Identifying the Common Elements of Treatment Engagement Interventions in Children’s Mental Health Services

Difficulty engaging families in mental health treatment is seen as an underlying reason for the disparity between child mental health need and service use. Interpretation of the literature on how best to engage families is complicated by a diversity of operational definitions of engagement outcomes and related interventions. Thus, we sought to review studies of engagement interventions using a structured methodology allowing for an aggregate summary of the most common practices associated with effective engagement interventions. We identified 344 articles through a combination of database search methods and recommendations from engagement research experts; 38 articles describing 40 studies met our inclusion criteria. Following coding methods described by Chorpita and Daleiden (J Consul Clin Psychol 77(3):566–579, 2009, doi:10.1037/a0014565), we identified 22 engagement practice elements from 89 study groups that examined or implemented family engagement strategies. Most frequently identified engagement practice elements included assessment, accessibility promotion, psychoeducation about services, homework assignment, and appointment reminders. Assessment and accessibility promotion were two practice elements present in at least 50 % of treatment groups that outperformed a control group in a randomized controlled trial. With the exception of appointment reminders, these frequently identified engagement practice elements had a high likelihood of being associated with winning treatments when they were used. This approach offers a novel way of summarizing the engagement literature and provides the foundation for enhancing clinical decision-making around treatment engagement.     

Did I turn off the gas? Reality monitoring of everyday actions

Failing to remember whether we performed, or merely imagined performing, an everyday action can occasionally be inconvenient, but in some circumstances it can have potentially dangerous consequences. In this fMRI study, we investigated the brain activity patterns, and objective and subjective behavioral measures, associated with recollecting such everyday actions. We used an ecologically valid “reality-monitoring” paradigm in which participants performed, or imagined performing, specified actions with real objects drawn from one of two boxes. Lateral brain areas, including prefrontal cortex, were active when participants recollected both the actions that had been associated with objects and the locations from which they had been drawn, consistent with a general role in source recollection. By contrast, medial prefrontal and motor regions made more specific contributions, with supplementary motor cortex activity being associated with recollection decisions about actions but not locations, and medial prefrontal cortex exhibiting greater activity when remembering performed rather than imagined actions. These results support a theoretical interpretation of reality monitoring that entails the fine-grained discrimination between multiple forms of internally and externally generated information.     

The Relationship Between Sluggish Cognitive Tempo and Impairment in Children With and Without ADHD

This study examined impairment in multiple domains of functioning in children with and without ADHD who present with high or low levels of sluggish cognitive tempo (SCT) while taking into account the total symptom ratings of ADHD. Participants were 584 children in kindergarten through eighth grade (55.7 % male, 91.7 % Caucasian), drawn from five archival datasets. Two, 2 (SCT groups: high and low) x 3 (ADHD Status: ADHD-I, ADHD-C, and non-ADHD) MANCOVAs were conducted with the total ADHD symptom ratings and child age as covariates. One MANCOVA was conducted on scores on the teacher Impairment Rating Scale (IRS; Fabiano et al. Journal of Clinical Child and Adolescent Psychology 35:369–385, 2006) and the other on the 6 scores on the parent IRS. The results indicated that the presence of SCT symptoms was associated with greater functional impairment at home according to parent report while it was associated with less functional impairment at school according to teacher report. Thus, the relationship between SCT symptoms and impairment differs depending on the informant and the context in which impairment is evaluated.     

Identifying Emergent Social Networks at a Federally Qualified Health Center-Based Farmers’ Market

Identifying potential mechanisms connecting farmers’ market interventions with health, economic, and community outcomes could inform strategies for addressing health disparities. The present study used social network theory to guide the in-depth examination of naturally occurring social interactions at a farmers’ market located at a federally qualified health center located in a rural, low-income community. Trained observers recorded 61 observation logs at the market over 18 weeks. Thematic analysis revealed a range of actors and nonhuman facilitators instrumental to the farmers’ market context. These actors connected with one another for communication and relationship development, economic and financial exchange, education, resource sharing, community ownership of the farmers’ market, and conflict resolution. These interactions provided opportunities for social networks to develop among attendees, which may have facilitated the acquisition of social supports related to improved health, economic and community outcomes. Results provide insight into the role social networks may play in mediating the relationship between a farmers’ market intervention and individual benefits. Findings also contribute to defining the typology of social networks, which may further disentangle the complex relationships between social networks and health outcomes. Future research should identify strategies for purposefully targeting social networks as a way to reduce diet-related health disparities.     

Recall-to-reject: The effect of category cues on false recognition

Four experiments examined the effect of category cueing on recall-to-reject, one of the central memory-editing mechanisms thought to prevent the occurrence of false memories. When category names were used as retrieval cues, the typically observed false recognition effect was eliminated for semantically associated distractors (Experiment 1a) and, moreover, a reduction in the absolute level of the false alarm rate was found for phonologically associated distractors (Experiment 2a). In addition to the old/new-recognition data, analyses using multinomial models support the interpretation that category cueing was successful in increasing the probability of recall-to-reject (Experiments 1b and 2b). The results are in line with dual-process theories of recognition memory and provide further evidence for recall-to-reject in single item recognition. They demonstrate its potential to reduce false recognition even when explicit instructions are not given. In addition, the results demonstrate that the paradigm can give rise to side effects that oppose recall-to-reject. A simultaneous familiarity increase can explain why many studies failed to find evidence for recall-to-reject in terms of false alarm rates.     

The impact of a stress induction task on tic frequencies in youth with Tourette Syndrome

Tourette Syndrome (TS) is a neuropsychiatric disorder characterized by motor and vocal tics. Tic fluctuations are common and thought to be attributable in part, to contextual variables. Stress is one such variable, but its effects and mechanism of action are poorly understood. The current study measured the effects of a stress induction task on tic frequencies during periods of suppression and non-suppression of tics. Ten youth with TS between the ages of 9 and 17 were exposed to four conditions in random sequence: free-to-tic baseline (BL), reinforced tic suppression (SUP), reinforced tic suppression plus a stress induction task (SUP + STRESS), and a stress induction task alone (STRESS). Tic frequencies did not differ during STRESS and BL. Tic frequencies were greater in SUP + STRESS than SUP. Stress may impact tics through disrupting suppression efforts. Clinically, results suggest that interventions designed to improve tic inhibition in the presence of acute stressors may be beneficial.     

Recall-to-reject: The effect of category cues on false recognition

Four experiments examined the effect of category cueing on recall-to-reject, one of the central memory-editing mechanisms thought to prevent the occurrence of false memories. When category names were used as retrieval cues, the typically observed false recognition effect was eliminated for semantically associated distractors (Experiment 1a) and, moreover, a reduction in the absolute level of the false alarm rate was found for phonologically associated distractors (Experiment 2a). In addition to the old/new-recognition data, analyses using multinomial models support the interpretation that category cueing was successful in increasing the probability of recall-to-reject (Experiments 1b and 2b). The results are in line with dual-process theories of recognition memory and provide further evidence for recall-to-reject in single item recognition. They demonstrate its potential to reduce false recognition even when explicit instructions are not given. In addition, the results demonstrate that the paradigm can give rise to side effects that oppose recall-to-reject. A simultaneous familiarity increase can explain why many studies failed to find evidence for recall-to-reject in terms of false alarm rates.     

Women coping with AIDS in Africa: contributions of a contextually grounded research methodology

The primary objective of this report is to describe a contextually grounded approach to the investigation of coping and psychological functioning in AIDS-sick mothers. Five AIDS-sick women on antiretroviral therapy who had at least one child under 6 years of age living in their households were interviewed. Among the issues that emerged was the complexity of the women's psychological functioning, the fact that they made strategic decisions about disclosure aimed at protecting important social support networks, and that their well-being was dynamically influenced by factors in the home and community. The study provides evidence for the value of a contextual approach when investigating the psychological functioning of HIV positive mothers living in poor high-HIV prevalence communities in developing countries.