Exposure and response prevention of morbid ruminations and compulsive avoidance

Two patients with morbid ruminations and compulsive avoidance behavior were independently treated by the authors with exposure and response prevention strategies. The patients were quite different with respect to age (23 vs 58), occupational status (student vs civil servant) and length of disorder (2 vs 40 years), although their disorders were quite similar. The present report describes the patients and treatment procedures and reports on dramatic behavioral changes that occurred within brief time periods.     

Risk Factors for Learning-Related Behavior Problems at 24 Months of Age: Population-Based Estimates

We used a large sample of singleton children to estimate the effects of socioeconomic status (SES), race/ethnicity, gender, additional socio-demographics, gestational and birth factors, and parenting on children’s risk for learning-related behavior problems at 24 months of age. We investigated to what extent these factors increased a child’s risk of displaying inattention, a lack of task persistence, disinterest, non-cooperation, or frustration as he or she completed a series of cognitive and physical tasks with a non-caregiver. Results indicated that boys are about twice as likely as girls to display learning-related behavior problems. Children from lower SES households are about twice as likely as those from high SES households to display such behavior problems, which is largely attributable to the effects of having a mother with a low educational level. Statistically controlling for these factors, we found consistently significant patterns of elevated learning-related behavior problems for some Asian and Native American children. Results for African-American children were mixed. Hispanic children did not have consistently elevated risks of problem behaviors. Only small portions of these effects are explained by variation in the children’s gestational or birth characteristics. A significant portion, but still less than half of the socio-demographic effects are attributable to measured features of the children’s parenting. This study helps provide population-based estimates of children’s risk for learning-related behavior problems while at an age when early interventions are most effective.

Issues Arising in Psychological Consultations to Help Parents Talk to Minor and Young Adult Children about their Cancer Genetic Test Result: a Guide to Providers

The defining difference between genetic and traditional medicine is that genetic findings have implications not just for the patient, but also for their relatives. Discussion of a test result between parent and child is both a transformative and a translational moment in the life of a family. Parents report wanting help in talking to their children. The challenge for genetic counselors and other providers is to be able to recognize which issues are at the core of parental distress and be able to offer recommendations to empower and support parents. The complexity of potential genetic findings, including variants of uncertain significance (VUS) and incidental findings have vastly increased, requiring considerable explanation and leaving less time for discussion of emotional issues. While the nature of the testing (single gene to multigene panel and genomic testing) is dramatically changing, the nature of parent concerns remains remarkably constant. Families differ in many respects, so no “recipe” suffices to answer parents’ questions about how this important task should be approached in each family. Successful consultation to parents requires true counseling, matching parents’ fears and questions with information, exploration and advice specific to their concerns, their circumstances and strengths.     

Do tests of malingering concur? Concordance among malingering measures

Malingering test accuracy is increasingly a major issue in psychology and law. Integrating results across measures might offset limitations of a single test, but the practical benefits of using several tests depend on the extent to which they misclassify the same individuals. Data from 66 evaluatees were used to assess the degree of overlap and consistency of classification among several commonly used malingering instruments. Although correlative data indicated that measures were highly redundant even across symptom domains, classification accuracy analyses revealed that findings based on conjunctions of these scales may not overlap to the degree that the correlations might suggest.