Midi-level measurement of social anxiety in psychiatric and non-psychiatric samples

This paper reports the development and assessment of midi-level behavioral measures of social anxiety in the context of two experiments, one studying an analog student sample, the other a psychiatric sample. Judgments on nine categories of clinically practical midi-level behaviors (e.g. Facial Expression, Orienting, Sense of Timing), based on a review of the literature on human ethology and on pilot research, were compared to global judgments of social anxiety and social skill and to physiological arousal. Intraclass correlations exceeded 0.80 for judgments of the global and midi-level behavioral ratings on both samples. Results of correlational analyses indicated that while there were several significant predictors of global skill and anxiety among the midis, the magnitude of the relationship between midis and globals was stronger for the patient than the student sample. Further analyses based on S's heart rate (HR) reactivity suggested that while global ratings did not significantly predict H R in a high social anxiety situation, one midi-level behavioral rating (self-manipulations) did. The clinical utility of the newly developed measures is discussed with particular attention to their practicality for behavior therapy.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.     

Challenging racism, sexism, and social injustice: support for urban adolescents' critical consciousness development

This mixed-model study examined the relationship between urban adolescents' perceived support for challenging racism, sexism, and social injustice from peers, family, and community members and their critical consciousness development. These relationships were examined by relating participants' qualitative perceptions of support for challenging racism, sexism, and social injustice to quantitative data obtained from Likert-type measures of the reflection and action components of critical consciousness. Perceived support for challenging racism, sexism, and social injustice had a significant impact upon the reflection component of critical consciousness; the significance criterion was supported by effect size estimates. Support for challenging racism, sexism, and social injustice was not significantly related to the action component of critical consciousness. Participants perceived the most support for challenging racism, moderate support for challenging social injustice, and the least support for challenging sexism. Additionally, female participants perceived more support for challenging sexism than male participants. These results suggest that the informal interactions of urban adolescents play a role in shaping their critical consciousness, and hold implications for psychosocial interventions and research with marginalized populations.     

An Ethical Framework for the Design,Development, Implementation,and Assessment of Drones Used in Public Healthcare

Science and Engineering Ethics - The use of drones in public healthcare is suggested as a means to improve efficiency under constrained resources and personnel. This paper begins by framing drones...     

Teacher Acquisition of Functional Analysis Methods Using Pyramidal Training

Pyramidal training involves an experienced professional training a subset of individuals who, in turn, train additional individuals. Pyramidal training is effective for training a variety of behavior-analytic skills with direct-care staff, parents, and teachers. As teachers’ roles in behavioral assessment increase, pyramidal training may be useful to improve the procedural fidelity with which teachers conduct functional analyses. In the current study, previously trained teachers taught six other teachers (trainees) to conduct standard functional analysis conditions in a pyramidal training model. All trainees quickly acquired the skills necessary to conduct attention, escape, play, and tangible conditions during analog role-plays. Trainees also implemented functional analysis conditions with fidelity in their classrooms with students. Using a pyramidal training model may help to disseminate behavior-analytic procedures.     

Self-Reported Questionnaire Detects Family History of Cancer in a Pancreatic Cancer Screening Program

Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer death; approximately 5–10% of PDAC is hereditary. Self-administered health history questionnaires (HHQs) may provide a low-cost method to detail family history (FH) of malignancy. Pancreas Center patients were asked to enroll in a registry; 149 with PDAC completed a HHQ which included FH data. Patients with FH of PDAC, or concern for inherited PDAC syndrome, were separately evaluated in a Prevention Program and additionally met with a genetic counselor (GC) to assess PDAC risk (n?=?61). FH obtained through GC and HHQ were compared using Wilcoxon signed-rank sum and generalized linear mixed models with Poisson distribution. Agreement between GC and HHQ risk-assessment was assessed using kappa (κ) statistic. In the Prevention Program, HHQ was as precise in detecting FH of cancer as the GC (all p?>?0.05). GC and HHQ demonstrated substantial agreement in risk-stratification of the Prevention Program cohort (κ?=?0.73, 95% CI 0.59–0.87.) The sensitivity of the HHQ to detect a patient at elevated risk (i.e., moderate- or high-risk) of PDAC, compared to GC, was 82.9% (95% CI 67.3–92.3%) with a specificity of 95% (95% CI 73.1–99.7%). However, seven patients who were classified as average-risk by the HHQ were found to be at an elevated-risk of PDAC by the GC. In the PDAC cohort, 30/149 (20.1%) reported at least one first-degree relative (FDR) with PDAC. The limited sensitivity of the HHQ to detect patients at elevated risk of PDAC in the Prevention Program cohort suggests that a GC adds value in risk-assessment in this population. The HHQ may offer an opportunity to identify high-risk patients in a PDAC population.     

Social validity: Perceptions of check and connect with early literacy support

This article underscores the potential advantages of qualitative methods to illustrate the depth and complexity of social validity. This investigation evaluates the social validity of Check and Connect with Early Literacy Support (CCEL), through the perspectives of teachers and caregivers whose children participated in the intervention. Teachers from six classrooms and caregivers from six families participated in evaluating the social validity of this intervention using a combination of qualitative and quantitative methods. Participants completed the Treatment Acceptability Rating Scale—Revised (TARF-R; Reimers, T. M., Wacker, D. P., Cooper, L. J. & DeRaad, A. O. (1992). Clinical evaluation of the variables associated with treatment acceptability and their relation to compliance. Behavioral Disorders, 18(1), 67-76.), a quantitative measure of treatment acceptability (a component of social validity), and were interviewed using qualitative interviews and focus groups. Results were analyzed through ethnographic methodology and indicate complex, reciprocal relationships among factors related to social validity. This investigation is considered in light of recent efforts to develop a systematic approach to evaluate the adequacy of intervention research using qualitative methods.     

Initial development of a brief measure of psychological distress

This paper addresses the preliminary development, construct validity, and psychometric properties of a brief self-report measure of psychological distress. 40 items were originally generated by doctoral level psychologists for use in the preliminary clinical sample. Inpatients from a psychiatric unit (N = 125) completed the items, and a principal-components analysis with a direct oblimin rotation was used to evaluate construct validity. The study indicated a four-factor solution, using the constructs of Depression, Hopelessness, Anxiety, and Anger, with good estimates of reliability. After evaluation of factor structure, item analyses, and reliability estimates, a redacted 19-item scale was identified.