Attachment Stories in Middle Childhood: Reliability and Validity of Clinical and Nonclinical Children's Narratives in a Structured Setting

Middle childhood is one of the most understudied periods of development and lacks a gold standard for measuring attachment representations. We investigated the reliability and validity of a Dutch version of the Story-Stem Battery coded using the Little Piggy Narrative (LPN) Coding System in a clinical (N = 162) and a nonclinical group (N = 98) of 4-10-year-old children. Their attachment stories were furthermore coded using the coherence scale. Factor analyses showed that the items of the LPN system formed four attachment scales and a separate scale reflecting distress/anxiety, with sufficient internal consistency for the scales and high interrater reliability (n = 20). Furthermore, we studied construct and discriminatory validity. The attachment scores correlated with coherence and child behavioral problems in the expected direction. Results showed age and gender differences, indicating that separate norm groups are necessary. In particular, disorganized attachment, coherence and distress/anxiety differ between clinical and nonclinical children across age and gender. Results for the other three organized attachment scales were more complex. For instance, older boys from the nonclinical group had higher scores on secure attachment than their clinical peers, while girls from the clinical and nonclinical groups did not differ, even though girls in the nonclinical group had higher secure attachment scores than boys. Results are discussed in light of attachment theory and developmental pathways in middle childhood, as well as their clinical implications

Measuring individual significant change on the Beck Depression Inventory-II through IRT-based statistics

<p>Several researchers have emphasized that item response theory (IRT)-based methods should be preferred over classical approaches in measuring change for individual patients. In the present study we discuss and evaluate the use of IRT-based statistics to measure statistical significant individual change on the Beck Depression Inventory-II (BDI-II, Beck, Steer, & Brown, 1996). We compare results obtained with a simple IRT-based statistical test (Z-test) to those obtained with the Reliable Change Index (RCI) in a sample of clinical outpatients. Mean group differences between the Z-test and the RCI were similar, but for some individuals change classifications differed. Differences were most evident for change scores within the lower range of depression scores. We show that this may have consequences for the measurement of individual change in psychotherapy outcome research and clinical practice.</p>

A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy

Contains fulltext : 90761.pdf (publisher's version ) (Open Access)Objectives: Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy. Methods: Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Results: Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER-that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy-was estimated at (sic)52,384 per QALY gained. Conclusions: Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.8 p

Gifted infants: What kinds of support do they need?

The main question addressed in this chapter is what kinds of experiences in the very first years of life foster the development of special talents in children. Topics include: the role of experience in the development of talents; a supportive environment for gifted infants is one that fosters competence motivation (evidence from the lives of eminent achievers, evidence from intervention studies, why competence motivation is particularly vulnerable in infancy, why early experience is as important as later experience for the development of talents); quality of support provided by parents (essential ingredients of adequate support, quality of parental support in disadvantaged families); and quality of parental support and achievement of excellence in Surinamese-Dutch infants (the children and their families, measuring the quality of support provided by the mothers, quality of support provided by Surinamese-Dutch, indigenous Dutch, and Japanese mothers: a comparison, conditions impairing parents' ability to provide adequate support to their infants, 5 excellently achieving Surinamese-Dutch infants). (PsycINFO Database Record (c) 2016 APA, all rights reserved