Hierarchical classes: Model and data analysis

A discrete, categorical model and a corresponding data-analysis method are presented for two-way two-mode (objects × attributes) data arrays with 0, 1 entries. The model contains the following two basic components: a set-theoretical formulation of the relations among objects and attributes; a Boolean decomposition of the matrix. The set-theoretical formulation defines a subset of the possible decompositions as consistent with it. A general method for graphically representing the set-theoretical decomposition is described. The data-analysis algorithm, dubbed HICLAS, aims at recovering the underlying structure in a data matrix by minimizing the discrepancies between the data and the recovered structure. HICLAS is evaluated with a simulation study and two empirical applications.This research was supported in part by a grant from the Belgian NSF (NFWO) to Paul De Boeck and in part by NSF Grant BNS-83-01027 to Seymour Rosenberg. We thank Iven Van Mechelen for clarifying several aspects of the Boolean algebraic formulation of the model and Phipps Arabie for his comments on an earlier draft.     

Personal and Environmental Factors Predict Participation of Children With and Without Mild Developmental Disabilities

Enhancing participation in age-related activities is a key goal in the education and rehabilitation of children with diverse disabilities. The aim of this study was to explore a multidimensional and ecological model of participation for young children. Seventy eight children with mild developmental disabilities (MDD, such as motor and visual-motor difficulties), and 110 children without disabilities, between the ages 4 and 6 years old, participated in the study together with their parents. Data were collected using standardized assessments for child capacities and newly developed questionnaires for child participation and for human and physical environmental factors. Associations were found between personal and environmental factors and the participation dimensions amongst young children, thus supporting the validity of the proposed model of participation. Moreover, the study results outline different pathways for the participation of children with and without MDD. Child factors (e.g. process skills) were found to be crucial predictors of participation particularly for children with MDD, whereas human environmental factor (e.g. maternal self-efficacy beliefs) was associated with higher participation scores especially for children without disabilities. These findings may facilitate the development of effective intervention programs which focus on environmental factors as well as on child factors.     

Delaying approval of a critical drug: Safety,efficacy, economics,compassion

Biotechnological advance is speeding the development of drugs. The approval processes for new drugs will inevitably involve a regulatory agency in making political-economic and scientific choices. Interests of specific patients and the public in general are to be considered, and enormous stakes are involved for companies concerned. A medical regulatory authority must be at once insulated from and responsive to many different mixes of singular and general interests and pressures. Access to new drugs can be spurred by the press of patient advocacy groups, but if there are well organized groups to monitor the testing and approval process for such as AIDS or cancer drugs there is often no similar group to represent patient needs. If there is no organized patient advocacy group, compassionate responsibility by a medical regulatory authority is indeed called for. Delay in the approval of new drugs for fighting severe blood infections raises the question of how to insure the compassionate responsibility of a regulatory authority.     

Growing Up Can Be Painful: A Case Report of the Bat Mitzvah and Chronic Pain

Among a subgroup of adolescents with chronic pain syndromes, anxiety about “growing up” appears common and may be exacerbated by developmental transitions. Using the bat mitzvah ceremony as one example of a developmental rite of passage, we present two cases in which adolescent girls facing this transition developed new chronic musculoskeletal pain syndromes or experienced recurrences of pain symptoms. In both cases, the transition to adulthood, symbolized by the bat mitzvah, was associated with anxiety in adolescents who were unusually focused on the negative aspects of becoming independent adults. The aims of this case report are (1) to highlight the role of developmental transitions as a possible factor in the biopsychosocial model of pediatric pain; (2) to illustrate how to address emotional and cognitive responses to these transitions in the context of cognitive-behavioral treatment for pain; and (3) to suggest systematic approaches to investigating this clinically-observed phenomenon in future research.     

Parental reports of executive dysfunction in adolescents with bipolar disorder.

Bipolar disorder (BPD) is a serious mental illness that affects children and adolescents at a rate similar to that seen in adults. Extremely little is known, however, about cognitive functioning in childhood and adolescent BPD. The present study represents an initial effort to examine executive functioning in adolescents with BPD who are in a manic or mixed mood state, by collecting data from caregivers about the participants' performance on everyday tasks thought to be mediated by executive functioning abilities, using the Behavior Rating Inventory of Executive Function. In comparison to healthy volunteers, adolescents with BPD exhibited significant elevations across all of the measured functional domains. These elevations were evident even in adolescents with BPD who did not have comorbid ADHD, although they were most prominent in those with comorbidity. The findings suggest that adolescents with BPD have functional deficits on tasks requiring executive functioning skills that are not explicable solely on the basis of comorbid ADHD.     

Youth Self-Views,Coping with Stress,and Behavioral/Emotional Problems: The Role of Incremental Self-Theory

Previous research has established associations between stress and coping processes and internalizing and externalizing problems among adolescents and emerging adults. The purpose of the present study was to integrate this literature with research demonstrating the importance of self-theory—views that individuals hold about themselves and their abilities. We examined the extent to which self-theory may influence both coping processes and internalizing and externalizing problems among adolescents and emerging adults. Using moderated mediation, we tested whether coping serves as a mechanism through which self-theory of both intelligence and personality influences internalizing and externalizing problems among adolescents and emerging adults. One hundred and forty participants (adolescents aged 14–17; emerging adults aged 18–30; 60 % female; 8.5 % ethnic minority) completed questionnaires on self-theory, coping responses, and behavioral/emotional problems. Results of moderated mediation analyses were consistent with coping as a mechanism through which self-theory influences psychopathology symptoms such that more malleable beliefs are associated with increased productive coping strategies and lower levels of internalizing and externalizing problems. The current findings also indicate that these associations were significant for adolescents but not for emerging adults. Although cross-sectional, findings suggest that fostering malleable beliefs among adolescents may increase the use of productive coping strategies and positively influence adjustment.