Family Processes and Treatment Outcome in the MTA: Negative/Ineffective Parenting Practices in Relation to Multimodal Treatment

To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.     

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.     

The politics of certainty: Conceptions of science in an age of uncertainty

The prestige of science, derived from its claims to certainty, has adversely affected the humanities. There is, in fact, a "politics of certainty". Our ability to predict events in a limited sphere has been idealized, engendering dangerous illusions about our power to control nature and eliminate time. In addition, the perception and propagation of science as a bearer of certainty has served to legitimate harmful forms of social, sexual, and political power. Yet, as Ilya Prigogine has argued, renewed attention to the irreducible reality of time has brought us to "the end of certainty". As we enter the age of uncertainty, there is disagreement about how science should be understood and communicated. Some scientists cling to the ideal of certainty, while others emphasize the creative potential of spontaneity, novelty, and surprise.     

Self-appraised social problem solving abilities, emotional reactions and actual problem solving performance

Self-report measures of social problem solving abilities have yet to be associated with objective problem solving performance in any consistent manner. In the present study, we investigated the relation of social problem solving abilities--as measured by the Social Problem Solving Skills Inventory--Revised (SPSI-R [Maydeu-Olivares, A. & D'Zurilla, T. J. (1996). A factor analytic study of the Social Problem Solving Inventory: an integration of theory and data. Cognitive Therapy and Research, 20, 115-133])--to performance on a structured problem solving task. Unlike previous studies, we examined the relation of problem solving skills to performance curves observed in repeated trials, while controlling for affective reactions to each trial. Using hierarchical modeling techniques, a negative problem orientation was significantly predictive of performance and this effect was not mediated by negative affectivity. Results are discussed as they pertain to contemporary models of social problem solving.     

Evidence for 40-Hz oscillatory short-term visual memory revealed by human reaction-time measurements

Four experiments show that presentation of a synchronous premask frame within a 40-Hz, flickering premask matrix primes subsequent detection of a Kanizsa-type square by generation of a 40-Hz prime. Reaction time (RT) priming effects indicated a 150-200-ms prime duration following premask display. RTs were also found to be sensitive to the phase relationship between offset of the premask display relative to the onset time of the target: Priming effects were maximal when the target was presented out of phase with premask presentation (i.e., at interstimulus intervals displaced by 180 degrees relative to the 40-Hz rhythm of premask-frame presentation). Taken together, these results demonstrate the existence of a very short-term visual memory that oscillates at 40 Hz. The findings are discussed in the context of complementary psychological and neurophysiological findings related to visual-object coding and the role of gamma-band activity in the brain.     

Secondary prevention interventions for young drug users: a systematic review of the evidence

This paper reviews the international scientific evidence on the effectiveness of secondary prevention interventions for young drug users. The review provides insight into the effectiveness of interventions that have been evaluated using moderately strong research designs. Most of the studies included are from the United States of America. Some interventions are effective in reducing drug use and associated problems while others have no or mixed effect. Those successful in reducing drug use include behavior therapy, Minnesota 12-step programs, residential care, and general drug treatment. Those with either no effect or mixed effect include schools interventions. Involving parents and other agencies may enhance an intervention's effect. There is a lack of good quality studies outside the USA. Future interventions should focus on either low- or high-risk groups of young drug users. Future research should be conducted on a wider range of services for young people and include non-medical outcomes such as communication skills, schooling, employment, family relations, and economic costs.     

Taxonicity of anxiety sensitivity: an empirical test among youth

Taxometric coherent cut kinetic analyses were used to test the latent structure of anxiety sensitivity (AS) among 371 youth. Anxiety sensitivity was indexed by the 18-item Childhood Anxiety Sensitivity Index (CASI; Silverman et al., J. Clin. Child Psychol. (1991), 20, 162-168). Two sets of manifest indicators of AS were constructed using the CASI: (1) three item-parcel manifest indicators: disease concerns, unsteady concerns, and mental illness concerns; and (2) nine single-item indicators representing each of these three facets of AS. Results from standard and short-scale MAXCOV procedures, internal consistency tests, analyses of simulated Monte Carlo data, and MAMBAC external consistency tests indicated that the latent structure of anxiety sensitivity among youth was taxonic. Estimated base rate of the observed AS taxon ranged between 13.6 and 16.5%. The present findings are discussed in terms of theoretical implications for the study of AS and vulnerability for anxiety psychopathology.     

Modeling error variance in job specification ratings: the influence of rater, job, and organization-level factors

The authors modeled sources of error variance in job specification ratings collected from 3 levels of raters across 5 organizations (N=381). Variance components models were used to estimate the variance in ratings attributable to true score (variance between knowledge, skills, abilities, and other characteristics [KSAOs]) and error (KSAO-by-rater and residual variance). Subsequent models partitioned error variance into components related to the organization, position level, and demographic characteristics of the raters. Analyses revealed that the differential ordering of KSAOs by raters was not a function of these characteristics but rather was due to unexplained rating differences among the raters. The implications of these results for job specification and validity transportability are discussed.