Personality Disorders in Adolescence: Label or Opportunity?

The articles in this special issue testify to the rapidly growing body of research concerning the assessment and treatment of personality disorders (PDs) in adolescence. In this commentary, we will first attempt to summarize what we consider to be the overall take‐home messages of the articles in this issue in the context of current limitations in our knowledge of PDs in adolescence. Further, we comment on the gap between science and practice in this field, stressing the importance of diagnosing PDs in adolescence. We close with some thoughts and recommendations concerning the future of research on PDs in adolescence.     

Don't Mourn: Organize. Reviving Mental Health Services Research for Healthcare Quality Improvement

The structure, organization, management, and design of the mental health system are changing profoundly as new healthcare policies reshape its configurations. This special issue is a call to action for the mental health services research field. The articles represent an important attempt to identify specific concepts, constructs, and findings from psychosocial treatment research about fidelity and integrity of treatment and align them with healthcare quality. However, the current structure and processes for deriving quality indicators place other demands on the extant research base. These will challenge this migration unless changes are made in leadership around consistent measurement strategies, payment mechanisms to support quality, and attention to technological infrastructure development. The mental health services research field should be proactive. Pediatric issues need special attention, especially as applied to community‐based services for children and their families.     

Issues in Understanding and Treating Comorbidity in People With Serious Mental Illness

Medical and substance abuse comorbidity are highly prevalent and significant problems among people with serious mental illness. This article provides commentary on several articles in this special issue, and highlights some important issues involved in understanding the impact of dual disorders and in treatment needs. Data are presented that illustrate the ability of people with serious mental illness to provide reliable and valid information about their substance use and attitudes about their motivation and willingness to change. Questions are raised about the impact of motivation enhancement interventions, and the need for extrinsic motivation for change versus extrinsic motivation and environmental supports.     

Adherence and Flexibility: They Can (and Do) Coexist!

[Clin Psychol Sci Prac 17: 258–264, 2010] Using their experiences disseminating the Triple P parenting program, Mazzucchelli and Sanders (2010) make a strong case for how flexibility enhances provider satisfaction, critical thinking about intervention delivery, and most importantly, adherence and fidelity. Their article makes an outstanding and innovative contribution to the literature on implementation research, advancing the field to a view of flexibility as a feature that may facilitate adherence. In this commentary, we place Mazzucchelli and Sanders’s work within the context of ongoing implementation research. We also call for embedding questions about implementation science into effectiveness trials to better inform dissemination efforts aimed at facilitating provider adoption and adherence to empirically supported treatments.     

Implementation science approaches for integrating eHealth research into practice and policy

PurposeTo summarize key issues in the eHealth field from an implementation science perspective and to highlight illustrative processes, examples and key directions to help more rapidly integrate research, policy and practice.MethodsWe present background on implementation science models and emerging principles; discuss implications for eHealth research; provide examples of practical designs, measures and exemplar studies that address key implementation science issues; and make recommendations for ways to more rapidly develop and test eHealth interventions as well as future research, policy and practice.ResultsThe pace of eHealth research has generally not kept up with technological advances, and many of our designs, methods and funding mechanisms are incapable of providing the types of rapid and relevant information needed. Although there has been substantial eHealth research conducted with positive short-term results, several key implementation and dissemination issues such as representativeness, cost, unintended consequences, impact on health inequities, and sustainability have not been addressed or reported. Examples of studies in several of these areas are summarized to demonstrate this is possible.ConclusionseHealth research that is intended to translate into policy and practice should be more contextual, report more on setting factors, employ more responsive and pragmatic designs and report results more transparently on issues important to potential adopting patients, clinicians and organizational decision makers. We outline an alternative development and assessment model, summarize implementation science findings that can help focus attention, and call for different types of more rapid and relevant research and funding mechanisms.     

Epigenetic perspectives on development: Evolving insights on the origins of variation

The articles in this special section of Developmental Psychobiology explore topics discussed at the 24th Annual Winter Conference on Current Issues in Developmental Psychobiology held in January 2009 in St. Croix. The final session of the meeting: “Epigenetics and Behavioral Development Within and Across Generations” included discussion of several emerging issues relevant to the study of individual differences, parental influences on development, and the stability versus plasticity of the underlying mechanisms involved in behavioral variation. The contributions to this special section highlight the importance of the epigenetic regulation of gene expression to the field of developmental psychobiology and the critical role of these molecular mechanisms in mediating the interplay between genes and the environment. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: e1–e3, 2010.     

The Quest for Tailored Treatments: A Meta‐Discussion of Six Social Cognitive Therapies

In this commentary on the 6 articles comprising this In Session issue on metacognition and mentalizing in the psychotherapeutic treatment of severe mental disorders, we strive to contextualize and bring together salient issues reflected in these articles. In the foreground of our discussion is the point that the commonalities of these and related social cognitive treatments far outweigh their differences. We attempt to pinpoint some of the more specific tailored treatment elements described by the authors and relate these to empirical findings and theoretical and practical problems. Among the key issues addressed in this commentary are conceptual fallacies, therapist transparency, personality disorder and self‐harm in adolescence, therapeutic alliance, and a metacognitive‐informed group psychotherapy practice for patients with avoidant personality disorder or alexithymia.     

Child Neuropsychology: An Introduction to Theory,Research and Practice (Book)

Provides a critical commentary on the state-of-the-art of research on information-processing (I-P) factors in clinical child and adolescent psychology. The articles in this special section amply demonstrate the value of the I-P paradigm as a heuristic framework for conceptualizing and studying the role(s) of cognitive factors in the etiology and maintenance of child and adolescent psychopathology. However, the current status of such research also reflects a number of limitations that warrant consideration if the potential value of the I-P paradigm is to be fully realized. Specifically, understanding the role(s) played by such factors is impeded by a variety of insufficiently addressed methodological and psychometric issues, as well as by insufficiently articulated theories regarding such factors. These issues are particularly challenging for child and adolescent psychopathology researchers because of the complexities added by development. The value of I-P theories of childhood and adolescent psychopathology will be considerably enhanced if these issues are more fully considered in future research.     

Custody Data as Decision-Theory Information: Evaluating a Psychological Contribution by Its Value to a Decision Maker

Many issues raised by O'Oonohue and Bradley (this issue) are epistemologic in nature, challenging what we can understand and predict in the child custody area, both currently and in the future. Our commentary presents a four-tiered model that can be used to assess the degree to which a contribution to the field can be considered scientific. Proof is offered that data exist which conform to this model. The advantages of seeing psychology as a decision science are given. The main criteria of a decision science are detailed, along with the implications of these criteria for custody-relevant research. Validity studies are considered from the perspective of "value to a decision maker" (with an emphasis on relevance) rather than from the sole perspective of the point in time when such studies are conducted. Several areas often confused by commentators in the custody field are specified. These include confusing reliability and validity issues with the issue of the environments in which the predictions of a model are applicable, the misguided assumption that a concept cannot be validated and useful until its definition finds universal acceptance, and the important implications for validity studies in separating methods for recommending a legal custodian from those used to suggest a time-share plan. Next, the role of values in all sciences is considered, and the (negative) implications in assuming that values can be separated from so-called "facts." Finally, the recommendation for a moratorium on practice advocated by O'Donohue and Bradley is considered from epistemological, ethical, and practical perspectives.     

Recent advances in psychosocial oncology

The April 2005 issue of Journal of Consulting and Clinical Psychology presents 5 articles that address the cancer experience. In this commentary, Vicki S. Helgeson examines how the authors of these articles advance the field in important ways, in particular by using theory-based research, identifying mechanisms of change, identifying moderators of treatment effectiveness, incorporating partners in studies, moving beyond self-report measures of distress, using longer term follow-ups, extending studies to more diverse samples, focusing on sexuality, and using longitudinal designs. Helgeson concludes by identifying several challenges that researchers in this area face and by highlighting future avenues for research.     

Advances in the use of dendritic cells and new adjuvants for the development of therapeutic vaccines

The recent advances in immunology and biotechnology have opened new perspectives for the development of immunotherapy strategies against cancer and infectious diseases. The understanding of the pivotal role of dendritic cells in the initiation and regulation of the immune response has led to an ensemble of preclinical studies and pilot clinical trials, which have provided some evidence on the potential advantages of using dendritic cells as cellular adjuvants for the development of therapeutic vaccines against infectious diseases and malignancies. Current research efforts are focused on the definition of optimal protocols for dendritic cell-based therapies in patients. An additional area of emerging importance in the field of immunotherapy is the identification of safe, selective, and more powerful adjuvants, capable not only of enhancing immune protection against pathogens, but also of breaking tolerance against certain tumor-associated antigens, which is the critical issue for the development of cancer vaccines. The recent recognition of the key role of certain cytokines, such as type I interferons, in linking the innate and adaptive immunity through their action on dendritic cells opens new perspectives for using these natural factors as adjuvants for the development of therapeutic vaccines. We review some of the emerging research aspects in immunotherapy, with special attention to the perspectives of using new adjuvants and dendritic cell-based vaccines for the treatment of cancer and infectious diseases.     

Promise of Interventions and Services Research: Can It Transform Practice?

This special issue grapples with how best to use science to encourage the use of evidence-based practices. We use this commentary to respond to this broad theme. We emphasize that (a) concerns about gaps between the promise of science and implementation are not unique to mental health, but mental health conditions should be included in national efforts to address the overall quality gap; (b) advances are needed in implementing evidence-based psychotherapy and in creating efficiencies in therapy protocols across multiple disorders; (c) research as well as practice should become more responsive to the values of clients and communities; and (d) leadership is needed across these areas to transform science advances into practice solutions.     

Introduction to the special issue on spirituality and psychotherapy

Religion and spirituality have been topics of interest to psychologists since the inception of the field, and this special issue devoted to spirituality and psychotherapy reflects the maturation of decades of research. Psychotherapy clients would like to discuss religious or spiritual issues with therapists, but therapists feel poorly prepared to do so. This special issue hopefully represents a step towards bridging the needs of clients and the expertise of providers. The seven articles in this issue reflect the progress psychologists have made toward understanding religion and spirituality, and they represent state-of-the-art attempts at integrating these dimensions into treatment.     

The role of organizational behavior in occupational health psychology: a view as we approach the millennium

This special section of the Journal of Occupational Health Psychology provides ample illustration of the increasingly important role of organizational behavior research on work-related issues of health and well-being. More specifically, the 9 articles contained in this special section highlight the varied application and potentially widespread benefit of considering the main effects of employee physical health and psychological well-being. The authors conclude with a discussion of how emerging research issues in occupational health psychology can be used to build a stronger science of organizational behavior.     

A Tale of Two Paradigms

The articles in this special issue of Clinical Psychology: Science and Practice address topics that may improve the flow of knowledge from research to clinical practice settings. In this commentary, these topics are viewed from the perspective of an efficacy researcher. Progress in the treatment for mental disorders depends on the bidirectional flow of knowledge between researchers and practitioners. Evidence-based practice is possible for most mental disorders (i.e., schizophrenia, bipolar affective disorder, major depressive disorder, the full range of anxiety disorders, and alcoholism and the other chemical dependence disorders), yet there is strong evidence that many (if not most) sufferers do not receive treatments that are known to be effective. Therefore, there is at least a partial disconnect between the processes that result in discovery and confirmation of novel therapeutics and implementation of new approaches to treatment in day-to-day practice settings.     

Integrative commentary: Implications of blunted reactivity

The previous issue of the International Journal of Psychophysiology was a special issue that collected some of the latest emerging evidence on blunted reactivity and its relationships with a variety of negative health outcomes. This commentary on the special issue briefly reviews each of the contributions and then provides some thoughts on the general themes that run through these papers. The findings from the special issue suggest that both lower and higher than expected cardiovascular and neuroendocrine responses to active psychological challenges may be maladaptive and differentially associated with adverse health sequelae.     

Teacher-student relationships and school adjustment: progress and remaining challenges

This commentary highlights the ways in which the articles in this special issue contribute to the second generation of research on teacher-student relationships. Second generation research aims to increase our understanding of the development of these relationships, and the processes responsible for their effects, as well as to evaluate theoretically-informed interventions designed to enhance teacher-student interactions. Despite unanswered questions and challenges that confront this field of inquiry, the current state of knowledge is adequate to apply the knowledge gained to the task of increasing teachers' abilities to provide positive social and emotional learning environments, thereby improving students' learning and behavioral adjustment.