The Course of Childhood Anxiety Symptoms: Developmental Trajectories and Child-Related Factors in Normal Children

This three-wave longitudinal study explored developmental trajectories for various types of childhood anxiety symptoms (i.e., specific fears, social anxiety, generalized anxiety, and separation anxiety) and examined how these trajectories were associated with several factors thought to be involved in the pathogenesis of anxiety. Parents of a community sample of 224 children aged 4 to 11 years repeatedly completed a standardized questionnaire of anxiety symptoms during a 2-year period. At Time 1, parents also filled out scales for measuring children’s level of behavioral inhibition (BI), internalizing and externalizing symptoms, and prosocial behaviors, while an interview was conducted with children to assess Theory-of-Mind (TOM) ability. Growth Mixture Modeling identified multiple developmental trajectories in childhood anxiety symptoms of which the ‘stable-low’ or ‘stable-medium’ reflected the normative trajectories. Further, multinomial regression analyses indicated that the higher developmental trajectories of anxiety were associated with higher levels of BI and internalizing symptoms at Time 1. In sum, results show heterogeneity in the development of anxiety symptoms and underline the importance of early prevention programs for children at high risk for developing an anxiety disorder.     

Quality adjusted survival analysis: A neglected application of the quality of well-being scale

Abstract

Background In survival analysis, those who are alive are statistically coded as 1.0 while those who are dead are coded as 0.0. Since everyone who remains alive is given the same score, a person confined to bed with an irreversible coma is alive and is counted the same as someone who is active and asymtomatic. The Quality of Well-being (QWB) scale defines levels of wellness on the continuum between death and optimum function and integrates morbidity and mortality into the same number. This paper demonstrates the effect of including mortality in QWB estimates for male adults with HIV infection.

Method This study involves follow-up of a cohort of 386 male adults participating in the San Diego HIV Neurobehavioral Research Center (HNRC). Patients were evaluated using the QWB at enrollment and at six month intervals. All patients were classified into three stages of HIV disease according to the Center for Disease Control (CDC) classification: CDC IV (symptomatic HIV disease), CDC II or III (asymptomatic infection) and uninfected male controls.

Results QWB scores were calculated with and without mortality included for men in each CDC class who completed a one year (N = 148) or two year follow-up (N = 60). At each evaluation, there were significant differences among CDC classes and inclusion of deaths increased the variance accounted for by CDC class at each evaluation.

Conclusions HIV infection has significant impacts upon both morbidity and mortality. Survival analysis captures only the mortality dimension, while quality adjusted survival analysis using the QWB includes both dimensions. We propose quality adjusted survival analysis as a more sensitive method for assessing outcome in HIV disease and other health conditions.     

How Many is Enough? Determining Optimal Sample Sizes for Normative Studies in Pediatric Neuropsychology

The purpose of this investigation was to determine how confidence intervals (CIs) for pediatric neuropsychological norms vary as a function of sample size, and to determine optimal sample sizes for normative studies. First, the authors calculated 95% CIs for a set of published pediatric norms for four commonly used neuropsychological instruments. Second, 95% CIs were calculated for varying sample size (from n?=?5 to n?=?500). Results suggest that some pediatric norms have unacceptably wide CIs, and normative studies ought optimally to use 50 to 75 participants per cell. Smaller sample sizes may lead to overpathologizing results, while the cost of obtaining larger samples may not be justifiable.     

Global and Local processing in Williams Syndrome: Drawing versus Perceiving

It has been hypothesized that a local processing bias underlies overall visuospatial impairments in Williams syndrome (WS). However, recent studies have challenged this hypothesis by providing evidence against a local processing bias at the perceptual level. The aim of the present study was to further examine drawing and perceptual skills in children with WS using closely matched-hierarchical stimuli. In the drawing task children with WS exhibited a local processing bias. However, no significant preferential bias was found in the perceptual task. This indicates that children with WS do not systematically present a preferential bias for local information. Taken together the findings of the present study suggest that perceptual processing deficits per se are unlikely to explain local processing biases in visuoconstructive tasks often described in people with WS.     

Structural Equation Modeling of Spatial Presence: The Influence of Cognitive Processes and Traits

This article examines the formation process of spatial presence, which is conceived as a two-step process involving the construction of a mental model of the mediated environment, followed by the emergence of spatial presence. During both stages, cognitive processes and user traits are in effect. We present data derived from a pooled set of data of three studies using the same virtual environment. Structural equation modeling is used to confirm the proposed theoretical model. The results show that attention and the trait of visual spatial imagery are positive predictors of the mental model of the mediated environment. In the second step, the formation of spatial presence is governed by involvement, the suspension of disbelief, and the domain-specific interest, together with the mental model.     

Task dependent modulation of exogenous attention: Effects of target duration and intervening events

Inhibition of return (IOR) consists of slower reaction times in response to stimuli appearing at previously attended or inspected locations. The exact mechanisms underlying the effect have not yet been determined. In the present work, we manipulated two variables, target duration and intervening event (fixation cue between cue and target), through which we modulated the IOR effect as a function of task. When the target was presented until response, the presence of an intervening event made the cueing effect more negative in all tasks, although facilitation in the absence of an intervening event was only observed in discrimination and go–no-go tasks. When the target duration was 50 ms, the effect of the intervening event on cueing was also only observed for the discrimination and go–no-go tasks. Target duration had no effect at all in the discrimination task. Possible mechanisms for these modulations (detection cost and spatial selection benefit, both of which are based on cue–target integration processes) are discussed.     

A theoretical exploration and model of consumer expectations,post‐purchase affective states and affective behaviour

Through a detailed review of the service quality and (dis)satisfaction literatures, this paper presents a theoretical model exploring the interrelationship between expectations, affective post‐purchase states and affective behaviour. Drawing together a comprehensive hierarchy of expectations culled from the service quality literature, the authors seek to apply levels of expectation to specific post‐purchase affective states and affective behaviour. The authors argue that consumers have two types of expectation that influence post‐purchase affective states: the core or predictive ‘will be’ expectation; and peripheral expectations—that can range from the ideal standard to the minimum tolerable level. By applying the levels‐of‐expectation approach to the expectation‐disconfirmation paradigm, the authors argue that there are four types of post‐purchase affective states: delight, satisfaction (or positive indifference), acceptance (or negative indifference) and dissatisfaction. These four states may lead onto affective action—ie varying degrees of complaining or complimenting behaviour. The paper presents 11 propositions relating to expectations and their interrelationship with post‐purchase affective states and subsequent consumer behaviour, with the aim of stimulating further scholarly enquiry. The managerial implications of the analysis are also considered. Copyright © 2003 Henry Stewart Publications.