Putting families in the center: family perspectives on decision making and ADHD and implications for ADHD care

Objective: To examine components of family-centered care in families' stories about treatment decision making for their child with ADHD. Method: Twenty-eight families participated in qualitative interviews that addressed families' perspectives on (a) the treatment decision-making process, (b) the cause and impact of their child's symptoms, and (c) treatment goals and preferences. Results: The majority of families preferred to be primary or shared decision makers regarding treatment decisions. Families' perspectives on the cause of the child's symptoms varied and often were not consistent with a biomedical framework. Families described multiple areas of impairment on child, family relationships, and family functioning. Perspectives toward evidence-based treatments were mixed, with families also expressing interest in and pursuing interventions not delineated in current treatment guidelines. Conclusion: These findings reinforce the importance of eliciting families' perspectives and involving these important stakeholders in shared decision making as critical components of family-centered care for children with ADHD.     

A method to monitor upper limb movement direction encoding in the corticomotor pathway

ABSTRACT Abnormal shoulder and elbow muscle coactivation patterns, or muscle synergies, are commonly present following stroke and may arise through dysfunctional descending neural control from the cortex. The authors evaluated a novel technique for examining corticomotor movement encoding of the upper limb in three dimensions. A 6-degree-of-freedom loadcell recorded arm twitch responses in healthy adults following stimulation over the cortex or over Erb's point in the periphery. Stimuli were delivered while the arm generated a 5 N preload in each of the 6 axial directions. The initial force twitch response to stimulation was used to construct twitch direction vectors for each preload direction. General linear mixed model analyses were used to determine the influence of stimulation location, preload direction, posture, and stimulation intensity on twitch direction. Cortical stimulation gave rise to arm twitch responses that were predictably modified by preload direction. Peripheral stimulation elicited stereotypical twitches that were not influenced by preload. Our stimulation, recording, and analysis techniques were able to capture movement encoding of the upper limb in three dimensions. Such techniques could be utilized in the stroke population to determine and monitor the presence of upper limb synergies during muscle activation.     

"Do social networks explain 12-step sponsorship effects? A prospective lagged mediation analysis": Correction to Rynes and Tonigan (2011)

Reports an error in "Do social networks explain 12-step sponsorship effects? A prospective lagged mediation analysis" by Kristina N. Rynes and J. Scott Tonigan (Psychology of Addictive Behaviors, Advanced Online Publication, Sep 5, 2011, np). There is an error in the last paragraph of the Participants section. It was reported that 14.8% of the sample were Asian, however, 14.8% of the participants were American Indian or Alaskan Native and no participants were Asian. (The following abstract of the original article appeared in record 2011-20052-001.) Sponsorship is a basic and important part of the 12-step approach to recovery from substance abuse (Alcoholics Anonymous, 2005) and research has shown that having a sponsor is associated with increased involvement in 12-step programs and improved outcomes (Bond, Kaskutas, & Weisner, 2003; Tonigan & Rice, 2010). However, little is known about how sponsorship improves outcomes. Given research demonstrating bivariate associations between sponsorship and social support for abstinence (Majer, Jason, Ferrari, Venable, & Olson, 2002), we hypothesized that the association between having a sponsor and increased abstinence outcomes would be explained by increases in one's abstinence-based social network. Prospective fully lagged mediational analyses did not support this hypothesis and these results ran counter to findings of five previous studies (cf. Groh, Jason, & Keys, 2008). A review of these studies showed that researchers often used cross-sectional or partially lagged methods to test mediation and the mediational effect of the social network was small in magnitude. Results suggest that the prospective association between sponsorship and abstinence is not explained by increases in the abstinence-based social network and demonstrate the need for future studies to use rigorous and time-lagged methods to test social support for abstinence as a mediator of the effects of 12-step involvement. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Assessing the Level of Structural Integration Using Operationalized Psychodynamic Diagnosis (OPD): Implications for DSM-5

A key ingredient in the current proposal of the DSM-5 Work Group on Personality and Personality Disorders is the assessment of overall severity of impairment in personality functioning: the Levels of Personality Functioning Scale (LPFS). The aim of this article is to contribute a conceptual and empirical discussion of the LPFS from the perspective of the Operationalized Psychodynamic Diagnosis (OPD) system (OPD Task Force, 2008 ). First, we introduce the OPD Levels of Structural Integration Axis (OPD-LSIA), a measure of individual differences in severity of personality dysfunction that is rooted in psychodynamic theory. We show that the OPD-LSIA is reliable, valid, and highly associated with observer ratings of personality disorders. In the second part, we present results from an OPD expert consensus study exploring potential limitations of the current LPFS item set from the perspective of the OPD-LSIA. We conclude with highlighting implications for future revisions of the DSM-5 proposal.     

Differentiation of Self, Stress, and Emotional Support as Predictors of Psychological Distress

We explored the relations among stress, emotional support, and differentiation of self from the family of origin as predictors of psychological distress in a sample of 200 college students. First, we investigated the discrepant findings of Murdock and Gore (Contemp Fam Ther 23: 319–335, 2004) and Skowron et al. (J Couns Dev 82: 69–78, 2004) regarding the relationships among stress, differentiation, and symptoms (a question of mediation vs. moderation). Second, we examined the role of emotional support in concert with stress and differentiation. When both stressful events and perceived stress were measured, differentiation of self was found to be a significant partial mediator of their effects on psychological distress. Emotional support was also found to partially mediate the relationship between differentiation of self and psychological distress. Differentiation of self partially mediated the relationship between actual and perceived stress, and perceived stress partially mediated the relationship between differentiation of self and psychological distress.     

Utilizing Benchmarking to Study the Effectiveness of Parent–Child Interaction Therapy Implemented in a Community Setting

Benchmarking is a program evaluation approach that can be used to study whether the outcomes of parents/children who participate in an evidence-based program in the community approximate the outcomes found in randomized trials. This paper presents a case illustration using benchmarking methodology to examine a community implementation of Parent–Child Interaction Therapy (CI-PCIT) utilized as a child maltreatment prevention effort. Data were collected from 83 parent–child dyads. Change scores were compared to treatment and control effect sizes aggregated from the PCIT literature. Pre-post results indicated significant positive changes in child behavior for CI-PCIT completers. Benchmarking analyses revealed that parents who completed CI-PCIT reported significantly greater positive child outcomes than the aggregate control group benchmark, and significantly less than observed in the treatment benchmark. A summary of decision points and implications for utilizing this methodology in the child maltreatment field are postulated.     

A test of the circumvention-of-limits hypothesis in scientific problem solving: the case of geological bedrock mapping

Sources of individual differences in scientific problem solving were investigated. Participants representing a wide range of experience in geology completed tests of visuospatial ability and geological knowledge, and performed a geological bedrock mapping task, in which they attempted to infer the geological structure of an area in the Tobacco Root Mountains of Montana. A Visuospatial Ability × Geological Knowledge interaction was found, such that visuospatial ability positively predicted mapping performance at low, but not high, levels of geological knowledge. This finding suggests that high levels of domain knowledge may sometimes enable circumvention of performance limitations associated with cognitive abilities.     

Spatial working memory for clustered and linear configurations of sites in a virtual reality foraging task

Two experiments using an immersive virtual reality foraging environment determined the spatial strategies spontaneously deployed by people in a foraging task and the effects on immediate serial recall of trajectories though the foraging space, which could conform or violate specific organisational constraints. People benefitted from the use of organised search patterns when attempting to monitor their travel though either a clustered "patchy" space or a matrix of locations. The results are discussed within a comparative framework.