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Biomedical subjects

M J Lambert

Publications and source records attributed to M J Lambert.

At least 19 recordsLinked to original sources
PubMed1995

Graduate training in psychotherapy: are therapy outcomes enhanced?

Several sources of indirect evidence supporting the value of graduate training in psychotherapy are reviewed here. Training protocols that are known to enhance trainees' skills are briefly discussed, as are conclusions of meta-analytic reviews examining relationships between therapist experience and training, and therapy outcome. An updated meta-analysis of therapy outcome studies involving within-study comparisons of psychotherapists of different levels of training and experience is summarized. It is concluded that a variety of outcome sources are associated with modest effect sizes favoring more trained therapists. In many outpatient settings, therapists with more training tend to suffer fewer therapy dropouts than less trained therapists. Shortcomings of available research and speculations about possible variables influencing outcomes are discussed.

Curriculum↗
PubMed1995

Clinical significance of the National Institute of Mental Health Treatment of Depression Collaborative Research Program data.

The clinical significance of research findings is an important issue that, until recently, was often neglected. Statistical methods are available, however, to evaluate the meaningfulness of pre- to post-treatment change. The clinical significance of the National Institute of Mental Health Treatment of Depression Collaborative Research Program Data was evaluated. A substantial number of clients receiving treatment for depression made reliable improvements and had posttreatment scores that fell within a functional distribution. A small number of clients reliably deteriorated despite undergoing 12 sessions of treatment. No differences in clinical significance rates among treatment groups existed for measures of depressive symptoms. Treatments differed in terms of clinical significance on a measure of general symptom severity. There was substantial agreement among diverse methods of measurement regarding the identification of individuals making clinically significant change.

Cognitive Behavioral Therapy↗
PubMed1995

An exploration of the relationship between interpersonal problems and psychological health.

The relationship between interpersonal distress and psychological health was investigated using a sample of 185 college undergraduates. Subjects completed the Inventory of Interpersonal Problems (a measure of interpersonal distress), the Personal Orientation Inventory (a measure of self-actualization), and the Miller Social Intimacy Scale (a measure of interpersonal closeness). The mean of scores on the Inventory of Interpersonal Problems was compared with the mean of the clinical sample reported in 1988 by Horowitz, et al. The measures of psychological health were correlated with the Inventory of Interpersonal Problems total and with the octant scales of the Inventory of Interpersonal Problems-Circumplex version. The measures were also projected onto the circumplex to summarize their interpersonal connotations.

Adaptation, Psychological↗
PubMed1995

Ethnic differences on the Outcome Questionnaire.

The Outcome Questionnaire is a 45-item inventory of client-report symptoms and distress, used to track therapeutic change on a session-by-session basis. Data collected with the cooperation of a managed care provider were analyzed to note ethnic differences on the questionnaire. 1552 first session questionnaires were selected and mean total and subscale scores were analyzed using analysis-of-variance procedures for differences by ethnicity. No significant differences were found; however, significant ethnic differences on some items were noted, and these are reported with ethnic trends in clients' problems, diagnoses, and therapists' ratings on Global Assessment of Functioning. These findings were contrasted with those of other studies reporting ethnic differences on various measures such as IQ and personality assessment.

Adaptation, Psychological↗
PubMed1994

Psychological consequences of athletic injury among high-level competitors.

Injury prohibiting continued athletic participation has been hypothesized to have a predictable emotional impact on athletes (Rotella & Heyman, 1986). However, the psychological impact of injury has not been well documented. This study examined the psychological reactions to injury among 343 male collegiate athletes participating in 10 sports. All athletes were assessed using measures of depression, anxiety, and self-esteem during preseason physical examinations. Injured athletes along with matched controls were later assessed within one week of experiencing an athletic injury and 2 months later. A 4 x 3 (Injury Status x Time of Testing) repeated measures multivariate analysis of variance (DM MANOVA) revealed that injured athletes exhibited greater depression and anxiety and lower self-esteem than controls immediately following physical injury and at follow-up 2 months later. These findings supported the general observation that physically injured athletes experience a period of emotional distress that in some cases may be severe enough to warrant clinical intervention.

Adolescent↗
PubMed1994

Anorexia nervosa: correlation between MR appearance of bone marrow and severity of disease.

PURPOSE: To identify bone marrow abnormalities on magnetic resonance (MR) images of patients with anorexia nervosa (AN) and to correlate the findings with body mass index (BMI) and blood cell count. MATERIALS AND METHODS: The signal intensity patterns in the lumbar, pelvic, and femoral marrow spaces were evaluated on MR images obtained in 14 patients with AN and 14 control subjects. RESULTS: Six patients with AN had a waterlike signal intensity pattern either throughout the three marrow spaces (five patients) or only in the marrow cavity of the proximal femur (one patient). Results of biopsy performed in one of the six patients showed that the marrow had findings typical of serous atrophy. The BMI values and blood cell counts in the six patients were lower than those of the eight other patients with AN and the 14 control subjects. CONCLUSION: Bone marrow has an unusual signal intensity and distribution at MR imaging in patients with AN who have a low BMI value and biologic signs of bone marrow dysfunction.

Adult↗
PubMed1993

Avulsion of the iliac crest apophysis: a rare fracture in adolescent athletes.

We report a case of an iliac apophyseal fracture in a 15-year-old boy, sustained while swinging a baseball bat. He presented with right hip pain one hour after the injury occurred. Diagnosis was made on the basis of radiographs of the pelvis. Pelvic avulsion fractures are uncommon injuries, seen almost exclusively in adolescent athletes. The iliac crest is an unusual site of injury for this avulsion fracture. Only one other well-described case of an acute, noncontact fracture of the iliac apophysis with a similar mechanism of injury has been reported.

Acute Disease↗
PubMed1991

The MMPI and premenstrual syndrome: profile fluctuations between best and worst times during the menstrual cycle.

The MMPI was administered during the patient-perceived best time of the menstrual cycle and during the patient-perceived worst time of the cycle in order to examine the stability of MMPI profile configurations. Subjects were 214 women who were referred to two metropolitan outpatient premenstrual syndrome (PMS) clinics for moderate to severe premenstrual complaints. This sample was selected from 1,849 intake files after screening by strict selection criteria for PMS. The results indicate that there are wide fluctuations in profile patterns between the best and worst times of the menstrual cycle for a large number of patients. Caution in using the MMPI is strongly advised.

Adult↗
PubMed1991

Neuropsychological rehabilitation: microcomputer-assisted treatment of brain-injured adults.

This study was designed to investigate the contribution of cognitive rehabilitation therapy delivered by computer within an educationally based treatment program for brain-injured adults. The effectiveness of two forms of computer-assisted neuropsychological treatment was examined, 36 head-injured adults received the treatment targeting either attention and memory skills or reasoning and logical thinking skills. Both groups were assessed on three measures of attention and memory and three measures of reasoning before and after the 8-wk. treatment. Analysis indicated significant improvement on five of six measures by both groups. No differential effect was observed by treatment condition. These findings did not support the hypothesis that computer-assisted neuropsychological rehabilitation programs which differ in both content and focus can produce specific effects on cognitive functioning of brain-injured adults.

Adult↗
PubMed1984

Telephone counseling and crisis intervention: a review.

The empirical research pertaining to the effectiveness of telephone counseling and referral systems personnel was critically reviewed. The assessment was organized according to several evaluation strategies that researchers have utilized to evaluate effectiveness. These strategies included, for example, client self-reports, client "shows" versus "no-shows" following referral, data pertaining to suicide rates, counselor ratings of personal effectiveness, and phone workers' ability to offer empathy to clients. It was concluded that discussions of effectiveness should be constrained by a careful consideration of the specific index of efficacy chosen by investigators as well as methodological issues associated with current research in this area. There is reason to believe that the availability of telephone crisis services may be related to reduced suicide rates among young white females. Also, there is a significant need to empirically associate counseling technique and indices of effectiveness with substantive measures of client outcome in future research. Additional topics reviewed include the probable differential effectiveness of lay workers with various presenting problems of clients, and the role that training and maturity seem to play in successful interventions. Guidelines for the use of evaluation techniques which coincide with service goals are also offered.

Attitude of Health Personnel↗
PubMed1984

A meta-analytic comparison of the Beck Depression Inventory and the Hamilton Rating Scale for Depression as measures of treatment outcome.

Some clinicians have considered the Beck Depression Inventory, a self-rating scale, too reactive to patient halo effects and, therefore, a liberal measure of treatment outcome. On the other hand, interviewer-rating scales, like the Hamilton Rating Scale for Depression have been viewed as more conservative measures of treatment gain. Studies which compared the Beck Depression Inventory to the Hamilton Rating Scale, as dependent measures, were reviewed for the purpose of determining if the scales provided comparable data for assessing treatment effects. The use of meta-analysis techniques resulted in a comparison of effect sizes which indicated that the Beck Depression Inventory was significantly less liberal than the Hamilton Rating Scale for Depression. The implications of these results for selecting outcome measures and the application of meta-analysis techniques for comparing dependent measures are discussed.

Bipolar Disorder↗
PubMed1983

Small cell neuroendocrine (oat cell) carcinoma of the breast.

A 52-year-old woman with small cell neuroendocrine (oat cell) carcinoma of the breast is described. Identical neoplasms have been reported in a variety of extrapulmonary sites, but this is the first description of a primary mammary tumor of this type. The patient had axillary and hepatic metastases at the time of diagnosis, and the clinical course suggests that this tumor behaves in an aggressive fashion, analogous to other small cell neuroendocrine carcinomas. The relationship of small cell neuroendocrine carcinoma of the breast to mammary "carcinoid tumor" or argyrophilic carcinoma is discussed.

Breast Neoplasms↗