John P. Garske

Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review.

To identify underlying patterns in the alliance literature, an empirical review of the many existing studies that relate alliance to outcome was conducted. After an exhaustive literature review, the data from 79 studies (58 published, 21 unpublished) were aggregated using meta-analytic procedures. The results of the meta-analysis indicate that the overall relation of therapeutic alliance with outcome is moderate, but consistent, regardless of many of the variables that have been posited to influence this relationship. For patient, therapist, and observer ratings, the various alliance scales have adequate reliability. Across most alliance scales, there seems to be no difference in the ability of raters to predict outcome. Moreover, the relation of alliance and outcome does not appear to be influenced by other moderator variables, such as the type of outcome measure used in the study, the type of outcome rater, the time of alliance assessment, the type of alliance rater, the type of treatment provided, or the publication status of the study.

Measurement of Sexual Risk Taking Among College Students

Current measures of sexual risk taking are either too narrowly focused to be used with college students or do not have adequate psychometric properties. The goal of the current study was to develop a broad and psychometrically sound measure of sexual risk taking. A total of 613 undergraduate students (302 men, 311 women) at a mid-sized Midwestern university in the U.S. were surveyed to develop and gather reliability and validity information on a new measure of sexual risk, the Sexual Risk Survey (SRS). The measure was found to be multifactorial with five factors. The measure was found to have good internal consistency and test–retest reliability. The SRS also demonstrated evidence of convergent and concurrent validity by its relationships with reported number of sexual partners and history of infidelity as well as measures of sensation seeking, sexual desire, substance use, sexual excitation and inhibition, and sexual health consequences. Social desirability was not found to be related to sexual risk taking scores and threat of sexual disclosure was only weakly related. An investigation of sex differences revealed that men reported greater intentions to engage in sexual risk behaviors and greater overall sexual risk taking behavior compared to women. The SRS provides researchers with a valid and comprehensive measure of sexual risk taking that can be used to clarify inconsistent findings in the literature and to assess outcome in programs designed to prevent and reduce sexual risk behaviors among college students.

Patterns and Correlates of Sexual Activity and Condom Use Behavior in Persons 50-Plus Years of Age Living with HIV/AIDS

This study characterized rates of sexual activity and identified psychosocial and behavioral correlates of sexual activity and condom use in a metropolitan sample of 290 HIV-infected adults 50-plus years of age. Thirty-eight percent of participants were sexually active in the past three months, 33% of whom had at least one occasion of anal or vaginal intercourse that was not condom protected. Rates and correlates of sexual activity and condom use differed between gay/bisexual men, heterosexual men, and heterosexual women. In the past three months, 72% of heterosexual men were sexually active compared to only 36% of gay/bisexual men and 21% of heterosexual women. However, among sexually active persons, only 27% of heterosexual men reported inconsistent condom use compared to 37% of gay/bisexual men and 35% of heterosexual women. As the number of older adults living with HIV/AIDS in the U.S. continues to increase, age-appropriate secondary risk-reduction interventions are urgently needed.

Personality, Sexuality, and Substance Use as Predictors of Sexual Risk Taking in College Students

Sexual risk taking among college students is common and can lead to serious consequences, such as unintended pregnancies and sexually transmitted infections. This study utilized responses from 310 undergraduate psychology students aged 18 to 23 to examine personality, sexuality, and substance use predictors of sexual risk behaviors over a six-month period. Data were collected from 2005 to 2006 at a medium-sized Midwestern U.S. university. Results indicated that greater alcohol and recreational drug use, higher extraversion, and lower agreeableness were related to sexual risk taking in men. For women, greater alcohol and drug use, higher sexual excitation, and lower sexual inhibition were predictive of sexual risk taking. Among women, but not men, sensation seeking was found to mediate the relationship between the four significant substance use, personality, and sexuality variables and sexual risk taking. Implications for sexual risk behavior prevention and intervention programming are discussed.

Telephone-Delivered, Interpersonal Psychotherapy for HIV-Infected Rural Persons With Depression: A Pilot Trial

OBJECTIVE Rural areas account for approximately 6% of AIDS cases in the United States. Many HIV-infected persons in rural areas live with elevated levels of psychiatric distress, suicidal ideation, and loneliness. This pilot study tested whether brief interpersonal psychotherapy delivered via telephone could reduce psychiatric distress among persons living with HIV-AIDS in rural areas in the United States. METHODS Seventy-nine participants were assigned randomly to a usual care control condition or to a six-session, telephone-delivered, interpersonal psychotherapy intervention (hereafter referred to as the teletherapy group); participants in the teletherapy group continued to receive standard services available to them in the community. Participants completed self-administered surveys pre- and postintervention that assessed depressive and psychiatric symptoms, perceptions of loneliness, and social support. RESULTS Participants in the teletherapy group evidenced greater reductions in depressive symptoms and in overall levels of psychiatric distress, compared with those in the control group. Nearly one-third of teletherapy participants reported clinically meaningful reductions in psychiatric distress from pre- to postintervention. CONCLUSIONS The telephone-delivered interpersonal therapy intervention showed potential to reduce depressive and psychiatric symptoms among HIV-infected persons in rural areas. On the basis of these encouraging findings, additional research examining this intervention with this clinical population is warranted.

FAMILY ENVIRONMENT, ADJUSTMENT, AND COPING AMONG CHILDREN OF HOLOCAUST SURVIVORS: A Comparative Investigation

Family environment, adjustment, maladjustment, and coping style were studied among matched groups of children of Holocaust survivors, children of Eastern European immigrants, Jewish controls, and non-Jewish controls. No significant differences were found among the groups on measures of adjustment or maladjustment. Group differences were found in family environment and coping style.

The Prediction of Adjustment to Prison by Means of an MMPI-Based Classification System

The predictive validity of an empirically derived, MMPI-based offender classification system was evaluated in a medium-security state facility. Incoming MMPI data were obtained for 495 male inmates, who were then assigned to one of ten categories or to an unclassified group using the computer program and clinical guidelines developed by Megargee and his colleagues. Behavioral measures of institutional adjustment (e.g., nights spent in correctional cell) during the first six months of incarceration served as the dependent variables, and a 2 × 7 (race by Megargee group) multivariate analysis was employed to investigate adjustment differences between the seven largest MMPI-based groups. Consistent with the results of previous studies, the classification system proved to be generalizable to a state population, with 92% of the inmates assigned to one of the ten categories. While between-groups differences in adjustment were observed, the most noteworthy finding was that these manifested themselves only among the white offenders, raising questions regarding the systems applicability to nonwhite populations.

Personality and Generalized Expectancies for Interpersonal Trust

College undergraduates were given Rotters Interpersonal Trust Scale and Cattells 16 PF. Intercorrelations between the total score of the Interpersonal Trust Scale and the 16 PF indicated convergent and discriminant validation for the generalized expectancy construct of trust; interpersonal trust tended to be related with personality traits that suggested a social orientation and adaptive functioning. Trust was also viewed as bearing a relationship with concrete thinking and conformity. Correlations between the factors of the Interpersonal Trust Scale (Political Trust, Paternal Trust, and Trust of Strangers) and the 16 PF were similar to the above correlations but less substantial. The total trust score appeared to be a better predictor of personality than any of its factor scores.

Interpersonal Trust and Construct Complexity for Positively and Negatively Evaluated Persons

College subjects were administered Rotters Interpersonal Trust Scale and a modified version of Bieris grid procedure for measur ing cognitive complexity for positive and negative social stimuli. As hypothesized, low trusters had significantly more differentiated cognitions for socially distant persons than high trusters. Contrary to hypotheses, socially close persons yielded significantly lesser complexity for high trusters than low trusters and significantly greater complexity for females than males. It was concluded that low generalized expectancies for interpersonal trust might be more adaptive and less problematical than previously contended.

Role Variation as a Determinant of Attributed Masculinity and Femininity

One-hundred twenty-seven men and women college students attributed items from a sex-role stereotype questionnaire to one of six hypothetical stimulus persons who varied as a function of gender and role designation (adult, undergraduate, graduate student). Results hypothesized from previous studies of sex-role stereotypes and theoretical conceptions of the attribution process and social learning influences on personality were obtained: the adult stimuli yielded predictable sex-role stereotypy; the undergraduate stimuli produced no differential attributions; and the graduate student stimuli generated greater masculine attributions for the female. The results were interpreted in terms of the significance of situationally specific stimuli as determinants of attributions about men and women.