Improving quality of life in diverse rural older adults: a randomized trial of a psychological treatment

The efficacy of home-delivered cognitive-behavioral therapy (CBT) in improving quality of life and reducing psychological symptoms in older adults was examined in this study. One hundred thirty-four participants, predominately African American and characterized as primarily rural, low resource, and physically frail, were randomly assigned to either CBT or a minimal support control condition. Results indicate that CBT participants evidenced significantly greater improvements in quality of life and reductions in psychological symptoms. Mediation of treatment through cognitive and behavioral variables was not found despite the acceptable delivery of CBT by research therapists. These data suggest that treatment can be effective with a disadvantaged sample of older adults and extend efficacy findings to quality of life domains. Creating access to evidence-based treatments through nontraditional delivery is an important continuing goal for geriatric health care.     

Affect, Social Behavior, and the Brain in Williams Syndrome

ABSTRACT— Williams syndrome (WS) is a rare genetic disorder characterized by intellectual impairment and a distinctive physical and neuropsychological profile. Relative to their level of intellectual functioning, individuals with WS exhibit strengths in language and face recognition, with deficits in visual-spatial cognition. A heightened appetitive drive toward social interaction is a strong behavioral feature. Relative to other neurodevelopmental disorders, WS has a clearly defined genetic basis, together with a consistent neurocognitive profile of strengths and deficits. Thus, this disorder offers unique opportunities for elucidating gene–brain–behavior relationships. We focus on manifestations of the unusual social profile in WS, by examining data within and across levels of cognition, brain, and molecular genetics.     

Improving assessment of personality disorder traits through social network analysis

When assessing personality disorder traits, not all judges make equally valid judgments of all targets. The present study uses social network analysis to investigate factors associated with reliability and validity in peer assessment. Participants were groups of military recruits (N=809) who acted as both targets and judges in a round-robin design. Participants completed self- and informant versions of the Multisource Assessment of Personality Pathology. Social network matrices were constructed based on reported acquaintance, and cohesive subgroups were identified. Judges who shared a mutual subgroup were more reliable and had higher self-peer agreement than those who did not. Partitioning networks into two subgroups achieved more consistent improvements than multiple subgroups. We discuss implications for multiple informant assessments.     

Effects of teacher greetings on student on-task behavior

A multiple baseline design across participants was used to determine how teacher greetings affected on-task behavior of 3 middle school students with problem behaviors. Momentary time sampling was used to measure on-task behavior during the first 10 min of class. Teacher greetings produced increases in students' on-task behavior from a mean of 45% in baseline to a mean of 72% during the intervention phase. Teacher greetings represent an antecedent manipulation that can easily be implemented in classrooms to improve students' on-task behavior.     

Factor structure of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4)

The Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) appears to offer excellent potential as an easily administered and patient acceptable assessment and monitoring measure of quality of life (QoL). However, a principle psychometric criterion crucial to the use and validity of the instrument concerns the underlying factor structure. The SQLS-R4 comprises two sub-scales, these being cognition and vitality QoL and psychosocial feelings QoL. However, the factor structure of the SQLS-R4 has yet to be established in a patient group in the UK. Confirmatory factor analysis was conducted on the SQLS-R4 to determine its psychometric properties in 100 patients with a primary ICD-10 diagnosis of schizophrenia. Internal reliability of the SQLS-R4 cognition and vitality QoL and psychosocial feelings QoL sub-scales was found to be excellent. Consistent with the original validation of the SQLS-R4, two correlated factors comprising cognition and vitality QoL and psychosocial feelings QoL were observed to offer the best fit to the data. In conclusion, the SQLS-R4 would appear to be suitable for use in patients with a primary diagnosis of schizophrenia in the UK. Potential clinical uses and the direction of future research with the SQLS-R4 are indicated.     

Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction.

OBJECTIVE: To compare the impact of network support and different types of perceived functional support on all-cause mortality or nonfatal reinfarction for patients with a recent acute myocardial infarction (AMI). DESIGN: Participants were recruited from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) trial; 2,481 AMI patients with depression or low social support were randomized to a cognitive-behavioral intervention or to a usual care control group. Data collection for certain measures of social support was limited: 2,466 participants completed the ENRICHD Social Support Inventory; 2,457 completed the Perceived Social Support Scale; 1,296 completed the Social Network Questionnaire; and 707 completed the Interpersonal Support and Evaluation List, Tangible Support subscale. Patients also completed the Beck Depression Inventory and were followed for up to 4.5 years. MAIN OUTCOME MEASURE: Time to death or nonfatal reinfarction. RESULTS: Over the follow-up period, 599 patients (24%) died or had a nonfatal AMI. Survival models controlling age, sex, race, socioeconomic status, smoking, antidepressant use, and a composite measure of increased risk revealed that higher levels of perceived social support were associated with improved outcome for patients without elevated depression but not for patients with high levels of depression. Neither perceived tangible support nor network support were associated with more frequent adverse events. CONCLUSION: AMI patients should be assessed for multiple dimensions of perceived functional support and depression to identify those at increased psychosocial risk who may benefit from treatment.     

Ethical Principles and the Communication of Forensic Mental Health Assessments

Our premise is that ethics is the essence of good forensic practice and that mental health professionals must adhere to the ethical principles, standards, and guidelines of their professional bodies when they communicate their findings and opinions. We demonstrate that adhering to ethical principles can improve the quality of forensic reports and communications. We demonstrate this by focusing on the most basic principles that underlie professional ethical standards and guidelines, namely, Fidelity and Responsibility, Integrity, Respecting Rights and Dignity of Persons, and Justice and Fairness. For each principle we offer a brief definition and explain its demands. Then we identify ways in which the principle can guide the organization, content, or style of forensic mental health report writing, offering illustrative examples that demonstrate or abuse the principle.     

Oscillatory motion induces change blindness

Change blindness is the relative inability of normally sighted observers to detect large changes in scenes when the low-level signals associated with those changes are either masked or of extremely low magnitude. Change detection can be inhibited by saccadic eye movements, artificial saccades or blinks, and 'mud splashes'. We now show that change detection is also inhibited by whole image motion in the form of sinusoidal oscillations. The degree of disruption depends upon the frequency of oscillation, which at 3 Hz is equivalent to that produced by artificial blinks. Image motion causes the retinal image to be blurred and this is known to affect object recognition. However, our results are inconsistent with good change detection followed by a delay due to poor recognition of the changing object. Oscillatory motion can induce eye movements that potentially mask or inhibit the low-level signals related to changes in the scene, but we show that eye movements promote rather than inhibit change detection when the image is moving.