Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.     

Moral Responsibility and Unavoidable Action

The principle of alternate possibilities (PAP), making the ability to do otherwise a necessary condition for moral responsibility, is supposed by Harry Frankfurt, John Fischer, and others to succumb to a peculiar kind of counterexample. The paper reviews the main problems with the counterexample that have surfaced over the years, and shows how most can be addressed within the terms of the current debate. But one problem seems ineliminable: because Frankfurt's example relies on a counterfactual intervener to preclude alternatives to the person's action, it is not possible for it to preclude all alternatives (intervention that is contingent upon a trigger cannot bring it about that the trigger never occurred). This makes it possible for the determined PAPist to maintain that some pre-intervention deviation is always available to ground moral responsibility.In reply, the critic of PAP can examine all the candidate deviations and argue their irrelevance to moral responsibility (a daunting prospect); or the critic can dispense with counterfactual intervention altogether. The paper pursues the second of these strategies, developing three examples of noncounterfactual intervention in which (i) the agent has no alternatives (and a fortiori no morally relevant alternatives), yet (ii) there is just as much reason to think that the agent is morally responsible as there was in Frankfurt's original example. The new counterexamples do suffer from one liability, but this is insufficient in the end to repair PAP's conceptual connection between moral responsibility and alternate possibilities.     

Word-Monitoring Tasks Interact with Levels of Representation During Speech Comprehension

Researchers frequently use data from monitoring tasks to argue that constraints on meaning facilitate lower-level processes. An alternate hypothesis is that the processing level that a monitoring task requires interacts with discourse-level processing. Subjects monitored spoken sentences for a synonym (semantic match), a nonsense word (phonological match), or a rhyme (phonologically and semantically constrained matching). The critical targets appeared at the beginning of the final clause in two-clause sentences that began with if, which signals a semantic analysis at the discourse level, or with though, which maintains a surface representation. Synonym-monitoring times were faster for if than for though, nonsense word-monitoring times were faster for though than for if, and rhyme-monitoring times did not differ for if and though. The results show that conjunctions influence how listeners allocate attention to semantic versus phonological information, implying that listeners form these kinds of information independently.     

Functionality and spatial relations in memory and language

We examined whether the functionality of spatial relations affects the construction and memory of information in situation models. A functional relationship involves the interaction of entities that is implied by either typical use or contextual demands. Previous research has shown that spatial relations are less likely to be encoded during comprehension unless there is extensive prior knowledge, explicit instructions to attend to spatial information, or a clear emphasis on spatial information. If the construction of a situation model is guided by a need to understand the functional structure of a situation, then functional spatial relations should be more likely to be encoded. The results of our study showed that sentences with functional spatial relations were read faster and remembered better in both recall and recognition tests than sentences with nonfunctional spatial relations.     

Internal languages of retrieval: The bilingual encoding of memories for the personal past

In contrast to most research on bilingual memory that focuses on how words in either lexicon are mapped onto memory for objects and concepts, we focus on memory for events in the personal past. Using a word-cue technique in sessions devoted exclusively to one language, we found that older Hispanic immigrants who had come to the United States as adults internally retrieved autobiographical memories in Spanish for events in the country of origin and in English for events in the U.S. These participants were consistently capable of discerning whether a memory had come to them "in words" or not, reflecting the distinction between purely imagistic or conceptual memories and specifically linguistic memories. Via examination of other phenomenological features of these memories (sense of re-living, sensory detail, emotionality, and rehearsal), we conclude that the linguistic/nonlinguistic distinction is fundamental and independent of these other characteristics. Bilinguals encode and retrieve certain autobiographical memories in one or the other language according to the context of encoding, and these linguistic characteristics are stable properties of those memories over time.     

Morphological priming: Dissociation of phonological, semantic, and morphological factors

Previous experiments based on a masked-priming paradigm revealed robust morphological priming effects induced by two derivational morphemes in Hebrew: the root and the verbal pattern. However, considering the special characteristics of the masked-priming paradigm, the possible contributions of phonological and/or semantic factors to these morphological effects could not be firmly assessed. In the present study, the role of these factors in morphological priming was examined, using cross-modal presentation. Experiment 1 revealed that priming between morphologically related words in Hebrew is determined by higher level linguistic characteristics and cannot be reduced to phonological overlap. Experiment 2 confirmed that morphological priming occurs in Hebrew even when primes and targets are not semantically related but, nevertheless, increases with semantic similarity. The results support the claim that morphological priming cannot be accounted for by considering semantic and phonological factors alone, and they exemplify the potential of using both masked and cross-modal priming to examine morphological processing.     

A Pathological View of Disease

This paper is a response to Christopher Boorse's recent defense of hisBiostatistical Theory (BST) of health and disease. Boorse maintains that hisconcept of theoretical health and disease reflects the ``consideredusage of pathologists.' I argue that pathologists do not use ``disease' inthe purely theoretical way that is required by the BST. Pathology does notdraw a sharp distinction between theoretical and practical aspects ofmedicine. Pathology does not even need a theoretical concept of disease. Itsfocus is not theoretical, but practical; pathology's goal is to contribute tothe healing of patients. Pathology, even experimental pathology, is notvalue-free. Not only ``disease' but also such terms as ``nerve' and ``organ'are laden with conceptual values.     

Vertical versus horizontal spatial compatibility: Right-left prevalence with bimanual responses

For two-choice tasks in which stimulus and response locations vary along horizontal and vertical dimensions, the spatial compatibility effect is often stronger on the horizontal than vertical dimension. Umiltà and Nicoletti [(1990) Spatial stimulus-response compatibility (pp. 89–116). Amsterdam: North-Holland] attributed this right-left prevalence effect to an inability to code vertical location when horizontal codes are present simultaneously. Hommel [(1996) Perception & Psychophysics, 43, 102–110] suggested instead that it reflects a voluntary strategy. This study reports four experiments that examine this issue. Experiment 1 was a conceptual replication of Hommel's Experiment 1, with responses made on a numeric keypad and subjects instructed in terms of the vertical or horizontal dimension. The results replicated Hommel's findings that showed a right-left advantage with horizontal instructions; however, with vertical instructions, we found a benefit of vertical compatibility alone that he did not. This benefit for vertical compatibility alone was eliminated in Experiment 2 using a varied practice schedule similar to that used by Hommel. Experiment 3 showed right-left prevalence and a benefit of vertical compatibility alone, even with varied practice and vertical instructions, when subjects responded on perpendicularly arranged handgrips. These benefits were eliminated in Experiment 4 using Hommel's method of urging subjects to respond only in terms of the instructed dimension. With bimanual responses, right-left prevalence is a robust phenomenon that is evident when comparing across vertical and horizontal instructions and, when the right-left distinction is relatively salient, within the vertical instructions condition alone. Received: 4 February 2000 / Accepted: 5 May 2000