BackgroundPostpartum depression (PPD)—the most common complication of childbirth—is a significant and prevalent public health problem that severely disrupts family interactions and can result in serious lasting consequences to the health of women and the healthy development of infants. These consequences increase in severity when left untreated; most women with PPD do not obtain help due to a range of logistical and attitudinal barriers.ObjectiveThis pilot study was designed to test the feasibility, acceptability, and potential efficacy of an innovative and interactive guided Web-based intervention for postpartum depression, MomMoodBooster (MMB).MethodsA sample of 53 women who satisfied eligibility criteria (<9 months postpartum, ≥18 years of age, home Internet access and use of personal email, Edinburgh Postnatal Depression Survey score of 12-20 or Patient Health Questionnaire score from 10-19) were invited to use the MMB program. Assessments occurred at screening/pretest, posttest (3 months following enrollment), and at 6 months follow-up.ResultsAll six sessions of the program were completed by 87% (46/53) of participants. Participants were engaged with the program: visit days (mean 15.2, SD 8.7), number of visits (mean 20.1, SD 12.2), total duration of visits in hours (mean 5.1, SD 1.3), and number of sessions viewed out of six (mean 5.6, SD 1.3) all support high usage. Posttest data were collected from 89% of participants (47/53) and 6-month follow-up data were collected from 87% of participants (46/53). At pretest, 55% (29/53) of participants met PHQ-9 criteria for minor or major depression. At posttest, 90% (26/29) no longer met criteria.ConclusionsThese findings support the expanded use and additional testing of the MMB program, including its implementation in a range of clinical and public health settings.Trial RegistrationClinicaltrials.gov NCT00942721; http://clinicaltrials.gov/ct2/show/NCT00942721 (Archived by WebCite at http://www.webcitation.org/6KjYDvYkQ).
The Levenson, Kiehl, and Fitzpatrick (1995) Self-Report Psychopathy Scale (LSRP) was introduced in the mid-1990s as a brief measure of psychopathy and has since gained considerable popularity. Despite its attractiveness as a brief psychopathy tool, the LSRP has received limited research regarding its factor structure and convergent and discriminant validity. The present study examined the construct validity of the LSRP, testing both its factor structure and the convergent and discriminant validity. Using a community sample of 1,257 undergraduates (869 females; 378 males), we tested whether a 1-, 2-, or 3-factor model best fit the data and examined the links between the resultant factor structures and external correlates. Confirmatory factor analysis (CFA) findings revealed a 3-factor model best matched the data, followed by an adequate-fitting original 2-factor model. Next, comparisons were made regarding the convergent and discriminant validity of the competing 2- and 3-factor models. Findings showed the LSRP traditional primary and secondary factors had meaningful relations with extratest variables such as neuroticism, stress tolerance, and lack of empathy. The 3-factor model showed particular problems with the Callousness scale. These findings underscore the importance of examining not only CFA fit statistics but also convergent and discriminant validity when testing factor structure models. The current findings suggest that the 2-factor model might still be the best way to interpret the LSRP.
BackgroundPostpartum depression is a significant public health problem affecting approximately 13% of women. There is strong evidence supporting Cognitive Behavioral Therapy (CBT) for successful psychosocial treatment. This treatment model combines cognitive and behavioral strategies to address pessimism, attributions for failure, low self-esteem, low engagement in pleasant activities, social withdrawal, anxiety, and low social support. Encouraging results have been reported for using Web-based CBT interventions for mental health domains, including the treatment of panic disorder, post-traumatic stress disorder, and complicated grief and depression. To date, however, Web-based interventions have not been used and evaluated specifically for the treatment of postpartum depression.ObjectiveWe describe the formative work that contributed to the development of our Web-based intervention for helping to ameliorate symptoms of postpartum depression, and the design and key components of the program.MethodsA total of 17 focus group participants and 22 usability testers, who shared key characteristics with the participants of our planned feasibility study, took part.The proposed structure and ingredients of the program and mock-ups of selected webpages were presented to focus group participants. At various points, participants were asked a series of thought questions designed to elicit opinions and set the occasion for group discussion. At the end of the session, participants were asked to describe their overall reaction to the proposed features of the program emphasizing candid opinions about what they did not like and features they thought were missing and should be added.Usability testers were asked to interact with a series of seven different Web-based interactions planned for the program while receiving minimal direction. Each tester was asked to describe her thoughts using a think-aloud technique. They were then asked to consider all that they had learned about the program and complete the System Usability Scale that we adapted slightly to be appropriate for evaluating the proposed website.Transcripts from the focus groups and usability tests were reviewed by research team members for overarching themes with particular emphasis on suggested changes. A list emerged, and iterative and incremental adjustments were made as a result.ResultsThe qualitative and quantitative data gathered in the focus groups and usability sessions reported here suggest that the new mothers involved had largely positive reactions to the major features of the program and that those program features performed well in terms of usability.ConclusionsAn overview of the eventual design, architecture, and key program ingredients of the MomMoodBooster program is provided including innovative features supplementing 6 core CBT sessions, which include a partner’s website, a library, and individual feedback by a personal coach.
This review paper discusses the construct of child and adolescent psychopathy and outlines controversy about the topic as well as some of the reasons that it might be developmentally appropriate. Past research has suggested that child psychopathy may be inapplicable to youth because the symptoms cannot be reliably distinguished from features of normative adolescent development. Concerns have also been raised regarding the possibility that the syndrome does not closely resemble the adult construct of psychopathy. We conclude that there is some truth to both sides of this story. Research shows that child psychopathy has a considerable degree of reliability and construct validity; however, there are also some important developmental differences. Furthermore, emerging evidence indicates potential changes in psychopathic symptoms over time and the important role of protective factors. Although, current research suggests that the concept of child psychopathy may be like an impressionist painting (i.e., clearer from a distance but messier as one gets closer), we argue this is not necessarily problematic from a developmental perspective. However, we conclude that a rigorous set of research studies will be needed to further advance our understanding of child psychopathy and the way it manifests itself over time.
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