Change in the Psychological Adjustment of Children with Cystic Fibrosis or Sickle Cell Disease and Their Mothers

Objectives: This study has three interrelated objectives: (1) to track the adjustment of children and adolescents with sickle cell disease (SCD) or cystic fibrosis (CF) and their mothers through a third assessment point 2 years after the initial assessment; (2) to determine whether the adaptational processes of the transactional stress and coping model associated with adjustment at the initial assessment continue to be associated with adjustment 2 years later; and (3) to determine whether the pattern of association of adaptational processes with adjustments differs by illness subgroup. Methods: The study samples included 59 children with CF and 50 children with SCD and their mothers. Measures were obtained on maternal adjustment and appraisals of daily and illness stress, coping methods, and family functioning. Child measures included child-reported and mother-reported child adjustment and child perceptions of self-worth and health locus of control and pain coping methods. Results: Consistency in adjustment classification was only 31–32% for child self-report, 66% for mother-reported child behavior problems, and 56–77% for mother self-reported adjustment for the CF and SCD groups, respectively. Support was provided for the association of adaptational processes with maternal adjustment and with the adjustment of children with SCD but not for children with CF. Conclusion: The stability of adjustment has implications for prevention and treatment intervention and subsequent research steps. Intervention efforts should be focused on the relatively small subgroups of children with chronic illnesses and their mothers with consistently poor adjustment.     

Visual acuity improvement following fading and feedback training—I. Comparison of myopic and emmetropic volunteers

18 myopes and 18 emmetropes were randomly assigned in pairs to either Fading and Feedback training or a no-treatment control condition. The emmetropes were fitted with plus lenses equivalent to the spherical correction of the paired myope to simulate myopic visual acuity. Extensive visual acuity measures were obtained pre- and post-training. Data analyses indicated significant increases in recognition visual acuity for trained subjects, compared to no-treatment controls. The myopia/emmetropia variable did not interact with training even though there were noticably greater increases in visual acuity for trained myopes compared to the other conditions. Resolution visual acuity did not change as a function of training. These data are discussed in terms of their implications for better understanding the mechanisms responsible for visual acuity increases following behavioural training.     

Racial Mistrust and Deviant Behaviors Among Ethnically Diverse Black Adolescent Boys1

While it has been suggested that mistrust of the dominant White society may be an important protective factor for some members of racial minorities, the question of whether mistrust may also be related to nonnormative behaviors among minority members has not been explored. Using survey data from Miami, Florida, this study empirically tests this hypothesis among a sample of African American, Haitian, and other Caribbean island Black adolescent boys. Bivariate analyses suggest a strong relationship between racial mistrust and conventional forms of delinquency for all three ethnic groups. These findings also held in multivariate analyses in which six traditional predictors of deviance were statistically controlled. The authors conclude that racial mistrust adds a new dimension to empirical prediction models. In addition, they conclude that issues associated with racial mistrust should be considered when developing and implementing prevention strategies.     

Effects of two levels of treatment intensity on a young child with severe disabilities

This single-case study evaluated the effects of two levels of center-based behavioral intervention for a young child with diagnoses of autism, severe attention deficit hyperactivity disorder, bipolar disorder, and severe developmental delay. The child entered an applied behavior analysis school and residential program at age 4 years. At that time he was receiving fluoxetine and valproic acid for control of challenging behavior. Six other medication trials had been attempted previously. Assessments completed just before the child entered the behavioral program estimated his overall functioning at the 8–16 month level. Throughout the study, the child participated in comprehensive behavioral programming for about 30 hours per week. For the first (A) phase of the study, the teacher:student ratio was 1:1. This phase lasted 12 months. At that point resource limitations necessitated changing the teacher:student ratio to 1:2 (the B Phase), which continued for 9 months. Then 1:1 intervention was reinstated. Dependent variables included out-of-seat behavior, aberrant behavior, motor imitation, stereotypic responses, matching to sample, and appropriate communication (recognizable signs and pictures used as mands). By the end of the first A phase (1:1 intervention), substantial improvements were documented in five of six dependent variables, and fluoxetine was discontinued. These improvements were maintained for all dependent variables three months into the B phase, but after an additional six months of 1:2 intervention gains were maintained on only one dependent variable. Nine months after a return to 1:1 intervention, improvements over B-phase levels were evident for five dependent variables, four of which returned to levels comparable to those at the end of the first 1:1 phase. © 1998 John Wiley & Sons, Ltd.     

Opium of the people? National identification predicts well-being over time

Social group membership and its social-relational corollaries, for example, social contact, trust, and support, are prophylactic for health. Research has tended to focus on how direct social interactions between members of small-scale groups (i.e., a local sports team or community group) are conducive to positive health outcomes. The current study provides evidence from a longitudinal cross-cultural sample (N = 6,748; 18 countries/societies) that the prophylactic effect of group membership is not isolated to small-scale groups, and that members of groups do not have to directly interact, or in fact know of each other to benefit from membership. Our longitudinal analyses suggest that national identification (strength of association with the country/society of which one is a citizen) predicts lower anxiety and improved health; national identification was in fact almost as positively predictive of health status as anxiety was negatively predictive. The findings indicate that identification with large-scale groups, like small-scale groups, is palliative, and are discussed in terms of globalization and banal nationalism.     

Extended analysis and treatment of self‐injurious behavior

In experiment 1, an extended functional analysis of self‐injury was conducted with a 21‐year‐old male diagnosed with autism and profound mental retardation. The multielement phase yielded undifferentiated results. Subsequent blocking of conditions plus the addition of a component allowing access to multiple sensory stimuli suggested that self‐injury was unrelated to programmed positive or negative reinforcement contingencies. The behavior appeared to be automatically reinforced; its occurrence decreased when access to alternative sensory stimuli was provided. Experiment 2 evaluated a treatment condition in which response‐independent access to these sensory stimuli was provided within the participant's everyday environment. Baseline and treatment frequencies of self‐injury were compared in a combined, multiple‐baseline‐across‐settings and ABAB design. The level of self‐injury decreased substantially during treatment. These results support the use of extended analog analyses of aberrant behavior in instances in which undifferentiated responding occurs in the initial analogue analysis. Additionally, a procedure is described for generalizing the intervention derived from the experimental analysis into the participant's everyday environment. Copyright © 2001 John Wiley & Sons, Ltd.