Group-Based Symptom Trajectories in Indicated Prevention of Adolescent Depression

Background: Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression preven- tion trials and examine how cognitive-behavioral (CB) interventions and baseline predictors relate to trajectory membership. Methods: Six hundred thirty-one participants were assigned to one of three conditions: CB group intervention, CB bibliotherapy, and brochure control. We used group-based trajectory modeling to identify trajectories of depressive symptoms from pretest to 2-year follow-up. We examined associations between class membership and conditions using chi- square tests and baseline predictors using multinomial regressions. Results: We identified four trajectories in the full sample. Qualitatively similar trajectories were found in each condition separately. Two trajectories of positive symptom course (low-declining, high-declining) had declining symptoms and were dis- tinguished by baseline symptom severity. Two trajectories of negative course (high-persistent, resurging), respectively, showed no decline in symptoms or de- cline followed by symptom reappearance. Participants in the brochure control condition were significantly more likely to populate the high-persistent trajectory relative to either CB condition and were significantly less likely to populate the low-declining trajectory relative to CB group. Several baseline factors predicted trajectory classes, but gender was the most informative prognostic factor, with males having increased odds of membership in a high-persistent trajectory rel- ative to other trajectories. Conclusions: Findings suggest that CB preventive interventions do not alter the nature of trajectories, but reduce the risk that adolescents follow a trajectory of chronically elevated symptoms.

Pour éviter de nuire, 10 ans plus tard

Éditorial portant sur les pratiques controversées de certains psychoéducateurs québécois.

Égalité et identité ne sont pas synonymes

Éditorial en réponse à l'article suivant : Cossette, L. (2014). Science et égalité des sexes ne sont pas inconciliables. Revue de psychoéducation, 43(1), 155-159.

Guérir avec l'EMDR : preuves et controverses

L'EMDR est une thérapie qui a été développée pour traiter les souvenirs traumatiques, puis proposée pour traiter une variété de troubles psychologiques. Ce texte est le premier à recenser en français les études qui ont évalué l'efficacité de cette forme de thérapie. L'efficacité de l'EMDR est d'abord démontrée à l'aide d'études de cas qui comportent des limites importantes. Les études de cas basées sur un protocole expérimental donnent des résultats plus mitigés. Les études contrôlées qui examinent l'efficacité de l'EMDR sont ensuite décrites en fonction du type de contrôle exercé et du type de trouble traité. L'EMDR est aussi efficace que la thérapie cognitivocomportementale pour traiter le trouble de stress posttraumatique, mais pas pour le traitement de la phobie spécifique ni du trouble panique. De plus, les études montrent de façon répétée que l'absence des mouvements oculaires ne modifie pas l'efficacité de l'EMDR. Une analyse des différences et des similitudes entre l'EMDR et l'approche cognitivo-comportementale est présentée. Les caractéristiques pseudo-scientifiques qui ont marquées le développement et la diffusion de l'EMDR sont aussi abordées.

Les bases fragiles de la communication facilitée

La communication facilitée (CF), une méthode d'assistance impliquant une aide pour faciliter la composition de messages sur un clavier, passe souvent pour la solution privilégiée dans le cas des sujets dont la communication est entravée par de graves problèmes. Trente-cinq études empiriques destinées à valider cette approche sont ici analysées. Deux conclusions s'en dégagent : seuls 6% des sujets manifestent une réelle "capacité" à communiquer dans le cadre de la CF et plus l'échantillon est vaste, moins on constate de réussites; en fait les études impliquant 10 sujets et plus donnent un taux de réussite inférieur à 1%. Malgré ces résultats décevants, les tenants de la CF continuent d'en faire la promotion tout en les attribuant aux résistances des sujets en situation d'évaluation plutôt qu'aux limites de la méthode elle-même. Une telle attitude comporte des enjeux éthiques qui feront l'objet de la discussion. En conclusion, les auteurs font état d'une alternative à la CF pour des individus encore plus handicapés au niveau de la communication.

Pour dissiper quelques confusions

Éditorial en réponse à un article d'Andrée Quiviger.

Vaccin RRO et autisme : la désinformation à l'œuvre

L'objectif de ce texte est de faire le point sur la controverse soulevée par Wakefield et ses collaborateurs concernant l'effet du vaccin RRO à titre de déclencheur éventuel d'une forme d'autisme. Après avoir présenté les travaux de Wakefield et al., les auteurs montrent que les recherches effectuées dans plusieurs pays mettent en évidence que l'hypothèse du lien entre le vaccin RRO et l'autisme n'est nullement fondée. La présentation de l'ensemble des résultats débouche sur une discussion comprenant trois volets: la nature de l'augmentation du nombre de cas d'autisme au cours des dernières années, la méthodologie utilisée pour vérifier l'hypothèse du lien vaccin RRO et autisme et les enjeux éthiques d'une telle controverse.

Programme Prevent-Teach-Reinforce : une intervention comportementale pour diminuer les comportements problématiques en milieu scolaire

Cet article a pour but de décrire le programme d’intervention Prevent-Teach-Reinforce (PTR; Dunlap et al., 2010) en mettant l’accent sur les théories béhaviorales sous-jacentes qui ont servi à son développement. Le PTR est un programme visant la diminution des comportements problématiques chez les enfants et les adolescents en milieu scolaire qui est basé sur l’évaluation fonctionnelle pour développer une intervention individualisée et intensive. Nous effectuons une analyse critique afin de proposer un protocole de validation scientifique puisque le programme n’a fait l’objet que d’une seule évaluation randomisée. Les implications pour la pratique clinique sont aussi discutées en mettant l’accent sur le rôle du psychologue dans l’implantation de ce programme.

Do Too Many Chefs Really Spoil the Broth? The European Commission, Bureaucratic Politics and European Integration, CES Germany & Europe Working Papers, No. 09.2, 5 August 1999

There is a puzzling, little-remarked contradiction in scholarly views of the European Commission. On the one hand, the Commission is seen as the maestro of European integration, gently but persistently guiding both governments and firms toward Brussels. On the other hand, the Commission is portrayed as a headless bunch of bickering fiefdoms who can hardly be bothered by anything but their own in­ ternecine turf wars. The reason these very different views of the same institution have so seldom come into conflict is quite apparent: EU studies has a set of relatively autonomous and poorly integrated sub­ fields that work at different levels of analysis. Those scholars holding the "heroic" view of the Com­ mission are generally focused on the contest between national and supranational levels that character­ ized the 1992 program and subsequent major steps toward European integration. By contrast, those scholars with the "bureaucratic politics" view are generally authors of case studies or legislative his­ tories of individual EU directives or decisions. However, the fact that these twO images of the Commis­ sion are often two ships passing in the night hardly implies that there is no dispute. Clearly both views cannot be right; but then, how can we explain the significant support each enjoys from the empirical record? The CommiSSion, perhaps the single most important supranational body in the world, certainly deserves better than the schizophrenic interpretation the EU studies community has given it. In this paper, I aim to make a contribution toward the unraveling of this paradox. In brief, the argument I make is as follows: the European Commission can be effective in pursuit of its broad integration goals in spite of, and even because of, its internal divisions. The folk wisdom that too many chefs spoil the broth may often be true, but it need not always be so. The paper is organized as follows. 1 begin with an elaboration of the theoretical position briefly out­ lined above. 1 then tum to a case study from the major Commission efforts to restructure the computer industry in the context of its 1992 program. The computer sector does not merely provide interesting, random illustrations of the hypothesis 1 have advanced. Rather, as Wayne Sandholtz and John Zysman have stressed, the Commission's efforts on informatics formed one of the most crucial parts of the en­ tire 1992 program, and so the Commission's success in "Europeanizing" these issues had significant ripple effects across the entire European political economy. I conclude with some thoughts on the fol­ lowing question: now that the Commission has succeeded in bringing the world to its doorstep, does its bureaucratic division still serve a useful purpose?

The Path to European Integration: A Historical Institutionalist Perspective, CES Germany & Europe Working Papers, No. 05.2, 25 October 1994

Many European and American observers of the EC have criticized "intergovemmentalist" ac­ counts for exaggerating the extent of member state control over the process of European integra­ tion. This essay seeks to ground these criticisms in a "historical institutionalist" account that stresses the need to study European integration as a political process which unfolds over time. Such a perspective highlights the limits of member-state control over long-term institutional de­ velopment, due to preoccupation with shorHerm concerns, the ubiquity of unintended conse­ quences, and processes that "lock in" past decusions and make reassertions of member-state control difficult. Brief examination of the evolution of social policy in the EC suggests the limita­ tions of treating the EC as an international regime facilitating collective action among essentially sovereign states. It is ore useful to view integration as a "path-dependent" process that has pro­ duced a fragmented but still discernible "multitiered" European polity.

The Politics of Retrospective Justice in Germany & the Czech Republic. CES Germany & Europe Working Papers, No. 05.4, 1994

Ongoing German and Czech efforts to confront legacies of injustice in their recent pasts provides opportunity to examine policies of retrospective justice adopted from where there is no threat of old elites with residual power. Instead of evoking existing explanations of these measures that concentrate on normative issues, the role of former dissidents, or mode of transition, this account focuses on the importance of the character and structure of the political representation in post-Communist regimes in general, and in the German and Czech successor regimes in particular.

A House Divided: Employers & the Challenge to Pattern Bargaining in a United Germany. CES Germany & Europe Working Papers, No. 05.5, 1994

Recently, increasing numbers of new German firms have begun to break from tradition and refuse to join employers' associations. Simultaneously, an unprecedented portion of affiliates have begun to reconsider employers' association membership. The spectre of declining membership in German employers' associations-century-old pillars of organized capitalism-is particularly noteworthy because of the importance of these institutions to the German economy as a whole. Some observers have attributed this trend to the impact of German unification, yet a careful analysis reveals that its principal causes arose in the decade preceding it. The economic strain of unification, however, has accelerated "association flight'' and has provided dissidents with an unprecedented opportunity to challenge the hegemony of employers' associations over the regulation of wages and working conditions in the Federal Republic.

The Fall of the East German Birth Rate After Unification: Crisis or Means of Adaptation? CES Germany & Europe Working Papers, No. 05.6, 26 June 1995

Since the fall of the Wall, Eastern Germans have drastically changed their demographic behavior. Marriages and births have dropped to an unprecedented low level. Our paper tracks birth rates of the East German population, past, present, and future. We propose a simulation model of future cohort fertility. The hypotheses we develop build on the historical record of reproductive behavior in the German Democratic Republic (GDR) since 1960 and on an analysis of the pattern of change between 1990 and 1994. The particular emphasis lies in the assumption that East German couples will rapidly westernize their family size by trying to reach completed fertility levels of the corresponding West German cohort. This implies that the resulting adaptation process includes the postunification crisis as a logical first step.