The Significance of Strategic Community Engagement in Recruiting African American Youth & Families for Clinical Research

We present baseline data and describe the utility of a community engaged, culturally relevant approach to recruiting African American youth and families for phase I of The AAKOMA Project. The AAKOMA Project is a two phase treatment development study to improve mental health service use among depressed African American youth. We completed capacity building activities using a community engaged framework and Community Based Participatory Research (CBPR) methods. Replicating the (Alvarez et al. in West J Nurs Res 28:541–560, 2006) model of systematic community outreach enhanced our ability to effectively recruit partners and evaluate outreach efforts as demonstrated by our Recruitment Success Factor (RSF—i.e. ‘an adjusted ratio of eligible participant yield to contacts made’). Using the chi-square goodness-of-fit statistic; we compared the RSFs of the various modes of participant study entry to determine which was most effective. Our target enrollment was 56 persons. We recruited 130 and enrolled 57. Our baseline data is drawn from a gender balanced and socioeconomically diverse sample who participated in youth focus groups and individual interviews and adult focus groups. We identified 3 study participant referral modes (self-referral, provider referral and participant-to-participant referral) with multiple sources per mode and an overall RSF of 0.41. Study findings support the effectiveness of assiduous and systematic community interaction, reflective review of recruitment efforts and the importance of disseminating information on strategic recruitment processes for engaging diverse populations in clinical research.     

Killing Versus Witnessing Trauma: Implications for the Development of PTSD in Combat Medics

Killing in combat uniquely predicts elevated PTSD symptomatology among military veterans. This study investigated the effects of combat killing in a sample of 345 U.S. Army combat medics who had recently returned from operational deployments to Iraq or Afghanistan. Combat medics provide frontline medical care before, during, and after battles but also fight alongside other soldiers when under attack. Attempting to kill in combat was a significant predictor of PTSD symptomatology even after accounting for passively witnessing trauma in fellow soldiers. Medics may be well prepared to cope with the passive experiencing and witnessing of war-zone trauma, but may benefit from training to cope with the negative consequences of taking actions to kill.     

Neuropsychological profile following suicide attempt by hanging: two adolescent case reports

Hippocampal damage and amnesia following hypoxia and ischemia are described in the few published adult cases of suicide attempt by hanging. However, a recent review (Caine &; Watson, 2000 Caine, D. and Watson, J. D. 2000. Neuropsychological and neuropathological sequelae of cerebral anoxia: A critical review. Journal of the International Neuropsychology Society, 6: 86–99. [CROSSREF][Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) suggests a variable pattern of brain involvement and neuropsychological impairments following hypoxic-ischemic injury that may or may not involve amnesia. To help clarify the impact of hanging on the developing brain, we examined neuropsychological functioning in two adolescents who survived suicide attempt by hanging. Despite differences in Glasgow Coma Scale (GCS), coma duration, and structural imaging findings, both patients had similar IQ (VIQ > PIQ) and presented with various combinations of deficits in expressive/receptive language, visual-constructional and perceptual ability, processing speed, attention, working memory, and/or executive functioning shortly after injury. In spite of their similarities, only one of the patients presented with classic amnesia symptoms in his early recovery. This patient was evaluated 1 year postinjury, and persistent deficits in processing speed and memory encoding were noted. Several hanging-related variables, including longer estimated hanging duration, greater weight, and severe airway edema, were thought to place this patient at increased risk for cognitive deficits. Clinical MRI scans of this patient obtained 6 weeks postinjury revealed mild volume loss as well as abnormalities in bilateral superior cortex. However, CT and MRI scans obtained throughout early recovery did not reveal overt evidence of injury to specific memory-related structures. Comprehensive neuropsychological evaluation of all adolescent survivors of suicide attempt by hanging is recommended, as a variety of postacute cognitive deficits were observed in these patients despite relatively short (≤ 15 minutes) estimated hanging durations.     

Is Reading Recovery an Effective Intervention for Students with Reading Difficulties? A Critique of the i3 Scale-Up Study

The recently reported i3 Scale-Up of Reading Recovery (May et al., 2015) found an effect size of + 0.69 in favor of Reading Recovery compared to the control group. We discuss four issues: (a) many of the lowest achieving students were excluded from participation in Reading Recovery; (b) the control group received a range of different experiences; (c) the successful completion rate of students in the program was modest; and (d) no data supported the claim that Reading Recovery leads to sustained literacy learning gains. We question the value of this study as the basis for widespread implementation of Reading Recovery.     

Treatment Effectiveness of a Brief Behavioral Intervention for Preschool Disruptive Behavior

Parent management training is an evidence-based treatment for disruptive behavior. However, the number of treatment sessions can be high, contributing to high attrition rates. The purpose of this study was to examine post-treatment, 6-month, and 1-year treatment outcomes of the Brief Behavioral Intervention. One hundred twenty children aged 2–6.5 years demonstrating clinically significant disruptive behavior were referred to an outpatient clinic for treatment and participated in the study. Attrition was below reported rates in the literature. Significant decreases in child disruptive behavior and parent stress were found from pre-to-post intervention, and improvements were maintained at follow-ups. Significant pre-to-post intervention teacher reported decreases in behavior were reported.     

Classroom Changes in ADHD Symptoms Following Clinic-Based Behavior Therapy

This study examined classroom behavioral outcomes for children with Attention-Deficit/Hyperactivity Disorder (ADHD) following their participation in a manualized, 10-week intervention called Family Skills Training for ADHD-Related Symptoms (Family STARS). Family STARS combined behavioral parent training (BPT) and child-focused behavioral activation therapy (CBAT). Participants were children ages 7–10 diagnosed with ADHD-Combined Type. Pre- and post-treatment teacher ratings of ADHD symptoms were compared using a single group, within-subjects research design. Intervention effectiveness was analyzed using paired-samples t-tests. Results indicated statistically significant classroom improvements for externalizing behaviors and attention problems with medium and large main effects (respectively) for the intervention. Possible implications for combining CBAT with BPT for the treatment of ADHD are discussed as well as the relevance of these results for improving the effectiveness and portability of empirically supported interventions.     

Understanding boundary extension: Normalization and extension errors in picture memory among adults and boys with and without Asperger's syndrome

Boundary extension is the tendency for people to “remember” information that fell outside a picture's boundaries. We used a novel test of boundary extension to provide absolute estimates of the magnitude of extension errors and of the degree to which people are influenced by the way a picture is presented at the time of testing. Participants were shown photographs on a computer and subsequently allowed to adjust their magnification to match the size they remembered. The test produced reliable boundary extension of around 11% in adults and large influences of initial test size. In a second experiment we tested boys diagnosed with Asperger's syndrome and matched controls. Both groups demonstrated boundary extension comparable to that observed in adults but greater effects of initial test size. High performance IQ in Asperger's was linked with high levels of boundary extension, while for the matched control group the opposite pattern was obtained.     

Representation of mental illness in Christian self-help bestsellers

The present study examined messages about mental illness in 14 contemporary Christian self-help bestsellers. Content analysis revealed that most texts focused upon depression. Categories of textual units included Underlying Assumptions Regarding Depression, Representations of Depression, Roots/Causes/Reasons for Depression, and Christian Responses to Depression. Demonic influence was the most frequently cited reason for depression. Other reasons included negative cognitions, failure as a Christian, and negative emotions. Christian responses to depression included trusting God, religious activity, and individual willpower. Discussion of these results focused upon the problematic impact of these messages upon individuals with depression, and upon suggestions for reducing mental illness stigma in religious communities.     

Personality,Demographic, and Intellectual Variables Associated with Readiness for Discharge from Psychiatric Treatment

This study examined the relationship between staff rated discharge readiness and patient personality, demographic, and intellectual variables. Chi square and t test analyses were performed on data of 88 male and female adult patients of a short-term residential psychiatric treatment program. Patient diagnosis, trait anxiety level, marital status, age, and abstract intelligence scores assessed at admission were found to be significantly associated with staff ratings of patients’ readiness for discharge following six weeks of treatment. Findings were discussed in terms of prior process and outcome literature and implications for future research.     

Racial Differences in Adolescent Coping and Self-Esteem

Racial differences in coping strategies and self-esteem were examined for 361 male and female adolescents in Grades 7–12. Coping strategies were assessed with the Adolescent Coping Orientation for Problem Experiences (J. M. Patterson & H. I. McCubbin, 1986). Self-esteem was assessed by the Coopersmith Self-Esteem Inventory (S. Coopersmith, 1987). Multivariate analysis revealed racial differences in adolescent coping strategies of ventilating feelings, seeking diversions, developing self-reliance, avoiding problems, seeking spiritual support, investing in close friends, engaging in demanding activities, solving family problems, and relaxing. In particular, African American adolescents reported using diversions, self-reliance, spiritual support, close friends, demanding activities, family problems, and relaxation more frequently than Caucasian adolescents did. Implications for professionals and recommendations for future research are discussed.