Evaluation of two physical guidance procedures in the treatment of pediatric feeding disorder

Children with pediatric feeding disorder may refuse to consume an adequate variety and/or volume of food to maintain expected growth. They can consume food but may actively or passively refuse, resulting in escape or avoidance of eating. Behavioral interventions like positive reinforcement with escape extinction can increase consumption. However, sometimes these interventions are insufficient, especially in treating passive refusal. In these cases, physical guidance may be used to prompt an open mouth to deposit food. Research indicates open-mouth prompts are effective and rated as acceptable. This study replicated an existing physical guidance procedure, the finger prompt, and compared its efficacy and acceptability with that of a spoon prompt. This study extended research by defining and measuring passive refusal as a dependent variable and assessing social validity among different stakeholders and times. Both prompts were effective in treating food refusal, and caregivers rated the finger prompt as more preferred.     

Proposing Abolition Theory for Carceral Medical Education

Medical schools, like all institutions, are conservative since they seek to maintain and expand on their accomplishments. Stakes are high in carceral medicine given the risks of replicating the inhumane social conditions that exist within prisons and allow prisons to exist. Given the increasing number of partnerships between state and municipal carceral systems with academic medical centers, medical schools must consider which guiding theory they will use to teach carceral medicine. The interdisciplinary theory of prison abolition is best fit for the task of training medical students to think about the long term goals of societal change and public health.

     

Acceptance of Illness Among Patients Pursuing Transplantation or Left Ventricular Assist Device

Acceptance of illness is related to better mental health among patients with chronic illness; however, this construct has not been evaluated as part of routine transplantation evaluations. The purpose of this study was to create a brief measure of acceptance of illness for patients pursuing organ transplantation and examine how acceptance is related to distress. Retrospective medical record reviews were conducted for 290 patients who completed a routine psychosocial evaluation prior to transplant listing which included the Illness Acceptance Scale (IAS). Internal consistency for the IAS was excellent (Cronbach’s alpha?=?.92). Illness acceptance was negatively correlated with depression, anxiety, and catastrophizing and was not related to health literacy or health numeracy. The IAS is a reliable and valid measure for patients who are pursuing thoracic transplant or left ventricular assist device. Clinicians may want to screen transplant candidates for illness acceptance and refer those with lower levels to psychological interventions.

     

Physical Activity Among Urban Children with Asthma: Does Sleep Matter?

Journal of Clinical Psychology in Medical Settings - The present study examined associations between sleep and physical activity among a diverse sample of 97 urban children (ages 7–9) with...     

Successful Postgraduate Placement Experiences: What is the Influence of Job and Supervisor Characteristics?

We know little about what determines an effective placement experience, yet vocational placements are an integral part of many professional degree programmes. The aim of this research was to examine the influence of job (task variety, task identity, task significance, feedback, and autonomy) and supervisor (relationship quality and mentoring) characteristics on placement outcomes. The findings were tested on samples from two professions for which placement were a compulsory part of their course. Sample 1 consisted of 266 undergraduate nurses, and sample 2 consisted of 176 postgraduate psychologists. The findings showed that job and supervisor characteristics explained unique variance in professional development and placement satisfaction. Of the five job characteristics examined, skill variety, feedback from the job, and task significance influenced placement outcomes. Mentoring emerged as the most important supervisor characteristic that was associated with professional development and placement satisfaction, and to a slightly less extent, supervisor–student relationship quality was also important. The research and practical implications of the findings were discussed.     

Longitudinal treatment mediation of traditional cognitive behavioral therapy and acceptance and commitment therapy for anxiety disorders

ObjectiveTo assess the relationship between session-by-session putative mediators and treatment outcomes in traditional cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for mixed anxiety disorders.MethodSession-by-session changes in anxiety sensitivity and cognitive defusion were assessed in 67 adult outpatients randomized to CBT (n = 35) or ACT (n = 32) for a DSM-IV anxiety disorder.ResultsMultilevel mediation analyses revealed significant changes in the proposed mediators during both treatments (p < .001, d = .90–1.93), with ACT showing borderline greater improvements than CBT in cognitive defusion (p = .05, d = .82). Anxiety sensitivity and cognitive defusion both significantly mediated post-treatment worry; cognitive defusion more strongly predicted worry reductions in CBT than in ACT. In addition, cognitive defusion significantly mediated quality of life, behavioral avoidance, and (secondary) depression outcomes across both CBT and ACT (p < .05, R² change = .06–.13), whereas anxiety sensitivity did not significantly mediate other outcomes.ConclusionsCognitive defusion represents an important source of therapeutic change across both CBT and ACT. The data offered little evidence for substantially distinct treatment-related mediation pathways.     

Does a Positive Bias Relate to Social Behavior in Children With ADHD?

This study examines whether positively biased self-perceptions relate to social behaviors in children with attention-deficit/hyperactivity disorder (ADHD) as compared to control children. The social behaviors of children with ADHD (n = 87) were examined relative to control children (CTL; n = 38) during a laboratory-based dyadic social interaction task. Children with ADHD were subgrouped into those with a positive illusory bias (PIB) in their self-perceptions (ADHD + PIB) versus those without such a bias (ADHD – PIB). Using a behavioral coding system adapted for this study, ADHD + PIB, ADHD – PIB, and CTL participants were compared on objectively coded social behaviors occurring within the context of the social interaction task. Whereas both ADHD groups displayed more disruptive behavior than controls, only the ADHD + PIB group displayed less prosocial behavior and less effortful behavior. This study breaks new ground by examining positively biased self-perceptions as they relate to social behavior in children with ADHD and provides promising new insight into the social problems experienced by these children.     

The co-construction of adolescent narrative identity: narrative processing as a function of adolescent age, gender, and maternal scaffolding

The current study aimed to situate the development of adolescent narrative identity in the context of past-event conversations between adolescents and their mothers, extending work on conversational contexts in early childhood to adolescence. We examined a cross-section of 63 adolescents with 2 goals: (1) to examine how adolescent age and gender interacted with mothers' scaffolding behaviors and how those interactions were associated with adolescents' narrative processes of meaning-making, vulnerability, and resolution; (2) to examine mothers' behaviors in conversation and how the interactions between those behaviors and event type (important, sad, and happy themes) were associated with those narrative processes. We found that maternal behavior in the conversation was related to adolescent narrative processes, yet this link varied as a function of characteristics of the adolescent and type of event discussed. Overall results suggest that those with potentially less practice at narrating the self in elaborative ways--younger adolescents and boys--receive more supportive scaffolding, and that for those with likely more practice with elaborative narration--girls and older adolescents--mothers engage in more negation behavior. The role of these scaffolding behaviors in adolescent narrative identity development is discussed.     

Long-term improvement in coping skills following multimodal treatment in war veterans with chronic PTSD

Due to the long-lasting and resistant symptoms characteristic of chronic combat posttraumatic stress disorder (PTSD), its treatment is complex and often requires a tailored therapeutic approach incorporating both psychotherapy and pharmacotherapy. A multimodal approach of psychoeducative, sociotherapeutic, and dynamically oriented trauma-focused groups is described. We assessed the short- and long-term effectiveness of this therapeutic program by monitoring its impact on PTSD symptoms, depression, neurotic symptoms, coping skills, and quality of life for three years. The findings revealed short-term reduction in the symptoms of PTSD and depression, while the long-term results were manifested as the increased use of all coping mechanisms and a greater level of obsession.