A multidisciplinary treatment for encopresis in children with developmental disabilities

Achieving continence of one's bowel movements is a key step in development and failure to do so leads to many negative consequences. Treatments for encopresis appearing in the literature have employed behavioral strategies; medications such as suppositories, laxatives, or enemas; and in some studies a combination of these approaches. To date, attempts to extend successful treatments for encopresis in typically developing children to those with developmental disabilities have been limited. The current study included three participants diagnosed with developmental disabilities who had a history of encopresis. None of the participants had a continent bowel movement under baseline conditions. Continent bowel movements increased during treatment that included the addition of suppositories to elicit continent bowel movements. Two participants began having independent continent bowel movements (i.e., without requiring suppositories) and medication was successfully faded out for the remaining participant. Treatment took between 13 and 21 days.     

The Social Construction of Emotions: A New Direction in the Pastoral Work of Healing

Interviews with pastoral practitioners revealed that exploration of feelings, both personal and interpersonal, is considered the sine qua non of pastoral care and counseling. This emphasis on personal and interpersonal feelings is largely attributable to the enduring influence of Carl Rogers on contemporary pastoral care and counseling. While recognizing that Rogers was not as narrowly focused on personal and interpersonal relationships and oblivious to the larger social order than is generally assumed, I contend that he did not give sufficient attention to the fact that emotions are socially constructed and draw on recent literature on the social construction of emotions and on critical race theory to argue for a new direction in the pastoral work of healing, one that takes more adequate account of the sociocultural factors that create and sustain unhealthy emotions and that recognizes that emotions are signals about the social order.     

The interface of mental and emotional health and pregnancy in urban indigenous women: Research in progress

Research among indigenous women in Australia has shown that a number of lifestyle factors are associated with poor obstetric outcomes; however, little evidence appears in the literature about the role of social stressors and mental health among indigenous women. The not‐for‐profit organization beyondblue established a “Depression Initiative” in Australia. As part of this they provided funding to the Townsville Aboriginal and Torres Strait Islander Health Service in the “Mums and Babies” clinic. The aim of this was to establish a project to (a) describe the mental health and level of social stressors among antenatal indigenous women and (b) assess the impact of social stressors and mental health on perinatal outcome. A purposive sample of 92 indigenous women was carried out. Culturally appropriate research instruments were developed through consultations with indigenous women's reference groups. The participants reported a range of psychosocial stressors during the pregnancy or within the last 12 months. Significant, positive correlations emerged between the participants' Edinburgh Postnatal Depression Scale (EPDS; J. Cox, J. Holden, & R. Sagovsky, 1987) score and the mothers' history of child abuse and a history of exposure to domestic violence. A more conservative cutoff point for the EPDS (>9 vs. >12) led to 28 versus 17% of women being identified as “at risk” for depression. Maternal depression and stress during pregnancy and early parenthood are now recognized as having multiple negative sequelae for the fetus and infant, especially in early brain development and self‐regulation of stress and emotions. Because of the cumulative cultural losses experienced by Australian indigenous women, there is a reduced buffer to psychosocial stressors during pregnancy; thus, it is important for health professionals to monitor the women's emotional and mental well‐being.     

A Model of Knower-Level Behavior in Number Concept Development

Abstract We develop and evaluate a model of behavior on the Give- N task, a commonly used measure of young children's number knowledge. Our model uses the knower-level theory of how children represent numbers. To produce behavior on the Give- N task, the model assumes that children start out with a base rate that makes some answers more likely a priori than others but is updated on each experimental trial in a way that depends on the interaction between the experimenter's request and the child's knower level. We formalize this process as a generative graphical model, so that the parameters—including the base rate distribution and each child's knower level—can be inferred from data using Bayesian methods. Using this approach, we evaluate the model on previously published data from 82 children spanning the whole developmental range. The model provides an excellent fit to these data, and the inferences about the base rate and knower levels are interpretable and insightful. We discuss how our modeling approach can be extended to other developmental tasks and can be used to help evaluate alternative theories of number representation against the knower-level theory.     

Parafoveal processing during reading is reduced across a morphological boundary

A boundary change manipulation was implemented within a monomorphemic word (e.g., fountaom as a preview for fountain), where parallel processing should occur given adequate visual acuity, and within an unspaced compound (bathroan as a preview for bathroom), where some serial processing of the constituents is likely. Consistent with that hypothesis, there was no effect of the preview manipulation on fixation time on the 1st constituent of the compound, whereas there was on the corresponding letters of the monomorphemic word. There was also a larger preview disruption on gaze duration on the whole monomorphemic word than on the compound, suggesting more parallel processing within monomorphemic words.     

When should clinicians switch treatments? An application of signal detection theory to two treatments for women with alcohol use disorders

Statistical application of signal detection theory has been used to study the clinical utility of early treatment response in a range of treatments and psychiatric disorders. The current study sought to examine the predictive value of weekly within-treatment drinking using receiver operator curves (ROCs) and zero-inflated Poisson (ZIP) regression in 102 women with alcohol use disorders (AUDs) randomized to either alcohol behavioral individual treatment (ABIT; n = 52) or alcohol behavioral couples treatment (ABCT; n = 50). ROC analyses indicated that failure to achieve or sustain abstinence by the end-of-treatment and one-year follow-up was predicted with reasonable accuracy by week 4 percent days abstinent (PDA) in ABIT. ZIP models yielded similar results with evidence for within-treatment PDA with week 6 PDA predicting both the abstinence as well as percent days drinking at the end-of-treatment and one-year follow-up. Within-treatment PDA was a significantly better predictor of outcomes for ABIT than ABCT, despite a better overall treatment response for ABCT. Implications for stepped care models of alcohol treatment are discussed and recommendations for future research made. When Should Clinicians Switch Treatments: An Application of Signal Detection Theory to Two Treatments for Women with Alcohol Use Disorders.