Journal of Consulting & Clinical Psychology

Multiculturalism: A paradigmatic force in psychology.
Prior to the advent of multiculturalism, mainstream psychology mirrored the Euro-American culture. In contrast, multiculturalism acts as a prism that reveals the diversity in the human condition. Since most empirical research is still conducted on Western, educated, industrialized, rich, and democratic populations, we need to construct a representative map of the human psychological and behavioral phenome. To work toward this goal, multicultural psychologists go beyond personal transformation and openness to the other. They question power relations, oppose oppressive systems, address psychology’s fallacy of neutrality, and engage in social justice action. Specifically, multicultural psychologists work to restore the humanity of both the oppressed and the oppressor. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Examining strength at home couples to prevent intimate partner violence on a military installation: A randomized controlled trial.
Objectives: In this study, the effectiveness of a couples-based group intervention to prevent intimate partner violence (IPV), Strength at Home Couples (SAH-C), was examined on a military installation relative to a comparison intervention, Supportive Prevention (SP). It was expected that greater reductions in use of physical, psychological, and sexual IPV behaviors, as well as reduced suicidality, would be found among service members and their partners in SAH-C relative to SP. Method: Participants included 138 couples randomized to SAH-C and SP through a clinical controlled trial embedded in a hybrid effectiveness implementation study which took place on a military installation. The Revised Conflict Tactics Scales and Multidimensional Measure of Emotional Abuse were used to measure IPV, and 13 Military Suicide Research Consortium common data elements were used to assess suicidality. Results: Service members randomized to SAH-C evidenced greater reductions based on effect sizes across the assessment time points for all IPV variables, including use of overall physical IPV, severe physical IPV, sexual IPV, psychological IPV, and coercive control IPV relative to those randomized to SP. Partners of service members demonstrated a similar general pattern for reductions in use of IPV, but findings were not as robust as for service members. Both service members and partners demonstrated greater reductions in suicidality based on effect sizes when randomized to SAH-C relative to SP. Conclusions: Findings extend prior work demonstrating the promising effects of SAH-C delivered in the military context and highlight the possible benefits of SAH-C in preventing self-harm thoughts and behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Peak experiences during insight mindfulness meditation retreats and their salutary and adverse impact: A prospective matched-controlled intervention study.
Objective: We sought to address a growing debate regarding the adverse and salutary impact of unusual, extraordinary or intense subjective experiences during meditation-based interventions. To do so, we empirically characterized such peak experiences during an intensive meditation intervention and their impact postintervention. Method: We conducted a preregistered prospective intervention study among 96 adults who registered for 6-day insight (Vipassana) mindfulness meditation retreats and 47 matched controls. Controls were selected from a pool of 543 people recruited from the same community of meditators as retreat participants and systematically matched to retreat participants on age and lifetime meditation experience. Measures included the novel Peak Meditative Experience Scale and the Impact of PMES. Results: Seventeen peak experiences that were primarily pleasant (e.g., deep and unusual peace, aha! Moment) occurred more frequently among retreat participants than among matched controls in daily living (ps< .05; mean ϕ = .33). In contrast, 14 peak experiences that were mostly unpleasant (e.g., flashbacks, overwhelming sadness) occurred at similar rates in both groups (ps >.05). At 2-week follow-up, the perceived impact of all pleasant and most unpleasant peak experiences was more salutary than adverse (ps ≤ .015; M Cohen’s d = 1.61). Conclusions: Peak experiences that resulted from meditation retreats were primarily pleasant and had a large salutary impact postretreat. Inconsistent with conclusions from uncontrolled retrospective studies, findings document that intensive insight mindfulness meditation training in retreats may not contribute to unpleasant peak experiences and even when they occurred their impact was typically more salutary than adverse. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Predicting effects of a digital stress intervention for patients with depressive symptoms: Development and validation of meta-analytic prognostic models using individual participant data.
Objective: Digital stress interventions could be helpful as an “indirect” treatment for depression, but it remains unclear for whom this is a viable option. In this study, we developed models predicting individualized benefits of a digital stress intervention on depressive symptoms at 6-month follow-up. Method: Data of N = 1,525 patients with depressive symptoms (Center for Epidemiological Studies’ Depression Scale, CES-D ≥ 16) from k = 6 randomized trials (digital stress intervention vs. waitlist) were collected. Prognostic models were developed using multilevel least absolute shrinkage and selection operator and boosting algorithms, and were validated using bootstrap bias correction and internal–external cross-validation. Subsequently, expected effects among those with and without a treatment recommendation were estimated based on clinically derived treatment assignment cut points. Results: Performances ranged from R² = 21.0%–23.4%, decreasing only slightly after model optimism correction (R² = 17.0%–19.6%). Predictions were greatly improved by including an interim assessment of depressive symptoms (optimism-corrected R2 = 32.6%–35.6%). Using a minimally important difference of d = −0.24 as assignment cut point, approximately 84.6%–93.3% of patients are helped by this type of intervention, while the remaining 6.7%–15.4% would experience clinically negligible benefits (δ^ = −0.02 to −0.19). Using reliable change as cut point, a smaller subset (39.3%–46.2%) with substantial expected benefits (δ^ = −0.68) receives a treatment recommendation. Conclusions: Meta-analytic prognostic models applied to individual participant data can be used to predict differential benefits of a digital stress intervention as an indirect treatment for depression. While most patients seem to benefit, the developed models could be helpful as a screening tool to identify those for whom a more intensive depression treatment is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Grief-focused cognitive behavioral therapies for prolonged grief symptoms: A systematic review and meta-analysis.
Background: Studies suggest that cognitive behavioral therapies (CBTs) may be efficacious in reducing symptoms of prolonged grief disorder (PGD), but no comprehensive overview and pooled estimate of CBTs’ effect on PGD in adulthood exist. We conducted a systematic review and meta-analysis of randomized controlled trials. Method: Studies were selected independently by two researchers based on a systematic literature search in Pubmed, APA PsycInfo, Web of Science, and Embase. Meta-analyses provided pooled effect sizes for the effects of CBTs on PGD symptoms and secondary outcomes. We explored potential moderators of effect, risk of bias of included studies, and evaluated the quality of the meta-analytical evidence through the Grading of Recommendations, Assessment, Development, and Evaluation system. Results: The meta-analysis included 22 studies of 2,602 bereaved adults (averaged study Mage = 49 years). CBTs had a statistically significant medium effect on PGD symptoms at postintervention (K = 22, g = 0.65, 95% CI [0.49, 0.81]), and a large effect at follow-up (K = 7, g = 0.90, 95% CI [0.37, 1.43]). Statistically significant small-to-medium effects were found at postintervention on posttraumatic stress symptoms (K = 10, g = 0.74, 95% CI [0.49, 0.98]), depression (K = 19, g = 0.53, 95% CI [0.36, 0.71]), and anxiety (K = 9, g = 0.35, 95% CI [0.22, 0.49]). The effects on PGD remained unchanged when adjusted for possible outliers. None of the moderator analyses reached statistical significance. Conclusion: This review suggests that CBTs are efficacious in reducing PGD symptoms in adulthood. Generalization of findings should be done with caution due to considerable inconsistency and indirectness of meta-analytic evidence. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Changes in positive and negative affect in psychotherapy for depression and anxiety.
Objective: Positive and negative affect play critical roles in depression and anxiety treatment, but the dynamic processes of how affect changes over treatment in relation to changes in symptoms is unclear. The study goal was to examine relationships among changes in positive and negative affect with changes in depression and anxiety symptoms. Method: This secondary analysis used a combined sample (N = 196) of two trials (Craske et al., 2019, 2023) comparing positive affect treatment (PAT) to negative affect treatment. Longitudinal cross-lag panel models explored whether changes in positive and negative affect (Positive and Negative Affect Schedule; Watson et al., 1988) predicted subsequent changes in depression and anxiety symptoms (Depression Anxiety Stress Scales; Lovibond & Lovibond, 1995), whether symptoms predicted subsequent changes in affect, and whether treatment condition moderated these relationships. Results: Increases in positive affect predicted subsequent decreases in depression and anxiety symptoms, regardless of treatment condition. Symptoms did not reciprocally predict changes in positive affect. For individuals in PAT, decreases in negative affect predicted subsequent decreases in symptoms. Moreover, decreases in symptoms predicted subsequent decreases in negative affect, regardless of treatment condition. Conclusions: Results did not support a reciprocal relationship between positive affect and symptoms of depression and anxiety since positive affect predicted depression and anxiety symptoms but not vice versa. Results supported a reciprocal relationship between negative affect and symptoms of depression and anxiety since negative affect predicted depression and anxiety symptoms in PAT, and depression and anxiety symptoms predicted negative affect in both treatment conditions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Journal of Consulting and Clinical Psychology - Vol 92, Iss 4