Outpatient Clinic Identification of Trauma Symptoms in Children in Foster Care

As understanding of the impact of trauma on children has grown, there has been increasing interest in the use of screening the medical setting to identify which children at risk may be symptomatic. This study was undertaken to determine whether the use of a trauma assessment tool to screen for trauma symptoms in the setting of a foster care clinic was feasible and more sensitive than non-standardized approaches in the context of outpatient primary care. Using a chart review of trauma symptom identification before and after the implementation of the Trauma Symptom Checklist for Children (TSC-C) and the Trauma Symptom Checklist for Young Children (TSC-YC), validated trauma assessment tools, we looked at the feasibility of use of this tool and likelihood of trauma symptom identification. 73 % (n = 204) of eligible patients had a trauma screening tool in the medical record following the introduction of the use of the TSC. Detection of trauma symptoms was higher in the screening period than in the baseline period for the entire population (78 vs. 46 %, p < 0.0001), and trauma symptoms were identified with more specificity following the introduction of, and likely due to, formal trauma screening. However, there were limitations as to feasibility in the outpatient medical clinic. In conclusion, the use of the TSC-C and TSC-YC in the setting of an outpatient foster care evaluation clinic increased rates and precision of identification of trauma symptoms, but had limitations to its feasibility of use in the outpatient clinic setting.     

Reliability and Validity of the Dyadic Observed Communication Scale (DOCS)

We evaluated the reliability and validity of the Dyadic Observed Communication Scale (DOCS) coding scheme, which was developed to capture a range of communication components between parents and adolescents. Adolescents and their caregivers were recruited from mental health facilities for participation in a large, multi-site family-based HIV prevention intervention study. Seventy-one dyads were randomly selected from the larger study sample and coded using the DOCS at baseline. Preliminary validity and reliability of the DOCS was examined using various methods, such as comparing results to self-report measures and examining interrater reliability. Results suggest that the DOCS is a reliable and valid measure of observed communication among parent-adolescent dyads that captures both verbal and nonverbal communication behaviors that are typical intervention targets. The DOCS is a viable coding scheme for use by researchers and clinicians examining parent-adolescent communication. Coders can be trained to reliably capture individual and dyadic components of communication for parents and adolescents and this complex information can be obtained relatively quickly.     

Calvinism and psychoanalysis: A comparative study

Summary Although the title of this essay suggests a comparison of psychoanalysis and Calvinism, I have chosen to compare primarily the two leaders of these movements. On many points they shared similar beliefs. Certain of these areas have been highlighted and discussed briefly: ascetic tendencies, work, religion, concepts of God and of man, actions as symptoms, and predestination and determinism.     

Justice and power: when will justice concerns encourage the advantaged to support policies which redistribute economic resources and the disadvantaged to willingly obey the law?

Two studies are presented which test whether justice can motivate support for government policies and authorities even when such support is not in people's obvious personal or group interest. In the first study, White San Francisco Bay area residents' attitudes toward Congressionally-authored affirmative action policies and anti-discrimination laws were investigated. In the second study, African-American San Francisco Bay area residents' feelings of obligation to obey the law were investigated. The results from both studies show a significant relationship between evaluations of social justice and respondents' political attitudes. More importantly, a significant relationship between relational evaluations of Congress and political attitudes is found in both studies. This relationship suggests how justice can motivate policy and government support even if such support does not yield direct personal or group benefits. Finally, the results from both studies indicate when instrumental and relational concerns will be related to political attitudes. If people identified with their particular advantaged or disadvantaged group, instrumental concerns were more strongly related to their political attitudes, but if people identified with a superordinate category that included both potential outgroup members and relevant superordinate authorities, relational concerns were more strongly related to their political attitudes.     

A preliminary scale to measure connected and separate knowing: The Knowing Styles Inventory

The present investigation reported the development and validation of the Knowing Styles Inventory (KSI), a scale to measure connected and separate knowing [M. F. Belenky, B. M. Clinchy, N. R. Goldberger, and J. M. Tarule (1986), Women's Ways of Knowing: The Development of Self, Voice, and Mind New York, Basic Books]. In Study 1, principal components analyses for samples of females (N = 300) and males (N = 253) yielded two components, Connected and Separate Knowing. Studies 2 and 3 focused on females exclusively. The results indicated adequate test—retest reliability and internal consistency for both components. Additionally, Connected Knowing was positively correlated with empathic concern, perspective-taking, social desirability, and the femininity factor of the Bem Sex Role Inventory (BSRI). Separate Knowing was positively correlated with the masculinity factor of the BSRI and negatively correlated with social desirability. Suggestions for future research were presented.The authors wish to thank Jill Mattuck Tarule for the insight that she offered in the early stages of this project, and they wish to acknowledge the contribution of Nicole Bressler who participated in item development.     

Measuring Possessions as Extensions of Self and Links to Significant Others in Hoarding: the Possessions as Others and Self Inventory

Journal of Psychopathology and Behavioral Assessment - This paper presents the development and validation of the Possessions as Others and Self Inventory (POSI). The POSI is a 23-item self-report...     

Body Type Preferences in Asian and Caucasian College Students

While there is an extensive literature on gender differences in body image, little has focused on ethnic group differences in men's body image. College students ( N = 466) from a prestigious New England university indicated their current and ideal figures. Compared to Caucasians (N = 289), Asians (N = 92) reported smaller current figures. Both Caucasian and Asian women rated their current figure as larger than their ideal. Caucasian males reported no discrepancy between their current and ideal figures. However, Asian males rated their current figures as smaller than ideal. The effect of ethnicity on body satisfaction depended upon gender. For women, the ideal was thinner than current figure regardless of actual size, producing a discrepancy between current and ideal figures for both Caucasian and Asian women. Conversely, Asian and Caucasian men identified a similar ideal, producing a discrepancy between current and ideal figures only for Asian men.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

IS A LITTLE (PSYCHIATRIC) KNOWLEDGE A DANGEROUS THING?

One hundred thirty-four participants completed a revised Menstrual Distress Questionnaire (MDQ), which included criteria for premenstrual dysphoric disorder (PMDD). Two weeks later the participants again completed the revised MDQ after reading either the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for the PMDD or a copy of the same criteria retitled Episodic Dysphoric Disorder, with all menstrual cycle references removed. Knowledge of the diagnosis did not affect women's perceptions of their own menstrual cycle-related symptoms, but it increased participants' perceptions of premenstrual changes as a problem for women in general. Chi-square analyses revealed that participants were more willing to attach a psychiatric diagnosis to women they know if they believed the diagnosis was related to the menstrual cycle.