An Examination of Post-Traumatic Stress Symptoms and Aggression among Children with a History of Adverse Childhood Experiences

Childhood aggression is associated with many deleterious outcomes and is a common reason for psychiatric referral (Card & Little, 2006; Gurnani et al., 2016). One factor associated with childhood aggression is Adverse Childhood Experiences (ACEs; Felitti et al., 1998). However, existing research remains equivocal on which characteristics of ACEs (e.g., cumulative impact, typology, etc.) are significantly elated to aggression, especially when considering differential effects of ACEs on proactive aggression (PA) and reactive aggression (RA; Dodge & Coie, 1987). Post-traumatic stress symptoms (PTSS) are a common negative sequalae of ACEs and are characterized by disruptions in several cognitive, emotional, and behavioral processes similar to those associated with both RA and PA (e.g., Marsee, 2008). As such, the examination of PTSS as an underlying mechanism of influence on the relation between ACEs, PA, and RA is warranted. The present study fills several gaps in the literature by examining ACE characteristics that might be related to PTSS, PA, and RA while also examining direct and indirect effects on the relation between ACEs, PTSS and PA and RA. Results indicated the type of ACE, specifically child maltreatment ACEs (CM-ACEs), was most strongly related to all outcome variables. Therefore, CM-ACEs were included in a path analysis with PTSS, PA, and RA. Results indicated a significant indirect effect for PTSS on the relation between CM-ACEs and RA (β?=?.18, p?<?.01) but not PA. Findings have several implications for future research and clinical practice, especially for children with an extensive history of CM-ACEs.

     

SEX SIMILARITIES AND DIFFERENCES IN TYPES OF PLAY IN GAMES AND SPORTS

In two studies, 374 participants gave retrospective reports of their favorite games, toys, and hobbies (games) and of their favorite exercise and sports (sports) in elementary school, high school, and college. We tested Gilligan's (1982) expectation that more of males' play would be group activities played in public places, whereas more of females' games and sports would be home-based play in "intimate" dyads. Results showed that sex similarities and differences varied as a function of kind of play. For both sexes, games tended to be home-based and individual or dyadic play, however sports tended to be group, public-based play. Whereas team sports play was most frequent in childhood for both sexes and decreased in frequency from childhood into adulthood, the decrease in team, as compared to individual and dyadic, sports was significantly more dramatic for girls than for boys. The data indicated that whereas girls participate in a variety of types of play, boys' sports play is dominated by team activity across development. Thus, sex differences in the types of sports play provided the strongest support for Gilligan's hypothesis that socialization in team play may foster a reliance upon rights-based moral reasoning in boys.     

Statistical Learning of Unfamiliar Sounds as Trajectories Through a Perceptual Similarity Space

In typical statistical learning studies, researchers define sequences in terms of the probability of the next item in the sequence given the current item (or items), and they show that high probability sequences are treated as more familiar than low probability sequences. Existing accounts of these phenomena all assume that participants represent statistical regularities more or less as they are defined by the experimenters—as sequential probabilities of symbols in a string. Here we offer an alternative, or possibly supplementary, hypothesis. Specifically, rather than identifying or labeling individual stimuli discretely in order to predict the next item in a sequence, we need only assume that the participant is able to represent the stimuli as evincing particular similarity relations to one another, with sequences represented as trajectories through this similarity space. We present experiments in which this hypothesis makes sharply different predictions from hypotheses based on the assumption that sequences are learned over discrete, labeled stimuli. We also present a series of simulation models that encode stimuli as positions in a continuous two‐dimensional space, and predict the next location from the current location. Although no model captures all of the data presented here, the results of three critical experiments are more consistent with the view that participants represent trajectories through similarity space rather than sequences of discrete labels under particular conditions.     

Cognitive testing of an instrument to evaluate acceptability and use of pre-exposure prophylaxis products among women

Given the range of pre-exposure prophylaxis (PrEP) products currently being tested to prevent HIV in women, a standardized Acceptability and Use of PrEP Products Among Women Tool may facilitate comparisons of product acceptability and use across different geographies, trials, and users. We conducted three rounds of cognitive interviewing over 2 months in 2016, with 28 South African women who had experience participating in a range of PrEP product trials. The final instrument contained 41 items, including five new items that improved construct validity and 22 items modified for clarity. Changes were made due to unclear wording, difficulty answering, participant embarrassment, low response variability, and administrative formatting. Cognitive interviewing provided a means to address issues that would have inhibited this tool's ability to accurately collect data otherwise. This rapid, low-cost study provided valuable insight into participants' understanding of questions and demonstrated the utility of cognitive interviewing in international clinical trials.     

Effectiveness of Cognitive Behavioral Therapy for Anxiety and Depression Among Orthodox Jews

Several clinical papers have provided clinical recommendations for how to provide cognitive behavioral therapy (CBT) for obsessive-compulsive symptoms among Orthodox Jewish individuals. However, no published studies have described culturally adapted CBT for anxiety or depression in this population or quantified the effectiveness of such approaches. We evaluated the effectiveness of CBT for symptoms of generalized anxiety and depression in a sample of Orthodox Jews (n = 65) and a comparison sample (n = 42) presenting to the Center for Anxiety, a private outpatient clinic with three offices in the New York area (www.centerforanxiety.org). A chart review revealed that all patients received CBT-based interventions with appropriate religious-cultural adaptations of treatment, which we present in two case studies. We observed statistically and clinically significant treatment gains from pretreatment to midtreatment (anxiety: t = 8.56, p < .001; depression: t = 8.01, p < .001), and again from midtreatment through termination (anxiety: t = 3.68, p < .001; depression: t = 3.62, p < .001). No significant differences in anxiety or depression were observed between Orthodox Jewish patients and controls at any time point or for treatment effects (anxiety: Wilks’ Lambda = .950, F = 2.65, p = .076, η_p² = .050; depression: Wilks’ Lambda = .99, F = 2.00,p = .49, η_p² = .014). This paper offers clinical insight into delivery of CBT to Orthodox Jewish patients, as well as preliminary support for the effectiveness of CBT in treating symptoms of generalized anxiety and depression within this population.