Evaluating a Comprehensive Strategy to Improve Engagement to Group-based Behavioral Parent Training for High-risk Families of Children with ADHD

Behavioral parent training (BPT) is an evidence-based intervention for the treatment of attention-deficit/hyperactivity disorder (ADHD) and related disruptive behavioral disorders of childhood. Despite convincing data on effectiveness, engagement to BPT, particularly for high-risk families, has been a long standing, yet understudied, issue. Data from a clinical trial of a comprehensive BPT approach to enhance engagement and outcomes (the Strategies to Enhance Positive Parenting [STEPP] program) are presented herein. The STEPP program was compared to a traditional group-based BPT program on propensity to attend treatment, propensity to complete homework over the course of treatment, and dropout from BPT. Additionally, factors empirically related to engagement to treatment and targeted by the STEPP program were analyzed to determine whether these factors were enhanced by participation in the STEPP program. In a randomized cohort of 80 single-mothers of school-age children with ADHD, analyses demonstrated that the STEPP program lead to greater propensity to attend treatment over time and a greater propensity to complete homework over the course of treatment. Furthermore, participation in the STEPP Program was associated with a lower rate of dropout. Finally, data suggested that parents assigned to the STEPP program reported significant improvements in factors empirically related to engagement that were targeted within the STEPP program (i.e., amount and quality of social support from their group members, expectations for treatment, and perceived barriers to treatment participation). Results of the study have implications for targeting engagement throughout the process of BPT, particularly for high-risk families.     

Expressive disclosure to improve well-being in patients with amyotrophic lateral sclerosis: A randomised,controlled trial

Amyotrophic lateral sclerosis (ALS) is a terminal neurological disease associated with progressive paralysis, loss of communicative ability and functional decline. Expressive disclosure may help people with ALS, particularly those who are emotionally or socially inhibited, meet psychological challenges associated with the disease. People with ALS (N?=?48) were randomised to expressive disclosure about their disease or no disclosure. Psychological well-being (affect, depression and quality of life) was assessed pre-intervention and also three and six months later. Results of multi-level models indicated that the group that disclosed thoughts and feelings about ALS had higher well-being than the control group at three months post-intervention, but not six months. Ambivalence over emotional expression (AEE) moderated three-month post-intervention well-being. Those low in AEE had higher well-being than those high in AEE regardless of condition. Those high in AEE, who disclosed, had increased well-being from pre-intervention, whereas controls had decreased well-being from pre-intervention. Expressive disclosure may be helpful for people with ALS, but only those who have difficulty expressing emotions. In addition, the intervention had only temporary effects; the dynamic challenges of ALS progression may mean that the effect of processing thoughts and feelings about the disease in one stage may not generalise to later stages.     

Executive functioning in individuals with a history of ASDs who have achieved optimal outcomes

Executive functioning (EF) is examined among children and adolescents once diagnosed with an autism spectrum disorder (ASD), but who no longer meet diagnostic criteria. These individuals have average social and language skills, receive minimal school support and are considered to have achieved “optimal outcomes” (OOs). Since residual impairments in these individuals might be expected in deficits central to autism, and in developmentally advanced skills, EF was examined in 34 individuals who achieved OOs, 43 individuals with high-functioning autism (HFA), and 34 typically developing (TD) peers. Groups were matched on age (M = 13.49), gender, and nonverbal IQ (NVIQ) but differed on verbal IQ (VIQ; HFA < TD, OO). On direct assessment, all three groups demonstrated average EF; however, the OO and HFA groups exhibited more impulsivity and less efficient planning and problem-solving than the TD group, and more HFA participants exhibited below average inhibition than did OO and TD participants. Parent-report measures revealed average EF among the OO and TD groups; however, the OO group exhibited more difficulty than the TD group on set-shifting and working memory. HFA participants demonstrated more difficulty on all parent-reported EF domains, with a clinical impairment in attention-shifting. Results suggest that EF in OO appears to be within the average range, even for functions that were impaired among individuals with HFA. Despite their average performance, however, the OO and TD groups differed on measures of impulsivity, set-shifting, problem-solving, working memory, and planning, suggesting that the OO group does not have the above-average EF scores of the TD group despite their high-average IQs.     

Posttraumatic Stress Symptoms and Perceived Relationship Safety as Predictors of Dyadic Adjustment: A Test of Mediation and Moderation

The purpose of this study was to examine the predictive value of PTSD symptoms and perceived relationship safety on dyadic adjustment. Participants included 390 individuals who were in a committed romantic relationship. Data were gathered from two populations; clients of a university-based family therapy clinic (n = 132), and community respondents to an announcement on a large university's electronic bulletin board (n = 258). Structural equation modeling was used to test a model of mediation, as well as multiple group analysis to test for moderation by setting (clinical vs. community) and gender. Results indicated that perceived relationship safety fully mediated the relationship between PTSD symptoms and dyadic adjustment. Gender moderated the relationships in the model, but no differences were found between the clinical and community samples. Findings suggest the importance of addressing experiences of safety and security in relationships, as these may be of particular importance for those who have experienced trauma.     

Motivation for Reading and Middle School Students' Performance on Standardized Testing in Reading

This study examined middle school students' reading motivation and its relations to their performance on a standardized test (ISTEP+) in reading. Participants included 388 sixth- and eighth-grade students from two public middle schools. There were 229 females and 159 males. Participants responded to the Reading Motivation Questionnaire after they had completed the ISTEP+ test. Results showed that students who had high self-efficacy in their reading, read challenging material, and read for aesthetic enjoyment did better on the ISTEP+ test. Students who read mostly for social reasons did poorly on the ISTEP+ test. Grade, gender, and racial differences were found.     

Cognitive and emotional demands of black humour processing: the role of intelligence,aggressiveness and mood

Humour processing is a complex information-processing task that is dependent on cognitive and emotional aspects which presumably influence frame-shifting and conceptual blending, mental operations that underlie humour processing. The aim of the current study was to find distinctive groups of subjects with respect to black humour processing, intellectual capacities, mood disturbance and aggressiveness. A total of 156 adults rated black humour cartoons and conducted measurements of verbal and nonverbal intelligence, mood disturbance and aggressiveness. Cluster analysis yields three groups comprising following properties: (1) moderate black humour preference and moderate comprehension; average nonverbal and verbal intelligence; low mood disturbance and moderate aggressiveness; (2) low black humour preference and moderate comprehension; average nonverbal and verbal intelligence, high mood disturbance and high aggressiveness; and (3) high black humour preference and high comprehension; high nonverbal and verbal intelligence; no mood disturbance and low aggressiveness. Age and gender do not differ significantly, differences in education level can be found. Black humour preference and comprehension are positively associated with higher verbal and nonverbal intelligence as well as higher levels of education. Emotional instability and higher aggressiveness apparently lead to decreased levels of pleasure when dealing with black humour. These results support the hypothesis that humour processing involves cognitive as well as affective components and suggest that these variables influence the execution of frame-shifting and conceptual blending in the course of humour processing.     

The creation and validation of the Developmental Emotional Faces Stimulus Set

The Developmental Emotional Faces Stimulus Set (DEFSS) is designed to provide a standardized set of emotional stimuli that includes both child and adult faces and that has been validated by participants across a wide range of ages. This article describes the creation and validation of the DEFSS, which includes 404 validated facial photographs of people between 8 and 30 years old displaying five different emotional expressions: happy, angry, fearful, sad, and neutral. The emotions in all photographs were identified correctly by 86 % of the raters (minimum 55 %), and validity did not vary as a function of the age group of the model or of the raters, indicating that the pictures are equally appropriate for use across the entire age range. Strengths and limitations of the DEFSS are discussed.     

Teaching young children to make accurate portion size estimations using a stimulus equivalence paradigm

The prevalence of obesity among children and adolescents has increased over the past four decades. Obesity can be conceptualized as a problem related to energy balance, where more energy is consumed than is expended through physical activity. One way that children may have a positive energy balance is through the overconsumption of foods (i.e., eating large portion sizes). Therefore, interventions that teach children to make accurate portion size estimations may be important to maintain overall health. In the current study, seven children between the ages of 4 and 7 years were taught to make accurate portion size estimations using a stimulus equivalence paradigm. Results suggested that the stimulus equivalence paradigm was effective in teaching five of seven participants to make more accurate portion size estimations during posttraining. Furthermore, five of seven participants estimated the target portion size of a novel food during extension sessions. These findings extend the current literature related to teaching children to make accurate portion size estimations. Although this was a translational study, results might help to inform existing nutrition education programs aimed at teaching children healthier eating habits.