TEACHING SELF-ADMINSTRATION OF NASOGASTRIC TUBE INSERTION TO AN ADOLESCENT WITH CROHN DISEASE

We examined the effectiveness of simulation training to teach an adolescent male with Crohn disease to self-administer nasogastric tube insertion. Nasogastric tube insertion was taught using simulation training, after which self-insertion skills were assessed. Results across skill components indicated that this subject was able to self-administer insertion of the nasogastric tube.     

Deficient inhibitory control in attention deficit hyperactivity disorder

The purpose of this study was to examine two executive control processes — response inhibition and re-engagement of responses after inhibition in children with attention deficit hyperactivity disorder (ADHD). Thirty-three children with ADHD and 22 normal control children of similar age (7 to 11 years) and mean IQ (107) were tested with the change paradigm. ADHD subgroups were defined by the context in which the ADHD symptoms predominated (in the home only; at school only; and in both, i.e., pervasive ADHD). Children with marked oppositional defiant or conduct disorder were excluded. Children with ADHD exhibited deficits in inhibitory control and in response re-engagement. Deficits were greatest in pervasive ADHD and, to a lesser extent, in those with ADHD limited to the school context. ADHD limited to the home context showed the least deficit. These results replicate an earlier study that found deficient inhibitory control in pervasive ADHD and demonstrate that the deficit in ADHD involves a second aspect of executive control.We are grateful to Anne Rhodes and Isobelle Williams for their assistance in the conduct of this research. This research was supported by grants from Health and Welfare Canada and the Medical Research Council of Canada. This paper was prepared with the assistance of Medical Publications, The Hospital for Sick Children, Toronto, Ontario.     

Antecedent reinforcement contingencies in the stimulus control of an auditory discrimination

In order to assess possible confounding of discriminative stimulus effects with those produced by the reinforcing stimulus, three groups of four rats each were trained for 45 hr on a variable-interval 1-min reinforcement program. Two groups were run on a multiple variable-interval extinction schedule in which the reinforcement stimulus (S^D) and the nonreinforcement stimulus (S^Δ) were two intensities of a 4-kHz (cps) tone separated by 40 or 10 db. The third group was run on a mixed schedule with a single intensity constantly present. The mixed-schedule animals showed no discrimination of the reinforcement program. Under the multiple schedule, the highest S^Δ rates were obtained after S^D intervals, regardless of the reinforcement availability in the S^D interval. These local rate variations in S^Δ were small in proportion to those produced by the S^D versus S^Δ intensities.     

Narrative abilities in children with attention deficit hyperactivity disorder and normal peers

A story retelling task was used to assess narrative abilities in 30 boys with attention deficit hyperactivity disorder (ADHD) and 30 normally developing boys, matched on age and IQ. Each boy listened to two stories and retold them for another child. Results indicated that the two groups did not differ in their ability to comprehend and extract the main ideas from the stories, but did differ in the production of narratives. Boys with ADHD provided less information overall, and their stories were more poorly organized and less cohesive and contained more inaccuracies. As a result, their stories were often confused and hard to follow. Organization and monitoring of information are functions of executive control. Thus the observed deficits in narrative production in children with ADHD may reflect underlying deficits in executive processes.This work was supported by funds from Health and Welfare Canada (NHRDP) and Medical Research Council of Canada. Portions of this paper were presented at the annual meeting of the Society for Research in Child and Adolescent Psychopathology, Zandvoort, The Netherlands, June 1991. The authors gratefully acknowledge Michael Marriott and Patricia Fulford for their assistance with data collection and two anonymous reviewers for their insightful comments.     

Impure Agency and the Just War

Feminist critiques of intention challenge some aspects of traditional just war reasoning, including the criteria of right intention and discrimination (particularly as interpreted using the doctrine of double effect). I take note of these challenges and propose some directions just war reasoners might take in response. First, right intention can be evaluated more accurately by judging what actors in war actually do than by attempting to uncover inward dispositions. Assessing whether agents in war have taken due care to minimize foreseeable collateral damage, avoided intentional targeting of noncombatants, corrected previous mistakes in their later actions, and taken responsibility to repair unintended damage they cause are examples of ways in which just war reasoners can evaluate intention by looking at actions.     

The role of number words: the phonological length effect in multidigit addition

We explored the role of phonological representations of number words in exact calculation. The reaction times and accuracy of responses in multidigit addition problems were compared across three groups of participants (young healthy, older healthy, and 3 patients with severe aphasia) and two types of addition problems: phonologically long in English (containing the bisyllabic number word ??seven??) and short in English (monosyllabic number words??e.g., ??six??). Older healthy participants were significantly faster and more accurate in calculation than younger healthy participants. The older participants showed no evidence of a phonological length effect. However this effect was apparent in the younger adults, with longer reaction times on phonologically long problems. Furthermore, there was an association between the presence of a phonological length effect and the overall speed of response, suggesting that less proficient calculators were more reliant on phonological mediation of performance. The aphasic participants retained the ability to complete multidigit additions and were as accurate as the younger healthy group, although the response times of two of the 3 patients were slow. The aphasic participants varied with regard to the presence of a phonological length effect. Two participants showed no evidence of phonological mediation, while 1 displayed a phonological length effect. The results suggest that language resources are not mandatory for exact addition, although they may be used to scaffold math performance in less competent calculators. Evidence of phonological mediation of performance in aphasic participants may provide insight into the integrity or otherwise of inner speech in severe aphasia.     

THE EYE OF THE BEGETTER: PREDICTING INFANT ATTACHMENT DISORGANIZATION FROM WOMEN'S PRENATAL INTERPRETATIONS OF INFANT FACIAL EXPRESSIONS

Infant–caregiver attachment disorganization has been linked to many long‐term negative psychosocial outcomes. While various prevention programs appear to be effective in preventing disorganized attachment, methods currently used to identify those at risk are unfortunately either overly general or impractical. The current investigation tested whether women's prenatal biases in identifying infant expressions of emotion—tendencies previously shown to relate to some of the maternal variables associated with infant attachment, including maternal traumatization, trauma symptoms, and maternal sensitivity—could predict infant attachment classification at 18 months postpartum. Logistic regression analyses revealed that together with women's adult history of high betrayal traumatization, response concordance with a normative reference sample in labeling infant expressions as negatively valenced, and the number of infant facial expressions that participants classified as “sad” and “angry” predicted subsequent infant attachment security versus disorganization. Implications for screening and prevention are discussed.     

Haste makes waste,but not for all: The speed-accuracy trade-off does not apply to neurotics

ObjectivesTo examine if neurotics are the exception to the speed-accuracy rule and in fact are more accurate when making faster decisions.DesignThe study employed a laboratory-based, cross-sectional design.MethodOne hundred and ninety-six elite young cricketers completed measures of neuroticism before performing a cricket-specific computer-based decision-making task.ResultsNeuroticism significantly moderated the relationship between decision-making time and decision-making accuracy such that decreases in response time were associated with improvements in decision-making accuracy for individuals with high levels of neuroticism. Conversely, decreases in response time were associated with decrements in accuracy for individuals with low levels of neuroticism.ConclusionsThe study presents the first data that confirm that speed accuracy trade-offs do not occur across all individuals; individuals with high levels of neuroticism benefit from making faster decisions.