Parent satisfaction with neuropsychological consultation after pediatric mild traumatic brain injury

Few studies have focused on consumer satisfaction following neuropsychological evaluation. We sought to examine parent satisfaction with neuropsychological consultation following a mild traumatic brain injury (TBI) in school-age children. We surveyed 71 parents of 8- to 17-year-olds participating in a prospective longitudinal study examining neuropsychological consultation as an intervention for persistent postconcussive symptoms. Children had sustained injuries between 2 and 12 months prior to enrollment. Neuropsychological consultation occurred on average 5 months post-injury. Parent satisfaction data were collected via telephone approximately 4 months after the neuropsychological consultation. The vast majority of parents were quite satisfied with the service (e.g., 94% overall satisfaction rate; 96% rated the service as good or excellent). Satisfaction rates were associated positively with time since injury and negatively with parental education. No other child, parent, or provider variable correlated with satisfaction. The results add to the relatively sparse literature on parent satisfaction with neuropsychological evaluation. A pressing future need in pediatric neuropsychology is to examine the satisfaction of other consumers of the service, including healthcare personnel, educators, and the child patients themselves.     

Development and Refinement of a Targeted Sexual Risk Reduction Intervention for Women With a History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) is associated with sexual risk behavior in adulthood. Traditional sexual risk reduction interventions do not meet the unique needs of women who have been sexually abused. In the current paper, we describe the four-stage process we followed to develop and refine a targeted sexual risk reduction intervention for this population. First, initial quantitative work revealed that the intervention should address how maladaptive thoughts related to traumatic sexualization, trust, powerlessness, and guilt/shame (traumagenic dynamics constructs) influence current sexual behavior. Second, qualitative interviews with 10 women who reported a history of CSA (M age = 34 years; 90% African American) as well as current sexual risk behavior provided support for targeting maladaptive thoughts associated with these traumagenic dynamics constructs. Third, based on the qualitative and quantitative results, we developed a 5-session, group-delivered intervention to address the maladaptive thoughts that occurred as a result of CSA, as well as the cognitive-behavioral determinants of sexual risk behavior. This intervention drew heavily on cognitive behavioral techniques to address cognitions associated with CSA and the links between these cognitions and current sexual risk behavior. Techniques from trauma-based therapies, as well as motivational techniques, were also incorporated into the intervention. Finally, we refined the intervention with 24 women (M age = 33 years; 79% African American), and assessed feasibility and acceptability. These women reported high levels of satisfaction with the intervention. The resultant intervention is currently being evaluated in a small, randomized controlled trial.     

Quality of life research: a case for combining photo-elicitation with interpretative phenomenological analysis

In this article, we provide practical and theoretical discussion of the use of two complementary research methods to explore quality of life. We present a case example of the use of photo-elicitation alongside interpretative phenomenological analysis and use examples from our research with people living with paraplegia and chronic pain to demonstrate how these methods can be combined to provide a participant-led understanding of quality of life. This discussion includes consideration of practical and ethical issues relevant to others wishing to combine these research methods. Furthermore, we highlight some of the potential practical and therapeutic opportunities provided by the approach through an illustration of how photographs work to enhance self-reflection and promote hermeneutic sense making.     

Maternal Emotion Socialization: The Contribution of Inhibited Behaviour and Mothers' Dissatisfaction with the Parent–Child Relationship

In the present study, we examined the associations between children's inhibited behaviour, mothers' dissatisfaction with the parent–child relationship and mothers' self‐reported reactions to children's emotions. Fifty‐three mother–child dyads visited the laboratory, and mothers completed questionnaires about child temperament and emotion socialization. Maternal stress stemming from dissatisfaction with the parent–child relationship was negatively predictive of mothers' supportive reactions to happiness. In addition, the interaction between children's inhibited behaviour and parent–child relationship dissatisfaction significantly predicted mothers' supportive reactions to children's fear; specifically, mothers who reported the highest levels of dissatisfaction in their relationship with their children and had children who exhibited low levels of inhibition reported the lowest levels of supportive responses to their children's fear. Importantly, mothers reported the highest levels of supportive reactions to children's fear when their children were low in inhibition, and they reported low levels of dissatisfaction in their relationship with their child. Copyright © 2015 John Wiley & Sons, Ltd.     

Not every credible interval is credible: Evaluating robustness in the presence of contamination in Bayesian data analysis

As Bayesian methods become more popular among behavioral scientists, they will inevitably be applied in situations that violate the assumptions underpinning typical models used to guide statistical inference. With this in mind, it is important to know something about how robust Bayesian methods are to the violation of those assumptions. In this paper, we focus on the problem of contaminated data (such as data with outliers or conflicts present), with specific application to the problem of estimating a credible interval for the population mean. We evaluate five Bayesian methods for constructing a credible interval, using toy examples to illustrate the qualitative behavior of different approaches in the presence of contaminants, and an extensive simulation study to quantify the robustness of each method. We find that the “default” normal model used in most Bayesian data analyses is not robust, and that approaches based on the Bayesian bootstrap are only robust in limited circumstances. A simple parametric model based on Tukey’s “contaminated normal model” and a model based on the t-distribution were markedly more robust. However, the contaminated normal model had the added benefit of estimating which data points were discounted as outliers and which were not.     

Cognition at risk: Gestalt/feature-intensive processing, attention deficit, and substance abuse

Attention deficit hyperactive disorder (ADHD) is associated with elevated levels of substance abuse, but the cognitive linkages involved have been little explored. The present study builds upon earlier work showing that more gestalt, as opposed to feature-intensive, styles of processing are conductive to substance abuse, especially in those with ADHD symptoms. The work reported here indicates that a protective factor against substance abuse may lie in relatively efficient heuristic processing, especially synthetic or inferential heuristic processing, but further demonstrates that those with ADHD symptoms tend to have poorer abilities in this regard, even at the subclinical, nondiagnosed level. Results are discussed in terms of the gestalt/featureintensive processing theory of cognition.     

Attention problems and executive functions in children with spina bifida and hydrocephalus.

This study addressed the incidence of Attention-Deficit/Hyperactivity Disorder (ADHD) subtypes in children with spina bifida meningomyelocele and shunted hydrocephalus (SBH) as well as differences in executive functions among these subtypes. Parent rating scales revealed that 31% of the group with SBH could be identified with AD/HD, mostly the Inattentive type (23%). The group with SBH differed from normal controls on cognitive measures of executive functions, but subtype differences were not significant. Multivariate tests showed that children with SBH were rated with greater difficulties on the Behavior Rating Inventory of Executive Function (BRIEF) compared to controls; those with SBH and any subtype of ADHD differed from those with SBH and no ADHD; and those with ADHD (Combined Type) differed significantly from those with ADHD (Predominantly Inattentive Type). Subtype differences on univariate tests in the latter comparison were significant on the BRIEF Inhibit scale, showing more disinhibition in those with SBH and ADHD (Combined Type), but no significant differences were apparent on the BRIEF Sustain, Shift, and Initiate scales. The results show that the incidence of ADHD in children with SBH exceeds the population rate, is represented by problems with inattention rather than with impulsivity and hyperactivity; and that as with non-brain injured individuals, subtype differences in cognitive function remain to more clearly delineated.