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Journal Cover Journal of Consulting and Clinical Psychology
  [SJR: 3.073]   [H-I: 192]   [42 followers]  Follow
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 0022-006X - ISSN (Online) 1939-2117
   Published by APA Homepage  [74 journals]
  • Hidden from happiness: Structural stigma, sexual orientation concealment,
           and life satisfaction across 28 countries.
    • Abstract: Objective: Although structural stigma (i.e., discriminatory laws, policies, and community attitudes) toward sexual minorities predicts adverse health and wellbeing, this association has typically only been examined within a single country and potential mechanisms remain unknown. Consequently, we examined the association between structural stigma and sexual minorities’ life satisfaction across 28 countries, identity concealment as a potential mechanism of this association, and, in high-stigma countries, the potential for concealment to protect sexual minorities from discrimination and victimization, and therefore even poorer life satisfaction than they would otherwise experience in those countries. Method: Sexual minority adults (n = 85,582) from 28 European countries responded to questions regarding sexual minority stigma, identity concealment, and life satisfaction. Structural stigma was assessed as national laws, policies, and attitudes affecting sexual minorities in each country. Results: Country-level structural stigma explained 60% of country-level variation in life satisfaction and more than 70% of country-level variation in sexual orientation concealment. Sexual orientation concealment mediated the association between structural stigma and life satisfaction. Especially in high-stigma countries, concealment also protected against even lower life satisfaction than would be experienced if a sexual minority individual did not conceal in those countries because it partially protected against discrimination and victimization. Conclusions: Sexual minorities’ life satisfaction varies greatly across countries largely due to the structural stigma of those countries and associated demands to conceal one’s sexual orientation. Findings highlight the importance of reducing structural stigma to promote equitable life satisfaction and tailoring affirmative psychotherapies to address the structural context surrounding sexual minorities who seek treatment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • Minority stress and relationship functioning among young male same-sex
           couples: An examination of actor–partner interdependence models.
    • Abstract: Objective: In different-sex couples, individual and partner stress can both have a negative impact on relationship functioning (actor and partner effects). Gay and bisexual men experience unique stress (sexual minority stress), but few studies have examined the effects of this stress on relationship functioning among young male couples. The current study examined (a) actor and partner effects of general and minority stress (internalized stigma, microaggressions, victimization, and outness) on relationship functioning (relationship quality and negative relationship interactions), (b) interactions between individual and partner stress as predictors of relationship functioning, and (c) dyadic coping and relationship length as moderators of actor and partner effects. Method: Actor–partner interdependence models were tested using data from 153 young male couples. Results: There was strong support for actor effects. Higher general stress and internalized stigma were associated with lower relationship quality, but only for those in longer relationships. Additionally, higher general stress, internalized stigma, and microaggressions, and lower outness, were associated with more negative relationship interactions. There was limited support for partner effects. Having a partner with higher internalized stigma was associated with more negative relationship interactions, but none of the other partner effects were significant. There was no support for individual and partner stress interacting to predict relationship functioning or for dyadic coping as a stress buffer. Conclusions: Findings highlight the influence of one’s own experiences of general and minority stress on relationship functioning, but raise questions about how partner stress influences relationship functioning among young male couples. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • The importance of therapeutic processes in school-based psychosocial
           treatment of homework problems in adolescents with ADHD.
    • Abstract: Objective: To evaluate the importance of therapeutic processes in two brief school-based psychosocial treatments targeting homework problems in adolescents with attention-deficit/hyperactivity disorder (ADHD) as delivered by school mental health professionals. Method: A sample of 222 middle school students (72% male; Mage = 12.00 years, SD = 1.02) diagnosed with ADHD was randomized to receive either a contingency-management or a skills-based treatment for homework problems. Both treatments included 16 individual sessions (20-min each) and 2 parent/family meetings. Adolescents and school mental health professionals reported on the working alliance in the middle of the treatment; professionals rated adolescent involvement at each of the 16 sessions, parent involvement during both parent meetings, and parent commitment to carry out the established homework plan. Attendance at parent meetings was also recorded. Results: Therapeutic processes predicted objective, parent-reported, and teacher-reported academic outcomes. Parent engagement was particularly important for the contingency-based treatment, whereas working alliance and adolescent involvement were most important for the skills-based treatment. Conclusions: Therapeutic processes such as developing a strong working alliance and engaging parents and students are key elements of treatment delivery and receipt in school-based mental health programming and should be explicitly trained and monitored. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • Exploring evidence of a dissociative subtype in PTSD: Baseline symptom
           structure, etiology, and treatment efficacy for those who dissociate.
    • Abstract: Objective: With the inclusion of a dissociative subtype, recent changes to the DSM–5 diagnosis of posttraumatic stress disorder (PTSD) have emphasized the role of dissociation in the experience and treatment of the disorder. However, there is a lack of research exploring the clinical impact for highly dissociative groups receiving treatment for PTSD. The current study examined the presence and clinical impact of a dissociative subtype in a sample of individuals receiving treatment for chronic PTSD. Method: This study used latent transition analyses (LTA), an expanded form of latent profile analyses (LPA), to examine latent profiles of PTSD and dissociation symptoms before and after treatment for individuals (N = 200) receiving prolonged exposure (PE) or sertraline treatment for chronic PTSD. Results: The best fitting LTA model was one with a 4-class solution at both pretreatment and posttreatment. There was a latent class at pretreatment with higher levels of dissociative symptoms. However, this class was also marked by higher reexperiencing symptoms, and membership was not predicted by chronic child abuse. Further, although those in the class were less likely to transition to the responder class overall, this was not the case for exposure-based treatment specifically. Conclusion: These findings are not in line with the dissociative-subtype theoretical literature that proposes those who dissociate represent a clinically distinct group that may respond worse to exposure-based treatments for PTSD. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • Changes in posttraumatic stress disorder (PTSD) and depressive symptoms
           over the course of prolonged exposure.
    • Abstract: Objective: Prior studies of prolonged exposure therapy (PE) suggested that reduction of posttraumatic stress disorder (PTSD) precedes reduction in depression, yet no research has collapsed data across multiple studies to examine whether the directionality of reduction remains consistent in larger and diagnostically diverse samples. Thus, the objective of this study is to conduct an evaluation of bidirectional associations between PTSD and depression in PE. Method: Participants (n = 216) from three randomized controlled trials of PE alone, PE + alcohol use disorder treatment, and PE + nicotine use disorder treatment completed weekly PTSD and depression severity measures. First, we analyzed the directional relationship between PTSD and depression over time in 2 single models to separately examine the effects of PTSD on depression and vice versa. Second, we analyzed a combined model to examine the simultaneous effects of reduction in PTSD on reduction in depression over and above the effects of reduction in depression on reduction in PTSD, and vice versa. Results: Two single models suggested that reductions in PTSD lead to reductions in depression and vice versa. The combined models suggested that both directions of change are important and reciprocal. The strength of predictive power from PTSD to depression, and vice versa, is approximately equal. Most significant prediction of PTSD from depression and vice versa occurred early in treatment. Conclusion: The relationship between reductions in PTSD and depression during PE is transactional. Regardless of whether PTSD or depression decreases first, reduction in the other symptom cluster is likely to follow. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • Effects of anxiety sensitivity reduction on smoking abstinence: An
           analysis from a panic prevention program.
    • Abstract: Objective: Scientific evidence implicates anxiety sensitivity (AS) as a risk factor for poor smoking cessation outcomes. Integrated smoking cessation programs that target AS may lead to improved smoking cessation outcomes, potentially through AS reduction. Yet, little work has evaluated the efficacy of integrated smoking cessation treatment on smoking abstinence. The present study prospectively examined treatment effects of a novel AS reduction-smoking cessation intervention relative to a standard smoking cessation intervention on smoking abstinence. Method: Participants (N = 529; 45.9% male; Mage = 38.23, SD = 13.56) included treatment-seeking smokers who received either a 4-session integrated anxiety-reduction and smoking cessation intervention (Smoking Treatment and Anxiety Management Program; [STAMP]) or a 4-session standard smoking cessation program (SCP). The primary aims focused on examining the effects of STAMP on (a) AS reduction during treatment, (b) early and late smoking point prevalence abstinence, and (c) the mechanistic function of AS reduction on treatment effects across early and late smoking abstinence. Results: Results indicated a significantly greater decline in AS in STAMP relative to SCP (B = −.72, p < .001). Treatment condition did not significantly directly predict early or late abstinence. However, the effect of STAMP on early abstinence was significantly mediated by reductions in AS (indirect = .16, 95% CI [.02, .40]). Conclusions: Findings provide evidence for the efficacy of a novel, integrated anxiety and smoking cessation treatment to reduce AS. Moreover, the meditation pathway from STAMP to early abstinence through reductions in AS suggest that AS is a clinically important mechanism of change for smoking cessation treatment and research. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • How do electronic cigarettes affect cravings to smoke or vape' Parsing
           the influences of nicotine and expectancies using the balanced-placebo
    • Abstract: Objective: Although electronic cigarettes (e-cigarettes) are frequently initiated for smoking cessation, results from the first two clinical trials testing this suggest that the perceived benefits of vaping may be influenced by non-nicotine factors, including cognitive outcome expectancies. The current study investigated the separate and combined effects of nicotine delivery and outcome expectancies on cravings for cigarettes and e-cigarettes using a balanced-placebo experiment. Method: Drug dosage (contains nicotine or not) was crossed with instructional set (told nicotine or non-nicotine) during ad lib e-cigarette use sessions by 128 current e-cigarette users (52 identifying as current cigarette smokers or “dual users”). It was hypothesized that reduction in craving for both cigarettes and e-cigarettes following e-cigarette administration would be driven primarily by the instructional set manipulation, reflecting the influence of outcome expectancies. Results: As hypothesized, among dual users, a main effect of instructional set emerged on reductions in craving to smoke cigarettes, with participants who were told that their e-cigarette contained nicotine reporting greater craving reduction (p = .046). With respect to reduced cravings for e-cigarettes, we found an interaction between drug dose and instructional set (p = .02) such that nicotine e-cigarettes reduced cravings more than non-nicotine e-cigarettes only among participants told to expect nicotine. Conclusions: Findings suggest that cognitive expectancies contribute to the acute effects of e-cigarettes on craving, which may provide guidance for their potential as smoking cessation aids. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Mon, 23 Apr 2018 04:00:00 GMT
  • A randomized controlled trial of financial incentives to low income
           pregnant women to engage in smoking cessation treatment: Effects on
           post-birth abstinence.
    • Abstract: Objective: Evaluate the effectiveness of monetary incentives for increasing engagement in smoking cessation treatment and improving 6-month abstinence in low-income pregnant smokers. Method: Two-group randomized clinical trial recruiting low-income (Medicaid-registered) pregnant smokers receiving assistance through a perinatal support program. Participants were randomized to either an incentive (n = 505) or control condition (n = 509). All participants were offered identical smoking cessation counseling at contacts. Incentive condition participants received incentives for attending pre- and postbirth treatment contacts: $25 for each of 6 prebirth provider visits, $25–40 for each of 4 postbirth home visits at Weeks 1, 2, 4, and 6 (total = $130), $20 for each of 5 postbirth counseling calls and $40 for biochemically verified abstinence at the Week 1 and 6-month visits. Control condition participants received only $40 for attendance at the Week 1 and 6-month postbirth visits ($40 each). Main outcomes: Primary outcome was biochemically confirmed 7-day point-prevalence abstinence at 6-month postbirth follow-up. Secondary outcomes included number of home visits and phone calls taken over the first 6 months postbirth; biochemically confirmed abstinence at postbirth Week 1 visit; and self-reported smoking status at 2- and 4-month visits. Results: Incentive condition participants had a higher biochemically confirmed abstinence rate at 6-month postbirth than controls (14.7% vs. 9.2%, respectively: p < .01). This effect was mediated by incentive condition participants’ greater acceptance of postbirth home visits and counseling calls. Conclusions: Moderate incentive payments for smoking treatment engagement (a mean of ≈$214 paid) increased low-income pregnant smokers’ engagement and success in smoking cessation treatment. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
      PubDate: Thu, 01 Feb 2018 05:00:00 GMT
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