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- Snir, A, et al.
(author)
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Explicit Motives, Antecedents, and Consequences of Direct Self-Injurious Behaviors
- 2018
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In: Crisis. - : Hogrefe Publishing Group. - 2151-2396 .- 0227-5910. ; 39:4, s. 255-266
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Journal article (peer-reviewed)abstract
- Abstract. Background: Self-injurious behaviors in adolescence are a serious public health concern. Aims: The current study aims to expand our understanding of motives for direct self-injurious behaviors (D-SIB). We examined the explicit motives but also the actual antecedents and consequences of D-SIB over time. Method: As part of the Saving and Empowering Young Lives in Europe (SEYLE) study, adolescents between the ages of 14 and 18 years from Israel completed self-report questionnaires at baseline, 3-month, and 12-month follow-ups. Results: Decreases in social support predicted later increases in D-SIB, an effect mediated by negative affect. Both peer and parental support also exerted quadratic effects on D-SIB. Thus, low as well as high support predicted subsequent D-SIB. In turn, D-SIB was followed by increased peer and parental support. Limitations: Our methodology relies on self-reports, affected by social desirability and recall biases. Conclusion: The findings support a causal path for the development of D-SIB: from interpersonal distress to emotional distress and then to D-SIB. They also point to interesting avenues regarding subgroupings of adolescents who self-injure depending on their motives. Finally, our results reveal that D-SIB, although of negative import, might paradoxically be effective in serving certain functions such as gaining support from parents and peers.
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- Zalaznik, Dina, et al.
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Patient alliance with the program predicts treatment outcomes whereas alliance with the therapist predicts adherence in internet-based therapy for panic disorder
- 2021
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In: Psychotherapy Research. - : Routledge. - 1050-3307 .- 1468-4381. ; 31:8, s. 1022-1035
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Journal article (peer-reviewed)abstract
- Objective This study examines relationships among different aspects of therapeutic alliance with treatment outcome, adherence and attrition in internet delivered cognitive behavioral therapy (ICBT) for panic disorder. Methods: We examined alliance-outcome relationships in ICBT (N = 74) using a newly developed self-report alliance measure that disentangles alliance with program content (Internet Patients Experience of Attunement and Responsiveness with the program; I-PEARp) and with the therapist (I-PEARt). We compared ICBT outcomes of patient rated and therapist-rated alliance with conventional alliance scales (WAI-6 and WAI-T). Results: Consistent with our hypothesis, I-PEARp and I-PEARt distinguished between different aspects of the alliance and predicted outcomes better than standard alliance scales. Furthermore, higher ratings of I-PEARp were associated with subsequent lower symptoms and lower symptoms were associated with higher subsequent alliance. In contrast, I-PEARt predicted adherence, but not symptoms. Although therapists ratings of alliance (thI-PEAR) improved significantly during treatment, they did not predict subsequent symptoms, adherence, or dropout. Conclusion: Results indicate that the patient experience of the alliance in ICBT includes two aspects, each of which uniquely contributes to outcomes; patient connection to the program is related to symptom outcomes whereas the dyadic relationship with the therapist serves as the glue to allow the treatment to hold.
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