Cultural accommodation of group substance abuse treatment for Latino adolescents: Results of an RCT.

Comparative studies examining the difference between empirically supported substance abuse treatments versus their culturally accommodated counterparts with participants from a single ethnic minority group are frequently called for in the literature but infrequently conducted in practice. This randomized clinical trial was conducted to compare the efficacy of an empirically supported standard version of a group-based cognitive-behavioral treatment (S-CBT) to a culturally accommodated version (A-CBT) with a sample of Latino adolescents primarily recruited from the juvenile justice system. Development of the culturally accommodated treatment and testing was guided by the Cultural Accommodation Model for Substance Abuse Treatment (CAM-SAT). Seventy Latino adolescents (mean age = 15.2; 90% male) were randomly assigned to 1 of 2 group-based treatment conditions (S-CBT = 36; A-CBT = 34) with assessments conducted at pretreatment, posttreatment, and 3-month follow-up. Longitudinal Poisson mixed models for count data were used to conduct the major analyses. The primary outcome variable in the analytic models was the number of days any substance was used (including alcohol, except tobacco) in the past 90 days. In addition, the variables ethnic identity, familism, and acculturation were included as cultural moderators in the analysis. Although both conditions produced significant decreases in substance use, the results did not support a time by treatment condition interaction; however, outcomes were moderated by ethnic identity and familism. The findings are discussed with implications for research and practice within the context of providing culturally relevant treatment for Latino adolescents with substance use disorders.

Influence of social class perceptions on attributions among mental health practitioners.

OBJECTIVE: A vignette-based study assessed the influence of social class attributions toward a hypothetical client's difficulty. METHOD: 188 licensed mental health professionals who were recruited through professional listservs completed an online survey after reviewing one of two versions of a vignette describing a hypothetical client that varied based on social class cues. RESULTS: As expected, this sample of licensed mental health practitioners detected social class differences based on the descriptors of the hypothetical client across the two vignettes. These perceived social class differences, however, did not impact participants' attributions toward the client for causing or solving her problems, level of Global Assessment of Functioning score ascribed to the client, or willingness to work with the client. CONCLUSIONS: There was no evidence that participants differentially ascribed attributions based on social class. Implications and directions for future research are provided.

Interplay between the diradical character and third-order nonlinear optical properties in fullerene systems.

To reveal new structure-property relationships in the nonlinear optical (NLO) properties of fullerenes that are associated with their open-shell character, we investigated the interplay between the diradical character (y(i)) and second hyperpolarizability (longitudinal component, γ(zzzz)) in several fullerenes, including C(20), C(26), C(30), C(36), C(40), C(42), C(48), C(60), and C(70), by using the broken-symmetry density functional theory (DFT; LC-UBLYP (µ=0.33)/6-31G*//UB3LYP/6-31G*). We found that the large differences between the geometry and topology of fullerenes have a significant effect on the diradical character of each fullerene. On the basis of their different diradical character, these fullerenes were categorized into three groups, that is, closed-shell (y(i)=0), intermediate open-shell (0

Signature of singlet open-shell character on the optically allowed singlet excitation energy and singlet-triplet energy gap.

A signature of singlet open-shell character on the optically allowed singlet excitation energy and singlet-triplet energy gap is theoretically illuminated for open-shell singlet molecules. On the basis of a two-site diradical model with two electrons in two orbitals, the linear dependence of these excitation energies on the transfer integral, which is equivalent to the energy gap between the highest occupied (HOMO) and the lowest unoccupied (LUMO) molecular orbitals in the Hückel theory, is found to be broken down in the high diradical character region due to an increase in electron correlation in the open-shell singlet ground state. A series of polyacenes shows the similar behavior of the optically allowed singlet excitation energies obtained by time-dependent spin-flip density functional theory calculations and experiments, which bears testimony to the singlet open-shell character in long polyacenes.

Dose-effect relationship in routine outpatient psychotherapy: does treatment duration matter?

OBJECTIVE: There is an ongoing debate concerning how outcome variables change during the course of psychotherapy. We compared the dose-effect model, which posits diminishing effects of additional sessions in later treatment phases, against a model that assumes a linear and steady treatment progress through termination. METHOD: Session-by-session outcome data of 6,375 outpatients were analyzed, and participants were categorized according to treatment length. Linear and log-linear (i.e., negatively accelerating) latent growth curve models (LGCMs) were estimated and compared for different treatment length categories. RESULTS: When comparing the fit of the various models, the log-linear LGCMs assuming negatively accelerating treatment progress consistently outperformed the linear models irrespective of treatment duration. The rate of change was found to be inversely related to the length of treatment. CONCLUSION: As proposed by the dose-effect model, the expected course of improvement in psychotherapy appears to follow a negatively accelerated pattern of change, irrespective of the duration of the treatment. However, our results also suggest that the rate of change is not constant across various treatment lengths. As proposed by the "good enough level" model, longer treatments are associated with less rapid rates of change.

Uniformity of evidence-based treatments in practice? Therapist effects in the delivery of cognitive processing therapy for PTSD.

OBJECTIVE: Various factors contribute to the effective implementation of evidence-based treatments (EBTs). In this study, cognitive processing therapy (CPT) was administered in a Veterans Affairs (VA) posttraumatic stress disorder (PTSD) specialty clinic in which training and supervision were provided following VA implementation guidelines. The aim was to (a) estimate the proportion of variability in outcome attributable to therapists and (b) identify characteristics of those therapists who produced better outcomes. METHOD: We used an archival database of veterans (n = 192) who completed 12 sessions of CPT by therapists (n = 25) who were trained by 2 nationally recognized trainers, 1 of whom also provided weekly group supervision. Multilevel modeling was used to estimate therapist effects, with therapists treated as a random factor. The supervisor was asked to retrospectively rate each therapist in terms of perceived effectiveness based on supervision interactions. Using single case study design, the supervisor was interviewed to determine what criteria she used to rate the therapists and emerging themes were coded. RESULTS: When initial level of severity on the PTSD Checklist (PCL; McDonald & Calhoun, 2010; Weathers, Litz, Herman, Huska, & Keane, 1993) was taken into account, approximately 12% of the variability in the PCL at the end of treatment was due to therapists. The trainer, blind to the results, identified the following characteristics and actions of effective therapists: effectively addressing patient avoidance, language used in supervision, flexible interpersonal style, and ability to develop a strong therapeutic alliance. CONCLUSIONS: This study adds to the growing body of literature documenting the importance of the individual therapist as an important factor in the change process.

Young parenthood program: supporting positive paternal engagement through coparenting counseling.

OBJECTIVES: Because of their youth, adolescent parents often lack the interpersonal skills necessary to manage the relationship challenges involved in parenting, leaving them and their children vulnerable to the health risks associated with relational stress and conflict. The primary goal of this study was to test the efficacy of the Young Parenthood Program (YPP), a 10-week counseling program administered during pregnancy and designed to facilitate interpersonal skill development and positive parenting among adolescent parents. METHODS: Participants included 105 pregnant adolescents and their partners randomly assigned to YPP or treatment as usual. Assessments measured coparenting skills and parental functioning during the second trimester, 12 weeks after birth, and 18 months after birth. RESULTS: Results indicated that fathers completing YPP demonstrated more positive parenting than did fathers in the control group. Moreover, the positive outcomes in paternal functioning were mediated through changes in the mother's interpersonal skill development. CONCLUSIONS: Results supported the efficacy of this couples-focused, coparenting support program, particularly for facilitating positive paternal engagement. These findings underscored the relevance of including fathers in the delivery of maternal-child public health services.

Halide ion complexes of decaborane (B10H14) and their derivatives: noncovalent charge transfer effect on second-order nonlinear optical properties.

Quantum molecular engineering has been performed to determine the second-order nonlinear optical (NLO) properties in different halo complexes of decaborane (B(10)H(14)) and their derivatives using the density functional theory (DFT) method. These decaborane halo complexes of X(-)@B(10)H(14) (X = F, Cl, Br, and I) are found to possess noncovalent charge transfer interactions. The static polarizability (α(0)) and first hyperpolarizability (ß(0)) among these complexes increase by moving down the group from F to I, partly due to the increase in size of their anionic radii and the decrease in their electron affinities. A two-level approximation has been employed to investigate the origin of ß(0) values in these halo complexes, which show very consistent results with those by the finite-field method. Furthermore, in the same line, two experimentally existing complexes, I(-)@B(10)H(14) and I(-)@2,4-I(2)B(10)H(12), are found to have considerably large ß(0) values of 2859 and 3092 a.u., respectively, which are about three times larger than a prototypical second-order NLO molecule of p-nitroaniline, as reported by Soscun et al. [Int. J. Quantum Chem.2006, 106, 1130-1137]. Besides this, the special effects of solvent, counterion, and bottom substitutions have also been investigated. Interestingly, 2,4-alkali metal-substituted decaborane iodide complexes show remarkably large second-order NLO response with ß(0) amplitude as large as 62436 a.u. for I(-)@2,4-K(2)B(10)H(12) complex, which are explained in terms of their transition energies, frontier molecular orbitals and electron density difference plots. Thus, the present investigation provides several new comparative insights into the second-order NLO properties of halo complexes of decaborane, which possess not only large first hyperpolarizabilities, but also high tunability to get a robustly large second-order NLO response by alkali metal substitution effects.

Full configuration interaction calculations of the second hyperpolarizabilities of the H4 model compound: summation-over-states analysis and interplay with diradical characters.

The second hyperpolarizability (γ) of the one-dimensional H(4) model compound has been calculated at the full configuration interaction level to describe its relationships with the diradical characters y(i) [the occupation numbers of the lowest unoccupied natural orbital (LUNO) + i] and the geometry. It is found that the system with intermediate y(0) ( = 0.527) and small y(1) ( = 0.178) exhibits the largest γ value [enhanced by a factor of 9 compared to that of a nearly closed-shell H(4) analog (y(0) = 0.099, y(1) = 0.029)], where both the outer H-H distances are slightly larger than the inner one. These results provide a molecular design guideline for enhancing and controlling the third-order nonlinear optical properties of singlet multiradical linear molecular systems such as multiradical organic aggregates, supermolecular systems, and extended metal atom chains.

Emergent patterns in the development of young children's object play.

The present study set out to examine developments in object play in a contemporary sample of 289 typically developing children from 8- to 60-months of age. The value of object play centers on developments in object knowledge and mental representation, along with the developmental processes of decentration, substitution, and agency. The early play studies focused on one or another of these aspects of development, and generally for the age group 12-36 months. The present study sought to expand this age period and to examine these processes in relation to one another and how they build upon each other in development. Videorecorded observations of the children's play activities were collected in homes for children recruited at 8-, 12-, 18-, 24-, 30-, 36-, 42-, 48-, 54-, and 60-months of age. Children were White (70%); of mixed racial/cultural backgrounds (14%); Asian (7%); Black (6%); and Latinx (3%); 49% were boys; 51% were girls. Twenty-seven categories of object play were identified. Progress was analyzed in frequency of category occurrence and variety of examples expressed within a category. Some categories occurred with robust frequency and variety, and others did not. Within-subjects analyses of variance revealed significant interactions between age and categories. Exploratory factor analyses of variety suggested clusters of categories representing cognitive change. Discussion centers on the intersection of cognitive development with experience, the covariation of developments in play, and the usefulness of frequency and variety as measures of play.

Open-shell characters and second hyperpolarizabilities of one-dimensional graphene nanoflakes composed of trigonal graphene units.

The impact of topology on the open-shell characters and the second hyperpolarizabilities (γ) has been addressed for one-dimensional graphene nanoflakes (GNFs) composed of the smallest trigonal graphene (phenalenyl) units. The main results are: 1) These GNFs show not only diradical but also multiradical characters when increasing the number of linked units. 2) GNFs composed of an equivalent number of units can exhibit a wide range of open-shell characters-from nearly closed-shell to pure multiradical characters-depending on the linking pattern of the trigonal units. 3) This wide variation in open-shell characters is explained by their resonance structures and/or by their (HOMO-i)-(LUMO+i) gaps deduced from the orbital correlations. 4) The change in the linking structure of the units can effectively control their open-shell characters as well as their γ values, of which the longitudinal components are significantly enhanced for the singlet GNFs having intermediate open-shell characters. 5) Singlet alternately linked (AL) systems present intermediate multiradical characters even in the case of a large number of units, which creates a significant enhancement of γ with increasing the size, whereas nonalternately linked (NAL) systems, which present pure multiradical characters, possess much smaller γ values. Finally 6) by switching from the singlet to the highest spin states, the γ values of NAL systems hardly change, whereas those of AL systems exhibit large reductions. These fascinating structure-property relationships between the topology of the GNFs, their open-shell characters, and their γ values not only deepen the understanding of open-shell characters of GNFs but aim also at stimulating further design studies to achieve giant NLO responses based on open-shell graphene-like materials.

New York City social workers after 9/11: their attachment, resiliency, and compassion fatigue.

This study examines the relationship between attachment classification, resiliency, and compassion fatigue in New York social workers following 9/11. We used single occasion, quasi-random sampling, surveying 481 social workers living in Manhattan. Hierarchical regression analyses revealed that secure attachment is predictive of the ability to cope with secondary traumatic stress as well as capacity for resilience, explaining approximately 7% of the variance in both compassion fatigue and resiliency. These findings suggest that secure attachment may serve as a source of resilience for social workers, immunizing them from significant compassion fatigue. Such findings have significant implications for clinicians working with traumatized populations.

Theoretical study on exciton recurrence motion in anthracene dimer using the Ab initio MO-CI based quantum master equation approach.

We apply the ab initio molecular orbital (MO)-configuration interaction (CI) based quantum master equation (MOQME) method to the investigation of ultrafast exciton dynamics in an anthracene dimer modeled after anthracenophane, which is experimentally found to exhibit an oscillatory signal of fluorescence anisotropy decay. Two low-lying near-degenerate one-photon allowed excited states with a slight energy difference (42 cm(-1)) are obtained at the CIS/6-31G** level of approximation using full valence pi-orbitals. The time evolution of reduced exciton density matrices is performed by numerically solving the quantum master equation. After the creation of a superposition state of these near-degenerate states by irradiating a near-resonant laser field, we observe two kinds of oscillatory behaviors of polarizations: field-induced polarizations with faster periods, and amplitude oscillations of x- and z-polarizations, P(x) and P(z), with a slower period, in which the amplitudes of P(x) and P(z) attain maximum alternately. The latter behavior turns out to be associated with an oscillatory exciton motion between the two monomers, i.e., exciton recurrence motion, using the dynamic exciton expression based on the polarization density. From the analysis of contribution to the exciton distributions, such exciton recurrence motion is found to be characterized by both the difference in eigenfrequencies between the two near-degenerate states excited by the laser field and the relative phases among the frontier MOs primarily contributing to the near-degenerate states.

Theoretical study on exciton dynamics in dendritic systems: exciton recurrence and migration.

The optical functionalities such as exciton recurrence and migration for dendritic systems, e.g., dendrimers, are investigated using the quantum master equation (QME) approach based on the ab initio molecular orbital configuration interaction (MOCI) method, which can treat both the coherent and incoherent exciton dynamics at the first principle level. Two types of phenylacetylene dendrimers, Cayley-tree dendrimer and nanostar dendrimer with anthracene core, are examined to elucidate the features of excion recurrence and migration motions in relation to their structural dependences. It is found that the nanostar dendrimer exhibits faster exciton migration from the periphery to the core than Cayley-tree dendrimer, which alternatively exhibits exciton recurrence motion among dendron parts in case of small relaxation parameters. Such strong structural dependence of exciton dynamics demonstrates the advantage of dendritic molecular systems for future applications in nano-optical and light-harvesting devices.

Benchmarking the effectiveness of psychotherapy treatment for adult depression in a managed care environment: a preliminary study.

This preliminary study evaluated the effectiveness of psychotherapy treatment for adult clinical depression provided in a natural setting by benchmarking the clinical outcomes in a managed care environment against effect size estimates observed in published clinical trials. Overall results suggest that effect size estimates of effectiveness in a managed care context were comparable to effect size estimates of efficacy observed in clinical trials. Relative to the 1-tailed 95th-percentile critical effect size estimates, effectiveness of treatment provided in this setting was observed to be between 80% (patients with comorbidity and without antidepressants) and 112% (patients without comorbidity concurrently on antidepressants) as compared to the benchmarks. Because the nature of the treatments delivered in the managed care environment were unknown, it was not possible to make conclusions about treatments. However, while replications are warranted, concerns that psychotherapy delivered in a naturalistic setting is inferior to treatments delivered in clinical trials appear unjustified.

Theoretical study on second hyperpolarizabilities of singlet diradical square planar nickel complexes involving o-semiquinonato type ligands.

Hybrid density functional theory method is applied for investigating the diradical character dependence of the second hyperpolarizability (gamma) of square planar nickel complexes involving several types of bidentate ligands [o-C6H4XY, where X = Y = O, NH, S, Se, and PH as well as (X, Y) = (NH, NH2) and (S, NH2)]. It is found that, as a function of the donor atoms, the diradical character of these complexes varies from 0.0 to 0.884 and is associated with substantial variations of gamma ranging from 14 x 10(3) to 819 x 10(3) au. In particular, the largest gamma values are associated with intermediate diradical characters in good agreement with the structure-property relationship obtained for pure hydrocarbon systems. Increasing the electronegativity of the X and Y donor groups of the ligands leads to larger diradical characters as a result of the enhancement of the double bond nature of the C=X(Y) bonds, which further stabilizes the diradicals on both-end benzene rings. This demonstrates that the electronegativities of the donor atoms of the ligands become a tuning parameter of the diradical character and then of the gamma values of these complexes.

Core molecule dependence of energy migration in phenylacetylene nanostar dendrimers: Ab initio molecular orbital-configuration interaction based quantum master equation study.

The core molecule dependence of energy (exciton) migration in phenylacetylene nanostar dendrimers is investigated using the ab initio molecular orbital (MO)-configuration interaction based quantum master equation approach. We examine three kinds of core molecular species, i.e., benzene, anthracene, and pentacene, with different highest occupied MO-lowest unoccupied MO (HOMO-LUMO) gaps, which lead to different orbital interactions between the dendron parts and the core molecule. The nanostars bearing anthracene and pentacene cores are characterized by multistep exciton states with spatially well-segmented distributions: The exciton distributions of high-lying exciton states are spatially localized well in the periphery region, whereas those of low-lying exciton states are done in the core region. On the other hand, for the nanostar bearing benzene core, which also has multistep exciton states, the spatial exciton distributions of low-lying exciton states are delocalized over the dendron and the core regions. It is found that the former nanostars exhibit nearly complete exciton migration from the periphery to the core molecule in contrast to the latter one, in which significant exciton distribution remains in the dendron parts attached to the core after the exciton relaxation, although all these dendrimers exhibit fast exciton relaxation from the initially populated states. It is predicted from the analysis based on the MO correlation diagrams and the relative relaxation factor that the complete exciton migration to the core occurs not only when the HOMO-LUMO gap of the core molecule is nearly equal to that of the dendron parts attached to the core (anthracene case) but also when fairly smaller than that (pentacene case), whereas the complete migration is not achieved when the HOMO-LUMO gap of the core is larger than that of the dendron parts (benzene case). These results suggest that the fast and complete exciton migration of real dendrimers could be realized by adjusting the HOMO-LUMO gap of the core molecule to be smaller than that of dendron parts, although there exist more complicated relaxation processes as compared to simple dendritic aggregate models studied so far.

Benchmarks for psychotherapy efficacy in adult major depression.

This study estimates pretreatment-posttreatment effect size benchmarks for the treatment of major depression in adults that may be useful in evaluating psychotherapy effectiveness in clinical practice. Treatment efficacy benchmarks for major depression were derived for 3 different types of outcome measures: the Hamilton Rating Scale for Depression (M. A. Hamilton, 1960, 1967), the Beck Depression Inventory (A. T. Beck, 1978; A. T. Beck & R. A. Steer, 1987), and an aggregation of low reactivity-low specificity measures. These benchmarks were further refined for 3 conditions: treatment completers, intent-to-treat samples, and natural history (wait-list) conditions. The study confirmed significant effects of outcome measure reactivity and specificity on the pretreatment-posttreatment effect sizes. The authors provide practical guidance in using these benchmarks to assess treatment effectiveness in clinical settings.

Identifying highly effective psychotherapists in a managed care environment.

OBJECTIVE: To investigate the variability and stability of psychotherapists' effectiveness and the implications of this differential effectiveness for quality improvement in a managed care environment. STUDY DESIGN: Subset archival outcome data for patients receiving behavioral health treatment were divided into 2 time periods to cross-validate the treating therapists' effectiveness. After categorizing the therapists as "highly effective" and "others" during the baseline period, the stability of their individual effectiveness was cross-validated in the remaining time period. METHODS: Outcomes for 10 812 patients (76.0% adults, 24.0% children and adolescents) treated by 281 therapists were included. Patients initiated treatment between January 1999 and June 2004. Mean residual change scores obtained by multiple regression were used to adjust for differences in case mix among therapists. Raw change scores as well as mean residualized change scores were compared between the 71 psychotherapists identified as highly effective (25%) and those identified as other (remaining 75%). RESULTS: During the cross-validation period, mean differences in residualized change score between highly effective therapists and others were statistically significant (difference = 2.8; P < .001), which corresponded to an average of 53.3% more change in raw change scores with the highly effective therapists. Results could not be explained by case mix differences in diagnosis, age, sex, intake scores, prior outpatient treatment history, length of treatment, or therapist training/experience. CONCLUSION: Behavioral health outcomes for a large system of care could be significantly improved by measuring clinical outcomes and referring patients to therapists with superior outcomes.

A collaborative outcome resource network (ACORN): Tools for increasing the value of psychotherapy.

The authors describe a collaborative outcomes resource network (ACORN) and the suite of measurement and decision support tools (ACORN Toolkit) that have emerged from this collaboration for the purpose of providing clinical feedback to therapists. The ACORN Toolkit is most accurately described as a comprehensive clinical information system designed to increase the value of mental health services across large systems of care. It was built to integrate large datasets from multiple sources including outcome data, client demographics and diagnostic data, therapist credentialing information, pharmacy data, and service claims data. For the limited purposes of this article, the authors focus on the ACORN Toolkit for measuring and how it has contributed to improving outcomes in psychotherapy. Implications to current practice and future training are provided.