Journal Article Critique Paper (BSHS/435)

Complete the University of Phoenix Material: Journal Article Critique Paper.This is a group assignment and only my part needs to be completed in at least 235 words. My part is under Team member KeraEvaluation on the Methodology: TEAM MEMBER _ Kera________Comment on the sample size, sampling method, measures/data collection instrument and method usedThe article needed to complete the assignment is attached below


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Journal Article Critique Paper
BSHS/435 Version 1
This assignment is due SUNDAY April 15 @ 11:59 pm
Everyone needs to have their part in my FRIDAY noon.
This submission deadline will allow enough time for compiling, proofing
and any editing that is required before running through the plagiarism
Each person response must be a MINIMUM of 175 words
Journal Article Critique Paper
Read the following articles, available on your student website:
“A Nurse’s Guide to the Critical Reading of Research “
“Step-by-Step Guide to Critiquing Research, Part 1: Quantitative Research”
Select a peer-reviewed journal article about a quantitative research study related to human
services management that is also related to the Research Proposal topic selected by your
Learning Team. Make sure the article includes information on statistics.
Article Suggestions
1. Protocol investigating the clinical outcomes and cost-effectiveness of cognitivebehavioural therapy delivered remotely for unscheduled care users with health
anxiety: randomised controlled trial. (Jennifer, Kera_________________)
2. The People with Asperger syndrome and anxiety disorders (PAsSA) trial: a pilot
multicentre, single-blind randomised trial of group cognitive–behavioural therapy
(Jackie, Michael, _____________________)
Please submit your article selection and link to the article by Tuesday at 11:59 pm (pst)
in the discussion post titled Article Suggestions, the article with the most support by
team members will be used for this assignment.
3. Susan Suggested : Group cognitive behaviour therapy for adults with Asperger
syndrome and anxiety or mood disorder a case series – The article was attached
to a post titled ARTICLES.
Suggestions for the article
Write a 1,050- to 1,400- word paper critiquing your chosen journal article.
Include the following information in your summary and critique of the journal article:
A brief summary of what the research is about TEAM MEMBER _SUSAN E OLSON
Journal Article Critique Paper
BSHS/435 Version 1
Evaluate the Introduction/Literature Review. TEAM MEMBER JACQUELINE VASQUEZ__
Evaluation on the Methodology: TEAM MEMBER _ KERA________
Is the design appropriate to address the research question?
Were the independent variable(s) and dependent variable(s) clearly identified?
Identify the independent variable(s) and dependent variable(s).
Evaluation of Descriptive Statistics: TEAM MEMBER MICHAEL________
Comment on the sample size, sampling method, measures/data collection instrument
and method used
Evaluation of the Research Design: TEAM MEMBER JENNIFER________________
Comment on the statement of the research problem, question or hypothesis;
organization, flow and content of the literature review; and rationale or importance of the
Identify and discuss the descriptive statistics used to describe the data.
Do you think the methods used to describe the data are appropriate and sufficient?
Provide reasons for your response?
Evaluation of Discussion/Conclusion: TEAM MEMBER_SUSAN E OLSON_
I will do this extra section, but I am requesting that each team member make some side notes
regarding the answers to these questions when they are writing there section PLEASE
Are there any limitations identified in the article? If so, discuss how they were addressed.
Are the any ethical issues identified in the article? If so, discuss how they were
Format your paper consistent with APA guidelines; including a title page and a reference page
(No abstract is necessary).
Clinical Psychology and Psychotherapy
Clin. Psychol. Psychother. 17, 438–446 (2010)
Published online 25 May 2010 in Wiley Online Library ( DOI: 10.1002/cpp.694
Practitioner Group Cognitive
Behaviour Therapy for
Adults with Asperger
Syndrome and Anxiety
or Mood Disorder:
A Case Series
Jonathan A. Weiss1* and Yona Lunsky2
Department of Psychology, York University, Toronto, Ontario, Canada
Dual Diagnosis Program Centre for Addiction and Mental Health, Toronto,
Ontario, Canada
Individuals with Asperger syndrome are at increased risk for mental
health problems compared with the general population, especially
with regard to mood and anxiety disorders. Generic mental health
services are often ill-equipped to offer psychotherapeutic treatments
to this population, and specialized supports are difficult to find. This
case series used a manualized cognitive behaviour therapy group
programme (Mind Over Mood) with three adults diagnosed with
Asperger syndrome, who were each unable to access psychotherapy
through mainstream mental health services. This review highlights
the benefits of a cognitive behaviour therapy (CBT) group approach
for adults with Asperger syndrome and suggests some potential
modifications to traditional CBT provision. Copyright © 2010 John
Wiley & Sons, Ltd.
Key Practitioner Message:
• As a group, adults with Asperger syndrome are at high risk for
anxiety disorders and depression.
• Cognitive behaviour therapy can be adapted to help adults with
Asperger syndrome cope with anxiety or depression.
• Group cognitive behaviour therapy for adults with Asperger syndrome may hold a number of advantages to individual therapy.
Keywords: Group Psychotherapy, Asperger Syndrome, Cognitive
Behaviour Therapy, Anxiety Disorders, Mood Disorders, Autism
* Correspondence to: Jonathan A. Weiss, Department of Psychology, York University, Behavioural Science Building, 4700
Keele Street, Toronto, Ontario M3J 1P3, Canada.
Copyright © 2010 John Wiley & Sons, Ltd.
Group Cognitive Behaviour Therapy for Adults
The rate of mood and anxiety problems is
significantly higher in children (Kim, Szatmari,
Bryson, Streiner, & Wilson, 2000; Meyer, Mundy,
Vaughan Van Hecke, & Durocher, 2006), adolescents (Barnhill, 2001; Farrugia & Hudson, 2006;
Shtayermman, 2007) and adults (Ghaziuddin,
Weidmer-Mikhail & Ghaziuddin, 1998) with
Asperger syndrome (AS) or high-functioning
autism (HFA) compared with the general population or with matched comparison groups. Depression may be the most common psychiatric disorder
found in people with autism (Ghaziuddin, Tsai, &
Ghaziuddin, 1992; Tantam, 1988), and there has
been some suggestion that higher functioning individuals may be particularly affected (Ghaziuddin,
2005; Wing, 1981).
Few psychotherapy treatment studies for mood
and anxiety disorders in people with AS and
HFA have been published. Most studies that have
looked at non-medical treatments for people with
AS or HFA have been designed to address associated symptoms of autism, such as impaired social
skills, theory of mind or understanding of emotions
(e.g., Solomon, Goodlin-Jones, & Anders, 2004), but
have not focused on comorbid affective disorders.
To date, two randomized controlled trials (RCTs)
for the treatment of anxiety in individuals with
AS exist, which have shown some effectiveness
for children with AS or HFA and anxiety, compared with a wait-list control (Sofronoff, Attwood,
& Hinton, 2005; Wood et al., 2009). Although case
studies suggest that cognitive behaviour therapy
(CBT) can also benefit adults with AS (Cardaciotto
& Herbert, 2004; Hare, 1997), no controlled investigations exist. As well, no RCT studies exist examining the effect of CBT for depression, which arguably
is most needed given the high rate of mood problems in this population. Authors have called for
more research on how to adapt CBT models to best
meet the needs of individuals with AS (Anderson
Table 1.
& Morris, 2006). The purpose of this case series is
to describe the use of a published and empirically
supported manualized CBT treatment for mood
and anxiety disorders, Mind Over Mood (Greenberger & Padesky, 1995), with adults with AS.
Participants were referred by community service
agencies for individuals with autism spectrum disorders or through self-referral upon viewing online
postings about the group on AS Websites. After a
brief telephone screening, participants met with a
researcher, and the study was explained in detail.
All questions were answered prior to obtaining
signed informed consent. Three adults with AS
participated in the intervention and are presented
here as a case series, out of six who were screened.
One individual who was screened chose not to participate as a result of a scheduling conflict, and two
others were deemed inappropriate due to either
substance dependence or psychotic symptoms,
both exclusionary criteria for the project.
Participant information from the screening
session is displayed in Table 1. All participants
had clinically significant symptoms of depression and anxiety, met the Diagnostic and Statistical Manual of Mental Disorders-IV Text Revision
(DSM-IV-TR) criteria for Major Depressive Disorder (as well as Anxiety Disorders), had a diagnosis of AS by a psychologist or physician, and had
clinically significant AS symptoms as reflected in
the Adult Asperger Assessment (AAA), described
below (Baron-Cohen, Wheelwright, Robinson, &
Woodbury-Smith, 2005).
The inclusion criteria included:
1. A diagnosis of AS by a physician or psychologist, as well as meeting the criteria for Asperger
syndrome using the AAA (Baron-Cohen et al.,
Participant information at screening (pre-intervention)
SCID diagnoses
Major Depression
PTSD, Major Depression
Panic with Agoraphobia,
Major Depression
AAA score
BDI-II = Beck Depression Inventory-II. BAI = Beck Anxiety Inventory. SCID = Structured Clinical Interview of the Diagnostic and
Statistical Manual of Mental Disorders-IV Text Revision. AAA = Adult Asperger Syndrome. WASI = Weschler Abbreviated Scales
of Intelligence. PTSD = post-traumatic stress disorder.
Copyright © 2010 John Wiley & Sons, Ltd.
Clin. Psychol. Psychother. 17, 438–446 (2010)
DOI: 10.1002/cpp
J. A. Weiss and Y. Lunsky
2005). The AAA is designed to identify HFA
and AS in adults based on self-report and has
good specificity and sensitivity.
Aged 18–60 years.
IQ greater than 85, as assessed by the
Vocabulary and Matrix Reasoning subtests
of the Weschler Abbreviated Scales of Intelligence (The Psychological Corporation, 1999),
designed for individuals 6–89 years of age. It
takes approximately 30 minutes to administer
and yields verbal IQ, performance IQ and fullscale IQ estimates.
A DSM-IV-TR diagnosis of at least one anxiety
disorder or of major depressive disorder, using
the Structured Clinical Interview of DSM-IVTR Axis I Disorders, Research Version, Patient
Edition (SCID-I/P; First, Spitzer, Gibbon, &
Williams, 2002). The SCID-I/P is a published
semi-structured clinical interview designed to
assess the presence of major DSM-IV-TR disorders. Psychometric studies consistently yield
good reliability and validity statistics (First
et al., 2002).
Clinically significant symptoms of anxiety
as measured by the Beck Anxiety Inventory
(BAI; Beck & Steer, 1990) or of depression as
measured by the Beck Depression Inventory-II
(BDI-II; Beck, Steer, & Brown, 1996). The BAI
is a 21-item self-report questionnaire that lists
symptoms of anxiety. The respondent is asked
to rate how much each symptom has bothered
him/her in the past week. The symptoms are
rated on a four-point scale, ranging from 0 (not
at all) to 3 (severely). The instrument has excellent internal consistency and high test–retest
reliability (Beck & Steer, 1990). The BDI-II is
a 21-item self-report instrument that assesses
whether an individual is exhibiting symptoms
of major depression according to the criteria
outlined in the DSM-IV (American Psychiatric
Association, 1994). It has been shown to have
very high internal consistency scores and has
been well validated (Beck et al., 1996). The BAI
and BDI-II were given to participants pre-intervention, prior to each session, and at 8-week
Desire to participate in group therapy as
reflected in the Suitability for Short-Term
Cognitive Therapy interview (SSTC; Safran,
Segal, Shaw, & Vallis, 1990; Safran, Segal, Vallis,
Shaw, & Samstag, 1993). The SSTC has been
shown to have good reliability, and construct
and predictive validity (Safran et al., 1993).
Although the three participants demonstrated
Copyright © 2010 John Wiley & Sons, Ltd.
difficulties with differentiation of emotions,
acceptance of personal responsibility for
change and alliance potential, they were all
open to group treatment and showed a willingness to abide by group rules.
CBT Intervention
The CBT intervention was provided over 12
weekly 1-hour sessions, based on the structure
and information provided in the Mind Over
Mood workbook (Greenberger & Padesky, 1995)
and Mind Over Mood Clinician’s Guide (Padesky
& Greenberger, 1995). Each participant purchased
a copy of the book and was assigned homework
that included reading and completing a specific
chapter after each session. Each session consisted
of the same structure: Setting the Agenda, Checkin, Homework Review, New Content, Assigning
Homework and Feedback. Table 2 outlines the
general topics covered in each session, as well as
some relevant notes for each participant.
Case Studies
Frank, a single man in his mid-50s, was unemployed and lived alone. He excelled in academics,
obtained a doctoral degree and had worked in academia prior to being unemployed. He had two brief
psychiatric hospitalizations as a result of anger and
disruptive behaviours. Frank had received a diagnosis of AS in his mid-40s. Frank met criteria for
Major Depressive Disorder based on the SCID-I/P
and described his mood at screening as ‘totally
numb’ during his periods of depression. He felt
like crying would help, but was not capable of
crying easily. He felt like an ‘unperson, radically
marginalized’ and ‘blue’. He showed chronic poor
self-image and feelings of worthlessness.
Frank successfully participated in the group treatment, attending all of the sessions and completing
the assigned homework every week. As shown in
Figure 1, Frank’s scores on the BDI-II did not show
a linear reduction from the screening session, as
we had originally hoped. In contrast, there was an
increase from the first to the fifth session, which
we attribute to Frank’s increased awareness and
ability to consistently rate his mood and, specifically, his symptoms of depression. At first, Frank’s
‘hot thoughts’ would elicit only feelings of anger
towards himself (not measured on the BDI), even
though the content was typically associated with
Clin. Psychol. Psychother. 17, 438–446 (2010)
DOI: 10.1002/cpp
Copyright © 2010 John Wiley & Sons, Ltd.
Clin. Psychol. Psychother. 17, 438–446 (2010)
DOI: 10.1002/cpp
CBT = cognitive behaviour therapy.
Week 12: Termination
and feedback
Developed balanced throughts
with help from others.
Liked discussing the ‘five
aspects of life experience’
(i.e., cognitive, behavioural,
affective, physiological,
Became more comfortable with
group but not enough to
disclose own difficulities.
Related situations to her
emotional experience.
Enjoyed the discussion and
talking with others about
Appreciated the concrete
nature of the thought record
and decided to develop a
computerized version for
Learned ‘how to go deeper’
into thought records.
Enjoyed learning that she
was not the only one with
specific problems. Was able
to find alternative evidence.
Enjoyed linking hot thoughts to evidence.
Realized that the way he believes others may
see him is subjective and ‘has to do with the
way I think of myself’. Developing balanced
thoughts were difficult: ‘The next panic
attack I have will not be as bad as they have
been and will not lead to a heart attack.’
Enjoyed getting help from others to find
evidence against his hot thought and
eliciting strengths. Struggled sharing thought
record to group (emotionally draining) but
enjoyed and hated it at the same time.
Learned how to plan an experiment to increase
his heart rate while at physiotherapy to test
whether it will lead to a heart attack.
Rated anxiety that was linked to being in
public. Learned that he can have more than
one feeling for a situation.
Linked specific thoughts (of having a heart
attack and that the group will never help) to
his feelings of anxiety.
Linked feelings of anxiety to specific situations.
Learned that others also feel ‘alien’ and do
not ‘belong on earth’.
Liked hearing others talk about their
experiences and learned that others have
similar feelings as he does. Not comfortable
in speaking.
Was in a ‘deep depression’ because of the
Thought action plans were
anniversary of his mother’s death. Liked
useful and wanted more
listening to others speak about their action
help with them. One major
action plan was to obtain
additional psychiatric help.
Very positive group experience.
Appreciated supportive relationships that developed in the group.
Planning for future individual treatment; ‘next steps’.
Handing out personalized cards.
Tested belief that he was paralysed by
depression. Positive results. Had a
‘breakthrough in interpersonal dynamics’
by working with other clients.
Discussed goal of finding individual
counselling with CBT component. Difficult
task without therapist structure. Liked that
it had to be concrete, not abstract.
Week 9: Behavioural
Weeks 10–11: Action
Very difficult exercise, easier finding
strengths in others. Realized that he does
not need to make ‘enormous’ changes in
his thinking to show progress.
Examined the hot thought: ‘I am a failure.’
Realized that his thoughts can sometimes
be inaccurate and misleading, and that he
can examine the evidence to test them out.
Enjoyed helping others explore evidence.
Difference between anger and sadness, and
that ‘insecure’ can be used to describe a
Eliciting support from other group members,
going back to library. Felt he had made
progress in reaching the ‘core’ of his
depression—problematic hot thoughts.
Quickly understood the model and agreed
with its logic. Enjoyed hearing others speak
about their problems. Needed to talk of
feelings to be more concrete.
Very quiet at first, tentative to answer
Week 8: Explored
Week 3: Delineation
of moods and
Week 4: Situation/
activity mood
introduced hot
Weeks 5–7:
Thoughts records,
hot thoughts,
examining the
evidence and
balanced thoughts
Week 1: Group rules,
orientation, therapy
explanation of CBT
group structure
Week 2: Explanation
of cognitive model
Therapy organization and participant content or experience
General topics
Table 2.
Group Cognitive Behaviour Therapy for Adults
J. A. Weiss and Y. Lunsky
developed a template for himself that would allow
him to match his interests with therapist skill. As
we elaborate in the discussion section, there are no
specialized mental health-care services for adults
with AS in Ontario.
Figure 1. Beck Depression Inventory-II (BDI-II) scores
for each client
Figure 2.
Beck Anxiety Inventory (BAI) scores for each
feelings of sadness or shame (e.g., I am worthless).
Through therapy, Frank began to uncover the feelings of depression that lay underneath his initial
angry reactions. This recognition and shift in his
affect may have contributed to a decrease in emotional reactivity and comorbid anxiety. As shown
in Figure 2, Frank’s BAI scores showed an expected
decrease across sessions, from a pre-intervention
score of 15 to a final session score of 5 and an
8-week post-intervention score of 8.
At follow-up, …
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