Measuring Child Mental Health Status for Services Research

Epidemiological studies of the prevalence of mental health disorders typically contain multiple measures of mental health, using different instruments and different informants (child, parent, and interviewer). We used the Methods for the Epidemiology of Child and Adolescents Mental Disorder (MECA) study of U.S. youth to assess the effects of employing a range of these measures in mental health services research. We examined the effect of including various measures of mental health status in regressions of income on mental health service use. The estimated effect of income on service use varied widely, depending on the measure of mental health status used. Some measures of mental health status have little explanatory power in service use regressions. Measures of mental health status based on parental assessment of impairment or need, such as the Columbia Impairment Scale, are less costly to collect and also have good explanatory power, but are more strongly correlated with income. The Non-Clinician Child Global Assessment Scale (NC-CGAS) performs best in terms of explanatory power and correlation with income. Higher income parents appeared to judge behaviors differently from lower income parents, so analyses based on measures derived from parental report may lead to an understatement of the effect of income on service use.     

Proprioceptive feedback as a mediator in interlimb timing

Prior findings regarded as evidence for proprioceptive feedback as a mediator in interlimb timing can also be interpreted as evidence for motor outflow because they came from research that had subjects make voluntary movements, and such movements allow for both feedback and outflow to operate. The present study was designed to resolve this controversy by determining if these findings could be replicated with passive movements which allow for feedback, but not outflow, to operate. The interlimb timing task studied was one where subjects made the timing response with their right hand while moving their left arm during the 1.5-sec interval to be timed. Three groups of 16 male college students performed 50 trials of the right-hand response with knowledge of results, under one of three left-arm conditions: (a) passive movement, (b) voluntary movement, and (c) no movement. The results indicated that the findings were replicated with passive movements and this was interpreted as support for the involvement of proprioceptive feedback in interlimb timing.     

Dueling Experiences and Dual Ambivalences: Emotional and Motivational Ambivalence of Women in High Status Positions

A laboratory study demonstrates that women in high status positions experience emotional ambivalence (simultaneous experience of positive and negative affect) and motivational ambivalence (simultaneous desires to build relationships and display power). These effects were found with 2 different measures of ambivalence, 1 derived from the attitudinal ambivalence literature and the other from the structure of affect literature. These findings have implications about the experience of women in the workplace, as well as the current debates concerning structure of affect.     

Improvements in early care in Russian orphanages and their relationship to observed behaviors

This article describes a unique study that attempts to promote positive social‐emotional relationships and attachment between caregivers and children in orphanages in St. Petersburg, Russia. The children who reside in these orphanages are typically between birth and 48 months of age; approximately 50% are diagnosed with disabilities, and approximately 60% leave through foreign adoption. Initially, their orphanage caregivers showed a high level of current anxiety and depression and were detached from and communicated little with the children. Likewise, during baseline observations, the children demonstrated poor attachment behaviors such as indiscriminant friendliness, lack of eye contact with adults, aggression, and impulsive behavior. Two interventions were used in a quasiexperimental design: (a) training of caregivers to promote warm, responsive caregiving and (b) staffing and structural alterations to support relationship building, especially increasing the consistency of caregivers. The methodology required that both the training and staffing interventions be provided to one orphanage, only the training to a second, and neither to a third. (At any one time, ns = 80–120 in each condition.) Initial informal observations reveal positive behaviors for both the caregivers and the children, such as increased two‐way conversations, animated and enthusiastic emotional responses, and positive social and language interactions. Early data analyses show an increase in the consistency and stability of caregivers and increased scores for caregivers on every subscale of the HOME Scales. Children showed improvements in physical growth, cognition, language, motor, personal‐social, and affect, with children having severe disabilities improving the most. The implications of these findings suggest that training staff with modest educational backgrounds and structural changes are effective, can increase socially responsive caregiving behaviors, and improves social interactions of children, at least temporarily. ©2005 Michigan Association for Infant Mental Health.     

Video-based assessment of interpersonal problem solving skills in patients with schizophrenia, their siblings and non-psychiatric controls

The aim of this study was to analyze social functioning in patients with schizophrenia and their biological relatives with a Swedish version of the video-based vignette test Assessment of Interpersonal Problem Solving Skills (AIPSS). In a new video production with simulated "real life" situations we tested the ability to receive, process and send social information in 25 individuals with a DSM-IV diagnosis of schizophrenia, 20 siblings to patients with schizophrenia and 25 randomly selected non-psychiatric controls. The test proved to have good validity and interrater reliability. After controlling for positive or negative symptoms, patients had poor performance especially in acting out solutions leading to effective problem solving. Siblings generally did not differ from controls, but showed some deficiencies in non-verbal language. To conclude, AIPSS is appropriate for use in a Swedish-speaking context and might be useful in research on vulnerability indicators and in assessment of treatment interventions.     

A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers

In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both of their parents’ native language was German, stuttering onset had been at least 6 months before, and their stuttering frequency was higher than 3% stuttered syllables. Spontaneous speech samples were recorded at home and in the clinic prior to treatment and after 4 months. Compared to the wait-contrast group, the treatment group showed a significantly higher decrease in stuttered syllables in home-measurements (6.9%SS vs. 1.6%SS) and clinic-measurements (6.8%SS vs. 3.6%SS), and the same increase in articulation rate. The program is considered an enrichment of currently applied early stuttering interventions in Germany.

Educational objectives: Readers will discuss and evaluate: (1) the short-term effects of the Lidcombe Program in comparison to natural recovery on stuttering; (2) the impact of the Lidcombe Program on early stuttering in German-speaking preschool children.     

Decline in life satisfaction in old age: longitudinal evidence for links to distance-to-death

Using 12-year longitudinal data from deceased participants of the Berlin Aging Study (N = 414; age 70-103 years, at first occasion; M = 87 years, SD = 8.13), the authors examined whether and how old and very old individuals exhibit terminal decline in reported life satisfaction at the end of life. Relative to age-related decline, mortality-related decline (i.e., distance-to-death) accounted for more variance in interindividual differences in life satisfaction change and revealed steeper average rates of decline, by a factor of 2. By applying change-point growth models, the authors identified a point, about 4 years before death, at which decline showed a two-fold increase in steepness relative to the preterminal phase. For the oldest old (85+ years), a threefold increase was observed. Established mortality predictors, including sex, comorbidities, dementia, and cognition, accounted for only small portions of interindividual differences in mortality-related change in life satisfaction. The authors conclude that late-life changes in subjective well-being are related to mechanisms predicting death and suggest routes for further inquiry.     

Fitting in and feeling fine: conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students.     

Realism and illusion in Americans' temporal views of their life satisfaction: age differences in reconstructing the past and anticipating the future

We examined actual and perceived trajectories of change in life satisfaction in a national sample of 3,793 adults, ages 24 to 74 at baseline, who provided retrospective, present, and prospective ratings on two occasions 8 to 10 years apart. There was little actual change in satisfaction ratings, but there were age differences in anticipated change, with young adults expecting things to improve and older adults expecting decline. When we compared the actual (present) ratings with corresponding past or future ratings, older adults showed more temporal realism (retrospective and anticipatory ratings matched actual levels) than did young and middle-aged adults; in other words, young and middle-aged adults showed greater illusion (retrospective and prospective ratings overestimated or underestimated actual levels). At all ages, however, temporal realism was associated with more adaptive current functioning than was illusion. We discuss these findings from a life-span developmental perspective on motivational shifts from growth to maintenance and consider the implications of accuracy in evaluating the past and future.     

Intention to consent to living organ donation: an exploratory study

Living organ donation, that is the removal and transplantation of whole organs or segments of organs that a volunteering donor can live without, has been proposed as an effective and sustainable source of transplantable organs to mitigate the deficit in supply from the traditional cadaveric donor pool. In 2006, the Irish government deemed the development of a national Living Transplant Programme a service priority. The current study aimed to investigate the efficacy of the theory of planned behaviour (TPB) in the context of living organ donation intentions in an Irish sample. One hundred and thirty five undergraduate students (75 females, 60 males; mean age 20.6 years, SD 3.76) completed a self-report questionnaire assessing TPB variables while imagining themselves in a potential living liver donation scenario. In general, attitudes towards living donation were favourable. TPB components explained 44.8% of the variance in intentions. Attitude towards living donation emerged as the strongest predictor of intention. Self-reported levels of knowledge regarding living donation were generally poor. In light of recent EU Communications proposing the expansion of the use of living donors greater understanding of the determinants, psychological implications and ethical considerations in living donation decisions is necessary.