Conceptual,methodological, and clinical issues in cognitive-behavioral assessment

This article reviews cognitive-behavioral assessment principles and procedures. The functions of such assessments are noted, and issues and advances in cognitive assessment are discussed. The need for integrated cognitive, behavioral, and affective assessments is then explored. Finally, conceptual methodological, and clinical issues in the integration of assessments and study of reciprocal determinants are presented.Preparation of this paper was supported in part by a General Research Board Faculty Research Award from the University of Maryland. The author would like to thank Steve Graham, Donald Meichenbaum, Barbara Keogh, and Bernice Wong for their feedback during the preparation of this paper.     

Development of learning-disabled and normally achieving children's causal attributions

The causal attributions of learning-disabled (LD) and normally achieving (NA) children in grades 3 through 8 were compared. Attributions were measured by two scales that asked children to attribute hypothetical academic failure situations to factors that were either within (e.g., insufficient effort) or beyond (e.g., insufficient ability, blaming others) their control. Consistent with a learned helplessness hypothesis, LD girls, regardless of age, were more likely than NA children to attribute their failures to factors beyond their control. In contrast, LD boys' explanations for their failures paralleled those of NA children. That is, with increasing age the LD boys were more likely to attribute their failures to insufficient effort. Explanations and implications of sex differences in developmental patterns of LD children's causal attributions are discussed.The authors wish to thank Ruth Dusseault and Betty Wallace for their help in conducting this research. We also wish to thank the teachers, children, and administrators from the Leon County Schools for their cooperation.     

PROMOTING AUTOMOBILE SAFETY BELT USE BY YOUNG CHILDREN

A program using behavioral practice, assertiveness training, and social and contrived reinforcers was developed to establish and maintain automobile safety belt use by young children. Sixteen children (ages 4.8 to 7 years) who never used their safety belts during a 5-day preexperimental observation period were randomly assigned to two groups of eight each. A multiple baseline design across groups was used to evaluate the effectiveness of the training program. During the 8-day baseline period for Group 1, no children used their safety belts when unobtrusively observed while being driven from school. During the 26-day intervention period, the children were buckled up on 96% of the observations. Follow-up probes conducted 2–3 months after program discontinuance found safety belt use to range from 86% to 100%. For Group 2, the 14-day baseline safety belt use averaged 6% and increased to a mean of 81% during the 20-day training and maintenance program. Follow-up probes 2–3 months later found safety belt use to occur during 75% to 96% of the observations. Parent questionnaires indicated the generalizability and social validity of the program.     

The interview for antisocial behavior: Psychometric characteristics and concurrent validity with child psychiatric inpatients

The present study evaluated psychometric features and correlates of the Interview for Antisocial Behavior (IAB), a new measure designed to assess antisocial child behavior. Parents of 264 psychiatric inpatients (ages 6–13 years) completed the measure to evaluate antisocial behavior of their children. The investigation evaluated the relation of IAB scores to clinically derived diagnoses and to aggression and externalizing behaviors, as measured by different raters (parents, teachers), across different settings (home, school, hospital), and with different assessment methods (rating scales, behavioral role-play test). The results indicated that the IAB showed acceptable levels of internal consistency. A priori scores (severity, duration, total antisocial behavior) and factor analytically derived scales (Arguing/Fighting, Covert Antisocial Behaviors, Self-Injury) distinguished children with a DSM III diagnosis of conduct disorder, and scores on the IAB were more consistently related to other measures of aggression and externalizing behavior than to measures of internalizing behavior or overall severity of dysfunction. The implications of the results for use of the measure, particularly in relation to evaluation of the overt-covert dimension of antisocial behavior, are discussed.Completion of this research was facilitated by a Research Scientist Development Award (MH00353) and by grants (MH35408, MH39642) from the National Institute of Mental Health and the Rivendell Foundation.     

Gender and sex role differences in the perception of social support

This study examined the relationships among support types (i.e., emotional, instrumental, and nonintimate social participation), gender, sex role orientation, and stress level among college undergraduates (N=253). Dependent variables included need, perceived availability, and satisfaction with support. Sex differences were found only in emotional support, with men reporting less need, perceived availability, and marginally less satisfaction than women. The only gender by sex role interaction was on need for emotional support. Traditional sex-typed men reported less need than traditional women, whereas there was no difference between androgynous men and women. While sex differences do exist for emotional support, the effects of sex role orientation on perceptions of social support appears to be somewhat circumscribed.     

Cast of characters work: Systemically exploring the naturally organized personality

Cast of Characters Work conceives of the personality as a naturally organized unique group of characters who, together, function in an internal system. All characters bring their own histories, perceptions, feelings, beliefs, and behaviors to life's situations. Their survival strategies and interrelationships are felt as anxiety, conflict, ambivalence, or confidence. Heightening awareness of these multiple, simultaneous events increases access to the actual living process. The complex inner world of individuals, couples, and families can be precisely explored by working directly with each character and their relationships. Objectives are accountability and more functional, flexible, and satisfactory arrangements among characters internally and in couples and families.Also in private practice at 2 Pine Circle, Urbana, IL 61801.     

Assertiveness and cognitive processing in interpersonal situations

This study examined social skills components that precede the delivery of a skilled overt interpersonal response. Using a cognitive-behavioral systems approach to assertiveness, a task analysis of how women receive and process information in interpersonal situations requiring an assertive response to men was performed. Forty women were assigned to high- or low-assertive groups based on their Rathus Assertiveness Schedule scores. In small group sessions, each woman viewed four videotaped problem situations requiring an assertive response to both pleasant and angry males. After viewing each scene, each woman completed three questionnaires: (a) receiving information, (b) processing-generation of alternatives and decision making, and (c) processing-generation of consequences. High- and low-assertive participants were found to differ in their evaluation of consequences, for response options, particularly how a male would likely to behave to them. High-assertive participants were judged to evaluate more correctly than low-assertive participants the likely behavior of males if response options were implemented. All participants generated more complex alternatives and more assertive responses to situations involving an angry male as compared to a pleasant male. No differences were found between groups in their ability to receive information accurately. Correlational results were supportive of a cognitive-behavioral systems approach of assertion, that is, the emission of a skilled response depends on a chain of preceding responses.Thanks are due to Vida Dyson and Lenard Jason for their comments on an early draft of this paper.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.