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Background: Caring for a person with dementia can be a challenging experience, often associated with chronic stress and a heavy burden on family caregivers. Dementia also impacts the relationship between the caregiver and the person with dementia. The quality of this relationship is, in turn, an important factor influencing the well-being of both dyad members. The psychoeducational intervention "Learning to feel better... and help better" has shown positive results regarding family caregivers' subjective burden, psychological distress, and self-efficacy. However, relationship quality has not been addressed in the context of this intervention. Methods: A longitudinal constructivist grounded theory approach was used to explore relationship quality as perceived by caregivers, possible changes and intervention components facilitating or preventing such changes. Three qualitative, semi-structured interviews (before, during and after the intervention) were performed with 13 family caregivers from three different intervention groups. The resulting 39 interviews were analysed regarding individual caregiver trajectories, per time point for all caregivers and regarding specific caregiver subgroups. Findings: A model focusing on sustaining relationship quality in dementia was developed. It shows strategies that family caregivers develop and apply to facilitate positive interactions and feelings of connectedness with their family members with dementia. It also indicates that mastering such strategies requires reflective skills based on specific knowledge of dementia and coping strategies, which can be enhanced through active skills training, in which caregivers are guided to work on their individual stressful situations. Factors hampering change included difficulties in accepting dementia-related changes. Conclusion: Findings suggest that psychoeducation, with active skills training based on caregivers' current daily life situations, providing systematic procedures to handle daily challenges and specific knowledge about the impact of the disease, could support them in developing and applying supportive strategies to sustain or improve their relationship to their family member with dementia. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of substance use among adolescent psychiatric outpatients using a variety of data sources. Method: Using a questionnaire, 3-month prevalence of substance use data were obtained from 50 adolescents and their health care providers. Adolescents' self-reports and providers' clinical impressions were compared with urine screen results. Results: The prevalence of substance use was low with the exception of self-reported cannabis and alcohol use, 48% and 70%, respectively (N = 50). Conclusion: Urine screening did not provide extra information on adolescent psychiatric outpatients' substance use compared to patients' self-reports and health care providers' clinical impressions.

This study sought to assess the effectiveness of a marital distress prevention program for couples by examining how marital quality, especially marital competencies such as dyadic coping, could be improved by means of a prevention program focusing on the enhancement of coping resources (Couples Coping Enhancement Training). The study consisted of 59 couples in the intervention group and 59 couples in the matched comparison group. The results reveal that it is possible to improve marital quality, especially marital competencies, by means of one short-term intervention lasting 18 hrs. However, the effects decreased after 2 years, raising the importance of booster sessions in helping to maintain effects over a longer period of time. (Contains 2 tables and 1 figure.)

Most prior studies of skill-based preventive interventions for couples compare changes in problem-solving behaviors made by treated couples with those made by control couples. Unexpected findings in these studies highlight the need to examine within-group variability in behavior change among treated couples, alternative behavioral domains, including dyadic support and coping, and partners' intended and actual use of strategies taught in the interventions. A 24-month longitudinal study of 109 couples participating in an 18-hour intervention designed to enhance communication and dyadic coping revealed that marital outcomes are enhanced to the extent that (a) wives increase their positive problem-solving behavior and husbands decrease their negative problem-solving behavior over the course of the intervention, and (b) wives and husbands increase their positive dyadic coping behaviors, and husbands decrease their negative dyadic coping behaviors. Moreover, greater postintervention use of strategies taught in the intervention program produced better outcomes, and wives' improvements in positive and negative dyadic coping strengthened associations between strategy use and relationship satisfaction. Discussion emphasizes the importance of devising interventions that target key interpersonal processes and that motivate participants to display newly acquired behaviors. KEYWORDS marriage, communication, dyadic coping, support, prevention, distress

Youths with conduct disorders (CD) are particularly studied for their violent and aggressive behaviors. Many researchers considered aggressive behaviors as being either reactive or proactive. Moreover, factors such as age of CD onset, impulsivity, and callous-unemotional traits, separately, have been related to these different types of aggressive behaviors. However, very few studies addressed the combined contribution of these three factors on proactive and reactive aggression. This question was tested in a sample composed of 43 male adolescents with CD. A single regression analysis including all predictors and outcomes, using Bayesian statistics, was computed. Results indicated that impulsivity was related to reactive aggression, while CU traits were related to proactive aggression. These results suggest first, an important heterogeneity among youth with CD, probably leading to different trajectories and, second, that youths with callous-unemotional traits should receive special attention and care as they are more at risk for proactive aggression. [ABSTRACT FROM AUTHOR]

This study investigated whether implicit attitude (IA) and implicit self-concept (ISC) towards transgression predicted daily-life antisocial behaviour (ASB) in institutionalized adolescents. Eighty-seven adolescents completed two Implicit Association Tests (IAT) assessing IA and ISC towards transgression, and reported four times a day during eight days the intensity of their ASB. Staff members concurrently reported the intensity of each adolescent’s ASB. Adolescents filled in the Inventory for Callous-Unemotional Traits and answered a semi-structured interview assessing conduct disorder. Multilevel regression analyses confirmed that adolescents’ ISC towards transgression significantly predicted their self - and staff-reported ASB over and above conduct disorder and callous-unemotional traits. However, adolescents’ IA towards transgression did not predict their ASB. Results indicate that ISC towards transgression is a reliable predictor of daily-life ASB in institutionalized adolescents. These results suggest that transgression-related ISC represents a promising target for ASB prevention in institutionalized adolescents. [ABSTRACT FROM PUBLISHER]

Ecological Momentary Assessment (EMA) involves the repeated collection of data in everyday life. This method has helped uncover underlying mechanisms in several mental disorders. EMA studies are still scarce in adolescent patients and particularly incarcerated juvenile offenders (IJO), possibly due to their frequent rule-breaking and high impulsivity. This study evaluated the feasibility and reliability of EMA in IJO. One hundred three antisocial adolescents (mean age 14.8, 78% boys, including 52 IJO and 51 institutionalized antisocial adolescents, IAA) answered four times a day during 8 days questions about their antisocial behavior, negative affect, impulsivity, and fear of punishment, on a handheld computer. Staff members also regularly reported on each participant's antisocial behavior. This first application of EMA in IJO overall supported its feasibility, with an excellent participation rate (95%) and a good compliance in completers (84%). About one-third of IJO participants dropped out, with no evidence of sampling bias across a wide range of indicators, while 96% of IAA completed EMA. No reactivity or lack of objectivity was observed. One- to two-thirds of the variance was within-person and reliability was acceptable to good. EMA can thus be reliably used in IJO to study the dynamics of daily antisocial behavior as it naturally unfolds in its context. [ABSTRACT FROM AUTHOR]

Callous-unemotional (CU) traits are associated with impaired distress recognition, possibly leading to suboptimal empathy development. Evidence stems from computerized task results, having little in common with day-to-day experiences. We assessed institutionalized adolescents’ empathic accuracy in their ability to infer staff members’ emotions, using Ecological Momentary Assessment. A sample of 55 adolescents reported perceived levels of distress and anger in staff, 4 times per day over the course of 8 days. CU traits were assessed with the Youth Psychopathic Traits Inventory, and data were submitted to multilevel regression analyses. All adolescents well identified anger and distress; high CU adolescents even overestimated both anger and distress intensities. Our ecological data suggest that in real-life situations, cognitive empathy skills may compensate for high CU adolescents’ distress recognition impairment. However, this compensatory process results in the perception of excessively negative emotions. [ABSTRACT FROM AUTHOR]

The Youth Psychopathic Traits Inventory (YPI) assesses psychopathic traits cost-effectively while minimizing social desirability. To determine which YPI summary scores should be used, we tested (a) the factorial validity of its three scales and 10 subscales, (b) the fit of a new bifactor model, and (c) the measurement invariance of the best model across gender, age, and community/institutionalized samples. Three hundred ninety-five community adolescents (M age 15.8) and 200 institutionalized adolescents (M age 15.0) filled in the French translation of the YPI. The factorial validity of the 10 subscales was supported by confirmatory factor analysis. Model comparisons favored the new bifactor model, independent of age, gender, and community/institutionalized status. Measurement invariance was confirmed. These findings support the previous YPI validation studies conducted on the 10 subscale scores, and suggest that YPI users should rely in all samples on the simultaneous use of the total score and the three scale scores, which is a common practice. [ABSTRACT FROM PUBLISHER]

Background: Computer assisted cognitive remediation (CACR) was demonstrated to be efficient in improving cognitive deficits in adults with psychosis. However, scarce studies explored the outcome of CACR in adolescents with psychosis or at high risk. Aims: To investigate the effectiveness of a computer-assisted cognitive remediation (CACR) program in adolescents with psychosis or at high risk. Method: Intention to treat analyses included 32 adolescents who participated in a blinded 8-week randomized controlled trial of CACR treatment compared to computer games (CG). Cognitive abilities, symptoms and psychosocial functioning were assessed at baseline and posttreatment. Results: Improvement in visuospatial abilities was significantly greater in the CACR group than in CG. Other cognitive functions, psychotic symptoms and psychosocial functioning improved significantly, but at similar rates, in the two groups. Conclusion: CACR can be successfully administered in this population; it proved to be effective over and above CG for the most intensively trained cognitive ability. [ABSTRACT FROM AUTHOR]

Low motivation is frequent in chronic disorders such as psychosis and may limit treatment efficacy. Although some evidence supports this view in adults, few studies so far have focused on adolescents. We assessed the impact of baseline symptoms, cognitive deficits and cognitive treatment characteristics on treatment motivation (TM), and examined whether TM affected treatment outcome. Twenty-eight adolescents with psychotic disorders participated in 16 sessions of computerized cognitive remediation or games. TM was assessed for each session. Lower TM was predicted by more severe symptoms at baseline, and was associated with smaller improvements in symptoms and both cognitive and psychosocial functioning at the end of the intervention. Experiencing success in the treatment exercises enhanced TM in all patients. [ABSTRACT FROM PUBLISHER]

The use of ecological momellary assessment (EMA) for studying parenting has been rare. We examined the psychometric properties and structural validity of an EMA Parenting Scale based on 32 mothers' reports of their parenting over a period of 10 consecutive days, and explored the acceptance of the scale and compliance with the procedure. The results suggested that the EMA Parenting Scile was well accepted for the assessment of daily parenting, and that it consistently captured the overreaxive and lax dimensions of parenting acrcss different episodes of child misbehavior. Moreover, multilevel analyses suggested that the scale was sensitive to change across different parenting episodes, aid that it reliably assessed the dimensions at both the personal and situational levels. [ABSTRACT FROM AUTHOR]

This study investigates the effectiveness of a marital distress prevention program for couples with low marital satisfaction with regard to a possible improvement of physical and psychological well-being. Fifty-nine couples, composing the intervention group, participated in a prevention program lasting 18 hours and focusing on the enhancement of coping resources (Couples Coping Enhancement Training). These couples were matched with 59 couples receiving no intervention (comparison group). The results reveal that the prevention program is able to improve psychological well-being among both genders and life satisfaction among women. It seems that these effects are stable over 1 year. On the other hand, no significant effects could be observed on physical well-being. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]