Latent variable assessment of outcomes in a nurse-managed intervention to increase latent tuberculosis treatment completion in homeless adults.

OBJECTIVE: To assess predictors of latent tuberculosis infection (LTBI) completion by using structural equation modeling (SEM) among homeless adults, a group at great risk for LTBI and active tuberculosis (TB). LTBI therapy is effective in stemming the progression to active TB, yet treatment adherence among homeless persons is difficult to attain. DESIGN: By using SEM, the authors assessed predictors of LTBI completion among a sample of 494 homeless adults in Los Angeles, CA, who received either a nurse case-managed program (NCM) or a usual care program. MAIN OUTCOME MEASURES: Latent variables were created with the baseline variables of site type, age, intervention status, dissatisfaction with health care, depression, TB risk assessment, alcohol use, heroin or cocaine use, and TB knowledge. Outcome variables included many of the same baseline variables as well as treatment completion. RESULTS: LTBI treatment completion (100% adherence) was significantly and positively associated with participation in NCM, older age, and less heroin or cocaine use. NCM also predicted greater TB knowledge, greater ease of treatment, and more satisfaction with treatment (NCM completion rate = 64%, control rate = 42%). CONCLUSION: The culturally competent NCM program, combined with active tracking and incentives, was successful in a difficult-to-treat and highly transient population.     

Dynamic Motivational Processing of Antimarijuana Messages: Coactivation Begets Attention

In the theoretical framework of dynamic motivational activation, this study reveals the dynamics of antimarijuana public service announcement (PSA) processing, especially the processing of co‐occurring positive and negative content. It specifies the important role of endogenous feedback dynamics of the information processing system and teases them apart from exogenous message effects. As suggested by real‐time psychophysiological responses (heart rate, skin conductance level, and facial electromyography), the copresence of positive and negative content is most attention eliciting and is not moderated by individuals' marijuana experience. Marijuana experience, however, increases attention to arousing content in the PSAs, increases smiling responses to positive content, and escalates arousal to the PSAs in general. Implications for designing and evaluating PSAs and health campaigns are discussed.     

Children's Narratives Following Traumatic Brain Injury: Linguistic Structure, Cohesion, and Thematic Recall

Narrative discourse and intellectual functioning were examined 3 years following traumatic brain injury (TBI) in children 1 to 8 years of age at the time of injury. The language-impaired TBI group (n= 9) had language deficits during the subacute stage of recovery; their performance was contrasted with that of a TBI comparison group equated on neurologic and demographic variables that did not show subacute language impairment (n= 8) and a sibling comparison group (n= 9). The language-impaired TBI group had lower Verbal and Full-Scale IQ scores and produced fewer words and utterances than the sibling group on a story retelling task; their stories were characterized by fewer complete referential and lexical ties and more referential errors, indicating difficulty conjoining meaning across sentences. The language-impaired TBI group recalled approximately one-third of the propositions needed to maintain the story theme and made more errors sequencing the propositions than either the TBI or the sibling comparison groups. Group differences were not obtained on the Performance IQ scores or on measures of rate or fluency of speech production, mazes, use of conjunctives, or naming errors. The discourse deficiencies of children with TBI and acute language impairment were most pronounced at the level of cognitive organization of the text reflecting text macrostructure and were least apparent at the level of lexical and sentential organization reflecting text microstructure. Results are discussed in terms of the vulnerability of developing language abilities to disruption by brain injury.     

Circle size and diameter tilt: A new look at integrality and separability

In six experiments using the speeded classification paradigm, we provide evidence that the ostensibly “separable” dimensions of size and orientation can produce patterns of either separability or asymmetric configurality, depending on the spatial arrangement of the stimuli. In all experiments, subjects classified large or small circles contairting a single line in one of two possible orientations. When the line touched the circle’s perimeter, thereby defining the diameter of the circle (Experiments 1–4), asymmetric configurality obtained: Variations in size interfered with classification by orientation, but variations in orientation did not interfere with classification by size, and redundancy gain was weak or absent. When the lines fell completely within (i.e., did not touch) the circles (Experiments 5 and 6), the results were consistent with separability: There was neither redundancy gain nor interference. Taken together, the results add to the growing body of evidence that classification of specific dimensional pairs as separable or integral may be less feasible than identifying the more general conditions that increase or decrease the psychological salience of dimensional structures and facilitate or interfere with selection of optimal processing strategies.     

Children's binary prediction of partially learnable sequences followed by an all-correct procedure

Six groups of 20 subjects each were run individually in a binary prediction situation with each alternative occurring equally often. Two age groups were employed; subjects were either in second or sixth grades. For one-third of the subjects at each age level, the events occurred in runs of either two or six; another third observed events which occurred in runs of either five or six; the other subjects received a random sequence of events. All subjects then received an additional 50 trials in which every prediction was correct. The results indicated some sensitivity to run length characteristics. Fewer errors of all types were made in the prediction of 5–6 sequences. The verbal reports and all-correct trial protocols revealed that at least the sixth graders employed some simple run length structure rules, although many instances of runs other than those presented in training occurred, showing much processing error. The results were discussed in terms of a general limited-capacity model of information-processing.     

Modification of behavior problems in the home with a parent as observer and experimenter

Four parents enrolled in a Responsive Teaching class carried out experiments using procedures they had devised for alleviating their children's problem behaviors. The techniques used involved different types of reinforcement, extinction, and punishment. One parent increased the frequency of the wearing of an orthodontic device during five daily time checks by making an immediate monetary payoff contingent on wearing the device. A second parent increased the number of points earned for doing daily household tasks by providing back-ups for which the points could be exchanged. The parents of a 4-yr-old boy decreased the frequency of whines, cries, and complaints by removing social attention when such behavior occurred. A mother decreased the duration of time it took for her 5-yr-old daughter to get dressed by making permission to watch television contingent on dressing within 30 min of the time she got up in the morning. Brief reversals of contingencies were used to show causal relationships between the procedures used and the changes in behavior. Checks on the reliability of measurement were made by persons present in the home.     

Evidence for Context Switching in the Effects of Average Item Length and Item-Length Variability on Internal Consistency

This investigation examined the effects of 3 item characteristics—the average number of words per item, within-scale variability in item length, and item “direction”—on internal consistency reliability and interitem correlation. In Study 1, we examined the effects of these variables on overall scale-level reliability using 444 subscales from 9 personality scales. In Study 2, we examined interitem correlation at the paired-item level using 477 nonredundant item pairs from 14 personality scales. Lower scale reliability was associated with more average words per item, greater within-scale variability in item length, and a greater percentage of reverse-keyed items. Similarly, smaller interitem correlations were associated with a greater degree of mismatch in item length between the paired items and with a mismatch (vs. match) in the items' respective “directions.” The pattern of results across both studies supports our notion that lower internal consistency results from increased context switching; that is, from the confusion that occurs when respondents must switch back and forth between the interpretive frames pertaining to short versus long items, or between items pertaining to one pole of a personality dimension and its “opposite” pole. Suggestions for maximizing the internal consistency of personality scales are proposed.