Disruptive innovations for designing and diffusing evidence-based interventions

Evidence-based therapeutic and preventive intervention programs (EBIs) have been growing exponentially. Yet EBIs have not been broadly adopted in the United States. In order for our EBI science to significantly reduce disease burden, we need to critically reexamine our scientific conventions and norms. Innovation may be spurred by reexamining the traditional biomedical model for validating, implementing, and diffusing EBI products and science. The model of disruptive innovations suggests that we reengineer EBIs on the basis of their most robust features in order to serve more people in less time and at lower cost. A disruptive innovation provides a simpler and less expensive alternative that meets the essential needs for the majority of consumers and is more accessible, scalable, replicable, and sustainable. Examples of disruptive innovations from other fields include minute clinics embedded in retail chain drug stores, $2 generic eyeglasses, automated teller machines, and telemedicine. Four new research approaches will be required to support disruptive innovations in EBI science: synthesize common elements across EBIs; experiment with new delivery formats (e.g., consumer controlled, self-directed, brief, paraprofessional, coaching, and technology and media strategies); adopt market strategies to promote and diffuse EBI science, knowledge, and products; and adopt continuous quality improvement as a research paradigm for systematically improving EBIs, based on ongoing monitoring data and feedback. EBI science can have more impact if it can better leverage what we know from existing EBIs in order to inspire, engage, inform, and support families and children to adopt and sustain healthy daily routines and lifestyles. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Gene-environment interplay in the association between pubertal timing and delinquency in adolescent girls

Early pubertal timing places girls at elevated risk for a breadth of negative outcomes, including involvement in delinquent behavior. While previous developmental research has emphasized the unique social challenges faced by early maturing girls, this relation is complicated by genetic influences for both delinquent behavior and pubertal timing, which are seldom controlled for in existing research. The current study uses genetically informed data on 924 female-female twin and sibling pairs drawn from the National Longitudinal Study of Adolescent Health to (1) disentangle biological versus environmental mechanisms for the effects of early pubertal timing and (2) test for gene-environment interactions. Results indicate that early pubertal timing influences girls' delinquency through a complex interplay between biological risk and environmental experiences. Genes related to earlier age at menarche and higher perceived development significantly predict increased involvement in both nonviolent and violent delinquency. Moreover, after accounting for this genetic association between pubertal timing and delinquency, the impact of nonshared environmental influences on delinquency are significantly moderated by pubertal timing, such that the nonshared environment is most important among early maturing girls. This interaction effect is particularly evident for nonviolent delinquency. Overall, results suggest early maturing girls are vulnerable to an interaction between genetic and environmental risks for delinquent behavior.     

Perceptions of driver distraction among teenage drivers

Teenage drivers have been shown to have some of the highest crash risks. Crash data provide some insights on factors related to crash likelihood, but rarely capture all issues that can arise from driver distraction. The goal of this study was to assess teenage drivers’ opinions and perceptions of driver distraction. A survey of 1893 Iowa teenagers was conducted to determine and compare the frequency of engagement in distracting activities while driving to their opinions of what they actually consider to be distractions. A cluster analysis was conducted based on their indicated engagement in distracting activities with three groups emerging and classified as INFREQUENT, MODERATE, and FREQUENT engagers. Across all cluster groups, the majority (over 80%) indicated that they considered text messaging to be a distracting task. However, those clustered as FREQUENT engagers still reported a high level of texting while driving even though they considered this task to be distracting. A binary logistic regression model (adjusted for miles driven and license type) showed that FREQUENT and MODERATE engagers were more likely to be involved in a crash when compared to INFREQUENT engagers. The study demonstrates that not all teenagers place themselves at risk. There are subgroups of teenage drivers that often engage in activities they know are distracting, potentially putting themselves in danger. However, this is not the case for all teenage drivers and it is important to target interventions appropriately as well as foster a culture of safety both in schools and at home.     

Accuracy of perceptual and acoustic methods for the detection of inspiratory loci in spontaneous speech

The present study investigates the accuracy of perceptually and acoustically determined inspiratory loci in spontaneous speech for the purpose of identifying breath groups. Sixteen participants were asked to talk about simple topics in daily life at a comfortable speaking rate and loudness while connected to a pneumotach and audio microphone. The locations of inspiratory loci were determined on the basis of the aerodynamic signal, which served as a reference for loci identified perceptually and acoustically. Signal detection theory was used to evaluate the accuracy of the methods. The results showed that the greatest accuracy in pause detection was achieved (1) perceptually, on the basis of agreement between at least two of three judges, and (2) acoustically, using a pause duration threshold of 300 ms. In general, the perceptually based method was more accurate than was the acoustically based method. Inconsistencies among perceptually determined, acoustically determined, and aerodynamically determined inspiratory loci for spontaneous speech should be weighed in selecting a method of breath group determination.     

An Exploration of the Experience of Huntington’s Disease in Family Dyads: An Interpretative Phenomenological Analysis

Huntington’s disease (HD) is a hereditary, late onset, neurodegenerative disorder. Children of affected parents have a 50 % chance of inheriting HD. Research into the psychological consequences of HD for the family has focussed on individual family members, but little is known about the ways in which its impact is jointly experienced by members of these families. This is particularly important due to the hereditary nature of HD. To address this, the current study examined the experiences of dyads within affected families. Seven parent/adult child dyads were interviewed jointly about their experiences and relationships with their family and each other and interpretative phenomenological analysis was used to analyse the resultant data. Identified themes were: “A spectre hanging over us”: HD as a presence within the family, “Us against the world”: Protection, knowledge and control, and “That could be me in 50 years”: Cyclical changes in identity and role. These findings are examined in relation to previous research and indicate the need for an increased understanding of the needs of HD families. Clinical implications and suggestions for further research are discussed.     

Game theory and belief in God

In the last few decades game theory has emerged as a powerful tool for examining a broad range of philosophical issues. It is unsurprising, then, that game theory has been taken up as a tool to examine issues in the philosophy of religion. Economist Steven Brams (1982), (1983) and (2007), for example, has given a game theoretic analysis of belief in God, his main argument first published in this journal and then again in both editions of his book, Superior Beings. I have two main aims in this paper, one specific and one general. My specific aim is to show that Brams’ application of game theory to examine belief in God is, in particular, deeply flawed in two respects. My general aim is to show that any game-theoretic model in which a human being and God are players can only succeed at the cost of abandoning the assumption that God is omnibenevolent.     

Clinical strategies to promote compliance

Abstract

This article focuses on the need for effective client management throughout the therapeutic process. The appropriate and astute use of clinical strategies can promote client compliance with treatment and counteract the possibility of client dissatisfactions and ethical/legal complaints. This article offers a systemic explanation of compliance, identifies five major clinical strategies to foster treatment adherence, and discusses the need for clinical judgments that fulfill ethical/legal obligations while promoting quality care.     

Marital Estrangement,Positive Affect,and Locus of Control Among Spouses of Workaholics and Spouses of Nonworkaholics: A National Study

This study compared a sample of spouses of workaholics and spouses of nonworkaholics on ratings of marital estrangement, positive feelings toward husband, and locus of control. A random national sample of 326 participants drawn from the membership list of the American Counseling Association was surveyed. Spouses of workaholics reported greater marital estrangement and less positive affect towards husbands and higher external locus of control than spouses of nonworkaholics. These findings were the first empirical results to corroborate clinical and case study reports. Clinical implications of these findings are also presented.     

Perceptual specialization and configural face processing in infancy

Adults’ face processing expertise includes sensitivity to second-order configural information (spatial relations among features such as distance between eyes). Prior research indicates that infants process this information in female faces. In the current experiments, 9-month-olds discriminated spacing changes in upright human male and monkey faces but not in inverted faces. However, they failed to process matching changes in upright house stimuli. A similar pattern of performance was exhibited by 5-month-olds. Thus, 5- and 9-month-olds exhibited specialization by processing configural information in upright primate faces but not in houses or inverted faces. This finding suggests that, even early in life, infants treat faces in a special manner by responding to changes in configural information more readily in faces than in non-face stimuli. However, previously reported differences in infants’ processing of human versus monkey faces at 9 months of age (but not at younger ages), which have been associated with perceptual narrowing, were not evident in the current study. Thus, perceptual narrowing is not absolute in the sense of loss of the ability to process information from other species’ faces at older ages.