American Psychologist最新文献

Dropout has been identified as a significant problem among military populations seeking psychotherapy (Goetter et al., 2015; Hoge et al., 2014), yet an overall estimate of its exact prevalence and predictors does not exist. The aims of the current meta-analysis were to estimate outpatient psychotherapy dropout rates for this population and evaluate potential moderators of this event. In total, 283 articles-comprising data from 719,465 U.S. service members and veterans-met all inclusion criteria and were included in the meta-analysis. The average weighted dropout rate for all outpatient therapies was 25.6%, 95% CI [22.4%, 29.2%], and prediction interval [1.9%, 85.9%]. Furthermore, dropout was 27.0% for cognitive behavioral therapies (CBTs), 25.3% for trauma treatments, 27.6% for the Department of Veterans Affairs (VA), 28.9% for individual therapies, and 9.8% for intensive outpatient settings. Findings from metaregression analyses using mixed-effects models indicated that higher dropout was linked with the following after accounting for other moderators: younger age, CBTs, nonmanualized approaches, VA versus Department of Defense settings, individual versus group therapies, and weekly versus intensive outpatient formats. Dropout was not linked with other client, therapist, treatment, and research variables. Taken together, dropout estimates were obtained for a range of military populations and treatment characteristics, including theoretical orientation, presenting concern, setting, and therapy formats. These estimates may provide potential benchmarks for therapists, administrators, and policymakers serving military populations. Leveraging dropout prevention strategies with at-risk groups highlighted in this study may enhance mental health care outcomes for this high-need population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Suicide is a major public and mental health problem in the United States and around the world. According to recent survey research, there were 16,600,000 American adults and adolescents in 2022 who reported having serious thoughts of suicide (Substance Abuse and Mental Health Services Administration, 2023), which underscores a profound need for effective clinical care for people who are suicidal. Yet there is evidence that clinical providers may avoid patients who are suicidal (out of fear and perceived concerns about malpractice liability) and that too many rely on interventions (i.e., inpatient hospitalization and medications) that have little to no evidence for decreasing suicidal ideation and behavior (and may even increase risk). Fortunately, there is an emerging and robust evidence-based clinical literature on suicide-related assessment, acute clinical stabilization, and the actual treatment of suicide risk through psychological interventions supported by replicated randomized controlled trials. Considering the pervasiveness of suicidality, the life versus death implications, and the availability of proven approaches, it is argued that providers should embrace evidence-based practices for suicidal risk as their best possible risk management strategy. Such an embrace is entirely consistent with expert recommendations as well as professional and ethical standards. Finally, a call to action is made with a series of specific recommendations to help psychologists (and other disciplines) use evidence-based, suicide-specific, approaches to help decrease suicide-related suffering and deaths. It is argued that doing so has now become both an ethical and professional imperative. Given the challenge of this issue, it is also simply the right thing to do. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychologists have a traditional concern with participant samples from narrow populations and deleterious effects on researchers' ability to generalize findings. Recently, both individuals and authoritative organizations, such as the American Psychological Association, have merged this external validity concern with diversity and inclusion concerns. The American Psychological Association directive for researchers to include diverse samples seems obviously well-taken as it purports to mitigate these problems at once; it simultaneously increases external validity and promotes diversity and inclusion. However, we show that there are complications. These include problems with internal and external validity conceptualizations; that sometimes generalization failures can support, rather than detract from, external validity; the crucial role auxiliary assumptions play in impacting internal and external validity; Lakatosian degenerative science and its problematic application; and distinguishing between merely including diverse groups in research samples versus analyzing for group differences. These complications imply a nuanced perspective of whether samples from narrow populations are undesirable. That a sample is from a narrow population might, or might not, preclude strong support or disconfirmation for the theory, including its ability to generalize. Our nuanced perspective militates against the current trend of journal directives to require diverse samples. Sample suitability for particular researcher goals should be judged on a case-by-case basis that takes into account that sometimes samples from narrow populations can nevertheless engender impressive scientific progress and sometimes not. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Social support is the degree to which people are accepted by, cared for, and attended to by important others and is one of the most popular constructs in the psychological canon. This project synthesized data from 60 meta-analyses, which included over 2,700 studies and 2.1 million participants, to evaluate the association of social support with psychological adjustment. Results from a second-order meta-analysis indicated that, overall, social support yielded a robust association with psychological adjustment, r = .24, 95% CI [.22, .26]. Effects of social support were detectable across several outcome categories (mental health, psychological traits, educational outcomes, workplace outcomes), specific outcomes (depression, posttraumatic stress disorder, stress, burnout), and sources of support (friends, family, peers, teachers, coworkers, supervisors), and were detectable across age and cultural groups. However, perceived support was more strongly associated with psychological adjustment than received support. Furthermore, social support effects were larger when examining unhealthy samples, well-validated scales, and cross-sectional studies. Finally, effects were less pronounced in six meta-analyses that controlled for relevant covariates, r = .17, 95% CI [.10, .23]. Given the substantial variability of social support effects across prior meta-analyses (range = .07-.41), future study is needed to identify additional moderators of its association with psychological adjustment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

In 2021, the American Psychological Association offered an apology to people of color for harms, actions, and inactions and accepted responsibility for contributing to systemic inequities. The field of psychology has a complicated and long history of contributing to American racism and the belief in human hierarchy. This article illustrates the strategy the American Psychological Association followed to issue an apology at a scale that incorporated the voices and perspectives of the association's senior leaders and racial equity experts. The authors shed light on the organizational changes that were necessary to approve the apology and the changes that followed the apology to create long-term, institutional, and sustainable change and advance racial equity within psychology and society. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

For the first time in its 130-year history, the American Psychological Association formally admitted to its ugly racist past and acknowledged how White supremacy continues to pervade the profession. Although the apology spans the entire field of psychology, the primary focus of this article is on how the profession of counseling and psychotherapy has reinforced and contributed to the oppression of people of color. First, we contend that psychology mirrors cultural racism/White supremacy and represents the major framework from which psychologists and other social scientists with power and privilege located the source of problems within people of color, their family values/structures, and their communities. Second, we maintain that the concept of professionalism has resulted in four legitimizing pillars of counseling and psychotherapy in which polarities are created that value universalism over relativism, individualism over collectivism, objectivism over subjectivism, and empiricism over experientialism. These four foundations of a White epistemology channel and subsidize racism by equating racial/cultural differences with pathology; promoting color and power blindness; blaming the victim; dehumanization and objectification; and denial of different racial realities. Last, we offer solutions for dismantling racism in counseling and psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).