Using the Millon Behavioral Medicine Diagnostic to Delineate Treatment Outcomes in Rehabilitation

Patients undergoing rehabilitation have been evidenced to improve in different ways depending on their coping styles. Amplifiers, Repressors, and Social Copers are examples of patients who present differently in rehabilitation settings and tend to have differing levels of success in their response to treatment. The current study examined the differential treatment outcomes of three coping style groups undergoing multidisciplinary rehabilitation. A sample of 59 patients suffering from injuries associated with chronic pain were assessed using the Multidimensional Pain Inventory, Beck Depression Inventory, and Beck Anxiety Inventory before, during, and after multidisciplinary pain management treatment. Coping style groups derived from the Millon Behavioral Medicine Diagnostic consisting of Amplifiers, Repressors, and Social Copers were compared with regard to reductions in depression, anxiety, pain, functional impairment, and associated outcomes. Repeated measures ANOVA revealed that Amplifiers, Repressors, and Social Copers had varying levels of success in the treatment program. Hierarchical linear modeling analyses revealed the coping style groups to have significantly different change curves from pre to post-treatment in depression, anxiety, pain severity, functional impairment, affective distress, life control, social support, and soliciting help from others. These findings support prior research emphasizing the value of tailoring treatments in rehabilitation settings toward patients’ coping styles in order to maximize outcomes. A program (provided in either SAS or SPSS syntax) that will compute MBMD coping style group membership will be provided upon request. Request by e-mail to: dcipher@hsc.unt.edu or by fax to: +1-817-7352270.     

Community Influences on Adjustment in First Grade: An Examination of an Integrated Process Model

We examined the impact of neighborhood characteristics both directly and indirectly as mediated by parent coaching and the parent/child affective relationship on behavioral and school adjustment in a sample of urban dwelling first graders. We used structural equations modeling to assess model fit and estimate direct, indirect, and total effects of neighborhood structural and social characteristics on parenting behavior and child outcomes. Observed physical incivilities in the neighborhood were associated with lower levels of parent eliciting behavior and higher levels of child behavior problems. The effects of neighborhood structural characteristics were mediated partially through neighborhood community involvement with children, which had a direct significant impact on parent eliciting behavior and an indirect effect on child behavior problems. Neighborhood community involvement with children was associated with higher levels of parent eliciting behavior and lower levels of child behavior problems. Observed physical incivilities had a significant indirect association with poor school adjustment and a marginally significant association with positive school adjustment to first grade. Neighborhood community involvement with children was more strongly associated with positive school adjustment than poor school adjustment.     

Development of a parent training program for children with pervasive developmental disorders

Parent delivered interventions based on applied behavior analysis (ABA) for children with Pervasive Developmental Disorders (PDDs) have been evaluated using primarily single‐subject design methodology or small case series. While the results of these evaluations are encouraging, an important next step is to standardize the interventions to allow for replication across sites, in studies with large samples and measures of long‐term, clinically meaningful outcomes such as improvements in children's functioning and their relationships with parents. Accordingly, the Research Units on Pediatric Psychopharmacology and Psychosocial Interventions (RUPP Autism Network) assembled a detailed manual for a structured behavioral parent training (PT) program, developed treatment fidelity and training procedures, and conducted a pilot, feasibility study. The PT program is part of a large scale, multisite study intended to determine the efficacy of combined pharmacological treatment and behavioral intervention to improve behavior and adaptive functioning in children with PDD. This paper discusses the rationale for this project. A companion paper provides the results of our feasibility study on the PT program. Copyright © 2007 John Wiley & Sons, Ltd.     

Hippocampal CA1 spiking during encoding and retrieval: relation to theta phase

The hippocampal theta rhythm is a prominent oscillation in the field potential observed throughout the hippocampus as a rat investigates stimuli in the environment. A recent computational model [Hasselmo, M. E., Bodelon, C., & Wyble, B. P. (2002a). A proposed function for hippocampal theta rhythm: separate phases of encoding and retrieval enhance reversal of prior learning. Neural Computation, 14, 793-817. Neuromodulation, theta rhythm and rat spatial navigation. Neural Networks, 15, 689-707] suggested that the theta rhythm allows the hippocampal formation to alternate rapidly between conditions that promote memory encoding (strong synaptic input from entorhinal cortex to areas CA3 and CA1) and conditions that promote memory retrieval (strong synaptic input from CA3 to CA1). That model predicted that the preferred theta phase of CA1 spiking should differ for information being encoded versus information being retrieved. In the present study, the spiking activity of CA1 pyramidal cells was recorded while rats performed either an odor-cued delayed nonmatch-to-sample recognition memory test or an object recognition memory task based on the animal's spontaneous preference for novelty. In the test period of both tasks, the preferred theta phase exhibited by CA1 pyramidal cells differed between moments when the rat inspected repeated (match) and non-repeated (nonmatch) items. Also in the present study, additional modeling work extended the previous model to address the mean phase of CA1 spiking associated with stimuli inducing varying levels of retrieval relative to encoding, ranging from novel nonmatch stimuli with no retrieval to highly familiar repeated stimuli with extensive retrieval. The modeling results obtained here demonstrated that the experimentally observed phase differences are consistent with different levels of CA3 synaptic input to CA1 during recognition of repeated items.     

Cognitive Coping Tool Kit for Psychosis: Development of a Group-Based Curriculum

This article outlines an 8-week curriculum that was created to help outpatients develop cognitive and behavioral skills for coping with delusions and hallucinations as well as to reduce patients’ comorbid subjective levels of distress (e.g., depression, anxiety). The manualized protocol consisted of psychoeducation and training in a variety of CBT skills that have shown promise in treating individuals with residual psychosis, using recovery-oriented “naturalistic” methods and culminating in the creation of an individualized “tool kit” of cognitive coping resources. A preliminary study of the effectiveness of this brief group-based CBT program for outpatients with chronic, residual symptoms of schizophrenia was conducted. Participants were 24 outpatients diagnosed with schizophrenia spectrum disorders who were stable on medications and connected to case management community follow-up. The Positive and Negative Syndrome Scale for Schizophrenia interview and the Symptom Checklist-90 self-report symptom scales were administered pre- and post-intervention. The results suggest that there were significant improvements in psychotic symptoms and self-reported distress from pre- to posttreatment.     

Metaperceptions of bias in intimate relationships

Meta-awareness of bias in intimate partner judgments was investigated in 3 studies. In Study 1, participants rated fictional partners in happier relationships as more positively biased in their partner perceptions. In Study 2, participants thought their judgments of their own current partners were positively biased and that they were judged by their partners in a positively biased fashion. Using a sample of couples, Study 3 showed that metaperceptions of bias were anchored to actual levels of bias at the individual and relationship levels. In addition, positive bias was accentuated for traits that were more relevant to mate evaluation. These findings (as expected) suggest that positive bias in partner judgments can be a normative and consciously accessible feature of intimate relationships.     

Posture control and complex arm coordination: analysis of multijoint coordinative movements and stability of stance

The authors addressed the interactions between control of bimanual multijoint coordination tasks and posture. Participants (N = 6) performed 8 coordination patterns that differed in degree of complexity by using their bilateral elbows and wrists under 3 scaled motion speeds while standing on 2 force plates. Results indicated that producing complex bimanual multijoint coordinative tasks affected postural sway, thus resulting in an increase of sway activity. Behavioral as well as mechanical factors accounted for the increased disturbance in postural sway. Those findings suggest that performing complex coordination tasks disrupts postural control in normal young adults.     

Early identification of mental health problems in schools: The status of instrumentation

When embedded within a continuum of mental health services including both prevention and treatment, school-based mental health identification programs can promote improved academic and mental health functioning among students. This article describes the scientific status of assessment instrumentation that may be used for early mental health identification in schools. Currently available instruments are described in terms of their ability to accurately detect youth with mental health problems. Implications for selecting mental health screening and assessment instruments and integrating them into schools are discussed. Finally, a range of approaches to early identification in schools as well as some of the broader ethical and practical issues related to the integration of these strategies into a school-wide continuum of services are presented.     

Predictors of online information seeking by international students when disaster strikes their countries.

This study explores factors influencing international students' likelihood of using the Internet to seek disaster-related information should a disaster affect their countries. A cross-sectional survey was conducted in two universities in America between August 1 and September 30, 2005. Two hundred twenty-nine (n = 229) students completed the self-administered questionnaires. ANOVA analyses found that respondents' Internet self-efficacy had no significant impact on their intentions to seek disaster-related information on the Internet. However, respondents' Internet dependency and attitude toward seeking information online were found to have a significant effect on such intentions.