Measuring Symptoms and Functioning of Youth with ADHD in Middle Schools

The identification of reliable and valid means for evaluating the effectiveness of school-based treatments and completing diagnostic evaluations of middle school aged students are needed. The present study examined the inter-rater agreement of teacher ratings and the relationship between ratings and observational data in a middle school setting. The data are interpreted in the context of differences between a secondary and elementary school setting. Teacher ratings and observational data were collected regularly over the course of two academic years for middle school students diagnosed with ADHD. The results indicate low rates of inter-rater agreement as well as low rates of agreement between teachers and observational data, and between observational data collected in different classrooms. Inter-rater agreement was lowest in late fall and gradually increased over the second half of the year. Implications for conducting treatment outcome evaluations of school-based treatment programs and diagnostic evaluations are discussed.     

Treatment with medications affecting dopaminergic and serotonergic mechanisms: effects on fluency and anxiety in persons who stutter

Medications with dopamine antagonist properties, such as haloperidol, and those with serotonin reuptake inhibitor properties, such as clomipramine, have been shown to improve fluency. To examine the degree to which each of these two pharmacological mechanisms might independently affect fluency, a selective serotonin reuptake inhibitor, paroxetine, and a selective dopamine (D-2) antagonist, pimozide, were evaluated. Both types of medications also affect mood and anxiety, factors that could influence fluency levels. Therefore, we also evaluated the medications’ effects on generalized and speech-related anxiety and the relationships between changes in anxiety and changes in fluency in 11 subjects with a history of developmental stuttering. The randomized, double blind, placebo-controlled crossover study that was designed had to be terminated prior to completion due to severe side effects following withdrawal from paroxetine. Even with a reduced sample size (n = 6), significant improvement in percent fluent speaking time (p = 0.02) was found using a telephone task between baseline and pimozide (n = 6), with average duration of dysfluencies significantly shorter (p = 0.04) but no significant difference in the estimated number of dysfluencies per minute. This significant improvement was associated with non-significant increases in generalized anxiety, but non-significant decreases in speech-related anxiety. No significant differences were found in fluency between baseline and paroxetine (n = 5). These preliminary results suggest that fluency improvement is more likely to be mediated by dopaminergic rather than serotonergic mechanisms. Due to its side effects, however, pimozide may be considered a risk for treatment of stuttering.

Educational objectives: As a result of reading this paper the reader will describe and explain: (1) how medications may affect fluency and the rationale for selecting medications for treatment trials; (2) the interrelationship between fluency and anxiety; and (3) factors important in developing clinical trials using medications.     

Test of a mediated performance-turnover relationship highlighting the moderating roles of visibility and reward contingency

Despite the importance of understanding the conditions under which high performing employees are more likely or less likely to voluntarily leave an organization, the nature of the relationship between job performance and voluntary turnover has proven to be elusive. A model of the performance-turnover relationship that highlights important moderators and mediators is proposed and tested. Data consisted of organizational performance and turnover records and survey responses for 130 employees of a medical services organization. Results indicate that visibility and reward contingencies moderate performance relationships with alternatives and job satisfaction, respectively, and that performance may influence turnover through multiple mechanisms.     

Racial identity and the MMPI in African American male college students

The relation of the Minnesota Multiphasic Personality Inventory (MMPI) to the Racial Identity Attitude Scale--Black, Short Form (RIAS-B) was examined among 50 African American male college students in a reanalysis of unpublished MMPI data described in R. H. Dana (1993). This permitted study of relationships between MMPI scores and specific psychological variables hypothesized to produce cultural differences among African Americans. Results indicated RIAS-B scale scores functioned as predictors of MMPI scale scores. Similar research with the MMPI-2 incorporating larger samples that more adequately represent African American heterogeneity is needed. Methodological implications of these findings for MMPI-2 research with ethnic and racial groups are discussed, emphasizing the importance of research to depathologize African American racial and cultural identity.     

A review of common sleep disorders

What should clinicians know about sleep disorders? This article briefly introduces the reader to sleep medicine and succinctly reviews common sleep disorders. First, the authors describe the diagnostic tools unique to sleep medicine: the over-night polysomnogram and the multiple sleep latency test. Next, the authors review essential features of a subset of the sleep, described in the International Classification of Sleep Disorders-Revised, that sleep disorder specialists commonly evaluate, diagnose, and treat. The disorders reviewed include the intrinsic and circadian rhythm subsets of the dyssomnias group and the parasomnia group of sleep disorders. The authors identify the core signs and symptoms, polysomnogram findings, multiple sleep latency test findings, and treatment of these disorders.     

Sin,shame, and the subject

In this chapter I revisit construals of sin and shame, beginning with a moment of auto-investigation. I then set this data in conversation with historical, theological, and philosophical configurations of shame to reconceive sin and shame. I describe sin as curvatus ex carne (turning from the flesh) to signal sin as a refusal of both our embodied existence and a commodification of the land on which it lives. I then use a carnal hermeneutic to argue for a positive understanding of discerning shame as a resource for an ethical life that contrasts with shame of disgrace.     

Impact evaluation of the family expectations program and moderation by sociodemographic disadvantage

The federal government, through the Administration for Children and Families (ACF), has funded community-based relationship education programs for couples, individuals, and families, with a strong focus on serving economically disadvantaged and racially diverse families. This study evaluated the impact of a 36-hour, workshop-based couple relationship education program that was funded by ACF using a randomized controlled trial (RCT) design and intent-to-treat (ITT) analyses. Participants were 1320 couples who were either expecting a baby or had a baby within the past 3 months, at the time of enrollment. Follow-up surveys were administered 12 months later. Analyses evaluated program impacts on relationship stability, constructive communication, and destructive conflict compared to a no-treatment control group. Analyses showed a statistically significant impact of the program on destructive conflict (d = 0.10) but not on constructive communication (d = 0.06) or stability (d_Cox = 0.10). Based on findings from previous evaluations, we also examined whether participants’ levels of sociodemographic disadvantage moderated these effects. There was significant moderation by sociodemographic disadvantage on constructive communication and destructive conflict, but not on stability. Effects were observed for those at higher levels of sociodemographic disadvantage.     

Management of extended-wear contact lenses in infant rhesus monkeys

Infant rhesus monkeys were fitted with extended-wear contact lenses (EWCLs) to correct surgically induced aphakia. The protocol that produced the most favorable experimental outcome, including good lens-wear compliance, involved: (1) custom-made EWCLs with parameters adjusted for each animal, (2) selection for study of neonates who seemed to tolerate EWCLs most naturally, (3) individual housing of monkeys, (4) lens check at 2-h intervals around the clock by trained personnel, (5) a large inventory of EWCLs for each animal, (6) periodic ophthalmologic examinations, and (7) darkroom housing of monkeys during treatment of lens-wear-related incidents. The EWCL is a new tool for studies of the visual system and is a useful complement to existing experimental techniques.     

Rhythmic-movement facilitation of learning in working-class Afro-American children

In this study, we examined whether the cognitive performance of working-class Afro-American children could be enhanced based upon a presumed knowledge of the Black cultural experience. Children (6 and 9 years old) learned to match each of 12 pairs of pictures via a rhythmic movement-coordinated procedure accompanied by a musical beat or through a rote recitation procedure. It was expected and found that subsequent retention of the picture matches was superior in the rhythmic movement condition. Moreover, for the younger children, the effect was stronger for those who came from homes providing high stimulation and who had high levels of movement expressiveness.     

The effect of therapist interventions on the therapeutic alliance with borderline patients

The authors draw attention to the problems of establishing and maintaining a therapeutic alliance in the psychotherapy of the borderline patient. They elaborate an extensive methodology designed to study the manner in which shifts in collaboration occur in response to therapist interventions. This report demonstrates how one particular borderline patient increased his ability to collaborate with the therapist in response to a transference focus in the psychotherapy. Methodological problems are noted as are directions for future research. Only a series of patients studied with this or with similar methodology will allow for a sophisticated and empirical rationale for choosing a particular form of psychotherapy for a particular kind of borderline patient.