Increasing Communication Among Nursing Home Residents

In this preliminary, intrasubject study (N = 8), we examined the effects of communication skills training and the use of memory books by Nursing Assistants (NAs) on the social ecology of a nursing home. Through inservice and on-the-job training, NAs were taught to use communication skills and memory books during their interactions with residents with mild to moderate cognitive impairment (Mini Mental Status Examination, M = 16.25), but relatively intact communication abilities. An abbreviated staff motivational system called Behavioral Supervision (Burgio and Burgio, 1990. Int. J. Aging Hum. Deve. 30: 287–302.) was attempted to encourage performance of these skills on the nursing units. Results showed that, regardless of sporadic implementation of the intervention by nursing staff, the intervention improved communication between staff and residents during care routines, increased the amount of time other residents and visitors spent talking with target residents, and increased the rate of positive statements made by the target residents and others in their immediate environment. Results are discussed in terms of limitations of the staff motivational system and modifications made to the system in a larger ongoing intervention trial.     

Noncontingent reinforcement for the treatment of severe problem behavior: An analysis of 27 consecutive applications

Noncontingent reinforcement (NCR) is a commonly used treatment for severe problem behavior displayed by individuals with intellectual and developmental disabilities. The current study sought to extend the literature by reporting outcomes achieved with 27 consecutive applications of NCR as the primary treatment for severe problem behavior. All applications of NCR were included regardless of treatment outcome to minimize selection bias favoring successful cases. Participants ranged in age from 5 to 33 years. We analyzed the results across behavioral function and with regard to the use of functional versus alternative reinforcers. NCR effectively treated problem behavior maintained by social reinforcement in 14 of 15 applications, using either the functional reinforcer or alternative reinforcers. When we implemented NCR to treat problem behavior maintained by automatic reinforcement, we often had to add other treatment components to produce clinically significant effects (five of nine applications). Results provide information on the effectiveness and limitations of NCR as treatment for severe problem behavior.     

Validity of the inventory of interpersonal problems for predicting treatment outcome: an investigation with the Pennsylvania Practice Research Network

In this study, we examined the relationship between treatment outcome and variables from the Inventory of Interpersonal Problems Circumplex scales (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in the Pennsylvania Psychological Association's Practice Research Network (PRN; Borkovec, Echemendia, Ragusea, & Ruiz, 2001). The PRN was a naturalistic observation treatment outcome study conducted with clinicians who were providing outpatient therapy. Assessment instruments, including the Compass Assessment System (Howard, Brill, Lueger, O'Mahoney, & Grissom, 1993; Sperry, Brill, Howard, & Grissom, 1996) and the IIP-C, were used to assess outcome at the 7th session (N=73) and at termination (N=42). Significant associations were identified between seventh-session outcome and most of the IIP variables. Only IIP elevation and amplitude were related to termination outcome. Elevation, amplitude, and hostile submissive problems were related to treatment length. Ad hoc analyses indicated that the IIP elevation fully mediated the relationships between interpersonal problems and seventh-session outcome but not the relationship between amplitude and outcome. We discuss the results in relation to the external validity of the IIP.     

On the need for negative local item dependence

While negative local item dependence (LID) has been discussed in numerous articles, its occurrence and effects often go unrecognized. This is due in part to confusion over what unidimensional latent trait is being utilized in evaluating the LID of multidimensional testing data. This article addresses this confusion by using an appropriately chosen latent variable to condition on. It then provides a proof that negative LID must occur when unidimensional ability estimates (such as number right score) are obtained from data which follow a very general class of multidimensional item response theory models. The importance of specifying what unidimensional latent trait is used, and its effect on the sign of the LIDs are shown to have implications in regard to a variety of foundational theoretical arguments, to the simulation of LID data sets, and to the use of testlet scoring for removing LID.This paper is based in part on a chapter in the first author's doctoral dissertation, written at the University of Illinois at Urbana-Champaign under the supervision of William Stout. Part of this research has been presented at the annual meeting of the National Council on Measurement in Education, San Diego, California, April 14–16, 1998.The research of the first author was partially supported by a Harold Gulliksen Psychometric fellowship through Educational Testing Service and by a Research and Productive Scholarship award from the University of South Carolina.     

Spatial learning in the 5-HT1B receptor knockout mouse: selective facilitation/impairment depending on the cognitive demand

Age-related memory decline is associated with a combined dysfunction of the cholinergic and serotonergic systems in the hippocampus and frontal cortex, in particular. The 5-HT1B receptor occupies strategic cellular and subcellular locations in these structures, where it plays a role in the modulation of ACh release. In an attempt to characterize the contribution of this receptor to memory functions, 5-HT1B receptor knockout (KO) mice were submitted to various behavioral paradigms carried out in the same experimental context (water maze), which were aimed at exposing mice to various levels of memory demand. 5-HT1BKO mice exhibited a facilitation in the acquisition of a hippocampal-dependent spatial reference memory task in the Morris water maze. This facilitation was selective of task difficulty, showing thus that the genetic inactivation of the 5-HT1B receptor is associated with facilitation when the complexity of the task is increased, and reveals a protective effect on age-related hippocampal-dependent memory decline. Young-adult and aged KO and wild-type (WT) mice were equally able to learn a delayed spatial matching-to-sample working memory task in a radial-arm water maze with short (0 or 5 min) delays. However, 5-HT1BKO mice, only, exhibited a selective memory impairment at intermediate and long (15, 30, and 60 min) delays. Treatment by scopolamine induced the same pattern of performance in wild type as did the mutation for short (5 min, no impairment) and long (60 min, impairment) delays. Taken together, these studies revealed a beneficial effect of the mutation on the acquisition of a spatial reference memory task, but a deleterious effect on a working memory task for long delays. This 5-HT1BKO mouse story highlights the problem of the potential existence of "global memory enhancers."