Long‐Term Outcomes of Traumatic Brain Injury in Early Childhood

Mild traumatic brain injury (mTBI) is a leading cause of injury among children, with approximately 15% of children experiencing a TBI prior to 15 years of age. Acutely, mTBI has been associated with a range of cognitive, physical, emotional and behavioural impairments. However, few studies have examined outcomes beyond five years post injury, long before the developmental process is complete and the full extent of any deficits may manifest. Our group had the unique opportunity to use data from a longitudinal birth cohort of 1265 children (Christchurch Health and Development Study) to examine the long term outcomes of early injury (0–5 years). Information about these children, including mTBI events, had been collected at birth, 4 months and at yearly intervals until age 16, and again at ages 18, 21 and 25 years. We found that even after statistical control for a wide range of child and family confounds, children who had been hospitalized for an mTBI had increased inattention/hyperactivity and conduct as rated by mothers and teachers over ages 7–13 years. Increased rates of psychiatric disorders were over 14–16 years for those injured in the preschool, including symptoms consistent with Attention Deficit/Hyperactivity Disorder (ADHD), Odds Ratio = 4.6, Conduct Disorder (CD), Odds Ratio = 5.6 and Substance Abuse (Odds Ratio = 9.1). Over ages 21–25 ongoing behaviour problems were assessed using self‐reported arrests, violent offenses and property offenses. Compared to non‐injured individuals, mTBI groups were more likely to be arrested, involved in property, and violent offences. We controlled for a wide range of factors and there was still clear evidence of ongoing problems for individuals who had experienced a mTBI compared to their non injured counterparts. These findings provide compelling evidence of long term psychosocial and psychiatric outcomes following mTBI.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

A meta‐analysis of the differential relations of traditional and cyber‐victimization with internalizing problems

This meta‐analysis examined the associations between cyber‐victimization and internalizing problems controlling for the occurrence of traditional victimization. Twenty independent samples with a total of 90,877 participants were included. Results confirmed the significant intercorrelation between traditional and cyber‐victimization (r = .43). They both have medium‐to‐large bivariate correlations with internalizing problems. Traditional victimization (sr = .22) and cyber‐victimization (sr = .12) were also uniquely related to internalizing problems. The difference in the relations between each type of victimization and internalizing problems was small (differential d = .06) and not statistically significant (p = .053). Moderation of these effect sizes by sample characteristics (e.g., age and proportion of girls) and study features (e.g., whether a definition of bullying was provided to participants and the time frame used as reference) was investigated. Results are discussed within the extant literature on cyber‐aggression and cyber‐victimization and future directions are proposed.

     

Enhancing Critical Consciousness Through a Cross‐Cultural Immersion Experience in South Africa

Using phenomenological approaches, the author explored the meanings and essences of a cross‐cultural immersion experience in South Africa among counseling master's‐level students. Five core themes—the meaning of being American, sociopolitical awareness, engagement with South Africans and their communities, appreciation of life, and commitment to change—characterized the development of critical consciousness (Freire, 1973 , 2000 ). Findings support positive influences of cross‐cultural immersion as an experiential pedagogical method for multicultural development. Usando enfoques fenomenológicos, se exploraron los significados y esencias de una experiencia de inmersión transcultural en Sudáfrica entre estudiantes de nivel máster en consejería. Cinco temas centrales (el significado de ser estadounidense, la conciencia sociopolítica, la interacción con individuos sudafricanos y sus comunidades, la valoración de la vida y el compromiso con el cambio) caracterizaron el desarrollo de la conciencia crítica (Freire, 1973 , 2000 ). Los hallazgos confirman influencias positivas de la inmersión transcultural como un método pedagógico basado en la experiencia para el desarrollo multicultural.     

Best practices for missing data management in counseling psychology

This article urges counseling psychology researchers to recognize and report how missing data are handled, because consumers of research cannot accurately interpret findings without knowing the amount and pattern of missing data or the strategies that were used to handle those data. Patterns of missing data are reviewed, and some of the common strategies for dealing with them are described. The authors provide an illustration in which data were simulated and evaluate 3 methods of handling missing data: mean substitution, multiple imputation, and full information maximum likelihood. Results suggest that mean substitution is a poor method for handling missing data, whereas both multiple imputation and full information maximum likelihood are recommended alternatives to this approach. The authors suggest that researchers fully consider and report the amount and pattern of missing data and the strategy for handling those data in counseling psychology research and that editors advise researchers of this expectation.     

Taking a Turn Toward the Masculine: The Impact of Mortality Salience on Implicit Leadership Theories

The present research investigates the influence of subtle death-related thoughts (i.e., mortality salience) on people's images of effective leaders (i.e., their implicit leadership theories [ILTs]). We test the prediction that mortality salience will change the content of these implicit theories to be more gender stereotypical such that individuals will conceive of effective leaders in a significantly more masculine, or agentic, manner. To test this prediction, we assessed the communal and agentic components of participants' ILTs after they were presented with a mortality salience or control manipulation. Results show that priming individuals to think about their mortality with two open-ended questions resulted in a significant shift in their ILTs such that an effective leader is described in significantly more agentic terms compared to the control condition. This masculine shift in people's ILTs was demonstrated in both women and men, and mortality salience did not influence perceptions of effective leaders' communal traits. This work contributes to research on gender bias in leadership, ILTs, and terror management theory and has implications for female leaders.     

Defining ‘Modern’ Malay womanhood and the coexistent messages of the veil

The gender constructions and performances of Malay women are often perceived by outside researchers as ‘shrouded under a veil’ of increasing Islamic conservatism. Urban Malay women, however, argue that women actively engage in the construction and performance of gender identities. Based on research conducted in Kuala Lumpur, Malaysia, during 2001 and 2003, this article argues that women advantageously alter, transform and utilise the constructs placed upon them by Islam, by ethnic identification and by conceptions of ‘modernity’. Often one image of ‘womanhood’ is presented and in public e an image that is socially accepted, honoured and respected e while less publicly alternative forms of ‘womanhood’ articulate individual goals and aims. Using an agent-oriented perspective, this article further includes an analysis of women's individual renegotiations of larger cultural constructs and the ways in which the tudong, or headscarf, has become a symbol by which individual women express their understanding of social position and personal freedoms in an industrialised Islamic context.     

A Psychometric Evaluation of the Approach and Avoidance of Alcohol Questionnaire Among Alcohol-Dependent Patients Attending Residential Treatment

Despite research suggesting that alcohol-dependent individuals have both craving and avoidant tendencies for alcohol, few studies have measured self-report tendencies using the Approach and Avoidance of Alcohol Questionnaire (AAAQ). The goal of this study was to examine the psychometric properties of the AAAQ using a sample of adults receiving 12 step-based residential treatment for alcohol dependence. As part of a larger study, 100 adults receiving residential treatment completed the AAAQ and several other assessments shortly after treatment admission. Analyses of the AAAQ examined its factor structure, internal consistency, and convergent and predictive validity. A maximum likelihood estimation factor analysis using oblique rotation produced 3 factors accounting for 69 % of the variance. A confirmatory factor analysis suggested that the 3-factor model was a moderate fit for data from a second sample of patients. Internal consistency was fairly high and convergent validity was demonstrated by relationships with another scale of alcohol craving, time since last drink, and quantity and frequency of pre-treatment alcohol use. Regarding predictive validity, the level of approach tendencies on the AAAQ was significantly related to abstinence status during the first 6 months following treatment. Avoidance level was not related to abstinence. The results largely replicated past studies utilizing outpatient samples and suggest that the AAAQ shows promise as a psychometrically sound, internally reliable self-report craving measure for individuals with alcohol dependence.