 trainees and professionals in mental health, this study used 3 measures related to cultural sensitivity as predictors of therapists' expectancies for bond and prognosis with African American clients compared with White clients. The Multicultural Counseling Inventory (MCI; Sodowsky, Taffe, Gutkin, & Wise, 1994) was used to measure global multicultural competence. The Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) served as a measure of automatic prejudice toward Blacks. Additionally, a new self-report measure of anti-Black clinical prejudice was created specifically for this study. The Balanced Inventory of Desirable Responding (Paulhus, 1984) was included to control for socially desirable responding. Each predictor of cultural sensitivity uniquely explained variance in anti-Black bias in bond ratings, with the IAT accounting for more variance than the 2 self-reports. Our novel measure of clinical prejudice accounted for anti-Black bias in prognosis ratings, but the MCI and the IAT did not. Researchers studying cultural competence are encouraged to consider the roles of automatic and deliberate prejudice in determining disparities in clinical expectancies and cross-racial therapeutic alliances. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Performance-based assessment of falls risk in older veterans with executive dysfunction

Falling is a serious hazard for older veterans that may lead to severe injury, loss of independence, and death. While the American Geriatrics Society (AGS) provides guidelines to screen individuals at risk for falls, the guidelines may be less successful with specific subgroups of patients. In a veteran sample, we examined whether the Timed Up and Go (TUG) test, including a modified version, the TUG-Cognition, effectively detected potential fallers whose risk was associated with cognitive deficits. Specifically, we sought to determine whether TUG tasks and AGS criteria were differentially associated with executive dysfunction, whether the TUG tasks identified potential fallers outside of those recognized by AGS criteria, and whether these tasks distinguished groups of fallers. Participants included 120 mostly male patients referred to the Memory Assessment Clinic because of cognitive impairment. TUG-Cognition scores were strongly associated with executive dysfunction and differed systematically between fallers grouped by number of falls. These findings suggest that the TUG-Cognition shows promise in identifying fallers whose risk is related to or compounded by cognitive impairment. Future research should study the predictive validity of these measures by following patients prospectively.

Efficacy of psychotherapeutic interventions to promote forgiveness: a meta-analysis

OBJECTIVE

This meta-analysis addressed the efficacy of psychotherapeutic interventions to help people forgive others and to examine moderators of treatment effects.

METHOD

Eligible studies reported quantitative data on forgiveness of a specific hurt following treatment by a professional with an intervention designed explicitly to promote forgiveness. Random effects meta-analyses were conducted using k = 53 posttreatment effect sizes (N = 2,323) and k = 41 follow-up effect sizes (N = 1,716) from a total of 54 published and unpublished research reports.

RESULTS

Participants receiving explicit forgiveness treatments reported significantly greater forgiveness than participants not receiving treatment (Δ+ = 0.56 [0.43, 0.68]) and participants, receiving alternative treatments (Δ+ = 0.45 [0.21, 0.69]). Also, forgiveness treatments resulted in greater changes in depression, anxiety, and hope than no-treatment conditions. Moderators of treatment efficacy included treatment dosage, offense severity, treatment model, and treatment modality. Multimoderator analyses indicated that treatment dosage (i.e., longer interventions) and modality (individual > group) uniquely predicted change in forgiveness compared with no-treatment controls. Compared with alternative treatment conditions, both modality (individual > group) and offense severity were marginally predictive (ps < .10) of treatment effects.

CONCLUSIONS

It appears that using theoretically grounded forgiveness interventions is a sound choice for helping clients to deal with past offenses and helping them achieve resolution in the form of forgiveness. Differences between treatment approaches disappeared when controlling for other significant moderators; the advantage for individual interventions was most clearly demonstrated for Enright-model interventions, as there have been no studies of individual interventions using the Worthington model.

The role of therapeutic alliance in mindfulness interventions: therapeutic alliance in mindfulness training for smokers

OBJECTIVE

Mindfulness-based interventions have enjoyed a marked increase in support within biomedical and psychological research and practice in the past two decades. Despite the widespread application of these treatments for a range of psychological and medical conditions, there remains a lack of consensus regarding mechanisms through which these interventions effect change. One plausible yet underexplored mechanism is the therapeutic alliance between participants and mindfulness instructors.

METHODS

In this report, data are presented on therapeutic alliance from the mindfulness arm (n = 37) of a randomized controlled trial of a mindfulness-based smoking cessation treatment.

RESULTS

Results suggest that client-reported therapeutic alliance measured midtreatment did not significantly predict primary smoking outcomes. Alliance did predict improvement in posttreatment scores on several outcome variables linked to mindfulness practice, including emotion regulation (β = -.24, p = .042), mindfulness (β = .33, p = .007), negative affect (β = -.33, p = .040), as well as treatment compliance (β = .39, p = .011).

CONCLUSION

Implications of these relationships and the possible role of therapeutic alliance in mindfulness treatments are explored.

Monitoring mindfulness practice quality: an important consideration in mindfulness practice

Mindfulness-Based Stress Reduction (MBSR) is an experientially based group intervention empirically supported to reduce psychological symptomology. Although MBSR has shown to be an effective intervention, little is known about which facets of the intervention are important in producing positive outcomes. This study tested several aspects of mindfulness practice (total practice duration, practice frequency and practice quality) with the primary focus being on validating (i.e., predictive and convergent validity) a new measure of mindfulness practice quality (PQ-M). The PQ-M fit a two-factor solution via a Maximum Likelihood Exploratory Factor Analysis (n=99). Using longitudinal multilevel modeling on a smaller subsample (n=19), preliminary support was found for changes in practice quality over the course of the MBSR intervention. Further, change in practice quality was associated with improvements in psychological symptoms. While this study was exploratory, these findings suggest that practice quality is a relevant factor to promote positive outcomes and may guide mindfulness instructors in providing highly tailored interventions.

Applications of generalizability theory to clinical child and adolescent psychology research

Using generalizability theory to evaluate the reliability of child and adolescent measures enables researchers to enhance precision of measurement and consequently increase confidence in research findings. With an observer-rated measure of child self-regulation, we illustrate how multiple sources of error variance (e.g., raters, items) affect the dependability (replicability) of scores and demonstrate methods for enhancing dependability of observer ratings. Using ratings of 181 children, we illustrate the use of two-facet (i.e., raters and items as sources of error) and three-facet (i.e., raters, items and occasions) analyses to optimize design features of future studies using this measure. In addition, we show how generalizability theory provides a useful conceptual framework for thinking about determinants of scores on acquaintance (e.g., teacher or parent) ratings, as well as observer ratings, and sheds light on the strengths and limitations of both types of data for child and adolescent clinical research.

What Sources Contribute to Variance in Observer Ratings? Using Generalizability Theory to Assess Construct Validity of Psychological Measures

We illustrate the utility of generalizability theory (GT) as a conceptual framework that encourages psychological researchers to address this question and as a flexible set of analytic tools that can provide answers to inform both substantive theory and measurement practice. To illustrate these capabilities, we analyze observer ratings of 27 caregiver-child dyads, focusing on the importance of situational (contextual) factors as sources of variance in observer ratings of caregiver-child behaviors. Cross-situational consistency was relatively low for the categories of behavior analyzed, indicating that dyads vary greatly in their interactional patterns from one situation to the next, so that it is difficult to predict behavioral frequencies in one context from behaviors observed in a different context. Our findings suggest that single-situation behavioral measures may have limited generalizability, either to behavior in other contexts or as measures of global interaction tendencies. We discuss the implications of these findings for research and measurement design in developmental psychology.

Rater biases in genetically informative research designs: comment on Bartels, Boomsma, Hudziak, van Beijsterveldt, and van den Oord (2007)

Rater biases are of interest to behavior genetic researchers, who often use ratings data as a basis for studying heritability. Inclusion of multiple raters for each sibling pair (M. Bartels, D. I. Boomsma, J. J. Hudziak, T. C. E. M. van Beijsterveldt, & E. J. C. G. van den Oord, see record 2007-18729-006) is a promising strategy for controlling bias variance and may yield information about sources of bias in heritability studies. D. A. Kenny's (2004) PERSON model is presented as a framework for understanding determinants of rating reliability and validity. Empirical findings on rater bias in other contexts provide a starting point for addressing the impact of rater-unique perceptions in heritability studies. However, heritability studies use distinctive rating designs that may accentuate some sources of bias, such as rater communication and contrast effects, which warrant further study.

Responses to interpersonal transgressions in families: Forgivingness, forgivability, and relationship-specific effects

Social relations analyses examined the relative importance of forgivingness (disposition to forgive others), forgivability (tendency to obtain forgiveness from others), and relationship effects in determining family members' transgression-related interpersonal motivations (TRIMs) and their perceptions of others' TRIMs toward them (PTRIMs). In 2 studies, the individual and dyadic predictors of these components and their relative importance differed by family role (father, mother, or early adolescent child). Dispositional tendencies accounted for the most variance in father and child forgiveness, whereas mothers' TRIMs and PTRIMs were more strongly determined by relationship and partner effects. Personality correlates of forgivingness and forgivability were moderated by family role. The findings point to the need to embed the study of forgiveness in more complex psychosocial contexts. The theoretical, methodological, and applied implications of this conclusion are discussed.

Religious involvement and mortality: a meta-analytic review

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio = 1.29; 95% confidence interval: 1.20-1.39), indicating that people high in religious involvement were more likely to be alive at follow-up than people lower in religious involvement. Although the strength of the religious involvement-mortality association varied as a function of several moderator variables, the association of religious involvement and mortality was robust and on the order of magnitude that has come to be expected for psychosocial factors. Conclusions did not appear to be due to publication bias.

Religious involvement and mortality: a meta-analytic review

A meta-analysis of data from 42 independent samples examining the association of a measure of religious involvement and all-cause mortality is reported. Religious involvement was significantly associated with lower mortality (odds ratio = 1.29; 95% confidence interval: 1.20-1.39), indicating that people high in religious involvement were more likely to be alive at follow-up than people lower in religious involvement. Although the strength of the religious involvement-mortality association varied as a function of several moderator variables, the association of religious involvement and mortality was robust and on the order of magnitude that has come to be expected for psychosocial factors. Conclusions did not appear to be due to publication bias.