Involving family members in the treatment of OCD

This review focuses on previous research with families of adults and children with obsessive-compulsive disorder (OCD). Three primary areas of research are covered: (i) characteristics of family members and the family environment; (ii) the prediction of treatment response based on family variables; and (iii) the inclusion of family members in treatment. Much of the research supports a hypothesized model of family response to symptoms of OCD that ranges on a continuum from overly accommodating to overly antagonistic. Further research indicates that responses at either extreme of this continuum are associated with poorer response to both exposure and response prevention (ERP) and pharmacotherapy. Finally, results of preliminary treatment outcome studies suggest that family-based interventions aimed at reducing such responses and/or including family members in ERP as coaches or co-therapists may enhance patients' response to treatment. Based on current theory and research, suggestions for future research and general recommendations for involving family members in treatment are made.     

Traumatic impact predicts long-term memory for documented child sexual abuse

Prospective studies of adults' memories of documented child sexual abuse (CSA) reveal that the majority of individuals remember their victimization. However, the accuracy of these memories has rarely been investigated scientifically. The present study examined predictors of memory accuracy and errors 12 to 21 years after abuse ended for individuals with legal experiences resulting from documented CSA. Severity of posttraumatic stress disorder (PTSD) symptomatology was positively associated with memory accuracy. However, individuals nominating CSA as their most traumatic life event exhibited relatively accurate memory regardless of indicators of PTSD. Predictors of memory errors were also identified (e.g., less maternal support). These results indicate that, in addition to understanding the role of traditional cognitive factors, understanding an event's traumatic impact is important for predicting the accuracy of long-term memory for reported CSA.     

Body image, relationships, and time

The cultural standard of an impossible-to-attain ideal body image has been blamed for a plethora of psychological ills, from low self-esteem to eating disorders. In this study, the authors investigated the importance of current body image dissatisfaction compared with the ideal for married couples and for single people. The results indicated that although body image dissatisfaction exists in both married and single people, this discrepancy is of significantly less importance to married couples. The importance of long-lasting, satisfying relationships decreases the importance of body dissatisfaction and mitigates the impact of unrealistic ideal body image.     

Spatial metaphors of the mind

A case in which the author began to understand her patient as "collapsing the space between them," rather than as continuing only to free associate, is the occasion for a contemplation of the way psychoanalytic theory effects a transition between what is inner, or lived, and outer, or experienced. Metaphor is seen as the agent of this transition. The author discusses metaphor in relation to the case described, while also examining spatial metaphors of mind in classical analysis and in Kleinian theory. It is suggested that both may be integrated in a third metaphorical-spatial construct, Green's analytic space.     

Motor and functional skills of children with developmental coordination disorder: a pilot investigation of measurement issues

This paper reports on the motor and functional outcomes of 20 children with developmental coordination disorder (DCD) aged 4-8 years consecutively referred to a pediatric physiotherapy service. Children with a Movement ABC (M-ABC) score less than the 15th percentile, and with no concurrent medical, sensory, physical, intellectual or neurological impairments, were recruited. The Motor Assessment Outcomes Model (MAOM) [Coster and Haley, Infants and Young Children 4 (1992) 11] provided the theoretical base for measurement selection, and preliminary findings at the activities and participation levels of the model are reported in this article. Children with DCD performed at the lower end of the normal range on the Peabody Developmental Motor Scales (fine motor total score) (M=85.65, SD=12.23). Performance on the Visual Motor Integration Test (VMI) standard scores was within the average range (M=96.15, SD=10.69). Videotaped observations of the children's writing and cutting indicated that 29% were left-handed and that a large proportion of all children (31%) utilized unusual pencil grasp patterns and immature prehension of scissors. Measurement at the participation level involved use of the Pictorial Scale of Perceived Competence and Social Acceptance (PCSA) and Pediatric Evaluation of Disability Inventory (PEDI). Overall, these young children rated themselves towards the more competent and accepted end of the PCSA over the dimensions of physical and cognitive competence and peer and maternal acceptance. The PEDI revealed generally average performance on social (M=49.98, SD=16.62) and mobility function (M=54.71, SD=3.99), however, self-care function was below the average range for age (M=38.01, SD=12.19). The utility of the MAOM as a framework for comprehensive measurement of functional and motor outcomes of DCD in young children is discussed.     

Children's reasoning about physics within and across ontological kinds

Reasoning about seven physics principles within and across ontological kinds was examined among 188 5- and 7-year-olds and 59 adults. Individuals in all age groups tended to appropriately generalize what they learned across ontological kinds. However, children also showed sensitivity to ontological kind in their projections: when learning principles with reference to people they were more likely to assume that the principles apply to another person than to an inanimate object, and when learning with reference to an inanimate object they were more likely to assume that the principles apply to another inanimate object than to a person. Five-year-olds, but not 7-year-olds, projected concepts learned about people to a greater extent than principles learned about inanimate objects, closely paralleling the findings of Carey for the biological domain (Carey, S. (1985). Conceptual change in childhood. Cambridge, MA: MIT Press). Results from a separate sample of 22 5-year-olds suggest that the primary findings cannot be explained by response perseveration. The present findings indicate that children understand physics principles that apply to both animate and inanimate objects, but distinguish between these ontological kinds.     

AN EXTENSION OF INCIDENTAL TEACHING PROCEDURES TO READING INSTRUCTION FOR AUTISTIC CHILDREN

In an extension of incidental teaching procedures to reading instruction, two autistic children acquired functional sight-word reading skills in the context of a play activity. Children gained access to preferred toys by selecting the label of the toy in tasks requiring increasingly complex visual discriminations. In addition to demonstrating rapid acquisition of 5-choice discriminations, they showed comprehension on probes requiring reading skills to locate toys stored in labeled boxes. Also examined was postteaching transfer across stimulus materials and response modalities. Implications are that extensions of incidental teaching to new response classes may produce the same benefits documented in communication training, in terms of producing generalization concurrent with skill acquisition in the course of child-preferred activities.     

Scanning two memorized lists

Subjects were timed as they decided whether singly presented probe words belonged to one or the other of two memorized lists, or to neither list. Each list varied in length from one to four words. Reaction times increased linearly with the combined number of words in the two lists. When there was no a priori basis for distinguishing the lists, the slope of the function for positive test probes was 33–35 msec per word higher than that for negative probes. The slope for negative probes was 58 msec per word in one experiment and 46 msec per word in another. This suggests that subjects first scanned the combined lists exhaustively to determine whether the probe was present; if it was not, they made a negative response, and if it was, they scanned again to determine which list it was in. When the words in the two lists were conceptually distinct (one list representing animate and the other inanimate objects), the difference in slope was reduced to only 6 msec per word, suggesting that the second scan was all but eliminated.     

A PRACTICAL STRATEGY FOR ONGOING REINFORCER ASSESSMENT

There is a need for practical methods of reinforcer assessment that systematically track ongoing changes in clients' preferences. In this study, the effects of a time-efficient reinforcer assessment package were evaluated in a multiple baseline across 3 preschoolers with autism, comparing individualized item selections by experienced teachers with children's presession preferences for items of various sensory qualities. Systematic assessment of children's reinforcers for correct responding virtually eliminated nontargeted maladaptive behaviors, as well as yielding expected improvements in accuracy. The powerful side-effects of potent reinforcers underline the importance of increased attention to reinforcer assessment in research and practice.