Effects of the dialectical behavioral therapy-mindfulness module on attention in patients with borderline personality disorder.

Behav Res Ther. 2011 Dec 14;

Authors: Soler J, Valdepérez A, Feliu-Soler A, Pascual JC, Portella MJ, Martín-Blanco A, Alvarez E, Pérez V

Abstract
It is known that patients with borderline personality disorder (BPD) show attention deficits and impulsivity. The main aim of this study was to explore the effects of Dialectical Behavioral Therapy-Mindfulness training (DBT-M), used as an adjunct to general psychiatric management (GPM), on attention variables in patients diagnosed with BPD. A second objective was to assess the relation of mindfulness formal practice on clinical variables. A sample of 60 patients with BPD was recruited. Forty of them were allocated to GPM+DBT-M treatment and the other 20 received GPM alone. At the termination of the mindfulness training, DBT-M+GPM group showed a significant improvement on commissions, hit reaction time, detectability scores from the CPT-II neuropsychological test, and also on the composite scores of inattention and impulsivity. Further, the more minutes of mindfulness practice were correlated to greater improvement in general psychiatric symptoms and affective symptomatology, but not in CPT-II measures. This is probably the first study so far assessing the effects of this single DBT module in patients with BPD. The results suggest a positive effect of such intervention on attention and impulsivity variables.

PMID: 22225697 [PubMed - as supplied by publisher]

Randomized controlled trial on the effectiveness of metacognitive therapy and intolerance-of-uncertainty therapy for generalized anxiety disorder.

Behav Res Ther. 2011 Dec 21;

Authors: van der Heiden C, Muris P, van der Molen HT

Abstract
This randomized controlled trial compared the effectiveness of metacognitive therapy (MCT) and intolerance-of-uncertainty therapy (IUT) for generalized anxiety disorder (GAD) in an outpatient context. Patients with GAD (N = 126) consecutively referred to an outpatient treatment center for anxiety disorder were randomly allocated to MCT, IUT, or a delayed treatment (DT) condition. Patients were treated individually for up to 14 sessions. Assessments were conducted before treatment (pretreatment), after the last treatment session (posttreatment), and six months after treatment had ended (follow-up). At posttreatment and follow-up assessments, substantial improvements were observed in both treatment conditions across all outcome variables. Both MCT and IUT, but not DT, produced significant reductions in GAD-specific symptoms with large effect sizes (ranging between 0.94 and 2.39) and high proportions of clinically significant change (ranging between 77% and 95%) on various outcome measures, and the vast majority of the patients (i.e., 91% in the MCT group, and 80% in the IUT group) no longer fulfilled the diagnostic criteria for GAD. Results further indicate that MCT produced better results than IUT. This was evident on most outcome measures, and also reflected in effect sizes and degree of clinical response and recovery.

PMID: 22222208 [PubMed - as supplied by publisher]

Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalized anxiety disorder.

Behav Res Ther. 2011 Dec 21;

Authors: Aldao A, Mennin DS

Abstract
Recent models of generalized anxiety disorder (GAD) have expanded on Borkovec's avoidance theory by delineating emotion regulation deficits associated with the excessive worry characteristic of this disorder (see Behar, DiMarco, Hekler, Mohlman, & Staples, 2009). However, it has been difficult to determine whether emotion regulation is simply a useful heuristic for the avoidant properties of worry or an important extension to conceptualizations of GAD. Some of this difficulty may arise from a focus on purported maladaptive regulation strategies, which may be confounded with symptomatic distress components of the disorder (such as worry). We examined the implementation of adaptive regulation strategies by participants with and without a diagnosis of GAD while watching emotion-eliciting film clips. In a between-subjects design, participants were randomly assigned to accept, reappraise, or were not given specific regulation instructions. Implementation of adaptive regulation strategies produced differential effects in the physiological (but not subjective) domain across diagnostic groups. Whereas participants with GAD demonstrated lower cardiac flexibility when implementing adaptive regulation strategies than when not given specific instructions on how to regulate, healthy controls showed the opposite pattern, suggesting they benefited from the use of adaptive regulation strategies. We discuss the implications of these findings for the delineation of emotion regulation deficits in psychopathology.

PMID: 22218164 [PubMed - as supplied by publisher]

A preliminary exploration of predictors of outcome and cognitive mechanisms of change in cognitive behaviour therapy for psychosis in people not taking antipsychotic medication.

Behav Res Ther. 2011 Dec 11;

Authors: Morrison AP, Turkington D, Wardle M, Spencer H, Barratt S, Dudley R, Brabban A, Hutton P

Abstract
BACKGROUND: Cognitive behaviour therapy (CBT) has been shown to be effective in an open trial for people with psychotic disorders who have not been taking antipsychotic medication. There is little known about predictors of outcome in CBT for psychosis and even less about hypothesised mechanisms of change. METHOD: 20 participants with schizophrenia spectrum disorders received CBT in an exploratory trial. Our primary outcome was psychiatric symptoms measured using the PANSS. Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning, and hypothesised mechanisms of change included appraisals of psychotic experiences, dysfunctional attitudes and cognitive insight. We also measured patient characteristics that may be associated with outcome. RESULTS: T-tests revealed that several of the hypothesised mechanisms did significantly change over the treatment and follow-up periods. Correlational analyses showed that reductions in negative appraisals of psychotic experiences were related to improvements on outcome measures and that shorter duration of psychosis and younger age were associated with greater changes in symptoms. CONCLUSIONS: CBT based on a specific cognitive model appears to change the hypothesised cognitive mechanisms, and these changes are associated with good outcomes. CBT may be more effective for those who are younger with shorter histories of psychosis.

PMID: 22209267 [PubMed - as supplied by publisher]

Blushing-fearful individuals overestimate the costs and probability of their blushing.

Behav Res Ther. 2011 Dec 6;

Authors: Dijk C, de Jong PJ

Abstract
It has been proposed that blushing-fearful individuals overestimate both the probability and the interpersonal costs of blushing. To study these judgmental biases, we presented a treatment-seeking sample of blushing-fearful individuals a series of vignettes describing social events and tested whether this clinical sample would overestimate the costs and probability of blushing compared to non-fearful controls. To test if blushing-fearfuls overestimate and/or low-fearful individuals underestimate the cost of displaying a blush, a second experiment examined the effects of blushing in these situations on observers' judgments. Experiment 1 showed that blushing-fearfuls indeed have judgmental biases for the probability and costs of blushing. Experiment 2 showed that the observers' judgments were very similar to the judgments anticipated by the low-fear group in Experiment 1. Thus the judgmental biases that were evident in the high-fearfuls can be best interpreted as an overestimation of the social costs of displaying a blush. These findings help improving our understanding of the mechanisms that may drive blushing phobia and also point to the clinical implication that it might be worthwhile to challenge blushing-fearfuls' judgmental biases.

PMID: 22206720 [PubMed - as supplied by publisher]

Temporal patterns of anxious and depressed mood in generalized anxiety disorder: A daily diary study.

Behav Res Ther. 2011 Dec 7;

Authors: Starr LR, Davila J

Abstract
Research suggests that anxiety disorders tend to temporally precede depressive disorders, a finding potentially relevant to understanding comorbidity. The current study used diary methods to determine whether daily anxious mood also temporally precedes daily depressed mood. 55 participants with generalized anxiety disorder (GAD) and history of depressive symptoms completed a 21-day daily diary tracking anxious and depressed mood. Daily anxious and depressed moods were concurrently associated. Daily anxious mood predicted later depressed mood at a variety of time lags, with significance peaking at a two-day lag. Depressed mood generally did not predict later anxious mood. Results suggest that the temporal antecedence of anxiety over depression extends to daily symptoms in GAD. Implications for the refinement of comorbidity models, including causal theories, are discussed.

PMID: 22196213 [PubMed - as supplied by publisher]

A randomised controlled trial of acceptance-based cognitive behavioural therapy for command hallucinations in psychotic disorders.

Behav Res Ther. 2011 Dec 8;

Authors: Shawyer F, Farhall J, Mackinnon A, Trauer T, Sims E, Ratcliff K, Larner C, Thomas N, Castle D, Mullen P, Copolov D

Abstract
Command hallucinations represent a special problem for the clinical management of psychosis. While compliance with both non-harmful and harmful commands can be problematic, sometimes in the extreme, active efforts to resist commands may also contribute to their malignancy. Previous research suggests Cognitive Behaviour Therapy (CBT) to be a useful treatment for reducing compliance with harmful command hallucinations. The purpose of this trial was to evaluate whether CBT augmented with acceptance-based strategies from Acceptance and Commitment Therapy could more broadly reduce the negative impact of command hallucinations. Forty-three participants with problematic command hallucinations were randomized to receive 15 sessions of the intervention "TORCH" (Treatment of Resistant Command Hallucinations) or the control, Befriending, then followed up for 6 months. A sub-sample of 17 participants was randomized to a waitlist control before being allocated to TORCH or Befriending. Participants engaged equally well with both treatments. Despite TORCH participants subjectively reporting greater improvement in command hallucinations compared to Befriending participants, the study found no significant group differences in primary and secondary outcome measures based on blinded assessment data. Within-group analyses and comparisons between the combined treatments and waitlist suggested, however, that both treatments were beneficial with a differential pattern of outcomes observed across the two conditions.

PMID: 22186135 [PubMed - as supplied by publisher]

Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa.

Behav Res Ther. 2011 Nov 29;

Authors: Le Grange D, Lock J, Agras WS, Moye A, Bryson SW, Jo B, Kraemer HC

Abstract
Few of the limited randomized controlled trails (RCTs) for adolescent anorexia nervosa (AN) have explored the effects of moderators and mediators on outcome. This study aimed to identify treatment moderators and mediators of remission at end of treatment (EOT) and 6- and 12-month follow-up (FU) for adolescents with AN (N = 121) who participated in a multi-center RCT of family-based treatment (FBT) and individual adolescent focused therapy (AFT). Mixed effects modeling were utilized and included all available outcome data at all time points. Remission was defined as ≥95% IBW plus within 1SD of the Eating Disorder Examination (EDE) norms. Eating related obsessionality (Yale-Brown-Cornell Eating Disorder Total Scale) and eating disorder specific psychopathology (EDE-Global) emerged as moderators at EOT. Subjects with higher baseline scores on these measures benefited more from FBT than AFT. AN type emerged as a moderator at FU with binge-eating/purging type responding less well than restricting type. No mediators of treatment outcome were identified. Prior hospitalization, older age and duration of illness were identified as non-specific predictors of outcome. Taken together, these results indicate that patients with more severe eating related psychopathology have better outcomes in a behaviorally targeted family treatment (FBT) than an individually focused approach (AFT).

PMID: 22172564 [PubMed - as supplied by publisher]

Effects of an Internet-based intervention for subthreshold eating disorders: A randomized controlled trial.

Behav Res Ther. 2011 Nov 15;

Authors: Jacobi C, Völker U, Trockel MT, Taylor CB

Abstract
BACKGROUND: Women reporting initial eating disorder (ED) symptoms are at highest risk for the development of an eating disorder. Preventive interventions should, therefore, be specifically tailored for this subgroup. AIMS: To adapt and evaluate the effects of the Internet-based prevention program "Student Bodies™" for women with symptoms of disordered eating and/or subthreshold eating disorder (ED) syndromes. METHOD: 126 women, reporting subthreshold ED symptoms (high weight and shape concerns and below threshold bingeing, purging, chronic dieting or several of these symptoms) were randomly assigned to a Student Bodies™+ (SB+) intervention or a wait-list control group and assessed at pre-intervention, post-intervention, and 6-month follow-up. "Student Bodies™" was adapted to be suitable for subthreshold EDs. Main outcome measures were attitudes and symptoms of disordered eating. Pre-follow-up data were analyzed by ANCOVAS with mixed effects. RESULTS: At 6-month follow-up, compared to participants in the control group, participants in the intervention group showed significantly greater improvements on ED-related attitudes. Intervention participants also showed 67% (95% CI=20-87%) greater reductions in combined rates of subjective and objective binges, and 86% (95% CI=63-95%) greater reduction in purging episodes. Also, the rates of participants abstinent from all symptoms of disordered eating (restrictive eating, binge eating and any compensatory behavior) were significantly higher in the intervention group (45.1% vs. 26.9%). Post-hoc subgroup analyses revealed that for participants with binge eating the effect on EDE-Q scores was larger than in the pure restricting subgroup. CONCLUSION: The adapted "SB+" program represents an effective intervention for women with subthreshold EDs of the binge eating subtype.

PMID: 22137366 [PubMed - as supplied by publisher]

How awkward! Social anxiety and the perceived consequences of social blunders.

Behav Res Ther. 2011 Nov 18;

Authors: Moscovitch DA, Rodebaugh TL, Hesch BD

Abstract
Seventy high socially anxious (HSA) and 74 low socially anxious (LSA) participants rated perceived interpersonal and emotional consequences of both (a) autobiographical social blunders recalled from their own lives and (b) imagined blunders presented in standardized hypothetical social scenarios. Ratings of participants' autobiographical blunders were also provided by research assistants who were blind to hypotheses. Results indicated that HSA participants overestimated the negative consequences of their own autobiographical blunders. These negative perceptions among HSA participants extended to imagined blunders, even when participants were instructed to imagine a third party other than themselves as the person committing the blunder. This pattern of results suggests the conclusion that the perceived consequences of social blunders among HSA individuals are driven by the belief that social standards are high, inflexible, or both.

PMID: 22137365 [PubMed - as supplied by publisher]

The validation of an active control intervention for Mindfulness Based Stress Reduction (MBSR).

Behav Res Ther. 2011 Nov 11;

Authors: Maccoon DG, Imel ZE, Rosenkranz MA, Sheftel JG, Weng HY, Sullivan JC, Bonus KA, Stoney CM, Salomons TV, Davidson RJ, Lutz A

Abstract
Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η(2) = .18). There were significant improvements over time for general distress (η(2) = .09), anxiety (η(2) = .08), hostility (η(2) = .07), and medical symptoms (η(2) = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.

PMID: 22137364 [PubMed - as supplied by publisher]

Outcome predictors in guided and unguided self-help for social anxiety disorder.

Behav Res Ther. 2011 Nov 16;

Authors: Nordgreen T, Havik OE, Ost LG, Furmark T, Carlbring P, Andersson G

Abstract
Internet-based self-help with therapist guidance has shown promise as an effective treatment and may increase access to evidence-based psychological treatment for social anxiety disorder (SAD). Although unguided self-help has been suggested primarily as a population-based preventive intervention, some studies indicate that patients with SAD may profit from unguided self-help. Gaining knowledge about predictors of outcome in guided and unguided self-help for SAD is important to ensure that these interventions can be offered to those who are most likely to respond. Utilizing a sample of 245 patients who received either guided or unguided self-help for SAD, the present study examined pre-treatment symptoms and program factors as predictors of treatment adherence and outcome. The results were in line with previous findings from the face-to-face treatment literature: namely, the intensity of baseline SAD symptoms, but not depressive symptoms, predicted treatment outcomes in both unguided and guided self-help groups. Outcomes were unrelated to whether a participant has generalized versus specific SAD. Furthermore, for the unguided self-help group, higher credibility ratings of the treatment program were associated with increased treatment adherence. The findings suggest that guided and unguided self-help may increase access to SAD treatment in a population that is more heterogeneous than previously assumed.

PMID: 22134140 [PubMed - as supplied by publisher]

Do motivational interviewing behaviors predict reductions in partner aggression for men and women?

Behav Res Ther. 2011 Nov 15;

Authors: Woodin EM, Sotskova A, O'Leary KD

Abstract
Motivational interviewing is a directive, non-confrontational intervention to promote behavior change. The current study examined therapist behaviors during a successful brief motivational interviewing intervention for physically aggressive college dating couples (Woodin & O'Leary, 2010). Forty-five minute motivational interviews with each partner were videotaped and coded using the Motivational Interviewing Treatment Integrity scale (MITI; Moyers, Martin, Manuel, & Miller, 2003). Hierarchical modeling analyses demonstrated that therapist behaviors consistent with motivational interviewing competency predicted significantly greater reductions in physical aggression perpetration following the intervention. Specifically, greater reflection to question ratios by the therapists predicted reductions in aggression for both men and women, greater percentages of open versus closed questions predicted aggression reductions for women, and there was a trend for greater levels of global therapist empathy to predict aggression reductions for women. These findings provide evidence that motivational interviewing seems to have an effect on behavior change through therapist behaviors consistent with the theoretical underpinnings of motivational interviewing.

PMID: 22119133 [PubMed - as supplied by publisher]

Adolescent threat-related interpretive bias and its modification: The moderating role of regulatory control.

Behav Res Ther. 2011 Nov 7;

Authors: Salemink E, Wiers RW

Abstract
Dual process models describe psychopathology as the consequence of an imbalance between a fast, impulsive system and a regulatory control system and have recently been applied to anxiety disorders. The aim of the current study was to specifically examine the role of a regulatory control system in regulating 1) threat-related interpretive bias and 2) the effectiveness of interpretive bias training in adolescents. In total, 67 adolescents participated and followed either a positive Cognitive Bias Modification of Interpretation (CBM-I) training or a placebo-control condition. Results revealed that interpretive bias and the effectiveness of its modification depended on individual differences in regulatory control. That is, low levels of regulatory control in combination with high levels of state anxiety were associated with the strongest threat-related interpretive bias and those individuals benefited the most of the positive interpretation training. The current study provided empirical support for the role of dual processes in adolescent threat-related interpretive bias.

PMID: 22093764 [PubMed - as supplied by publisher]

Anxiety and depression and their links with delusions and hallucinations in people with a dual diagnosis of psychosis and substance misuse: A study using data from a randomised controlled trial.

Behav Res Ther. 2011 Nov 2;

Authors: Hartley S, Haddock G, Barrowclough C

Abstract
Rates of depression and anxiety have been linked to severity and distress associated with positive symptoms in psychosis. There is also tentative evidence to suggest that these concurrent symptoms might be related to delusional and hallucinatory content. Our aim was to assess the cross-sectional associations between anxiety and depression, and hallucination and delusion severity and distress in a sample of 327 people dually diagnosed with psychosis and substance misuse problems. In addition, the relationships between specific symptom content and levels of anxiety and depression were examined. Anxiety was associated with delusion distress and depression with hallucination distress, although neither was related to symptom severity. Auditory commands to harm or kill the self were associated with higher levels of depression. Delusions with themes pertaining to the paranormal, and those with references to celebrities were associated with lower levels of depression. No specific delusion or hallucination content was associated with level of anxiety, when other variables were controlled for. The results demonstrate that anxiety and depression are linked to distinct aspects of psychotic experience, highlighting the need to acknowledge the role of these concurrent symptoms in the context of psychosis. In addition, findings relating to specific types of delusions and hallucinations highlight avenues for further research.

PMID: 22088611 [PubMed - as supplied by publisher]

Effect of self-focused attention on post-event processing in social anxiety.

Behav Res Ther. 2011 Nov 3;

Authors: Gaydukevych D, Kocovski NL

Abstract
The study investigated the relationship between self-focused attention (SFA) and post-event processing (PEP) in social anxiety. SFA is the process of directing attention to internal stimuli during a social interaction. PEP is a detailed review of performance following an interaction. Highly socially anxious students (N = 82) were randomly assigned to a high SFA (n = 40) or low SFA condition (n = 42) and completed baseline measures of social anxiety, depression, trait SFA, and trait rumination. After SFA was manipulated via instructions, participants engaged in a 5-min unstructured conversation with a confederate, followed by a manipulation check. PEP was assessed the next day online. The high SFA group reported a similar amount of positive PEP but more frequent negative PEP over the 24-h period compared to the low SFA group. These results provide support for a causal relationship between SFA and PEP and have important applications for the development of effective cognitive-behavioural interventions.

PMID: 22088610 [PubMed - as supplied by publisher]

Pain anxiety, acceptance, and outcomes among individuals with HIV and chronic pain: A preliminary investigation.

Behav Res Ther. 2011 Oct 31;

Authors: Huggins JL, Bonn-Miller MO, Oser ML, Sorrell JT, Trafton JA

Abstract
The current study investigated the role of during treatment changes in pain anxiety in the relation between during treatment changes in pain acceptance and chronic pain outcomes. Participants included 45 (15 women) adults (M(age) = 50.42, SD = 7.69) who were HIV positive and experienced chronic pain. They were offered 12 weekly, 90-min group CBT sessions to increase understanding about chronic pain and to improve coping skills. Four hierarchical regression analyses were conducted to examine the mediating role of treatment changes in pain anxiety in the relation between treatment changes in pain acceptance and chronic pain outcomes. Results suggest that increases in pain acceptance during treatment were associated with decreased levels of pain anxiety during treatment, as well as decreases in pain-related impairment at treatment completion. Furthermore, decreases in pain anxiety during treatment were associated with decreases in pain-related impairment at treatment completion. Finally, treatment changes in pain anxiety were found to partially mediate the association between treatment changes in pain acceptance and pain-related impairment at treatment completion. Results are discussed within the context of better understanding the processes of change within a CBT model for chronic pain patients.

PMID: 22088609 [PubMed - as supplied by publisher]

Internet-delivered or mailed self-help treatment for insomnia? A randomized waiting-list controlled trial.

Behav Res Ther. 2011 Oct 24;

Authors: Lancee J, van den Bout J, van Straten A, Spoormaker VI

Abstract
Cognitive Behavioral Therapy (CBT) is effective in reducing insomnia complaints, but the effects of self-help CBT have been inconsistent. The aim of this study was to determine the effectiveness of self-help for insomnia delivered in either electronic or paper-and-pencil format compared to a waiting-list. Participants kept a diary and filled out questionnaires before they were randomized into electronic (n = 216), paper-and-pencil (n = 205), or waiting-list (n = 202) groups. The intervention consisted of 6 weeks of unsupported self-help CBT, and post-tests were 4, 18, and 48 weeks after intervention. At 4-week follow-up, electronic and paper-and-pencil conditions were superior (p < .01) compared to the waiting-list condition on most daily sleep measures (Δd = 0.29-0.64), global insomnia symptoms (Δd = 0.90-1.00), depression (Δd = 0.36-0.41), and anxiety symptoms (Δd = 0.33-0.40). The electronic and paper-and-pencil groups demonstrated equal effectiveness 4 weeks after treatment (Δd = 0.00-0.22; p > .05). Effects were sustained at 48-week follow-up. This large-scale unsupported self-help study shows moderate to large effects on sleep measures that were still present after 48 weeks. Unsupported self-help CBT for insomnia therefore appears to be a promising first option in a stepped care approach.

PMID: 22055281 [PubMed - as supplied by publisher]

Attention training toward and away from threat in social phobia: Effects on subjective, behavioral, and physiological measures of anxiety.

Behav Res Ther. 2011 Oct 25;

Authors: Heeren A, Reese HE, McNally RJ, Philippot P

Abstract
Social phobics exhibit an attentional bias for threat in probe detection and probe discrimination paradigms. Attention training programs, in which probes always replace nonthreatening cues, reduce attentional bias for threat and self-reported social anxiety. However, researchers have seldom included behavioral measures of anxiety reduction, and have never taken physiological measures of anxiety reduction. In the present study, we trained individuals with generalized social phobia (n = 57) to attend to threat cues (attend to threat), to attend to positive cues (attend to positive), or to alternately attend to both (control condition). We assessed not only self-reported social anxiety, but also behavioral and physiological measures of social anxiety. Participants trained to attend to nonthreatening cues demonstrated significantly greater reductions in self-reported, behavioral, and physiological measures of anxiety than did participants from the attend to threat and control conditions.

PMID: 22055280 [PubMed - as supplied by publisher]

Ethnicity differences in child and parental outcomes following involvement the PACE program.

Behav Res Ther. 2011 Oct 7;

Authors: Begle AM, Lopez C, Cappa K, Dumas JE, de Arellano MA

Abstract
This study investigated ethnic differences in the extent to which engagement (i.e., attendance and quality of participation) in the PACE (Parenting our Children to Excellence) program predicted positive child and parent outcomes. PACE is an 8-week preventive intervention aimed at parents of preschool children. The study investigated the relation of engagement to outcomes in an ethnically diverse sample of 298 African American and 280 European American parents. Overall results demonstrated that engagement in PACE significantly improved child and parent outcomes for both African American and European American participants. Some improvements were evident at post-assessment already and were maintained or became stronger at a one-year follow-up assessment, whereas others only became evident at follow-up. Specifically, results revealed that attendance in PACE significantly improved child coping competence and parenting stress for both the African American and European American samples. PACE attendance also significantly improved child behavior problems, parental satisfaction and parental efficacy for the European American sample. Findings indicate that PACE is a promising intervention for parents of African American and Caucasian preschoolers; although further research and program refinement is necessary in order to understand the mechanisms with the PACE intervention that seem to vary for African American compared to Caucasian families.

PMID: 22041087 [PubMed - as supplied by publisher]