Pain and Pain-Related Impairment in Adults with Cystic Fibrosis

The Multidimensional Pain Inventory (MPI) was utilized in a sample of adult outpatients with cystic fibrosis (CF) to assess their perception of pain and its psychosocial consequences. Subsequently, the data were compared to the ratings of pain and pain-related impairment in these patients as perceived by two nurses from the CF treatment team, as well as to a quantitative measure of illness severity. The results of these comparisons demonstrate that the majority of adult outpatients with CF reported experiencing lower levels of pain and pain-related impairment than expected, although the male patients tend to report experiencing significantly less impact in these domains than do the female patients. Additionally, the nurses do not underestimate the degree to which patients, especially males, experience pain and pain-related interference from chronic illness. Finally, there was no significant relationship between patients' self-report of pain severity or pain-related interference and an objective measure of disease severity.     

Potential Bone-Marrow Donors and Their Spouses: The Effects of Volunteerism on Distress Levels1

The current study sought to provide a better understanding of the reactions of bone-marrow volunteers to the possibility of donating by examining these volunteers in the context of their closest relationships. Using Tesser's (1988) self-evaluation maintenance (SEM) model as a guide, we examined the influence of spouses who are also volunteers on each member of the couple's distress levels and on the marrow volunteer's ambivalence about donating. We also examined the independent effects of known risk factors for donation-related distress and the combined effects of spouse volunteer status and these risk factors on distress levels. Questionnaire data were collected from 278 couples selected from 39 bone-marrow donor centers. Results demonstrated that when spouses of potential donors were engaged in any type of volunteer activity, members of the couple felt greater anxiety than when spouses were not volunteers. Additionally, other variables were found to have a conjoint effect with spouse volunteer status on volunteer and spouse anxiety levels.     

Potential Mediators in Parenting and Family Intervention: Quality of Mediation Analyses

Parenting and family interventions have repeatedly shown effectiveness in preventing and treating a range of youth outcomes. Accordingly, investigators in this area have conducted a number of studies using statistical mediation to examine some of the potential mechanisms of action by which these interventions work. This review examined from a methodological perspective in what ways and how well the family-based intervention studies tested statistical mediation. A systematic search identified 73 published outcome studies that tested mediation for family-based interventions across a wide range of child and adolescent outcomes (i.e., externalizing, internalizing, and substance-abuse problems; high-risk sexual activity; and academic achievement), for putative mediators pertaining to positive and negative parenting, family functioning, youth beliefs and coping skills, and peer relationships. Taken as a whole, the studies used designs that adequately addressed temporal precedence. The majority of studies used the product of coefficients approach to mediation, which is preferred, and less limiting than the causal steps approach. Statistical significance testing did not always make use of the most recently developed approaches, which would better accommodate small sample sizes and more complex functions. Specific recommendations are offered for future mediation studies in this area with respect to full longitudinal design, mediation approach, significance testing method, documentation and reporting of statistics, testing of multiple mediators, and control for Type I error.     

Child‐directed teaching and social learning at 18 months of age: evidence from Yucatec Mayan and US infants

In several previous studies, 18‐month‐old infants who were directly addressed demonstrated more robust imitative behaviors than infants who simply observed another's actions, leading theorists to suggest that child‐directed interactions carried unique informational value. However, these data came exclusively from cultural communities where direct teaching is commonplace, raising the possibility that the findings reflect regularities in infants' social experiences rather than responses to innate or a priori learning mechanisms. The current studies consider infants' imitative learning from child‐directed teaching and observed interaction in two cultural communities, a Yucatec Mayan village where infants have been described as experiencing relatively limited direct instruction (Study 1) and a US city where infants are regularly directly engaged (Study 2). Eighteen‐month‐old infants from each community participated in a within‐subjects study design where they were directly taught to use novel objects on one day and observed actors using different objects on another day. Mayan infants showed relative increases in imitative behaviors on their second visit to the lab as compared to their first visit, but there was no effect of condition. US infants showed no difference in imitative behavior in the child‐directed vs. observed conditions; however, infants who were directly addressed on their first visit showed significantly higher overall imitation rates than infants who observed on their first visit. Together, these findings call into question the idea that child‐directed teaching holds automatic or universal informational value.     

Definition and Measurement of Sexual Orientation

Measurement and definition of sexual orientations have increasingly become a central focus in both research design and public policy debates. This paper reviews major methods, and their theoretical underpinnings, for the definition and measurement of sexual orientations, highlighting their limitations and pitfalls, both practical and conceptual. The increasing politicization of this area is discussed and cautioned against. Recommendations, both general and geared toward measurement concerns with adolescent populations, are made. A specific measurement strategy, which can be utilized at a number of different levels, is detailed.     

Meta-Analysis of the Effects of Peer-Administered Psychosocial Interventions on Symptoms of Depression

Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost‐efficient adjunct providers. The effectiveness of these and other peer‐administered interventions (PAIs) for treating depression symptoms has not been well‐established. The current study is a meta‐analysis of PAIs’ effects on depression symptoms. Twenty‐three eligible studies were identified. Study characteristics were coded by multiple raters, random‐effects models were used to compare mean effect sizes, and mixed‐effects models were used to test for moderation. PAIs produced significant pre‐post reductions in depression symptoms (d = .5043 [95 % CI .3675–.6412]). In direct comparisons, PAIs performed as well as non‐peer‐administered interventions (.0848 [?.1455–.3151]), and significantly better than no‐treatment conditions (.2011 [.0104–.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer‐administered, and educational/skills‐based PAIs produced better outcomes than those that were mainly supportive. Follow‐up data, when available, indicated that PAIs’ benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs’ benefits, and whether they are better suited as stand‐alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.     

Using Community Partnerships to Better Understand the Barriers to Using an Evidence‐Based,Parent‐Mediated Intervention for Autism Spectrum Disorder in a Medicaid System

Service use disparities have been noted to impede under‐resourced families' ability to access high‐quality services for their child with autism spectrum disorder (ASD). These disparities are particularly relevant for parent‐mediated interventions and may suggest a lack of fit between these interventions and the needs of under‐resourced community settings. This study used Roger's Diffusion of Innovations theory to guide community partnerships aimed at understanding the perceived compatibility, complexity, and relative advantage of using an evidence‐based, parent‐mediated intervention (Project ImPACT) within a Medicaid system. Three focus groups were conducted with 16 Medicaid‐eligible parents, and three focus groups were conducted with 16 ASD providers operating within a Medicaid system. Across all groups, parents and providers reported general interest in using Project ImPACT. However, primary themes emerged regarding the need to (a) reduce the complexity of written materials; (b) allow for a more flexible program delivery; (c) ensure a strong parent–therapist alliance; (d) involve the extended family; and (e) help families practice the intervention within their preexisting routines. Results are discussed as they relate to the design and fit of evidence‐based, parent‐mediated interventions for under‐resourced community settings.     

Psychological Safety and Appreciation of Differences in Counselor Training Programs: Examining Religion,Spirituality, and Political Beliefs

This study focused on the extent to which religion, spirituality, and political beliefs predicted counseling students' perceptions of psychological safety and appreciation of differences in their programs. The authors used hierarchical regression models to analyze data from 264 students from 4 different institutions. Results indicated that student age, political conservatism, extrinsic religiosity, and intrinsic spirituality were significant predictors of perceived psychological safety and appreciation of differences. The authors discuss implications of these findings.