Perinatal Posttraumatic Stress Disorder: Implications for Occupational Therapy in Early Intervention Practice

The purpose of this article is to present literature regarding perinatal posttraumatic stress disorder and to describe the implications of research findings for occupational therapy screening and treatment in early intervention practice. Changes in legislation regarding early intervention practice and family centered care are presented as a rationale for including maternal mental health screening as a standard practice in the field of early intervention. A case study illustrates symptoms of perinatal posttraumatic stress disorder and the effect on maternal-infant co-occupational engagement. The Model of Human Occupation is used to guide clinical reasoning about potential occupational therapy interventions.     

Source credibility and syllogistic reasoning

Two experiments examined whether a source credibility effect would be observed for a syllogistic reasoning task. In the experiments, people were given two statements, presented as the results from a survey, followed by a conclusion that was supposedly made by one of two sources. In Experiment 1, one of the sources was described as honest and the other as dishonest, and in Experiment 2, one of the sources was described as an expert and the other as a non-expert. Because a pilot experiment showed that credibility can be overridden by people’s experience with a source, all conclusions in Experiments 1 and 2 were ones that were likely to be accepted (i.e., necessary and possible strong conclusions). Both experiments showed a clear source credibility effect, particularly for the invalid conclusions. These results, along with the belief bias effect and previous research with conditional reasoning, suggest that people can be influenced by extraneous context, such as the honesty or expertise of a source, in a syllogistic reasoning task.     

An empirical assessment of the form of utility functions

Utility functions, which relate subjective value to physical attributes of experience, are fundamental to most decision theories. Seven experiments were conducted to test predictions of the most widely assumed mathematical forms of utility (power, log, and negative exponential), and a function proposed by Rachlin (1992). For pairs of gambles for real monetary gains, undergraduate and nonstudent subjects either reported an equalizing amount for 1 outcome that made the gambles subjectively equal or chose between gambles where the amounts were varied across trial, which allowed the equalizing amount to be estimated from their pattern of choices. Using a novel method that eliminates several limitations of previous research, I manipulated the outcomes across trials such that each type of utility function predicted a linear relationship between the equalizing amounts and the amounts of the other outcomes, and made point predictions for either the slope or intercept of that relationship. In a meta-analysis across experiments, systematic departures from the point predictions were observed for each type of utility function. Thus, the data imply that despite their historical importance and incorporation in many psychological and economic decision theories, the most widely assumed models of utility are incorrect.     

Predictors of recidivism by stalkers: a nine-year follow-up of police contacts

In a subsample of a multisite stalking study (Mohandie, Meloy, McGowan, & Williams, 2006) comprising 78 offenders from one site, 77% committed new offenses within an average follow-up of 106 months (8.8 years). Over half (56%) were charged for new stalking related offenses and 33% for violent recidivism. Violent reoffending, including sexual offenses, was predicted by risk factors consistent with existing literature: younger age at first conviction, prior release failures, and criminal history. Stalking recidivism was predicted by pre-index offending scores, using the Cormier-Lang, and prior diagnosis of a mental illness. In addition, stalkers with previously diagnosed mental illness had significantly more police contacts as complainants than those without; their recidivism was also more likely to be non-violent.     

The female stalker

A study of 143 female stalkers was conducted, part of a large North American sample of stalkers (N=1005) gathered from law enforcement, prosecutorial, and entertainment corporate security files (Mohandie, Meloy, Green McGowan, & Williams, 2006). The typical female stalker was a single, separated, or divorced woman in her mid-30s with a psychiatric diagnosis, most often a mood disorder. She was more likely to pursue a male acquaintance, stranger, or celebrity, rather than a prior sexual intimate. When compared with male stalkers, the female stalkers had significantly less frequent criminal histories, and were significantly less threatening and violent. Their pursuit behavior was less proximity based, and their communications were more benign than those of the males. The average duration of stalking was 17 months, but the modal duration was two months. Stalking recidivism was 50%, with modal time between intervention and re-contacting the victim of one day. Any prior actual relationship (sexual intimate or acquaintance) significantly increased the frequency of threats and violence with large effect sizes for the entire female sample. The most dangerous subgroup was the prior sexually intimate stalkers, of whom the majority both threatened and were physically violent. The least dangerous were the female stalkers of Hollywood celebrities. Two of the McEwan, Mullen, MacKenzie, and Ogloff (2009b) predictor variables for stalking violence among men were externally validated with moderate effect sizes for the women: threats were associated with increased risk of violence, and letter writing was associated with decreased risk of violence.     

Addressing the Needs of Adolescents and Adults with Autism: A Crisis on the Horizon

The cohort of individuals with autism spectrum disorder (ASD) diagnosed as part of the first wave of what is often referred to as the autism epidemic is rapidly approaching adulthood. This cohort represents only the proverbial tip of the iceberg with some reports noting that 70% of the currently identified individuals with ASD are less than 14-years old. These numbers represent a looming crisis of unprecedented magnitude for adults with autism, their families, and the ill-prepared and underfunded adult service system charged with meeting their needs. A review of the current literature on outcomes for adults with ASD indicates that, independent of current ability levels, the vast majority of adults on the spectrum are either unemployed or underemployed and, further, that large numbers of adults with autism remain without any appropriate services. Many have had inadequate transition programming including little attention to service coordination, minimal direct family involvement and/or absence of treatment based on evidence-based practices. Lastly, issues related to staff and provider recruitment and retention present significant, systemic challenges to the provision of effective services. As such there is a significant and growing need for greater attention to individual needs of adults with ASD if we are provide the opportunity for a positive quality-of-life.     

An experimental approach towards the evaluation of a seat belt campaign with an inside view on the psychology behind seat belt use

A Belgian national safety belt campaign was evaluated by means of a questionnaire survey in an adolescent sample. The evaluation was done through a three group after-only design with the use of one control group and two experimental groups. The first experimental group, the attentive group, was exposed to the campaign material in a very direct, attentive way, whereas the second experimental group, the pre-attentive group, was exposed rather inattentively. The framework of the Theory of Planned Behaviour (TPB) was applied and extended with a habit and a past behaviour variable in order to verify whether seat belt usage is to be understood as an automaticity mechanism (i.e., habitual or repeated past behaviour) or as planned behaviour. In terms of campaign effect, the comparison of the pre-attentive group and the control group revealed no significant differences. However, the attentive group and the control group differed significantly regarding two basic dimensions of perceived behavioural control (i.e., confidence and motivation), habit, past behaviour, behavioural intention and behaviour. In terms of explaining seat belt usage, linear regression models were fitted and gave most support for the repeated past behaviour approach. According to the latter, using seat belts is recycling an originally reasoned behaviour, yet without systematically going through the whole underlying reasoning every time a situation in which the decision to wear a seat belt (or not) presents itself. The practical implications of these findings are discussed more in detail.     

Math weaknesses in survivors of acute lymphoblastic leukemia compared to healthy children.

Difficulties in math are the most frequently reported area of academic deficit in survivors of acute lymphoblastic leukemia (ALL) and the most frequent academic complaint among parents of ALL survivors. However, previous studies that included measures of math skills have been limited by the use of only a single measure of math skills, most often a measure of written calculations, without any assessment of math reasoning or math application skills. Further, the nature of these math difficulties has not been adequately investigated. The purpose of this study was to examine the performance of ALL survivors using multiple measures of math skills. Performance was compared to a group of healthy controls matched for age and sex as well as to normative levels. Other measures of neuropsychological function were also administered, and the relationships between these measures and the math measures were explored. Converging evidence for math difficulties in ALL survivors compared to healthy controls and normative levels was found. While ALL survivors generally performed within the average range on measures of math skills, math performance was mostly related to memory function and dominant-hand psychomotor speed. By contrast, math performance of healthy children was mostly related to basic reading skills and visual-motor integration. These findings shed light on the nature of math difficulties in ALL survivors and have implications for intervention.