Responses to Parental Cancer: A Clinical Perspective

Parental cancer constitutes a unique stressor, and newly diagnosed patients often express deep concerns about how their children will adapt to the illness and treatments. Although data on this underserved group of second-order patients is growing, the literature has yielded limited practical information for the clinician working with cancer patients who have children at home. The present study examines long-term adjustment in two samples of grown daughters of cancer patients. Subjects reported having experienced significant emotional upheaval and substantial family disruption during the acute phase of their parents' diagnosis and treatments. Many of the family problems were related to difficulties with the healthy parent. Subjects also recalled numerous positive changes during this acute phase of adjustment to the stressor. Over the long term, subjects did not differ from comparison women on several measures of psychological adjustment, suggesting that children of cancer patients are not necessarily at elevated risk for long-term psychological maladjustment. Nevertheless, many subjects continued to experience a lasting subjective impact of their cancer experiences that appeared to be too subtle or existential to be measured by general psychological instruments. Most of these changes were positive, and deriving a sense of benefit from the experience was a near-universal phenomenon. Subjects discussed what helped and hindered their coping efforts, and made a number of recommendations to others facing this family stressor. Inadequate communication about the cancer was identified by many subjects as an impediment to their eventual adjustment.     

Processing demands during mental operations

Man possesses a central system of limited capacity. Theorists at first described this system as a single limited capacity channel Two current theoretical alternatives to single-channel theory are (1) the undifferentiated capacity hypothesis that man possesses a pool of capacity units so that interference occurs oniy if the total number of capacity units that mental operations demand exceeds the system limit and (2) the hypothesis that some, but not all, mental operations require space in a limited capacity central mechanism and that any operation that requires space will interfere with any other operation that also demands space. Time on task fails as a sensitive measure of capacity demands because some task components require time but not full processing capacity. The secondary task technique uses the interference between a primary task and a secondary task to assess the extent to which the primary task makes processing demands on the central limited system. Processing demands have been measured for five categories of mental operation: (1) encoding, (2) multiple input, (3) rehearsal, (4) transformation, and (5) responding.     

The development of retrieval strategies in young children

Two incidental memory tasks were given to 3.5–6.5 yr old children to test for an age increase in the tendency to use a simple indirect retrieval strategy when direct retrieval efforts do not suffice. In both tasks, pictures of people were paired with very closely associated toy objects (e.g., farmer—toy tractor), and the indirect retrieval strategy consisted of thinking to use one member of the pair as a cue to the recall of the other, e.g., turning over the visible but facedown pictures and using them as retrieval cues for the toys. Support for the predicted age trend was obtained in one of the two tasks. It was suggested that the development of retrieval skills in children may show some parallels with that of storage skills.     

Comparison of stimulus control and reinforcement control effects on imitative behavior

An attempt was made to evaluate reinforcement and stimulus control of imitative and non-imitative behavior. The imitative response required the subject to duplicate the experimenter's response by matching blocks that varied in color. The factor designed to evaluate stimulus control was fading, a procedure that systematically varies the differences between the imitative and non-imitative stimuli. The topography and duration of the non-imitative stimuli were faded in. The factors designed to evaluate reinforcement control were differential reinforcement of non-imitative behavior and time out from positive reinforcement. The results showed stimulus control of non-imitation to be more important than reinforcement control, and that reinforcing events were not sufficient to control non-imitation; while the arrangement of stimulus events was sufficient to control non-imitation. These results were related to studies providing evidence for the processes of discrimination and generalization.     

THE EFFECTS OF PERFORMANCE FEEDBACK ON THE SAFETY OF CLIENT LIFTING AND TRANSFER

Individual written and verbal performance feedback was examined to determine its influence on the safety with which physically disabled clients were transferred. Two client-transfer techniques were task analyzed and six direct service providers' on-the-job performance was measured weekly. A multiple baseline across settings and subjects was used to evaluate effects of the feedback. Consumer satisfaction and the costs of the procedures were also assessed. Results showed that feedback was consistently followed by improvements in safe performance. These improvements tended to maintain as feedback was faded. Participants favorably rated the feedback procedure and consistently recommended its use with other staff.     

Children's use of sequence information in partially predictable reaction-time sequences

Second-, fourth-, and sixth-grade children and adults performed a four-choice reaction time task with partially predictable sequences and 250-, 500-, and 750-msec response-to-stimulus intervals. The relative advantage for in-sequence as opposed to out-of-sequence events was independent of the response-to-stimulus interval for all ages. Children, but not adults, were slower for nonrepeated than repeated out-of sequence events and this advantage for repeated signals decreased as age increased. A second experiment extended the range of intervals tested to zero. Second graders and adults responded to four-choice partially predictable sequences with 0-, 250-, and 500-msec response-to-stimulus intervals. As in the first experiment, the difference between in-sequence and out-of-sequence events did not vary with the response-to-stimulus interval. The results suggest that both children and adults are able to process advance sequence probability information about a subsequent event in parallel with an ongoing response.     

SMALL GROUP BEHAVIORAL TRAINING TO IMPROVE THE JOB INTERVIEW SKILLS REPERTOIRE OF MILDLY RETARDED ADOLESCENTS

Four retarded adolescents, enrolled in a short-term residential treatment program, received behavioral job interview skills training. Although potentially employable, each was unable to present himself effectively in standard employment interviews. Treatment consisted of a series of behavioral group sessions using instructions, modeling and rehearsal procedures to increase, in multiple baseline fashion, such skills as the adolescents' ability to disclose positive information about their experience and background, convey interest in the position and direct relevant questions to an interviewer. Effectiveness of treatment for each client was assessed by: (1) Objective ratings of performance during individual, structured role-play job interviews following each treatment group; (2) objective ratings of pre- and posttraining performance during tape recorded in vivo generalization job interviews at a fast-food restaurant; and (3) global evaluations of pre- and posttraining in vivo generalization interviews made by experienced personnel interviewers unfamiliar with the nature of the treatment. The results indicated that potentially employable retarded citizens can be successfully taught appropriate job interview behavior using a small group behavioral procedure. The need for such techniques in community and rehabilitation centers for retarded citizens and other clinical populations is discussed.     

Accounting for cognitive aging: context processing, inhibition or processing speed?

Age-related deficits in context processing were examined in relationship to two predominant theories of cognitive aging (the Inhibitory Deficit and Processing Speed Models). Older and younger adults completed a measure of context processing (AX Continuous Performance Test (CPT) task) as well as a computerized battery of inhibitory tasks: Stroop, garden path sentences, go no-go, and the stop-signal paradigm. Participants also completed a simple processing speed task. After controlling for baseline differences in processing speed, age effects were detected on the AX-CPT. Smaller, but significant age effects were noted on the Stroop and stop-signal tasks, but no significant age effects were found on the garden path sentence and go no-go tasks. Intertask correlations were weak, providing little evidence for a homogenous or uniform construct of inhibition. The sensitivity of the AX-CPT to cognitive aging is discussed in the context of existing theories of cognitive aging. The authors suggest that deficits in context processing and utilization may underlie cognitive aging phenomena.     

Secondary control reviewed and defined

Conclusions about secondary control have been hindered by researchers' disparate interpretations of the construct. The current review offers a definition that reflects commonality among researchers and the spirit of the original article (F. Rothbaum, J. R. Weisz, & S. S. Snyder, 1982): Secondary control refers to the process by which people adjust some aspect of the self and accept circumstances as they are. The authors also identify a "fit versus control" dimension, along which secondary control research can be classified and reviewed. The authors conclude that fit-focused secondary control is adaptive for coping, is relatively preferred in interdependent cultural contexts, and may serve the motivation for relatedness. Control-focused definitions lead to different interpretations of the function and cultural nature of secondary control. The proposed definition and dimension should enable researchers to articulate assumptions about the function and correlates of secondary control.