Neuropsychological changes in children with cancer: The treatment of missing data in longitudinal studies

Researchers conducting longitudinal studies with children or adults are inevitably confronted with problems of attrition and missing data. Missing data in longitudinal studies is frequently handled by excluding from analyses those cases for whom data are incomplete. This approach to missing data is not optimal. On the one hand, if data are missing at random, then dropping incomplete cases ignores information collected on those cases that could be used to improve estimates of population parameters (e.g., means, variances, covariances, and growth rates) and improve the power of significance tests of statistical hypotheses. On the other hand, if data are not missing at random, then dropping incomplete cases leads to biased parameter estimates and hypothesis tests that may be internally and externally invalid. This study uses three years of follow-up data from a longitudinal investigation of neuropsychological outcomes of cancer in children to demonstrate the problems presented by missing data in repeated measures designs and some solutions. In evaluating potential biasing effects of attrition, the study extends previous research on neuropsychological outcomes in pediatric cancer by inclusion of patients whose disease had relapsed, and by comparison of surviving and nonsurviving patients. Although the data presented have specific relevance to the study of neuropsychological outcome in pediatric cancer, the problems of missing data and the solutions presented are relevant to a wide variety of diseases and conditions of interest to researchers in child and adult neuropsychology.     

Setting up inpatient behavioral treatment programs: The staff needs assessment

Despite the success that behavior therapy has demonstrated in treating severely mentally ill adults, widespread impact of behavioral treatments on this population has been limited because the staff of many inpatient settings do not routinely utilize these strategies. Surveying staff regarding their perception of programatic and organizational needs is proposed as a valuable first step for selecting behavioral strategies to be introduced in these settings. Goldfried and D'Zurilla (1969) developed a behavioral assessment survey that is especially useful for identifying staff needs vis-à-vis behavioral rehabilitation. Using these strategies, survey questions addressed five problem areas: Administrative, Staff, Patient, Resource, and Programatic. Results using this survey with 40 clinicians on the extended care unit of a state hospital showed that staff members had greatest concern with the Patient Problem Area (i.e., aversive patient behaviors that are not sufficiently addressed by treatment plans). Further analyses showed staff members were interested in addressing Patient concerns using incentive procedures. The needs assessment in this study not only provided useful information that might be generalized to other treatment settings, but also showcased a reliable survey approach that program developers might implement prior to designing training curricula for behaviorally naive staff in inpatient settings.     

TRAINING INTERACTIONAL BEHAVIORS OF ADULTS WITH DEVELOPMENTAL DISABILITIES: A SYSTEMATIC REPLICATION AND EXTENSION

This study was a replication and extension of research by Foxx, McMorrow, Bittle, and Ness (1986) that assessed generalization effects of a social skills training program on the interactional behavior of adults with developmental disabilities. Target skills were a verbal action or reaction in six skill areas that specifically addressed the participants' skill deficits. In the present study, we trained 5 adult residents of a group home across these six skill areas using the “Sorry” game format and the scoring criteria described by Foxx et al. We extended the results of Foxx et al. by (a) using pretreatment assessment procedures to identify participants' specific skill deficits, (b) training all residents in the natural environment, (c) training participant—participant interactions, (d) training participants to respond to four of the six skill areas through the use of a role-play procedure, and (e) omitting rewards, criterion levels, and self-monitoring. Additionally, the trainer in the present study modeled correct responses only as an error correction procedure during training. Similar to those of Foxx et al., our results indicated that all participants increased their use of the trained interactional behaviors during the generalization assessments in the presence of other trained peers.     

Combining whole-school and targeted programs for the reduction of bullying victimization: A randomized,effectiveness trial

Despite the extensive evaluation of school-based interventions for bullying, victimization remains a significant problem in schools. Bullying victimization is significantly predicted by contextual (school-related) factors. As a consequence whole-school programs have been commonly used to prevent and reduce bullying victimization. Evidence also points to individual risk factors (such as emotional distress) in predicting victimization, yet programs to prevent bullying victimization by changing these individual risks are far less developed. Few studies have approximated “real-world” implementation conditions in their trials. The current effectiveness trial evaluated the combination of a whole-school program designed to prevent bullying perpetration and victimization together with a targeted intervention for at-risk students, teaching them individual and dyadic strategies to reduce their anxiety and manage victimization, allowing schools some latitude to implement programs as they typically would. Students from Grades 3 and 4 (N = 8,732) across 135 schools were randomly assigned to one of four conditions: combined intervention; whole-school intervention only; individual intervention only; and care as usual. Victimization decreased significantly and similarly across all four conditions at 12 and 24 months following baseline. Similar reductions and failure to discriminate conditions were found on other key constructs: anxiety; bullying perpetration; and depression. Possible reasons for the failure to demonstrate victimization prevention differences and lessons learned from this large, effectiveness trial are considered.     

The effect of ethanol treatment on social behavior in male rats

The effect of 0.50 g/kg of EtOH in male rats interacting with a stimulus male juvenile in a newly developed test of social interaction was examined. The adult male rats were treated with EtOH (8.0 to 12.0 g/kg/day) or equicaloric dextrin maltose for 2 weeks (studies 1 and 2) or 8 weeks (study 3) and social interaction was assessed both before and after chronic drug treatment was ended in study 1 and after chronic drug treatment was ended in studies 2 and 3. It was found that prior to chronic drug treatment, in study 1, 0.50 g/kg of EtOH increased both aggressive behavior and time spent interacting with the stimulus juvenile male from the first presentation of the juvenile to the second presentation (20 min apart) while saline injection decreased it. After chronic drug treatment was ended, in study 1 animals treated chronically with EtOH were more aggressive when they were not intoxicated than when they had been treated with 0.50 g/kg of EtOH. In studies 2 and 3, after chronic drug treatment was ended, aggressive behavior and time spent interacting with the juvenile were greater in the animals treated chronically with EtOH, regardless of whether they were injected with saline or 0.50 g/kg of EtOH. The results of these studies showed that chronic EtOH treatment can produce long-lasting changes in social behavior after drug treatment is over and can alter the animal's normal response to EtOH in a social setting.     

Prospective incidence of first onsets and recurrences of depression in individuals at high and low cognitive risk for depression

Do negative cognitive styles provide similar vulnerability to first onsets versus recurrences of depressive disorders, and are these associations specific to depression? The authors followed for 2.5 years prospectively college freshmen (N = 347) with no initial psychiatric disorders at high-risk (HR) versus low-risk (LR) for depression on the basis of their cognitive styles. HR participants had odds of major, minor, and hopelessness depression that were 3.5-6.8 times greater than the odds for LR individuals. Negative cognitive styles were similarly predictive of first onsets and recurrences of major depression and hopelessness depression but predicted first onsets of minor depression more strongly than recurrences. The risk groups did not differ in incidence of anxiety disorders not comorbid with depression or other disorders, but HR participants were more likely to have an onset of anxiety comorbid with depression.     

College women: eating behaviors and help-seeking preferences

Late adolescent women at a large, mid-Atlantic university were surveyed. Of the 578 who completed the survey, 17% were found to have eating disorders as defined by a score of 20 or above on the Eating Attitudes Test (EAT-26; Garner, Olmstead, Bohr, & Garfinkel, 1982). Participants who scored 20 or above were younger and more likely to be white, in a sorority, and Christian than were those who scored below 20 on the EAT-26. No correlation was found between EAT-26 scores and participation in organized athletics. In addition, the participants were asked about their choice of help and support should they have any worries about their eating. They were most likely to say that they would prefer a close friend to support them when dealing with disordered eating, followed by their parents and their significant other. In terms of professional services, most women reported that they would prefer individual assistance such as a consultation with a physician, a nutritionist, or a therapist, followed by family therapy, if they ever had questions about eating or thought they needed professional help with disordered eating.     

Reduction in children's symptoms of attention deficit hyperactivity disorder and oppositional defiant disorder during individual tutoring as compared with classroom instruction

Children who display symptoms of Attention Deficit Hyperactivity Disorder (ADHD) in classrooms are reputed to display fewer symptoms in one-on-one interaction. We tested this hypothesis with children who received tutoring for reading and behavior problems. We selected 30 children whose teacher-rated ADHD symptoms fit a pattern consistent with DSM criteria for the diagnosis. Teachers rated the frequency of symptoms in classrooms before and after tutoring. Tutors rated the frequency of the same behaviors during individual tutoring sessions. Children's ADHD symptoms, as well as oppositional symptoms, were significantly lower in the tutoring sessions than in the classrooms. The effect sizes for the difference between behavior in classrooms and in individual tutoring ranged from 0.7 to 2.5 standard deviations. These effect sizes appear as large as those reported for the effect of stimulant medication on ADHD symptoms. All 30 children at preintervention fit the pattern for ADHD using teachers' ratings of classroom behavior; 87% of them did not meet those DSM criteria using tutors' ratings of behavior in individual sessions. The confound of different raters for the two different settings must be resolved by another study with a new design.     

Psychological reactions to redress: diversity among Japanese Americans interned during World War II

The psychological reactions of 2nd-generation (Nisei) Japanese Americans to receiving redress from the U.S. government for the injustices of their World War II internment were investigated. The respondents, all of whom had been interned during the war, rated the degree to which the receipt of redress nearly 50 years after their incarceration was associated with 8 different areas of personal impact. Results indicated that redress was reported to be most effective in increasing faith in the government and least effective in reducing physical suffering from the internment. Women and older respondents reported more positive redress effects. In addition, lower levels of current income, an attitudinal preference for Japanese Americans, and preredress support for seeking monetary compensation each increased the prediction of positive redress effects. Findings are discussed in relation to theories of social and retributive justice.