Mothers' voices: Coping with their children's initial disability diagnosis

For parents of infants and toddlers receiving a diagnosis of disability, a variety of responses may result. Yet, little is known about the specific ways families cope with the initial diagnosis. This qualitative study investigated 6 mothers' memories of their children's diagnoses. Mothers described their use of both palliative strategies (denying, questioning, and wishful thinking) and problem‐solving strategies (searching for information, seeking social support, reframing, and seeking spiritual support) to cope with their children's initial diagnoses. The results of this study may improve professionals' understanding of parents' need for information and support at the time of initial diagnosis.     

Spirituality and Loss: Approaches for Counseling Grieving Adolescents

The death of a loved one has serious implications for adolescent growth and development. The authors review relevant research on the grief process and spirituality in adolescence, and they give a rationale for integrating spirituality into adolescent grief work. By way of a case illustration, they draw implications for counselors’ use of spirituality in addressing adolescent grief.     

Prediction of foot clearance parameters as a precursor to forecasting the risk of tripping and falling

Tripping and falling is a serious health problem for older citizens due to the high medical costs incurred and the high mortality rates precipitated mostly by hip fractures that do not heal well. Current falls prevention technology encompasses a broad range of interventions; both passive (e.g., safer environments, hip protectors) and active (e.g., sensor-based fall detectors) which attempt to reduce the effects of tripping and falling. However the majority of these interventions minimizes the impact of falls and do not directly reduce the risk of falling. This paper investigates the prediction of gait parameters related to foot-to-ground clearance height during the leg swing phase which have been physically associated with tripping and falling risk in the elderly. The objective is to predict parameters of foot trajectory several walking cycles in advance so that anticipated low foot clearance could be addressed early with more volitional countermeasures, e.g., slowing down or stopping. In this primer study, foot kinematics was recorded with a highly accurate motion capture system for 10 healthy adults (25-32 years) and 11 older adults (65-82 years) with a history of falls who each performed treadmill walking for at least 10 min. Vertical foot displacement during the swing phase has three characteristic inflection points and we used these peak values and their normalized time as the target prediction values. These target variables were paired with features extracted from the corresponding foot acceleration signal (obtained through double differentiation). A generalized regression neural network (GRNN) was used to independently predict the gait variables over a prediction horizon (number of gait cycles ahead) of 1-10 gait cycles. It was found that the GRNN attained 0.32-1.10 cm prediction errors in the peak variables and 2-8% errors in the prediction of normalized peak times, with slightly better accuracies in the healthy group compared to elderly fallers. Prediction accuracy decreased linearly (best fit) at a slow rate with increasing prediction horizon ranging from 0.03 to 0.11 cm per step for peak displacement variables and 0.34 × 10(-3) - 1.81 × 10(-3)% per step for normalized peak time variables. Further time series analysis of the target gait variable revealed high autocorrelations in the faller group indicating the presence of cyclic patterns in elderly walking strategies compared to almost random walking patterns in the healthy group. The results are promising because the technique can be extended to portable sensor-based devices which measure foot accelerations to predict the onset of risky foot clearance, thus leading to a more effective falls prevention technology.     

Measurement invariance and age-related differences of trait anger across the adult lifespan

The present study examined measurement invariance of trait anger with respect to age. In addition, age-related differences in latent variables (factor variances, factor covariances, and factor means) were investigated. A sample of 1216 participants, divided into six age groups, ranging from under 30 to over 70 years, was tested using the angry temperament and angry reaction scales from the State-Trait Anger Expression Inventory (STAXI; Spielberger, 1988). Results show that strong measurement invariance held across the six age groups. For both angry temperament and angry reaction, factor variances tended to decrease into middle age and then increase again into old age. Factor correlations decreased into old age, implying a differentiation of trait anger. Finally, regarding factor means, older adults showed less anger than younger adults, suggesting higher levels of self-regulation or less exposure to anger-provoking contexts in later life.     

Mixing metaphors in the cerebral hemispheres: what happens when careers collide?

Are processes of figurative comparison and figurative categorization different? An experiment combining alternative-sense and matched-sense metaphor priming with a divided visual field assessment technique sought to isolate processes of comparison and categorization in the 2 cerebral hemispheres. For target metaphors presented in the right visual field/left cerebral hemisphere (RVF/LH), only matched-sense primes were facilitative. Literal primes and alternative-sense primes had no effect on comprehension time compared to the unprimed baseline. The effects of matched-sense primes were additive with the rated conventionality of the targets. For target metaphors presented to the left visual field/right cerebral hemisphere (LVF/RH), matched-sense primes were again additively facilitative. However, alternative-sense primes, though facilitative overall, seemed to eliminate the preexisting advantages of conventional target metaphor senses in the LVF/RH in favor of metaphoric senses similar to those of the primes. These findings are consistent with tightly controlled categorical coding in the LH and coarse, flexible, context-dependent coding in the RH.     

Day-to-day variability in nap duration predicts medical morbidity in older adults

Objective: The objectives for the present study were to (a) examine within-person variability of nap duration and (b) assess how variability in nap duration is related to the number of health conditions in a sample of older adults. For highly variable behaviors such as sleep, it is important to consider fluctuations within the person instead of solely comparing averages of behaviors across persons. Method: Data were drawn from a previous study examining sleep in 103 community-dwelling older adults. Subjective estimates of napping behavior were obtained from sleep diaries and objective estimates of napping behavior were obtained using actigraphy. Both measures were collected for 14 consecutive days. The sampled data were aggregated in terms of (a) average daily time spent napping and (b) average within-person fluctuations in daily nap duration. The health measure consisted of the number of self-reported health conditions. Results: Both the objective and subjective measures revealed that there was considerable day-to-day fluctuation in nap duration and that variability in nap duration, not mean duration, uniquely predicted the number of health conditions, b = .03, b* = .26, t(100) = 2.71, p = .01. Conclusions: Duration of napping in older adults is a highly variable behavior, fluctuating as much within- as between-persons. Furthermore, variability in nap duration from day to day is predictive of greater medical morbidity, suggesting that clinicians should assess for inconsistencies in nap behavior in addition to duration, frequency, and timing. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

An integrated approach to delivering exposure-based treatment for symptoms of PTSD and depression in OIF/OEF veterans: preliminary findings

Combat-exposed military personnel from the wars in Iraq and Afghanistan report high rates of PTSD and associated psychiatric problems. A formidable body of research supports exposure therapy as a front-line intervention for PTSD; however, relative to studies of civilians, fewer investigations have evaluated the effectiveness of exposure therapy using military samples. Specifically, barriers to care (e.g., stigma associated with receiving mental health services ) may compromise utilization of evidence-based psychotherapy. As such, researchers have argued that veterans with PTSD may require an integrated and innovative approach to the delivery of exposure techniques. This paper presents the rationale for and preliminary data from an ongoing clinical trial that compares the home-based telehealth (HBT) application of a brief, behavioral treatment (Behavioral Activation and Therapeutic Exposure; BA-TE) for veterans with PTSD to the standard, in-person application of the same treatment. Forty OIF/OEF veterans with PTSD and MDD were consented, enrolled, and randomized to condition (BA-TE in-person, or BA-TE HBT) and symptoms of anxiety and depression were assessed at pre- and posttreatment. Participants in both conditions experienced reductions in depression, anxiety, and PTSD symptoms between pre- and posttreatment, suggesting that HBT application of an integrated PTSD treatment may be feasible and effective.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.