A Dose-Ranging Study of Behavioral and Pharmacological Treatment in Social Settings for Children with ADHD

Placebo and three doses of methylphenidate (MPH) were crossed with 3 levels of behavioral modification (no behavioral modification, NBM; low-intensity behavioral modification, LBM; and high-intensity behavior modification, HBM) in the context of a summer treatment program (STP). Participants were 48 children with ADHD, aged 5–12. Behavior was examined in a variety of social settings (sports activities, art class, lunch) that are typical of elementary school, neighborhood, and after-school settings. Children received each behavioral condition for 3 weeks, order counterbalanced across groups. Children concurrently received in random order placebo, 0.15 mg/kg/dose, 0.3 mg/kg/dose, or 0.6 mg/kg/dose MPH, 3 times daily with dose manipulated on a daily basis in random order for each child. Both behavioral and medication treatments produced highly significant and positive effects on children’s behavior. The treatment modalities also interacted significantly. Whereas there was a linear dose–response curve for medication in NBM, the dose–response curves flattened considerably in LBM and HBM. Behavior modification produced effects as large as moderate doses, and on some measures, high doses of medication. These results replicate and extend to social-recreational settings previously reported results in a classroom setting from the same sample (Fabiano et al., School Psychology Review, 36, 195–216, 2007). Results illustrate the importance of taking dosage/intensity into account when evaluating combined treatments; there were no benefits of combined treatments when the dosage of either treatment was high but combination of the low-dose treatments produced substantial incremental improvement over unimodal treatment.     

Direct and Indirect Effects of the Family Check-Up on Self-Regulation from Toddlerhood to Early School-Age

We examined the development of children’s inhibitory control from toddlerhood to early school-age (i.e., ages 2 to 7.5 years), investigated the effects of the Family Check-Up on the growth of inhibitory control, and explored whether such effects transferred to the school context. Participants were 731 low-income children (49 % female). Results indicated that parental reports of inhibitory control showed positive, nonlinear increase with the growth decelerating over time. Moreover, children in the intervention condition demonstrated higher levels of growth in parental ratings of inhibitory control compared to the control condition. More importantly, the intervention had indirect effects on teacher reports of children’s self-control and oppositional defiant behavior as well as examiner ratings of self-control through its promotion of growth in inhibitory control. The findings are discussed with respect to implications for more specifically targeting the promotion of self-regulation in early childhood in addition to reduction in early problem behavior.     

From Mourning to Action: African American Women's Grief,Pain, and Activism

The Movement for Black Lives has brought particular attention to the experience of grief in the lives of African American mothers and its use in their advocacy for social reform. Grief-inspired activism is historically significant in the African American community. By highlighting the historical connections between Mamie Bradley Till and present-day African American mothers’ grief over their deceased children, we will discuss the role of grief and mourning in the lives of African American mothers and the way in which their grief is pivotal in shaping their involvement in social justice movements. Furthermore, we will provide suggestions on how to promote social activism among African American mothers.     

Thin Is In? Think Again: The Rising Importance of Muscularity in the Thin Ideal Female Body

Research has documented an increased emphasis on fitness in media targeting women. However, it is unclear whether this emphasis has resulted in increased muscularity in the perceived ideal female body shape. We sought to evaluate whether the ideal female figure has incorporated increased muscularity into the existing ideal body type that already emphasizes thinness. In Study 1, 78 female undergraduates evaluated images of U.S. beauty pageant winners over the past 15 years on dimensions of thinness, muscularity, and attractiveness. Results indicated that muscularity and thinness ratings of pageant winners significantly increased over time. In Study 2, 64 female undergraduates evaluated two different versions of the same image of a model: a Thin Muscular image and a Thin Only image in which the appearance of muscularity was removed through digital editing. When images were presented in pairs, results indicated that participants found the Thin Muscular image more attractive than the Thin Only image. These results suggest that the current perceived ideal female figure includes both extreme thinness and muscularity and that women prefer this muscular thin figure to a solely thin figure. These findings have implications for clinical treatments related to body image, compulsive exercise, and media literacy.     

Time Costs for Genetic Counseling in Preconception Carrier Screening with Genome Sequencing

Advances in technology and the promise of personalized health care are driving greater use of genome sequencing (GS) for a variety of clinical scenarios. As health systems consider adopting GS, they need to understand the impact of GS on the organization and cost of care. While research has documented a dramatic decrease in the cost of sequencing and interpreting GS, few studies have examined how GS impacts genetic counseling workloads. This study examined the time needed to provide genetic counseling for GS in the context of preconception carrier screening. Genetic counselors prospectively reported on the time spent in the results disclosure process with 107 study participants who were part of the NextGen study. We found that the median time for results disclosure was 64 min (ranged from 5 to 229 min). Preparation work was the most time-consuming activity. Qualitative data from journal entries, debrief interviews with genetic counselors, and detailed case conference notes provided information on factors influencing time for results disclosure and implications for practice. Results suggest that expanded carrier screening could require significant increases in genetic counseling time, unless we are able to generate new resources to reduce preparation work or develop other strategies such as the creation of new models to deliver this type of service.     

Stages of Change in Smoking Cessation: A Comparison of Expectancies Among Precontemplators and Contemplators

Previous research has shown that smokers progress through a series of stages of change as they attempt to quit their habit. This study evaluated smokers in the precontemplation and contemplation stages in order to explore how we can effectively facilitate positive stage transition. Precontemplators (n = 71) and contemplators (n = 30) were compared in terms of two types of expectancies: self-efficacy beliefs and response outcome expectancies. Stage of change was defined according to both categorical and continuous dimensions, each of which led to different results. The findings are discussed in terms of their potential applications to smoking cessation programs and their implications regarding the stage model of change.     

At the intersection of social and cognitive development: internal working models of attachment in infancy

Three visual habituation studies using abstract animations tested the claim that infants' attachment behavior in the Strange Situation procedure corresponds to their expectations about caregiver-infant interactions. Three unique patterns of expectations were revealed. Securely attached infants expected infants to seek comfort from caregivers and expected caregivers to provide comfort. Insecure-resistant infants not only expected infants to seek comfort from caregivers but also expected caregivers to withhold comfort. Insecure-avoidant infants expected infants to avoid seeking comfort from caregivers and expected caregivers to withhold comfort. These data support Bowlby's (1958) original claims-that infants form internal working models of attachment that are expressed in infants' own behavior.     

Paranormal beliefs and religiosity: Chinese version of the Revised Paranormal Belief Scale

This paper reports an initial study investigating the relations of paranormal beliefs with religiosity in a Chinese sample, as well as the development of a Chinese version of the Revised Paranormal Belief Scale and a test of its psychometric properties with 310 college students (5.5% Christians, 21.3% Buddhists, 61% believers in traditional Chinese religions, and 12% atheists). The reliability and validity of the Chinese version were satisfactory. In general, traditional Chinese religious believers had higher scores on paranormal belief than did Christians and atheists, and the mean total score of the Chinese participants was higher than previously reported in a Western sample. It was concluded that the greater involvement of practitioners of traditional Chinese religions in activities emphasizing paranormal experiences might contribute to their greater paranormal belief, especially as compared to the minority Christian group. The results are consistent with the idea that Christianity may offer the least support for paranormal belief.     

Childless

This paper explores the complex interplay that unfolded between analyst and patient around their respective childlessness and aims to draw attention to the larger societal issues of imperative parenthood and the stigma of childlessness. As the analyst confronted her own internal conflicts about motherhood, children, and procreation as a woman living in a pronatalist society (one that encourages increasing birth-rates), she was treating a lesbian patient with a history of childhood relational trauma and sexual abuse who was undergoing fertility treatments. The patient’s experience with assisted reproductive technologies raised complicated questions and concerns within the analyst regarding their emotional impact on her patient and, more broadly, how they might reflect societal dissociation. Themes of trauma, loss, dissociation, and shifting self-states, which emerged during the fertility treatments and wove their way throughout the analysis, are discussed. In addition, the author describes the nature of the therapeutic action in this case.