The Children’s Attention-Deficit Hyperactivity Disorder Telemental Health Treatment Study: Caregiver Outcomes

The Children’s Attention-deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) tested the hypotheses that children and caregivers who received guideline-based treatment delivered through a hybrid telehealth service delivery model would experience greater improvements in outcomes than children and caregivers receiving treatment via a comparison delivery model. Here, we present caregiver outcomes. 88 primary care providers (PCPs) in seven geographically underserved communities referred 223 children (ages 5.5 ? 12.9 years) to the randomized controlled trial. Over 22 weeks, children randomized to the CATTS service delivery model received six sessions of telepsychiatry and six sessions of caregiver behavior management training provided in person by community therapists who were trained and supervised remotely. Children randomized to the comparison Augmented Primary Care (APC) service model received management in primary care augmented by a single telepsychiatry consultation. Caregiver outcomes included changes in distress, as measured by the Patient Health Questionnaire (PHQ-9), Parenting Stress Index (PSI), Caregiver Strain Questionnaire (CSQ) and Family Empowerment Scale (FES). Caregivers completed five assessments. Multilevel mixed effects regression modeling tested for differences between the two service delivery models in caregiver outcomes from baseline to 25 weeks. Compared to caregivers of children in the APC model, caregivers of children in the CATTS service model showed statistically significantly greater improvements on the PHQ-9 (β?=?-1.41, 95 % CI?=?[?2.74, ?0.08], p?<?.05), PSI (β?=??4.59, 95 % CI?=?[?7.87, ? 1.31], p?<?.001), CSQ (β?=??5.41, 95 % CI?=?[? 8.58, ?2.24], p?<?.001) and FES (β?=?6.69, 95 % CI?=?[2.32, 11.06], p?<?.01). Improvement in child ADHD symptoms mediated improved caregiver scores on the PSI and CSQ. Improvement in child ODD behaviors mediated caregiver CSQ scores. The CATTS trial supports the effectiveness of a hybrid telehealth service delivery model for reducing distress in caregivers of children with ADHD and suggests a mechanism through which the service model affected caregiver distress.     

Right hemisphere metaphor processing? Characterizing the lateralization of semantic processes

Previous laterality studies have implicated the right hemisphere in the processing of metaphors, however it is not clear if this result is due to metaphoricity per se or another aspect of semantic processing. Three divided visual field experiments varied metaphorical and literal sentence familiarity. We found a right hemisphere advantage for unfamiliar sentences containing distant semantic relationships, and a left hemisphere advantage for familiar sentences containing close semantic relationships, regardless of whether sentences were metaphorical or literal. This pattern of results is consistent with theories postulating predominantly left hemisphere processing of close semantic relationships and predominantly right hemisphere processing of distant semantic relationships.     

Working Class Masculinity: Keeping Gay Men and Lesbians out of the Workplace

Recent survey research suggests that heterosexuals’ attitudes toward lesbian and gay rights have become more progressive. However, we find in our research that negative attitudes and barriers against gay men and lesbians in workplaces still remain. Our project represents one case study of hidden animosity toward homosexuals, which varies from “overt disgust” to “don’t ask, don’t tell” policies that reinforce negative attitudes toward gay men and lesbians. As such, we contend that attitudes toward lesbian and gay rights are not becoming more progressive; instead various methods of discrimination are increasingly being used to exclude gay men and lesbians from the workplace. We argue that White working class men have constructed and maintained a form of White male solidarity, a collective practice directed toward women, People of Color, and non-heterosexuals that maintains racism, sexism, and homophobia in the local, national, and global context.     

Meta-analysis of family-centered helpgiving practices research

A meta-analysis of 47 studies investigating the relationship between family-centered helpgiving practices and parent, family, and child behavior and functioning is reported. The studies included more than 11,000 participants from seven different countries. Data analysis was guided by a practice-based theory of family-centered helpgiving that hypothesized direct effects of relational and participatory helpgiving practices on self-efficacy beliefs and parent, family, and child outcomes. Results showed that the largest majority of outcomes were related to helpgiving practices with the strongest influences on outcomes most proximal and contextual to help giver/help receiver exchanges. Findings are placed in the context of a broader-based social systems framework of early childhood intervention and family support.     

Nature and nurture: Williams syndrome across cultures

This study is concerned with ways in which children with Williams syndrome (WS), a rare neurodevelopmental disorder arising from a hemizygous deletion in chromosome band 7q11.23 including the gene for elastin (ELN) and approximately 20 surrounding genes, are affected by social mores of vastly differing cultures: the United States and Japan. WS presents a compelling model for the investigation because its genetic phenotype is well defined and results in an uneven cognitive profile as well as a social phenotype typical of the syndrome including overt over-friendliness toward strangers. While a number of research groups have been studying the cognitive strengths and weaknesses of individuals with WS in various countries, there have not been studies to date that explore the social phenotype in WS across different cultures. This study examines the ways in which social behavior in WS, stemming from specific genetic underpinnings, might be mediated by cultural expectations. We conducted a cross-cultural study using an instrument that measures aspects of sociability commonly found among people with WS. Quantitative analyses revealed a significant effect of diagnostic category in that in both countries, children with WS were rated as significantly higher in global sociability and more likely to approach strangers than were their normal counterparts. There was also an effect of culture, in that regardless of category, WS and normal children in Japan were rated lower than their counterparts in the US. We suggest that the excessively social phenotype of children with Williams syndrome, although markedly present across cultures, appears to vary in its intensity by culture. This is an intriguing illustration of interactions between nature and nurture.     

Depression, anxiety, and perceived hassles among entering medical students

This study investigated depression and anxiety among students who were entering medical school prior to the onset of their medical curriculum. Entering students reported financial, day-to-day, academic, and time hassles as concerns. Interestingly, the population characteristics of gender, marital status, and ethnicity impacted the type of self-reported hassles indicated by the students. Measurements of depression and anxiety indicated that entering medical school students' emotional status resembles that of the general population. The results suggest that it is the rigors of the medical curriculum that may play an important role in the increased prevalence of depression and anxiety for students during their medical education. Further, students who are entering medical field already have concerns about medical school and are in the process of anticipating the necessary adjustment to the challenges ahead of them. Preventative programming efforts should begin early in medical education and address a wide variety of concerns from academic, to interpersonal relationships and financial worries.     

Financial aspirations,financial success,and overall life satisfaction: who? and how?

Nickerson et al. (2003, Psychological Science 14, pp. 531–536) demonstrated in a longitudinal study that the negative relation between aspirations for financial success and subjective well-being found by other researchers was mitigated by high household income. The present study first refined the analysis in Nickerson et al. (2003) and then explored two additional issues: (a) who aspires to financial success? and (b) how is financial success achieved? Analysis indicated that individuals with strong financial aspirations are socially inclined, confident, ambitious, politically conservative, traditional, conventional, and relatively less able academically, but not psychologically distressed. Financial success is achieved via the job and, for women only, via marriage. Financial aspirations influence job income both by influencing choice of occupation and by influencing job income within occupation; however, achieving financial success depends on having the personal resources to do so. Women with strong financial aspirations tend to marry for money (or money-making potential) regardless of their work status; men with strong financial aspirations do not.     

Experiential simulations of negated text information

We investigated the question of whether comprehenders mentally simulate a described situation even when this situation is explicitly negated in the sentence. In two experiments, participants read negative sentences such as There was no eagle in the sky, and subsequently responded to pictures of mentioned entities in the context of a recognition task. Participants' responses following negative sentences were faster when the depicted entity matched rather than mismatched the negated situation. These results suggest that comprehenders simulate the negated situation when processing a negated sentence. The results thereby provide further support for the experiential-simulations view of language comprehension.     

Self‐monitoring and the propensity for risk

Apart from earlier research on sexual behavior, little is known about associations between self‐monitoring and engagement in risk behaviors. Our research verified that one component of self‐monitoring, public performing, is related to a range of risk behaviors. We then tested whether the greater engagement of high compared to low self‐monitoring individuals in risk behaviors could be attributed to: (a) greater discrepancies between perceptions of risk and reported risk behaviors for the high‐scoring group; or (b) higher levels of sensation seeking among high versus low self‐monitoring individuals. Data from a sample of 452 college students supported the second of these two explanations. Implications for self‐monitoring theory and measurement, as well as for adolescent and young adult risk behaviors, are discussed. Copyright © 2000 John Wiley & Sons, Ltd.