Parent–Child Informant Discrepancy is Associated with Poorer Treatment Outcome

In child clinical psychology, parent and child reports are typically used to make treatment decisions and determine the effectiveness of treatment. However, there are often moderate to large discrepancies between parent and child reports, and these discrepancies may reflect meaningful information about the parent, the child, and the parent–child relationship. Additionally, parent–child discrepancy may predict treatment outcome. This study examined parent–child discrepancy in a sample of 62 children (10.15±1.26 years old) with prominent social competence deficits and mixed diagnoses who were treated with a resilience-based, cognitive–behavioral group therapy program (the Resilience Builder Program) in a private clinical setting. Further analyses were conducted to investigate whether parent–child discrepancy related to treatment outcome. Consistent with the literature, prominent parent–child discrepancy was found across domains, with parents generally reporting more severe symptomatology. Treatment with the Resilience Builder Program resulted in significant improvement in parent report of multiple domains of functioning, including resilience, social skills, and emotion and behavior regulation. Importantly, larger parent–child discrepancy at the start of therapy was predictive of poorer overall treatment response. Given its impact on therapeutic effectiveness, these results suggest that parent–child disagreement regarding the child’s impairment at the onset of therapy is worthy of assessment prior to treatment, and may itself be a topic worthy of targeting in treatment.     

Attention Problems and Restlessness as Transdiagnostic Markers of Severity and Treatment Response in Youth with Internalizing Problems

Research on Child and Adolescent Psychopathology - Transdiagnostic models of psychopathology suggest that disorders may share common features that could influence their severity. Attention problems...     

A preliminary validation of the Regional Proficiency Assessment Tool (RPAT)

Regional proficiency is a multidimensional construct created by the Department of Defense (DoD) to characterize a person’s knowledge of a region’s social, economic, political, and linguistic features. The Regional Proficiency Assessment Tool (RPAT) was designed to capture the regional proficiency of the military workforce. The RPAT collects biographical self-report data (e.g., professional travel, language test scores) to provide military personnel with scores for each dimension of regional proficiency (e.g., study of a region, utility of language skills) for each of the different global regions. Cluster scores combine to render the overall ratings. In two studies, we provide evidence for the RPAT’s construct validity. In Study 1, 44 military participants completed the RPAT and individual difference measures. Aggregated, person-level RPAT ratings and appropriate cluster scores were moderately positively associated with cultural intelligence (.35–.47), but unrelated with self-reported cognitive styles and the Big Five personality dimensions, except for negative correlations with neuroticism. In Study 2, 11 subject matter experts rated the estimated RP of individuals by several world regions via reading narrative biographical sketches. The aggregate of the expert ratings was strongly, positively associated with the RPAT ratings (M across regions = .72), and was moderately correlated with cultural intelligence (.38–.48). This finding suggests that the RPAT provides assessments in line with the best of current practice (individual expert heuristic judgments), and that cultural intelligence assessments cannot replace the RPAT. Future research can examine the validity of the RPAT across larger samples and using different types of validation.     

Identification of angry faces in the attentional blink

According to cognitive and neural theories of emotion, attentional processing of innate threat stimuli, such as angry facial expressions, is prioritised over neutral stimuli. To test this hypothesis, the present study used a modified version of the rapid serial visual presentation (RSVP) paradigm to investigate the effect of emotional face stimuli on the attentional blink (AB). The target stimuli were schematic faces which depicted threatening (angry), positive or neutral facial expressions. Results showed that performance accuracy was enhanced (i.e., the AB was reduced) on trials in which the second target was an angry face, rather than a neutral face. Results extend previous research by demonstrating that angry faces reduce the AB, and that this effect is found for schematic facial expressions. These findings further support the proposal that, when there is competition for attentional resources, threat stimuli are given higher priority in processing compared with non-threatening stimuli.     

A biopsychosocial approach to liver transplant evaluation in two patients with Wilson's disease

Wilson's disease (WD) is characterized by hepatic, neurological, and/or psychiatric disturbances. In some cases, liver transplantation is indicated. Because psychologists and other health care workers play an increasing role in the evaluation of individuals presenting for transplant, an understanding of the heterogeneous phenotype of WD is important for mental health professionals working in medical settings. This article reviews two cases of patients with WD (one probable, one confirmed) presenting for liver transplantation and a biopsychosocial assessment approach is demonstrated. Patients are presented in terms of medical, psychiatric, and psychosocial history, neuropsychological examination results, and the subsequent indications for liver transplantation. Both patients exhibited neurocognitive and psychiatric symptoms. One patient was determined to be a marginally suitable candidate for transplantation, whereas the other was considered at high risk for negative outcome post-transplant. This article demonstrates the importance of considering phenotypic presentation, neurocognitive function, psychiatric status, and psychosocial circumstances in assessing transplant readiness in patients with WD. A comprehensive and integrative biopsychosocial assessment approach is appropriate for evaluating patients with WD presenting for liver transplantation.     

Causation and melanoma classification

In this article, I begin by giving a brief history of melanoma causation. I then discuss the current manner in which malignant melanoma is classified. In general, these systems of classification do not take account of the manner of tumour causation. Instead, they are based on phenomenological features of the tumour, such as size, spread, and morphology. I go on to suggest that misclassification of melanoma is a major problem in clinical practice. I therefore outline an alternative means of classifying these tumours based on causal factors. By analogy with similar systems that have recently emerged for other cancers, I suggest that this causal classification is likely to be both workable and helpful, even in the absence of a full causal-mechanistic understanding of the aetiology of the tumour.