What is the Role of the Arts in Medical Education and Patient Care? A Survey-based Qualitative Study

To inform medical education reform efforts, we systematically collected information on the level of arts and humanities engagement in our medical school community. Attitudes regarding incorporating arts and humanities-based teaching methods into medical education and patient care were also assessed. An IRB-approved survey was electronically distributed to all faculty, residents, fellows, and students at our medical school. Questions focused on personal practice of the arts and/or humanities, as well as perceptions of, and experience with formally incorporating these into medical teaching. Of 13,512 community members surveyed, 2,775 responded (21% overall response rate). A majority of respondents agreed or strongly agreed that medical education and patient care could be "enhanced" by the integration of the arts (67% and 74% respectively). There was enthusiastic support for the creation of a formal program in the arts at our medical school (72 %). Integration of the arts into medical education may have a role in improving the quality of medical training and would likely be well received by teachers and learners.     

Tumor Screening in Beckwith-Wiedemann Syndrome: Parental Perspectives

Children with Beckwith-Wiedemann Syndrome (BWS) and Isolated Hemihypertrophy (IHH) are at an increased risk for developing tumors. Tumor screening in this population is currently being reassessed by several groups and the effect on patients and patient-families has been argued both as a reason to screen and not to screen. Parental perspectives on this topic have never been systematically addressed for the BWS population. Here, we conducted a parent-based survey to evaluate knowledge and attitudes toward tumor screening in patients affected by BWS/IHH. A total of 261 surveys were completed. Overall, parents reported that screening decreased their worry and did not feel that screening increased worry or created a burden. This effect was observed across various demographic variables and other factors examined. Almost all significant differences observed could be attributed to parental knowledge of tumor risk. Parents who correctly identified their child’s tumor risk were more likely to agree with stratified screening recommendations according to BWS type and risk, and were less likely to feel worried if recommendations were changed. These results highlight the need to educate families about their child’s genetic type and tumor risk in order to facilitate an informed decision about tumor screening.     

Trait Forgiveness and Dyadic Adjustment Predict Postnatal Depression

The birth of a first child can be stressful on intimate partner relationships and the women having their first child. Conflict can occur, and hurts might be experienced, which could lead to post-partum depression. Thus, capacity for forgiveness with specific hurts might affect post-partum depression. We investigated women having their first child (N?=?52), and examined whether dyadic adjustment, trait forgiveness, and situational forgiving during pregnancy predicted postpartum depression. This study found that marital forgiveness predicted lower levels of depression above and beyond the effects of general dyadic adjustment. Dyadic adjustment and trait forgiveness predicted postpartum depression while situational forgiving was mixed. Postpartum depression researchers are encouraged to consider the inclusion of positive psychology variables, such as forgiveness, in future research studies.     

Pre-existing Perceptions of ADHD Predict Children’s Sociometrics Given to Classmates with ADHD

Considerable research documents that even young children possess stigma about mental illness, which may affect how they evaluate peers with mental health conditions. This study examined children’s pre-existing perceptions of Attention Deficit/Hyperactivity Disorder (ADHD) behaviors as predictors of their subsequent sociometric judgments of classmates with ADHD in a 2-week summer day camp. Participants were previously unacquainted children ages 6.8–9.8 years (113 typically-developing and 24 with ADHD; 48.2% boys; 81% White). Children initially more inclined to interact with a hypothetical classmate with ADHD gave fewer “dislike” nominations to real-life classmates with ADHD at camp. Children who initially believed that ADHD symptoms were uncontrollable gave more “dislike” nominations and lower liking ratings to classmates with ADHD when those classmates displayed severe ADHD symptoms. For children who had ADHD, their attribution of uncontrollability for ADHD symptoms predicted fewer “like” nominations and more “dislike” nominations given to classmates with ADHD. Lastly, children who initially reported they would help a hypothetical classmate with ADHD gave higher liking ratings to classmates with ADHD. These results were found after statistical control of the actual level of ADHD behaviors displayed by the classmates with ADHD. In summary, other children’s pre-existing or stigmatizing perceptions of ADHD behaviors may contribute, in part, to the substantial peer rejection typically experienced by ADHD populations. Findings have implications for understanding peer problems in children with this common mental health condition.     

Recalled Challenging Parenting Behavior and Anxiety in Adulthood: An Exploratory Retrospective Cohort Study

This research examined the relationship between recalled challenging parenting behavior (CPB) and adult anxiety and aimed to determine the underlying latent factors involved in CPB. CPB is a novel parenting construct that involves the encouragement of children to go beyond their own limits and engage with concepts they may find scary or that destabilises them, in a playful and fun way. Participants in the current study were 386 undergraduate psychology students (M age?=?19.89 years, SD?=?4.6; range 17–56). Questionnaire measures of CPB, anxiety, and social anxiety were delivered to participants via an online survey. An exploratory factor analysis was conducted using Principle Axis Factoring with Oblimin rotation. This identified three latent constructs underlying adults recall of CPB during childhood; parental encouragement of social assertion (‘Social’), parental encouragement to engage in novel or new situations (‘Novelty’), and intentional teasing (‘Teasing’) CPB. Both mother and father Social and Novelty CPB was associated with lower report of adult anxiety. However, only fathers Teasing was able to predict adult anxiety.     

Preliminary Validity of the Eyberg Child Behavior Inventory with Taiwanese Clinic-Referred Children

The Eyberg Child Behavior Inventory (ECBI) has previously been shown to be a psychometrically sound instrument used to assess disruptive behaviors in children in the United States and in other cultures/countries but not in Taiwan. The purpose of this study was to examine the factor structure and to establish the discriminative validity of the ECBI with two groups of Taiwanese children: 70 clinic-referred children with clinically elevated externalizing behavior problems and 70 community-based matched comparison children. Exploratory factor analyses resulted in a six-factor model for the clinic-referred sample and a five-factStrengths and Difficultieor model for the matched comparison sample, indicating that the ECBI is not unidimensional. Adequate convergent and divergent validity also were established between the ECBI Intensity and Problem Scales and another measure of child externalizing (for assessing convergent validity) and internalizing (for determining divergent validity) behavior. The results of the present study suggest that the ECBI is a valid measure of assessing externalizing behavior problems in Taiwanese children. Future research may seek to refine the factor structure of the ECBI in a Taiwanese sample. Future studies are also needed to examine other psychometrics of the ECBI, replicate this study with a larger sample, and establish its normative data in Taiwan.     

A Latent Profile Analysis of Co-occurring Youth Posttraumatic Stress and Conduct Problems Following Community Trauma

Although most research with youth exposed to violent manmade disasters has focused on internalizing problems, recent work suggests conduct problems (CPs) may also manifest in exposed youth. However, the extent to which youth postevent CPs present independently, versus co-present in conjunction with PTSD symptoms, remains unclear. The present study examined PTS and CP symptom profiles among affected Boston-area youth following the 2013 Boston Marathon bombing. This study used latent profile analysis to identify distinct PTS and CP symptom profiles among Boston-area youth ages 4–19 years (N?=?344) affected by the Boston Marathon bombing events. PTS and CPs were measured using the UCLA-PTSD-RI and the SDQ parent reports, respectively. Analyses identified 3 distinct profiles: presentations characterized by (a) low PTS, low CPs, (b) moderate PTS, low CPs, and (c) high PTS, elevated CPs. The profile characterized by the highest PTS was the only profile with elevated CPs; hyperarousal and emotional numbing/avoidance symptoms showed the greatest distinguishing properties among profiles with and without elevated CP. Types of traumatic exposure experienced by youth were differentially associated with profiles. Specifically, direct (but not relational) exposure distinguished youth classified in the profile showing elevated CPs. Findings suggest interventions following violent manmade disasters may do well to incorporate CP modules when working with youth showing the greatest hyperarousal and emotional numbing, and/or who have directly witnessed the most violence.     

Using computer‐assisted instruction to increase the eye gaze of children with autism

Many children diagnosed with autism spectrum disorders have difficulty making appropriate eye contact and engaging in joint attention. The current study evaluated a computer‐assisted instruction package (pairing visual stimuli with vocal stimuli) as a novel treatment to improve the eye gaze accuracy in 3 elementary school children with autism. The researchers measured the latency from a recorded verbal stimulus to the students making eye contact with pictures of familiar individuals displayed on a computer screen, and the duration for which eye gaze on the stimulus was maintained. An automated infrared camera system for measuring eye gaze was utilized that eliminated the need for an instructor to make subjective judgments regarding participants' eye gaze. For all three participants, duration of eye contact increased, and latency to responding decreased following exposure to the computer‐assisted instruction. The implications of these findings for the treatment of individuals with autism are discussed, along with suggestions for future research on the topic.     

Further evaluation of latency measures in the assessment and treatment of severe self‐injurious behavior

Recent research has demonstrated the utility of latency measures during the functional analysis of problem behavior; however, few studies have evaluated the utility of latency measures during subsequent treatment analyses. The current study seeks to extend the literature on the use of latency measures during the treatment of severe self‐injurious behavior (SIB). Following a latency‐based functional analysis, a treatment analysis was conducted using a hybrid procedure in which baseline sessions were terminated following the first instance of SIB, and test sessions ended after a fixed length of time. Latency to SIB was compared across conditions, whereas latency and rate measures for both SIB and functional communication responses were compared for the functional communication training condition. Results suggest that latency measures may be too sensitive during treatment analyses and that it is beneficial to use a hybrid procedure that allows for both latency and rate comparisons.