Confirmatory Factor Analysis of the Structure of Adult ADHD Symptoms

Previous research has examined the factor structure of ADHD symptoms in adults using confirmatory factor analysis and there is mixed support for two-factor, three-factor, or more complex bifactor models. The current study re-examines these factor structures on the basis of not only overall model fit, but also criteria such as chi-square difference tests, invariance, reliability, and validity. Three datasets were pooled to form a total sample of 430 adults (50% female). Participants completed questionnaires assessing their ADHD symptoms, education, psychopathology, and parenting (the latter as validity variables). Although the bifactor models demonstrated the best fit, the reliability and construct replicability of specific factors in these models was poor. The three-factor model had good fit and demonstrated good reliability, validity, construct replicability, and some invariance across gender and dataset. Our results replicate previous studies that find superior fit for bifactor models. However, the superior statistical fit may reflect only the increased complexity of these models. The more parsimonious three-factor model may demonstrate stronger validity and clinical utility.     

Reevaluating Cue Exposure and Response Prevention in a Pilot Study: An Updated Treatment for Binge Eating Disorder

Approximately half of individuals with binge eating disorder (BED) fail to improve when treated with cognitive behavioral therapy; thus, better treatments are needed. Cue exposure and response prevention (CERP) may be one option, but its full potential for reducing binge eating remains unknown because prior applications for binge eating have not utilized the broad range of strategies believed to optimize exposure therapy. The current single-subject AB design investigated the acceptability and effectiveness of a comprehensive CERP treatment among 8 women who met DSM-5 criteria for binge eating disorder. Changes in the number of binges were measured from baseline to the end of treatment, and desire to eat, salivation, and idiographic expectancies of aversive outcomes to food-cue exposure (idiographic CS-US expectancies), including expectancies about ability to tolerate distress when exposed to food cues were measured across the course of treatment. Statistical analysis revealed a significant reduction in the number of binges from baseline to the end of treatment. Across the course of treatment, desire to eat and idiographic CS-US expectancies reduced, and distress tolerance expectancies increased. No participants dropped out and all reported being maximally satisfied with the treatment. Based on these findings, future randomized-control trials with larger samples should examine the efficacy of CERP and mechanisms underlying change with the aim of establishing a more effective treatment for binge eating disorder.     

The Empirical Status of Cue Exposure and Response Prevention Treatment for Binge Eating: A Systematic Review

Approximately 50% of individuals fail to obtain treatment benefits when undergoing cognitive-behavioral therapy (CBT) for binge-eating behaviors, making it necessary to evaluate additional approaches. Cue exposure and response prevention (CERP) is one such approach, although its effectiveness across studies has been inconsistent. This may be due to inconsistent implementation of theoretically based CERP strategies. This possibility has not yet been systematically investigated. To address this gap, this review investigated which CERP strategies have been incorporated into treatment protocols for binge eating, and if the use of certain strategies improves treatment effectiveness. Relevant studies were identified through reference lists, grey literature, and searches of electronic databases using multiple search terms related to CERP and binge eating, which resulted in 18 eligible studies. Most studies were underpowered, many were of low methodological quality, and none of the included studies utilized all of the strategies that have been recommended to optimize CERP. Despite these weaknesses, CERP appeared to reduce the frequency of binge eating in the short and long term. This review underscores the need for higher quality research that utilizes larger samples and uniform outcome measures that are more strongly grounded in theory. Such research would help improve treatment outcomes for binge eating.     

Parenting Cognition and Affective Outcomes Following Parent Management Training: A Systematic Review

Parent management training (PMT) is considered the gold standard in the treatment of child behavior problems. The secondary effects of these interventions, particularly on parent well-being, are infrequently studied, despite evidence that parents of children with behavior problems often experience personal difficulties. This narrative review examined the affective and parenting cognition outcomes of PMT for mothers and fathers of children ages 2–13 years, across 48 controlled treatment studies. Substantial support was found for reductions in parenting stress, and increases in perceived parenting competence following PMT. Evidence indicated fewer improvements in domains more distal from parenting, including parent depressive symptoms and marital relationship dysfunction. A number of studies suggested parent gender as a moderator of parent outcomes of PMT; however, the underrepresentation of fathers in existing research limits conclusions in this regard. Avenues for future research are highlighted to address current gaps in the literature, and to further our understanding of the ways in which both children and parents may benefit from PMT.     

Optimizing preoperative expectations in cardiac surgery patients is moderated by level of disability: the successful development of a brief psychological intervention

Patients’ expectations have shown to be a major psychological predictor of health outcome in cardiac surgery patients. However, it is unclear whether patients’ expectations can be optimized prior to surgery. This study evaluates the development of a brief psychological intervention focusing on the optimization of expectations and its effect on change in patients’ expectations prior to cardiac surgery. Ninety patients scheduled for coronary artery bypass graft were randomly assigned to (1) standard medical care, (2) additional expectation manipulation intervention (EMI), and (3) additional attention control group. Therapists’ fidelity to intervention manuals and patients satisfaction with the intervention were assessed for both active intervention conditions. Patients’ expectations about post-surgical disability, treatment control, personal control, and disease duration were assessed before and after the psychological intervention. Demographical, medical, and psychosocial characteristics and disability were assessed at baseline. Treatment fidelity and patient satisfaction was very high in both intervention conditions. Only patients receiving EMI developed higher personal control expectations and longer (more realistic) expectations of disease duration. The effect of intervention group on patients’ disability expectations and patients’ personal control expectations was moderated by patient’s level of disability. EMI patients with low to moderate disability developed positive expectations whereas patients with high disability did not. This study shows the successful development of a short psychological intervention that was able to modify patients’ expectations, especially in those with low to moderate disability. Given the robust association of expectations and surgery outcome, such an intervention might offer the opportunity to enhance patients’ health following cardiac surgery.     

Children’s Binding of What-Where-When-Who in Episodic Memory: Identifying Oneself in the Past

It is usually accepted that the binding of what, where, and when is a central component of young children’s and animals’ nonconceptual episodic abilities. We argue that additionally binding self-in-past (what-where-when-who) adds a crucial conceptual requirement, and we ask when it becomes possible and what its cognitive correlates are. In the central task, children aged 3.5 years to 6.5 years watched a light display on Day 1, with 2 lights coming on simultaneously or in 1 of 2 orders. This light display was filmed from 1 of 3 positions: with the camera behind the child, above the child, or facing the child. On Day 2, children watched 3 videos from the original angle, and each represented 1 of the 3 light configurations, with the child in the video occluded. Participants had to decide which occluded child they were and justify their choice by reference to the lights. Above-chance performance was evident after 4.5 years of age. In addition, all children received the following tasks: spatial perspective taking, seeing leads to knowing, modus tollens reasoning, and second-order theory of mind. With age and verbal ability partialed out, only second-order theory of mind correlated significantly with performance on the central task.     

The format of children’s mental images: Penetrability of spatial images

To investigate the format of mental images and the penetrability of mental imagery performance to top-down influences in the form of gravity information, children (4-, 6-, 8- and 10-year-olds) and adults (N = 112) performed mental rotation tasks. A linear increase in response time with rotation angle emerged at 6-years, suggesting that spatial properties are represented in children’s mental images. Moreover, 6-, 8-, and 10-year-olds, but not 4-year-olds or adults, took longer to respond to rotated stimuli pairs when gravity information was incongruent with the direction of rotation rather than congruent. Overall, findings suggest that in contrast to adults’, 6- to 10-year-olds’ mental rotation performance was penetrated by top-down information. This research (a) provides insight into the format of young children’s mental images and (b) shows that children’s mental rotation performance is penetrable by top-down influences.     

From Boulder to Stockholm in 70 Years: Single Case Experimental Designs in Clinical Research

The Psychological Record - With the objective of increasing the magnitude of treatment effects in behavioral health, there is steadily growing interest in tailoring assessments and interventions to...     

Flow: Beyond Fluidity and Rigidity

The term flow refers to a particular type of experience characterized by feelings of fusion with an on-going activity, effortlessness and fluidity. This article concerns the results of an empirical investigation and phenomenological analysis of this type of experience. The analysis yields a distinction between three phenomenological structures, identified as arising in different combinations within concrete experiences of flow. These results are discussed in relation to the theories of Alfred Schutz and Erving Goffman regarding the organization of experience in everyday life, and in relation to the theory of Otto Friedrich Bollnow regarding moods in everyday life. The results of the analysis are also discussed in relation to different uses of the flow concept in a variety of contexts found in recent theoretical contributions. These differences of usage and approach are explained in the light of the results of the phenomenological analysis, which distinguishes qualitatively different varients within the phenomenon termed flow experience. In conclusion, the need to adopt a broader concept of experience in sociological analysis is emphasized, as well as the need for further empirical studies of the contextual frames of different variants of flow experiences.