Counseling and screening for cystic fibrosis in patients with congenital bilateral absence of the vas deferens: Patient perceptions

Congenital bilateral absence of the vas deferens (CBAVD) occurs in approximately 1.3% of infertile males and is thought to be, in most cases, a primarily genital form of cystic fibrosis (CF). Fourteen males with CBAVD considering microsurgical sperm aspiration from the epididymis (MESA) and in vitro fertilization were seen for genetic counseling and screening for CF. To retrospectively evaluate these patients' perceptions of the counseling and screening information, we conducted structured telephone interviews to assess their recall of information about CF and its impact on their health concerns and reproductive plans. We found that, as the health implications of CF are abstract and not as important to patients as the diagnosis of CBAVD itself, patients tend to view their CF status primarily in terms of their reproductive potential. Retrospective analysis afforded us an opportunity to identify the psychosocial issues of most concern to this unique patient population.     

An investigation into the relationships between gender and language

The present investigation focused upon the impact of gender and various powerful and less powerful linguistic features on the communication of unfamiliar male and female college students. Same-sex and mixed-sex dyads were recorded as they engaged in discussions regarding suggestions for a bogus freshman orientation booklet. Although few gender differences were found, the result of a factor analysis yielded three factors: questions, suggestions, and process variables. These factors are consistent with a power perspective in the use of various linguistic features. However, the present findings suggest that gender and power alone cannot explain differences in communication styles. Rather, the results suggest the need to consider other aspects of the speaker to explain differences that occur in the use of language.     

Vocational maturity in adulthood: Toward turning a model into a measure

It is postulated that adult vocational maturity needs to be assessed because of the changing developmental tasks encountered during the course of a career. Vocational maturity having been found to be multidimensional, existing undimensional inventories of adult vocational maturity are considered of limited although demonstrated validity. Relevant theories of adult vocational development and adjustment are reviewed. Super's proposed adult vocational maturity model is examined for the promise that it offers and for the problems that arise in developing a multidimensional measure of vocational maturity. A way of surmounting these problems is proposed as a basis for work now being undertaken.     

USE OF A SELF-RECORDING AND SUPERVISION PROGRAM TO CHANGE INSTITUTIONAL STAFF BEHAVIOR

The use of a self-recording and supervision program to increase interactions between direct care staff and profoundly retarded persons in a state residential facility was investigated. Following baseline, staff were provided with instructions regarding what to self-record, criteria for how many interactions to record, and a prepared card on which to make the recordings. Throughout the study, the staff supervisor monitored intermittently staff-client interactions. Observations indicated that when the staff recorded their interactions with clients in a loosely structured dayroom setting, the rate of interactions increased noticeably for each staff person. Behavioral ecology measures indicated that other staff responsibilities, such as maintaining the cleanliness of residents and the physical area, were not affected detrimentally when social interactions increased and actually showed small improvements. Additionally, small decreases in resident self-stimulatory and disruptive/aggressive behaviors occurred when the rate of social interactions from staff persons increased. Follow-up measures indicated that the rate of staff self-recording was variable, but when staff did self-record, the increased rate of staff-client interactions maintained.     

Profiles of stutterers' and nonstutterers' affective, cognitive, and behavioral communication attitudes

The purposes of this investigation were 1) to profile the affective, cognitive, and behavioral attitudinal dimensions of stutterers' and nonstutterers' communication attitudes and 2) to describe membership characteristics of each profile. To this end, 76 stutterers and 81 nonstutterers completed the Inventory of Communication Attitudes. This self-report inventory obtained ratings of different types of speaking situations, using five response scales reflecting behavioral, affective, and cognitive aspects of attitudes. Exploratory cluster analysis identified six attitudinal clusters or profiles. Some profiles were more typical either of stuttering respondents or of nonstuttering respondents, whereas one profile reflected attitudes of proportionately equal numbers of stutterers and nonstutterers. Examination of profile membership characteristics revealed two significant discriminators, classification as a stutterer or nonstutterer and an overall speech rating. Nondiscriminatory characteristics included sex, age, education, therapy experiences, stuttering severity self-rating, onset of stuttering, total therapy time, current therapeutic status, and familial history.     

Networks of happiness: applying a Network Approach to Well-Being in the General Population

Journal of Happiness Studies - Even though well-being can be seen as a multidimensional construct, made up of a variety of interacting aspects, most studies examine total scores on well-being...     

Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

Optimizing Engagement in Behavioral Parent Training: Progress Toward a Technology-Enhanced Treatment Model

Low-income families are more likely to have a child with an early-onset Behavior Disorder (BD); yet, socioeconomic strain challenges engagement in Behavioral Parent Training (BPT). This study follows a promising pilot to further examine the potential to cost-effectively improve low-income families’ engagement in and the efficiency of BPT. Low-income families were randomized to (a) Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003), a weekly, mastery-based BPT program that includes both the parent and child or (b) Technology-Enhanced HNC (TE-HNC), which includes all of the standard HNC components plus a parent mobile application and therapist web portal that provide between-session monitoring, modeling, and coaching of parent skill use with the goal of improved engagement in the context of financial strain. Relative to HNC, TE-HNC families had greater homework compliance and mid-week call participation. TE-HNC completers also required fewer weeks to achieve skill mastery and, in turn, to complete treatment than those in HNC without compromising parent satisfaction with treatment; yet, session attendance and completion were not different between groups. Future directions and clinical implications are discussed.