The effects of assertiveness training on the nontraditional role assumption of geriatric nurse practitioners

The Nurse Practitioner movement has been an important element in upgrading health care for the elderly, principally by reducing costs and increasing availability. One central concern in this movement is the ability of Nurse Practitioners [NPs] to break out of the restricted and repressed role of nurse. The teaching of assertive behavior has been an accepted method of assisting NPs in this role change. This study evaluates the effects of assertiveness training using a measure of role assumption in addition to the typical self-report attitude measures. Three cohorts of NP students (N=59) were evaluated with a pre-post administration of attitude measures of assertiveness and a six-month follow-up to measure role assumption. Although the training did have a significant impact on the attitude measures, the impact on nontraditional role assumption was minimal. Policy implications are discussed.     

Development and validation of the Illness Behavior Inventory

The development and validation of a measure of illness behavior are presented. From a large domain sample of illness-related behaviors, a 20-item self-report measure was developed, the Illness Behavior Inventory (IBI). Validation data are presented from a series of independent studies with healthy and chronically ill individuals. Results indicate that the IBI possesses acceptable levels of internal consistency, test-retest reliability, structural reliability, discriminant validity, concurrent validity, and predictive validity. The applicability of the IBI to various areas of inquiry in behavioral medicine research and practice is discussed and directions for future research are outlined.     

The history of a catatonic dog

This article is a condensed life-history of a dog (“V3”) born and reared in the Pavlovian Laboratory and studied until his death in 1961. A detailed study was made of his pathologic development, his relations to people, and the effects of drugs. Measurements recorded were heart rate, blood pressure, respiration, 24-hour activity, sexual reflexes, general behavior. Although early experiments were done chiefly for recording and were not considered noxious or traumatic, this dog’s general development and symptoms seem to have been “constitutionally” rather than environmentally determined. His external behavior was strikingly similar to that of a catatonic patient-flexibilitas cerea, general immobility. Of particular interest was the “Effect of Person”: in the presence of all humans who confronted him he showed catatonic postures, cardiovascular disorders (tachycardia up to 200 beats/min., bradycardia to 12 beats/min., drop of blood pressure from 150 to 75 mm Hg, arrest of heart-beat for as long as 8 seconds), moribund poses. His response to drugs illustrated the specificity to a definite “constitutional type”: sexual activity markedly increased by alcohol and rarely present except after administration of alcohol; no improvement after administration of tranquilizers, except alcohol and meprobamate, which made him act like a normal dog in behavior and in relations to people. His symptoms and reactions to both people and drugs were generally opposite to those of another dog, “Nick”, studied over his life span: Nick showed excessive activity in physiologic systems; hyperactivity (running); generally, improvement through “Effect of Person”; sexual inhibition with alcohol. Observations of the two dogs suggest that symptoms as well as reactions to drugs are the result of the “type” rather than the procedure used, that perhaps psychopathologic symptoms are due more to inborn constitution than to “conflict” (“collision”) between excitation and inhibition, and that neurotic or psychotic symptoms may not interfere with longevity-Nick lived to be 14 years old and died fighting; V3, who also spent most of his life in the laboratory, died at the age of 14.     

The personal and marital adjustment of parents as related to observed child deviance and parenting behaviors

The purpose of this study was to document the relationship of parents' personal and marital adjustment to their own behavior as parents and the behavior of their children. A total of 31 families who had been referred for behavioral counseling regarding their male child's behavior problems were given a diagnostic battery which included home observations as well as administration to parents of the Minnesota Multiphasic Personality Inventory (MMPI) and the LockeWallace Marital Adjustment Test. Results revealed consistent negative relationships between marital satisfaction and the observed level of child deviance. Similarly, there were consistent negative relationships between marital satisfaction and the level of observed “negativeness” to the child. Analyses using the MMPI indicated that a large number of the fathers ' MMPI scales were related to child deviance, but this finding was not replicated for mothers. Several MMPI scales were related to marital satisfaction for both parents. These results are discussed in terms of their implications for the assessment and treatment of families with a problem child.     

Sensory Extinction: A procedure for eliminating self-stimulatory behavior in developmentally disabled children

This study was designed to investigate the role of sensory reinforcement in the motivation of self-stimulation. If self-stimulatory behavior is maintained by its sensory consequences, such as the proprioceptive, auditory, or visual stimulation it produces, then such behavior should extinguish when those sensory consequences are not permitted. The present study introduces a new procedure, Sensory Extinction, in which certain sensory consequences are masked or removed, to examine whether self-stimulation is operant behavior maintained by sensory reinforcement. The effectiveness of Sensory Extinction was assessed by a reversal design for each of three autistic children, and the results showed the following. First, self-stimulation reliably extinguished when a certain sensory consequence was removed, then increased when that consequence was permitted. This was replicable within and across children. Second, different Sensory Extinction procedures were required for different self-stimulatory behaviors, since the sensory reinforcers supporting them were idiosyncratic across children. Finally, regarding clinical gains, the data suggest that Sensory Extinction may be a relatively convenient and rapid alternative for the treatment of self-stimulation. The present findings extend the efficacy of extinction as a behavior-modification technique to instances in which the reinforcer is purely sensory. The implications of these results for the treatment of other forms of deviant behavior are discussed.     

Assessment of Callous-Unemotional Traits in 6 to 12 Year-Old Children with Oppositional Defiant Disorder/Conduct Disorder by Parent Ratings

The factorial structure of the Inventory of Callous-Unemotional Traits (ICU; Frick 2004) has been inconsistent across previous studies using different rater versions (self-report, parent, teacher) and versions in different languages applied to both clinical and nonreferred samples predominantly of adolescents. The present study examined the factorial structure of the parent-report version of the ICU in a clinical sample of boys aged 6–12 years with Oppositional Defiant Disorder/Conduct Disorder (n?=?131) using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Results from the CFA supported previous findings, but even the preferred model with three independent factors (Callousness, Uncaring, and Unemotional) showed inadequate model fit. Subsequent EFA revealed a three-factor model consisting of two new subscales (Callousness/Lack of Guilt or Remorse, Unconcerned about Performance) and the original subscale Unemotional. Internal consistencies of the three subscales and total score were satisfactory, and intercorrelations of the subscales were weak, except for a moderate correlation between the subscales Callousness/Lack of Guilt or Remorse and Unconcerned about Performance. The corresponding subscales of the original and new versions were highly correlated. As expected, the ICU subscale Callousness/Lack of Guilt or Remorse showed associations with other measures of aggressive and oppositional behavior. The other two ICU subscales were not associated with aggression or oppositional/antisocial behavior, but Unconcerned about Performance correlated with a measure of attention problems and Unemotional correlated with the internalizing problem withdrawn. The implications of these findings are discussed, especially as a callous unemotional specifier for the diagnosis of Conduct Disorder is included in DSM-5.     

Covert behavior as a direct electromyographic measure of mediating responses

Electromyographic (EMG) measures (in addition to eye activity, and electroencephalograms, EEG) were taken from the tongue and arms of children under conditions of verbal oral mediation, non-oral (leg and arm) mediation based on the concepts of right and left, and no-mediation. It was found that amplitude of tongue EMG (a measure of covert oral behavior) significantly increased only for the Verbal Mediation Group, and the increase was significantly greater than for the other two (control) groups. The arms were possible loci of mediational behavior for the Non-oral Mediation Group; arm EMG was relatively large under this non-oral mediation condition, the changes being significant for the left arm. Eye movements, possible indicators of right and left mediational activity, were greater under the non-oral mediation condition, too. These psychophysiological measures of covert behavior during mediation are thus consistent with verbal mediational theory that has been based on the study of overt behavior.     

Parental characteristics and interactional dysfunction in families with child behavior problems: A preliminary investigation

Thirty-six families with a preteenage behavior problem child were assessed on measures of marital discord, parental psychopathology, and three parental cognitive factors: knowledge of behavioral principles, tolerance for child deviancy, and expectations regarding their child's behavior. Nine nonproblem families with demographic characteristics similar to the problem families were also assessed. Correlational analyses across all families revealed a strong association between marital discord and the parental index of child behavior problems. While a number of significant associations were discovered between the various measures of marital discord, parental psychopathology, and parental cognitive factors, no other measure besides marital discord was associated with parental perception of child behavior problems. The nonproblem families and 15 of the problem families also participated in home observations obtained through random audio recordings during high interaction periods. These observational data indicated a significant relationship between parental perception of child behavior problems and parental negative behavior toward the child, but no significant relationship between parental perception of child behavior problems and child behavior, even when child behavior was weighted by parents' reactions to that behavior. Through sequential analysis, several contingent relations between parent and child behavior were discovered. Findings are discussed in relation to family systems theory.     

Behavior and personality assessment in men labeled adaptive sociopaths

Few efforts have been made to understand antisocial-prone individuals who maintain adaptive functioning. This study identified a sample of potentially deviant but adaptively functioning persons to determine whether they differed significantly from their more conforming peers. A small sample of men was selected by Minnesota Multiphasic Personality Inventory (MMPI)-defined criteria for sociopathy and compared with MMPI-defined normals of similar ages, backgrounds, and intelligence. Response variables were those cited in the literature as characteristic of sociopathic psychopathology and included measures of abilities to plan ahead and inhibit impulsiveness, sensation seeking, interpersonal performance and style, and behavior conformity. Men labeled adaptive sociopaths showed greater impulsiveness and needs for experience seeking, earned lower scores on measures of socialization and self-control, and admitted greater adolescent behavior deviance. They were not shown to be less empathetic or less able to relate interpersonally in interview. The potential role of socially constructive self-determined goals and tangible vocational rewards as mediators of adaptive behavior are discussed in terms of overcoming antisocial tendencies and attenuation of behavior disinhibition.     

A brief scoring method for voice stress analysis

The Psychological Stress Evaluator (PSE) detects inaudible frequency changes in the human voice, and it is claimed that the pattern of these changes can provide a measure of psychophysiological arousal. A few studies have given some support to this hypothesis, but further clarifica tion is needed. One major technical problem in this research is that the traditional scoring esyStem is unreliable unless considerable numbers of scores are taken and averaged , The paper presents a conveniently brief scoring system which has fair reliahility, and which correlates significantly with a measure of Critical Flicker Fusion Threshold.     

Maternal Relationship Insecurity and Depressive Symptoms as Moderators of Home Visiting Impacts on Child Outcomes

The purpose of this study was to determine the extent to which maternal relationship insecurity and severe depressive symptoms moderate home visiting impacts on developmental and behavioral outcomes in 2-year old children. In an experimental trial of the Healthy Families Alaska home visiting program, families (N = 249) were randomly assigned to home visiting (n = 126) or community services as usual (n = 123). Maternal severe depressive symptoms (CES-D ≥ 24) and relationship insecurity were measured using the Center for Epidemiologic Studies Depression Scale and the Attachment Style Questionnaire at baseline. Child cognitive and psychomotor development and behavior problems were measured with the Bayley Scales of Infant Development and the Child Behavior Checklist at follow-up. The results revealed that home visiting significantly impacted three outcomes—child cognitive development, internalizing behavior, and externalizing behavior. Home visiting impacts were limited to subgroups defined by maternal depressive symptoms and relationship insecurity. Home visiting improved cognitive development (B = 6.02, p < .03), and decreased internalizing behavior (B = ?3.83, p = .02) and externalizing behavior problems (B = ?3.74, p = .03) in children of mothers with either severe depressive symptoms or high levels of discomfort with trust at baseline, but not both. Family engagement in home visiting seems to play a role in mediating these moderating effects. These findings reflect the importance of screening for maternal relationship insecurity and depressive symptoms to distinguish family subgroups likely to benefit from home visiting from those for whom an enhanced service model might be needed.     

Pronoun disambiguation: Accessing potential antecedents

Two general classes of pronoun disambiguation processes are considered. In reading “Jack threw a snowball at Phil, but he missed,” both possible antecedents of “he” (“Jack” and “Phil”) may be accessed initially. Or, the actual antecedent alone may be accessed after sufficient semantic context is encoded. To evaluate these alternatives, a yes-no-probe recognition task was used to measure priming of the potential antecedents in sentence comprehension. Subjects read sentences similar to the example and were presented a test word immediately following each sentence. Response times for the actual antecedent (“Jack”) and nonantecedent (“Phil”) probes were obtained. Results indicated that the nonantecedent as well as the antecedent was activated (accessed) in pronoun disambiguation. This conclusion was not affected by the ordering of the antecedent and nonantecedent in the first clause.     

HyperCard administration of a block-design task

HyperCard (Atkinson, 1987) is a new development environment for the Macintosh that shows promise for use in psychological research and testing. In this paper, we discuss the development of HyperCard stackware with which a block-design task similar to that of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) can be administered. The reliability and validity of the computerized block-design task was evaluated by administering both the computerized task and the WAIS-R subtest to college undergraduates. Results indicated that the computerized task’s reliability compared favorably with that of the WAIS-R subtest. Validity coefficients were equivocal; although an elapsed-time measure showed moderate correlation between the tasks, the numbers of designs correctly completed in each condition were not significantly correlated.     

Parenting Adolescents: Examining the Factor Structure of the Alabama Parenting Questionnaire for Adolescents

The Alabama Parenting Questionnaire (APQ) is a well studied assessment of parenting practices for school-age children, especially in relation to child externalizing behaviors. Given the developmental changes between school-age children and adolescents and subsequent changes to parenting approaches during that time, the utility of a public-accessed measure to span across a broad age range is of high clinical and empirical importance. This study investigated the psychometric properties of the APQ in a community sample of 376 parents of adolescents. In an Exploratory Factor Analysis the data suggested a 4-factor solution similar in composition to the original 5-factor model. Proposed factors for the APQ when given to parents of adolescents included Positive and Involved Parenting, Parental Monitoring, Discipline Practices, and Discipline Process.     

Trauma exposure is associated with increased context-dependent adjustments of cognitive control in patients with posttraumatic stress disorder and healthy controls

Recent evidence has suggested that posttraumatic stress disorder (PTSD) is associated with alterations in prefrontal-cortex-dependent cognitive processes (e.g., working memory, cognitive control). However, it remains unclear whether these cognitive dysfunctions are related to PTSD symptomatology or trauma exposure. Furthermore, regarding cognitive control, research has only focused on the integrity of selected control functions, but not their dynamic regulation in response to changing environmental demands. Therefore, the present study investigated dynamic variations in interference control, in addition to overall interference susceptibility and working memory (WM) performance in matched groups of 24 PTSD patients and 26 traumatized and 30 nontraumatized healthy controls. The Simon task was used to measure overall interference susceptibility and the flexible adjustment of cognitive control, on the basis of the occurrence of response conflicts (conflict adaptation effect). WM performance was assessed with the forward and backward digit span tasks. Since we have previously shown that trauma exposure per se is associated with reduced hair cortisol concentrations (HCC), we further explored whether PTSD/trauma-related cognitive alterations are related to HCC in proximal 3-cm hair segments. The results revealed that PTSD patients and traumatized controls showed significantly more pronounced conflict adaptation effects than nontraumatized controls. Moreover, the conflict adaptation effect was positively related to the number of lifetime traumatic events and the frequency of traumatization. The groups did not differ in overall interference susceptibility or WM performance. Exploratory analyses revealed no association between HCC and the observed cognitive differences. These results suggest that context-driven control adjustments constitute a sensitive correlate of trauma exposure, irrespective of PTSD.     

Dimensions of children's classroom social behavior: A factor analytic investigation

Dimensions of children's classroom social behavior were investigated using the Social Behavior Assessment (SBA), a 136-item teacher rating scale (Stephens, T. M.Social Behavior Assessment. Columbus, Ohio: Cedars Press, 1979). Six relatively independent factors were identified as dimensions of children's classroom social behavior: Academic Responsibility, Social Responsibility, Cooperation, Compliance, Adaptive Behavior, and Participation. These six factors accounted for over two-thirds of the variance in teacher ratings and do not correspond with Stephens' (1979) original categorization. Consistent with past research, teachers appeared to consider those academic-related social skills associated with classroom order and control particularly salient. Directions for future research and recommendations concerning multifactored assessment of children's social skills are discussed.     

Treating Parents with Attention-Deficit/Hyperactivity Disorder: The Effects of Behavioral Parent Training and Acute Stimulant Medication Treatment on Parent–Child Interactions

This multiple baseline study evaluated the efficacy of behavioral parent training (BPT) for 12 parents (M age?=?39.17 years; 91 % mothers) and their children (ages 6–12; 83 % boys) both with Attention-Deficit/Hyperactivity Disorder (ADHD), and also explored the acute effect of stimulant medication for parents before and after BPT. Parents rated their own and their children’s symptoms and impairment and were stabilized on optimally dosed medication. Then, parents discontinued medication and were randomly assigned to a 3, 4, or 5 week baseline (BL), during which they provided twice-weekly ratings of their impairment, parenting, and their child’s behavior. Following BL, parents and their children completed two laboratory tasks, once on their optimally dosed medication and once on a placebo to assess observable effects of medication on parent–child behavior, and they completed additional assessments of family functioning. Parents then completed eight BPT sessions, during which they were unmedicated. Twice-weekly ratings of parent and child behavior were collected during BPT and additional ratings were collected upon completing BPT. Two more parent–child tasks with and without parent medication were conducted upon BPT completion to assess the observable effects of BPT and BPT plus medication. Ten (83.33 %) parents completed the trial. Improvements in parent and child behavior were observed, and parents reported improved child behavior with BPT. Few benefits of BPT emerged through parent reports of parent functioning, with the exception of inconsistent discipline, and no medication or interaction effects emerged. These results, although preliminary, suggest that some parents with ADHD benefit from BPT. While pharmacological treatment is the most common intervention for adults with ADHD, further examination of psychosocial treatments for adults is needed.     

Psychometric Properties of the Revised Chen Internet Addiction Scale (CIAS-R) in Chinese Adolescents

The Revised Chen Internet Addiction Scale (CIAS-R) was developed to assess Internet addiction in Chinese populations, but its psychometric properties in adolescents have not been examined. This study aimed to evaluate the factor structure and psychometric properties of CIAS-R in Hong Kong Chinese adolescents. 860 Grade 7 to 13 students (38 % boys) completed the CIAS-R, the Young’s Internet Addiction Test (IAT), and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) in a survey. The prevalence of Internet addiction as assessed by CIAS-R was 18 %. High internal consistency and inter-item correlations were reported for the CIAS-R. Results from the confirmatory factor analysis suggested a four-factor structure of Compulsive Use and Withdrawal, Tolerance, Interpersonal and Health-related Problems, and Time Management Problems. Moreover, results of hierarchical multiple regression supported the incremental validity of the CIAS-R to predict mental health outcomes beyond the effects of demographic differences and self-reported time spent online. The CIAS is a reliable and valid measure of internet addiction problems in Hong Kong adolescents. Future study is warranted to validate the cutoffs of the CIAS-R for identification of adolescents with Internet use problems who may have mental health needs.