Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.     

The reception of Holocaust research in the world of psychology

After having spoken to lay and professional audiences in Germany, Switzerland, Austria, England, France and in the United States on the effects of the Shoah on people in psychotherapy today and found varying reactions, I decided to pursue the question in a more consequential way. I devised a questionnaire which I sent to a large number of international psychoanalytic societies. My initial impressions were confirmed: Freudian societies generally devote more work to the topic. Some Jungian societies with especially interested individuals have also devoted a substantial amount of work to the Shoah and its aftermaths. The Jungian hesitancy has to do with our often more archetypal approach and with shame about Jung's statements on the Jewish archetype. On the collective level, the presence of a survivor population seems to make research on the topic more difficult. A certain amount of time must evolve before a society (be it professional, individual or political) deals with collective trauma, be it the Shoah or political oppression. On the personal level, intimacy (also in future, adult relationships) seems blocked when fantasies about parents' implications in the Shoah prevail. The bottom line of both phenomena is taboo, a prohibition against touching tameh. I propose that the IAAP supports research projects on the Shoah. They could also, as the Freudians do, offer a special prize at each international conference for the best piece of research on the topic of collective trauma.     

Utility of the trauma symptom inventory's atypical response scale in detecting malingered post-traumatic stress disorder

The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.     

A Testimony to Muzil: Hervé Guibert, Foucault, and the Medical Gaze

Testimony to Muzil: Hervé Guibert, Michel Foucault, and the Medical Gaze examines the fictional/autobiographical AIDS writings of the French writer Hervé Guibert. Locating Guibert's writings alongside the work of his friend Michel Foucault, the article explores how they echo Foucault's evolving notions of the medical gaze. The article also explores how Guilbert's narrators and Guibert himself (as writer) resist and challenge the medical gaze; a gaze which particularly in the era of AIDS has subjected, objectified, and even sometimes punished the body of the gay man. It is argued that these resistances to the gaze offer a literary extension to Foucault's later work on power and resistance strategies.     

Family Environments of Women Seeking BRCA1/BRCA2 Genetic Mutation Testing: An Exploratory Analysis

Although there is some understanding of the shared characteristics and predictors of psychological distress of women participating in hereditary breast and ovarian cancer registries, these same characteristics are only beginning to be identified in research on community women seeking genetic testing for BRCA1/BRCA2 gene mutations. This study provides an initial exploration of characteristics associated with family environments for 51 community women waiting to receive such genetic testing results. Thirty-four of the 36 women classified on family environment type of the Family Environment Scale (FES) were from Personal Growth-Oriented families. Comparisons of women with and without personal cancer histories resulted in a trend for women with personal cancer histories to be classified as from Independence-Oriented families. Reported distress appears to vary for different family emphases based on family and personal cancer history. A moral-religious family emphasis consistently appeared to be associated with decreased psychological distress. Preliminary analyses comparing these community women (who were not part of a hereditary registry but were self- or physician-referred) seeking genetic testing with normal and distressed family means found that increased cohesion and expressiveness may be related to decreased conflict, indicative of potentially supportive family environments for these women. When compared with normative data, a subset consisting of the Ashkenazi Jewish women showed a trend of less cohesion than normal families, but similar cohesion levels as distressed families.     

Effects of environmental enrichment on spatial memory and neurochemistry in middle-aged mice

The present study compared the effects of environmental enrichment on spatial memory, glutamic acid decarboxylase (GAD) activity, and synaptophysin levels in middle-aged male and female mice. Prior to testing, a subset of 18-month-old male and female C57BL/6 mice was housed with two to three toys and a running wheel in the home cage for up to 29 d. Adult mice (7 mo) of both sexes and the remaining middle-aged mice were group (social) housed, but not exposed to enriching objects. After the enrichment period, all mice were tested in a 1-day version of the Morris water maze, in which both spatial and nonspatial memory were assessed. Immediately after testing, the hippocampus and frontoparietal cortex were dissected, and GAD activity and synaptophysin levels were measured. Environmental enrichment reduced the age-related impairment in spatial acquisition and retention; relative to adult social controls, middle-aged enriched mice were unimpaired, whereas middle-aged social controls were impaired. This reduction was similar in middle-aged males and females. Enrichment did not affect cued memory in either sex. Although hippocampal GAD activity was increased by enrichment in males, all other neurochemical measurements were unaffected by enrichment or aging in either sex. These data suggest that environmental enrichment initiated at middle age can reduce age-related impairments in spatial memory in males and females, although the underlying neurobiological mechanisms of this effect remain unknown.     

Physiological and self-reported disgust reactions to obesity

There is accumulating evidence that disgust plays an important role in prejudice toward individuals with obesity, but that research is primarily based on self-reported emotions. In four studies, we examined whether participants displayed a physiological marker of disgust (i.e. levator labii activity recorded using facial electromyography) in response to images of obese individuals, and whether these responses corresponded with their self-reported disgust to those images. All four studies showed the predicted self-reported disgust response toward images of obese individuals. Study 1 further showed that participants exhibited more levator activity to images of obese individuals than to neutral images. However, Studies 2–4 failed to provide any evidence that the targets’ body size affected levator responses. These findings suggest that disgust may operate at multiple levels, and that the disgust response to images of obese individuals may be more of a cognitive-conceptual one than a physiological one.     

Facial memory deficits in children with fetal alcohol spectrum disorders

Prenatal exposure to alcohol may lead to a range of neurobehavioral effects, including impaired learning and memory. Although children with fetal alcohol spectrum disorders (FASD) exhibit both verbal and nonverbal memory impairments, their memory for faces has not been as thoroughly investigated and the extent literature provides inconsistent results. The aim of the current study was to determine whether difficulties in face memory exist in children with FASD and whether the difficulties are mediated by task demands. To address this, we used two measures of immediate and delayed facial recognition memory, the Children's Memory Scale (CMS) and Test of Memory and Learning (TOMAL). Compared to typically developing controls, children with FASD showed memory deficits on all tests and were more likely to perform in a clinically significant range. As well, children performed more poorly on the CMS compared to TOMAL, a finding consistent with the greater difficulty of the CMS task. Our results are consistent with our hypothesis that children with FASD show impairment in facial memory, particularly on demanding memory tasks.