The Evidence Base for Occupational Therapy in Mental Health: More Systematic Reviews Are Needed

To shape its work, the Research Centre for Occupation & Mental Health is interested in research priorities. Systematic reviews develop an overview of the research available about an intervention, which can provide evidence to underpin practice. They also however, identify gaps in the knowledge base and so are useful for research-prioritization exercises. A rigorous literature search identified only four systematic reviews about occupational therapy in mental health, which suggests that more are needed to underpin practice. This article also explains a six-stage process for conducting a systematic review that can be used by occupational therapists in mental health.     

Using a touch screen paradigm to assess the development of mental rotation between 3½ and 5½ years of age

Mental rotation is an important spatial skill. However, there is controversy concerning its early development and susceptibility to intervention. In the present study, we assessed individual differences in the mental rotation abilities of children between 3½ and 5½ years of age, using a touch screen paradigm to simplify task demands. A figure or its mirror image was presented in 8 different orientations, and children indicated in which of two holes the figure would fit by touching one of the holes on the screen. Task instructions were varied in three conditions, giving the children the opportunity to gather manual or observational experience with rotations of different stimuli, or giving no additional experience. Children’s error rates and response times increased linearly with increasing angular disparity between the figure and the hole by the age of 5 years, but 4-year-olds were found to respond at chance for all angular disparities, despite the use of a touch screen paradigm. Both manual and observational experience increased the response accuracy of 5-year-olds, especially for children already performing well. However, there was no effect on 4-year-olds. Results point to an emerging readiness to use mental rotation and profit from observational and manual experience at age 5.     

Reasons for Declining Preconception Expanded Carrier Screening Using Genome Sequencing

Genomic carrier screening can identify more disease-associated variants than existing carrier screening methodologies, but its utility from patients’ perspective is not yet established. A randomized controlled trial for preconception genomic carrier screening provided an opportunity to understand patients’ decisions about whether to accept or decline testing. We administered a survey to potential genomic carrier screening recipients who declined participation (N = 240) to evaluate their reasons for doing so. Two thirds of women declined participation. We identified major themes describing reasons these individuals declined to participate; the most common were time limitation, lack of interest, not wanting to know the information, and potential cause of worry or anxiety. Most women eligible for genomic carrier screening indicated that their reasons for opting out were due to logistical issues rather than opposing the rationale for testing. As expanded carrier screening and genomic sequencing become a more routine part of clinical care, it is anticipated there will be variable uptake from individuals for this testing. Thus, the advancement of clinical carrier screening from single genes, to expanded screening panels, to an exome- or genome-wide platform, will require approaches that respect individual choice to receive genetic testing for reproductive risk assessment.     

Psychometric properties of the Behavioral Inhibition Questionnaire in preschool children

We examined the psychometric properties of the Behavioral Inhibition Questionnaire (BIQ; Bishop, Spence, & McDonald, 2003), a rating scale for children's behavioral inhibition. Parent and teacher ratings, parent interviews, and laboratory observations were obtained for 495 preschoolers. Confirmatory factor analysis yielded 6 factors, each reflecting the BIQ's subscales, and all loading onto a second-order general dimension. Model fit was acceptable for parent ratings, but only marginal for teacher ratings. The convergent and discriminant validity of the BIQ was examined by using a multitrait-multimethod approach. Results indicate that the BIQ displays evidence of reliability and validity that can complement observational paradigms.     

Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control

For adolescents with Type 1 diabetes, lower family income may be associated with poorer diabetes management through depleted parental psychological resources (i.e., higher parental depressive symptoms, lower parental acceptance). Adolescents (N = 252; 46% male) aged 10-14 years with Type 1 diabetes assessed the acceptance of their mother and father (e.g., "gives me the feeling that she likes me as I am"; "she doesn't feel she has to make me over into someone else"). Mothers provided information on family income and demographics. Both mothers and fathers reported their depressive symptoms. HbA1c scores were indexed via medical records. Lower family income was associated with higher (i.e., worse) HbA1c, more mother and father depressive symptoms, and less acceptance from both parents. Mediation analyses revealed that the relationship of lower family income with metabolic control occurred indirectly through lower maternal and paternal acceptance and lower adherence. Lower family income may impair the quality of parent--adolescent relationships that are beneficial for good diabetes management.     

Trouble articulating the right words: Evidence for a response‐exclusion account of distraction during semantic fluency

It is widely held that single‐word lexical access is a competitive process, a view based largely on the observation that naming a picture is slowed in the presence of a distractor‐word. However, problematic for this view is that a low‐frequency distractor‐word slows the naming of a picture more than does a high‐frequency word. This supports an alternative, response‐exclusion, account in which a distractor‐word interferes because it must be excluded from an articulatory output buffer before the right word can be articulated (the picture name): A high, compared to low, frequency word accesses the buffer more quickly and, as such, can also be excluded more quickly. Here we studied the respective roles of competition and response‐exclusion for the first time in the context of semantic verbal fluency, a setting requiring the accessing of, and production of, multiple words from long‐term memory in response to a single semantic cue. We show that disruption to semantic fluency by a sequence of to‐be‐ignored spoken distractors is also greater when those distractors are low in frequency, thereby extending the explanatory compass of the response‐exclusion account to a multiple‐word production setting and casting further doubt on the lexical‐selection‐by‐competition view. The results can be understood as reflecting the contribution of speech output processes to semantic fluency.     

The role of brain-derived neurotrophic factor genotype, parental depression, and relationship discord in predicting early-emerging negative emotionality

The brain-derived neurotrophic factor (BDNF) gene is a plausible candidate for early-emerging negative emotionality (NE), and evidence suggests that the effects of this gene may be especially salient in the context of familial risk for child maladjustment. We therefore examined whether the single-nucleotide polymorphism producing a valine-to-methionine substitution at codon 66 (val66met) of the BDNF gene was associated with childhood NE, in the context of parental depression and relationship discord. A sample of 413 three-year-old children was assessed for NE using standardized laboratory measures. The children's parents completed clinical interviews as well as a measure of marital satisfaction. Children with at least one BDNF methionine (met) allele exhibited elevated NE when a parent had a history of depressive disorder or when relationship discord was reported by a parent. In contrast, this allele was associated with especially low NE when parental depression was absent and when the parental relationship was not discordant. Our findings suggest that the BDNF met allele confers increased child sensitivity to both positive and negative familial influences.     

Correspondence of children's anticipated vocations, perceived competencies, and interests: Results from an Italian sample

Relations among anticipated vocations, self-assessments of competence, and interests in sample of 190 Italian children were examined. Children were asked what activities they liked, those they thought they were good at, and what job they expected when they grew up. The responses were coded into RIASEC Holland codes and agreement across the three questions was examined using kappa statistics. Results indicated that there was no relation between anticipated occupations and either interest or perceived competence. Thus, these anticipated occupations appear to be based on unrealistic criteria and the validity of studying such early expressions of interest is questionable. Conversely, results demonstrated a correspondence between interest and competence and this correspondence was similar for boys and girls and increased with age.