Multimethod Assessment of Psychopathology Among DSM-IV Subtypes of Children With Attention-Deficit/Hyperactivity Disorder: Self-, Parent, and Teacher Reports

Using data based on self-, parent, and teacher reports, we assessed various aspects of psychopathology in a large sample of control children and those with ADHD. Confirmatory factor analysis was employed to extract response bias from latent constructs of aggression, anxiety, attention problems, depression, conduct disorder, and hyperactivity. These latent constructs were then entered into logistic regression equations to predict membership in control versus ADHD groups, and to discriminate between ADHD subtypes. Results of the regression equations showed that higher levels of attention problems and aggression were the best predictors of membership in the ADHD group relative to controls. Logistic regression also indicated that a higher degree of aggression was the only significant predictor of membership in the ADHD-Combined group compared to the ADHD-Inattentive group. However, when comorbid diagnoses of Oppositional Defiant Disorder and Conduct Disorder were controlled for in the logistic regression, greater hyperactivity rather than aggression was the sole variable with which to distinguish the ADHD-Combined from the ADHD-Inattentive subtype. Results are discussed in the context of the DSM-IV ADHD nosology and the role of instrument and source bias in the diagnosis of ADHD.     

Effects of time-based administration of abstinence reinforcement targeting opiate and cocaine use

Polydrug use is a common problem among patients in opioid-substitution treatment. Polydrug use has been reduced by administering abstinence-reinforcement contingencies in a sequence, such that a single drug is targeted until abstinence is achieved, and then an additional drug is targeted. The present study examined effects of administering abstinence-reinforcement contingencies sequentially based on time rather than on achieved abstinence. Participants accessed paid work (about $10/hr maximum) in the Therapeutic Workplace by providing urine samples 3 times per week. The urine samples were tested for opiates and cocaine. During an induction period, participants earned maximum pay independent of drug abstinence. Then, maximum pay depended upon urine samples that were negative for opiates. Two weeks later, maximum pay depended upon urine samples that were negative for both opiates and cocaine. Opiate and cocaine abstinence increased following administration of the respective contingencies. The time-based administration of abstinence reinforcement increased opiate and cocaine abstinence.     

Cognitive bias via the Internet: a comparison of Web-based and standard emotional Stroop tasks in social phobia

There is accumulating evidence to suggest that social phobia is associated with attentional bias for words related to social threat. Information processing in individuals with social phobia (n = 87) was investigated in the present study using 2 versions of the emotional Stroop task. Results from a standard emotional Stroop task indicated delayed colour naming of socially threatening words relative to neutral words, in line with previous research, whereas results from a Web-based emotional Stroop task indicated a facilitation effect, with faster manual indication of colour choice for socially threatening words than for neutral words. Possible explanations for these contrasting findings and issues for further research are discussed.     

Diagnostic Stability of ADHD in a Community Sample of School-Aged Children Screened for Disruptive Behavior

A large school-based sample of children in Grades 1, 2, 3, and 4 were screened for disruptive behavior and subsequently assessed over a 5-year period for DSM-III-R symptoms of attention deficit hyperactivity disorder (ADHD) and other externalizing and internalizing behavior disorders. Parents completed structured diagnostic interviews in Years 1, 4, and 5, and teachers completed Behavioral Assessment for Children—Teacher Rating Scales behavioral ratings annually. For parent-derived diagnostic data, both inattention and hyperactivity/impulsivity symptom groups declined from Year 1 to Year 4, with hyperactivity showing more significant decline. For teacher-rated behavioral dimensions, the Attention Problems scale declined from Year 1 to Year 3 and stabilized thereafter. The Hyperactivity scale showed stability during the first 3 years before declining in Year 4. Of those children diagnosed with ADHD in Year 1, 69% still met criteria for ADHD in either Year 4 or 5. Persisters were more likely to exhibit coexisting conduct disorder in Year 1 and oppositional defiant disorder in Years 1, 4, and 5. Parents of persisters reported more psychosocial adversity on measures of parenting and marital satisfaction.     

Encounter with death: The thought of Robert Jay Lifton

Robert Jay Lifton begins his work in the psychosocial framework that he takes over from Erik Erikson. Lifton's thought is based upon a central paradigm—death and the continuity of life. Lifton makes important contributions with his five modes of symbolic immortality and with his investigation of the psychological themes in survivors. The origins and limits of Lifton's thought are critically examined.     

The moral lives of children: The thought of Robert Coles

Robert Coles combines the insights of literature with the resources of medicine and psychiatry in order to understand and bring healing to people. Using the distinction between character and personality, Coles explores the active moral lives of children. To Coles, the moral purpose of the family is to develop character. Coles's contribution is not a new theoretical approach; rather, it is a literary documentary perspective that seeks to awaken and sensitize our moral imaginations.He is an instructor in moral philosophy at Notre Dame College in Baltimore, Maryland.     

The emotional dynamics of funeral services

This paper explores how funerals are often restricted to a cognitive level and become exercises in denial based consolation. Clergy are responsible for addressing the emotional needs of the people gathered for the funeral. The issue is not whether or not we intervene buthow we intervene. Specific dynamics and opportunities in the family are examined and varied needs of other mourners are considered. The funeral is an intervention in the grief process. The funeral service has three essential functions. First, it is a proclamation of our faith. Secondly, the service speaks to the emotional needs of the grieving. Finally, the service is a recognition and celebration of the person's life.Dr. Lageman is a Fellow at the American Association of Pastoral Counselors and a Clinical Member of AAMFT.Valuable assistance in preparing this article was received from my colleague, Anne Nelson.