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OBJECTIVE This article examines outcomes of the first randomized controlled trial of Regulation Focused Psychotherapy for Children (RFP-C), a manualized, short-term, psychodynamic intervention for decreasing symptoms of the oppositional defiant disorder (ODD) in school-aged children. METHOD Participants (n = 43) were school-aged children who were randomly assigned to RFP-C or a waitlist control group. Symptoms of ODD and explicit emotion regulation capacities were assessed at baseline, end of waitlist, and end of treatment. Multilevel modeling was used to account for patient and therapist factors in outcomes. RESULTS At the end of treatment, parents reported significant reductions in children's ODD symptoms on the primary outcome measure. There were no observed changes in explicit emotion regulation. Reliable change index scores indicated that 79.4% of children were recovered or improved after 10 weeks of treatment. There were no identifiable patient or therapist effects. Treatment adherence and completion was high. CONCLUSION This study is the first randomized controlled trial of a manualized psychodynamic intervention for children with ODD. Participants demonstrated significant reductions in symptoms of ODD after 10 weeks of treatment. Further investigation is needed to compare RFP-C relative to active treatment, assess changes in implicit emotion, and to determine long-term maintenance of symptom improvement.Clinical trial registration information: Evaluation of Regulation Focused Psychotherapy for Children (RFP-C); https://clinicaltrials.gov/ct2/show/NCT03594253.

This study explored how trichotomous achievement goal orientations in each of three contexts (i.e., individual, individual-within-a-group, and group; Kim, Kim, & Svinicki, 2012) play different roles in predicting college students' enjoyment, sense of group community, and evaluation of group work processes during laboratory cooperative group work. We asked 174 undergraduate students to complete individual and group-related achievement goal orientation measures before and after participating in group work. The results indicated that individual and group-related achievement goal orientations in a cooperative group work setting strongly predicted the affective and cognitive variables and that these associations varied among the goals. For example, both individual-within-a-group performance-approach goal orientations and group performance-approach goal orientations were positively associated with the related affective and cognitive variables, whereas individual performance-approach goal orientations were negatively associated with those variables. Implications for current achievement goal orientation theory in a cooperative group work context are discussed.

This study examined the sequential relations among three pertinent variables in child psychotherapy: therapeutic alliance (TA) (including ruptures and repairs), autism symptoms, and adherence to child-centered play therapy (CCPT) process. A 2-year CCPT of a 6-year-old Caucasian boy diagnosed with autism spectrum disorder was conducted weekly with two doctoral-student therapists, working consecutively for 1 year each, in a university-based community mental-health clinic. Sessions were video-recorded and coded using the Child Psychotherapy Process Q-Set (CPQ), a measure of the TA, and an autism symptom measure. Sequential relations among these variables were examined using simulation modeling analysis (SMA). In Therapist 1’s treatment, unexpectedly, autism symptoms decreased three sessions after a rupture occurred in the therapeutic dyad. In Therapist 2’s treatment, adherence to CCPT process increased 2 weeks after a repair occurred in the therapeutic dyad. The TA decreased 1 week after autism symptoms increased. Finally, adherence to CCPT process decreased 1 week after autism symptoms increased. The authors concluded that (1) sequential relations differ by therapist even though the child remains constant, (2) therapeutic ruptures can have an unexpected effect on autism symptoms, and (3) changes in autism symptoms can precede as well as follow changes in process variables.

Five inpatients with borderline personality disorder (BPD) participated in 6 months of three times per week psychodynamic therapy (PDT). Patients completed a measure of psychological distress every week. A total of 127 sessions were audiotaped and coded using the psychotherapy process Q-set (PQS) and correlated with PQS prototypes of five treatment models—PDT, cognitive-behaviour therapy (CBT), interpersonal therapy, transference focused psychotherapy and dialectical behaviour therapy. Prototypical CBT process was most prevalent in three of the five PDT-labelled treatments. Prototypical PDT process significantly decreased over time in three of the five treatments. Prototypical process correlations with time were inversely proportional to prototypical process correlations with distress levels. In a multiple regression model that included all five prototypical process correlations across these three treatments, CBT and transference focused psychotherapy predicted distress reduction, whereas PDT predicted increases in distress. PQS items most negatively correlated with distress included the therapist's emphasis on feelings, empathic attunement and control over the interaction. Discussion of dreams or fantasies and therapist aloofness were most positively correlated with distress. An effective PDT treatment model for severely disturbed BPD inpatients requires technical flexibility to supplement CBT processes such as control over the interaction that can structure intense interpersonal dysregulation and stabilize distress. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Practitioners and their patients sense which prototypical processes to increase or decrease over time to reduce patients' distress. An effective PDT treatment model for severely disturbed BPD patients needs to integrate and encourage the emergence of empathically attuned interactions in the context of a highly structured therapy experience. Practitioners need to be flexible enough to change intervention strategies when they seem to be increasing distress in severely disturbed BPD patients.

With their heavy traffic and technological capabilities, social networking sites (SNS) introduced a new means of building and maintaining perceived social capital. This study aims to identify underlying factors and causal relationships that affect behavioral intention to use SNS. For this purpose, this research developed an extended technology acceptance model, incorporating subjective norm and perceived social capital for predicting SNS acceptance and usage. Exploratory correlation and path analyses were conducted to identify the relationships between five constructs: perceived usefulness, perceived ease of use, subjective norm, perceived social capital, and intention to use. The results showed that perceived usefulness and perceived ease of use had robust effects on the user's intention to use SNS. The research findings also demonstrated that subjective norm and perceived social capital were significant predictors of both perceived usefulness and perceived ease of use and therefore should be considered ...

To help researchers in multiple sclerosis (MS) take advantage of the measurement properties of the PROMIS Pain Interference instrument while maintaining continuity with previous research, we developed and tested a crosswalk table to transform Brief Pain Inventory pain interference scale (BPI-PI) scores to PROMIS-PI short form (PROMIS-PI SF) scores. The BPI-PI and the PROMIS-PI SF were administered in two studies that included persons with MS. One sample of 369 participants served as a developmental calibration sample, and a separate sample of 360 served as a validation sample. The crosswalk development included dimensionality assessment, item-level parameter estimation, and assessment of accuracy. BPI-PI and PROMIS-PI T scores were obtained from participants’ item responses, and using the crosswalk table, PROMIS-PI T scores were derived from responses to the BPI-PI items. Differences between observed and crosswalked T scores were compared in both samples. For BPI-PI summary scores ranging from 0 to 10, corresponding T scores ranged from 38.6 to 81.2. The mean difference between observed and crosswalked T scores was 0.51 (SD = 3.9) in the calibration sample and −1.47 (SD = 4.2) in the validation sample. Approximately 80 % of crosswalked scores in the calibration sample were within four score points of the observed PROMIS-PI SF scores, and 70 % were within four points in the validation sample. In both samples, the largest differences were at lower levels of the pain interference continuum. Crosswalked pain interference scores adequately approximated observed PROMIS-PI SF scores in both the calibration and validation samples. MS researchers and clinicians interested in adopting the PROMIS instruments can use this table to transform BPI-PI scores to enable comparisons with other studies and to maintain continuity with previous research.

Common stereotypes of virtual game or community users are often portrayed as young and socially inept male addicts. Recent studies, however, defy many of the common prejudices about game or community users. As an extension of recent research, this study looks at gender differences in Virtual Worlds and finds that female users are actually a driving force behind the recent success of online communities. The study results indicate that female users more actively participate in social life, information seeking, and building activities in Virtual Worlds than their male counterparts. Similarly, female users have greater appreciation for the value of Virtual Worlds, although both male and female users recognize Virtual Worlds as a highly useful entertainment tool.

Informed by achievement goal orientation and self-determination theories, we explored the role of cultural/contextual factors on Korean students' achievement motivation. Specifically, we examined the role of the Korean middle school students' family orientation as a mediator between their perceptions of parent goals or motivating styles and their achievement motivations in learning math, when their perceptions of classroom goal structures were controlled. We also investigated gender differences in the role of the students' family orientation and of their perceptions of their parents and classroom variables in predicting their own achievement motivations. Multi-sample path analyses indicated that both Korean boys' and girls' family orientation mediated between their perceptions of parent variables and their own achievement motivations. Korean students' family orientation predicted mainly controlled forms of motivation and ego-focused goals. In addition, the relationships between students' perceptions of parent variables and their achievement motivations statistically varied across gender.

The current study describes modification of change in R 2 (ΔR 2) indices used to describe a treatment's effect on the level and linear growth in outcome measures in single-subject experimental designs. A description of how to calculate each index, its standard error and associated test statistic is provided. A small simulation study was conducted to evaluate the Type I error rates of the ΔR 2 indices under various manipulated conditions, including sample size and ratio, autocorrelation, and the magnitude of the baseline phase's trend. Results are discussed and recommendations provided for researchers interested in using indices to aggregate single-subject experimental designs. Source of funding: Preparation of this article was supported by a grant from the Institute of Eduction Sciences, U.S. Department of Education. However, the opinions expressed do not express the opinions of this agency.

This study examined the accuracy of depression cross-walk tables in a sample of people with multiple sclerosis (MS). The tables link scores of two commonly used depression measures to the Patient Reported Outcome Measurement Information System Depression (PROMIS-D) scale metric. We administered the 8-item PROMIS-D (Short-Form 8b; PROMIS-D-8), the 20-item Center for Epidemiologic Studies Depression Scale (CESD-20), and the 9-item Patient Health Questionnaire (PHQ-9) to 459 survey participants with MS. We examined correlations between actual PROMIS-D-8 scores and the scores predicted by cross-walks based on PHQ-9 and CESD-20 scores. Intraclass correlation coefficients were used to assess correspondence. Consistency in severity classification was also calculated. Finally, we used Bland–Altman plots to graphically examine the levels of agreement. The correlations between actual and cross-walked PROMIS-D-8 scores were strong (CESD-20 = .82; PHQ-9 = .74). The intraclass correlation was moderate (.77). Participants were consistently classified as having or not having at least moderate depressive symptoms by both actual and cross-walked scores derived from the CESD-20 (90%) and PHQ-9 (85%). Bland–Altman plots suggested the smaller differences between actual and cross-walked scores with greater-than-average depression severity. PROMIS cross-walk tables can be used to translate depression scores of people with MS to the PROMIS-D metric, promoting continuity with previous research.

As part of the ongoing CRISP project (Communicating Risk in Internet Security and Privacy), we conducted a user study in a marginalized community to better understand community members' interactions with computers and the Internet in terms of security and privacy. We used the Health Belief Model to understand what factors affect members' behavior when a potential attack is present. In particular, we focused on two factors, perceived risk and self-efficacy, and interviewed 44 participants about them. In this paper, we report our preliminary quantitative and qualitative findings.

Objective Over a quarter million individuals in the United States have multiple sclerosis (MS). Chronic pain and depression are disproportionately high in this population. The purpose of this study was to examine the relationship between chronic pain and depression in MS and to examine potentially meditational effects of anxiety, fatigue, and sleep. Method We used cross-sectional data from self-reported instruments measuring multiple symptoms and quality of life indicators in this study. We used structural equation modeling to model direct and indirect effects of pain on depression in a sample of 1,245 community-dwelling individuals with MS. Pain interference, depression, fatigue, and sleep disturbance were modeled as latent variables with 2 to 3 indicators each. The model controlled for age, sex, disability status (Expanded Disability Status Scale), and social support. Results A model with indirect effects of pain on depression had adequate fit and accounted for nearly 80% of the variance in depression. The effects of chronic pain on depression were almost completely mediated by fatigue, anxiety, and sleep disturbance. Higher pain was associated with greater fatigue, anxiety, and sleep disturbance, which in turn were associated with higher levels of depression. The largest mediating effect was through fatigue. Additional analyses excluded items with common content and suggested that the meditational effects observed were not attributable to content overlap across scales. Conclusion Individuals living with MS who report high levels of chronic pain and depressive symptoms may benefit from treatment approaches that can address sleep, fatigue, and anxiety.

With its heavy traffic and technological capabilities, social networking sites (SNSs) introduced a new means of building and maintaining social relationships. This study aims to identify underlying factors and causal relationships that affect behavioral intention to use SNSs. For this purpose, this research developed an extended technology acceptance model (TAM), incorporating subjective norm (SN) and perceived social capital (PSC). Exploratory correlation and path analyses were conducted to examine the relationships between five constructs; perceived usefulness (PU), perceived ease of use (PEOU), subjective norm (SN), perceived social capital (PSC), and intention to use (IU). The results showed that PU and PEOU had robust effects on the user's intention to use SNSs. The research findings also demonstrated that SN and PSC were significant predictors of both PU and PEOU, and therefore should be considered as potential variables for extending TAM.

In order to test the difference between group means, the construct measured must have the same meaning for all groups under investigation. This study examined the measurement invariance of responses to the patient-reported outcomes measurement information system (PROMIS) pain behavior (PB) item bank in two samples: the PROMIS calibration sample (Wave 1, N = 426) and a sample recruited from the American Chronic Pain Association (ACPA, N = 750). The ACPA data were collected to increase the number of participants with higher levels of pain.Multi-group confirmatory factor analysis (MG-CFA) and two item response theory (IRT)-based differential item functioning (DIF) approaches were employed to evaluate the existence of measurement invariance.MG-CFA results supported metric invariance of the PROMIS-PB, indicating unstandardized factor loadings with equal across samples. DIF analyses revealed that impact of 6 DIF items was negligible.Based on the results of both MG-CFA and IRT-based DIF approaches, we recommend retaining the original parameter estimates obtained from the combined samples based on the results of MG-CFA.

Purpose The purpose of this study was to calibrate the items for the Communicative Participation Item Bank (CPIB; Baylor, Yorkston, Eadie, Miller, & Amtmann, 2009; Yorkston et al., 2008) using item response theory (IRT). One overriding objective was to examine whether the IRT item parameters would be consistent across different diagnostic groups, thereby allowing creation of a disorder-generic instrument. The intended outcomes were the final item bank and a short form ready for clinical and research applications. Method Self-report data were collected from 701 individuals representing 4 diagnoses: multiple sclerosis, Parkinson's disease, amyotrophic lateral sclerosis, and head and neck cancer. Participants completed the CPIB and additional self-report questionnaires. CPIB data were analyzed using the IRT graded response model. Results The initial set of 94 candidate CPIB items were reduced to an item bank of 46 items demonstrating unidimensionality, local independence, good item fit, and good measurement precision. Differential item functioning analyses detected no meaningful differences across diagnostic groups. A 10-item, disorder-generic short form was generated. Conclusions The CPIB provides speech-language pathologists with a unidimensional, self-report outcomes measurement instrument dedicated to the construct of communicative participation. This instrument may be useful to clinicians and researchers wanting to implement measures of communicative participation in their work.

Pain behaviors that are maintained beyond the acute stage post-injury can contribute to subsequent psychosocial and physical disability. Critical to the study of pain behaviors is the availability of psychometrically sound pain behavior measures. In this study we developed a self-report measure of pain behaviors, the Pain Behaviors Self Report (PaB-SR). PaB-SR scores were developed using item response theory and evaluated using a rigorous, multiple-witness approach to validity testing. Participants included: a) 661 survey participants with chronic pain and with multiple sclerosis (MS), back pain, or arthritis; b) 618 survey participants who were significant others of a chronic pain participant; and c) 86 participants in a videotaped pain behavior observation protocol. Scores on the PaB-SR were found to be measurement invariant with respect to clinical condition. PaB-SR scores, observer-reports, and the video-taped protocol yielded distinct, but convergent views of pain behavior, supporting the validity of the new measure. The PaB-SR is expected to be of substantial utility to researchers wishing to explore the relationship between pain behaviors and constructs such as pain intensity, pain interference, and disability.

This study examined the measurement invariance of responses to the patient-reported outcomes measurement information system (PROMIS) pain interference (PI) item bank. The original PROMIS calibration sample (Wave I) was augmented with a sample of persons recruited from the American Chronic Pain Association (ACPA) to increase the number of participants reporting higher levels of pain. Establishing measurement invariance of an item bank is essential for the valid interpretation of group differences in the latent concept being measured. Multi-group confirmatory factor analysis (MG-CFA) was used to evaluate successive levels of measurement invariance: configural, metric, and scalar invariance. Support was found for configural and metric invariance of the PROMIS-PI, but not for scalar invariance. Based on our results of MG-CFA, we recommend retaining the original parameter estimates obtained by combining the community sample of Wave I and ACPA participants. Future studies should extend this study by examining measurement equivalence in an item response theory framework such as differential item functioning analysis.

Objectives To identify interaction structures (i.e., patterns of reciprocal interaction) that characterize the treatments of patients with borderline personality disorder (BPD) in crisis. Design A 6-month naturalistic psychotherapy process and outcome study in which interaction structures were correlated with outcome data. Methods Five BPD patients in crisis participated in 6 months of three-times-per-week psychodynamic therapy. Patients completed a measure of psychological distress every week. One hundred and twenty-seven sessions were audiotaped and coded using the Psychotherapy Process Q-Set. Results Four interaction structures were identified: (1) collaborative relationship with supportive, reassuring therapist (IS1), (2) therapist empathic attunement (IS2), (3) erotized therapeutic relationship (IS3) and (4) directive therapist with compliant patient (IS4). The magnitude of these four interaction structures varied within and between the five therapist–patient dyads over time. Interaction structures correlations with time were inversely proportional to interaction structures correlations with distress levels. IS2 was correlated with two different outcomes in patient 3's and patient 5's treatments – a positive outcome for patient 3's treatment and a negative outcome for patient 5's treatment. Conclusions An effective treatment model for BPD patients in crisis needs to promote the emergence of empathically attuned interactions as well as supportive and directive interventions as dictated by the patient's individual needs. These treatments require flexibility to accommodate the patient's unique presentation in crisis. The therapeutic dyad senses which interaction structures to increase or decrease over time to reduce the patient's distress. Practitioner Points Unique constellations of four different interaction structures characterized the treatments of five BPD patients in crisis, which provide practitioners with a finite range of expectations in their therapeutic interactions with such patients. Practitioners need to implement intervention strategies with BPD patients in crisis tailored to the unique characteristics of each patient rather than strategies designed for all patients. Being empathic attuned, supportive or directive in treatment with BPD patients in crisis depends on the nature of the therapeutic dyad at any given moment in time. Practitioners need to be flexible enough to change intervention strategies when they seem to be increasing distress in BPD patients in crisis.