Calibrating for Comorbidity: Clinical Decision-Making in Youth Depression and Anxiety

Comorbidity in clinical youth populations is more the rule than the exception, yet few established guidelines exist to help practicing clinicians manage complex diagnostic profiles. The current paper reviews efforts within the treatment development literature to handle comorbidity in depressed and anxious children and adolescents, including single-target, modular-based, and transdiagnostic interventions. Two case studies are presented to describe how comorbid anxiety and depression are managed within two different evidence-based single-target interventions. A third case is presented to introduce a novel individual behavioral activation therapy (IBAT) designed to address co-occurring depression and anxiety by targeting a single maintaining mechanism (avoidance) that underlies both disorders. Implications for clinical decision-making (assessing complex clinical profiles in practice, prioritizing treatment goals, selecting interventions from a broad evidence base) are discussed.     

Evidence for a general factor model of ADHD in adults

Objective: To examine factor structures of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptoms of ADHD in adults. Method: Two sets of models were tested: (a) models with inattention and hyperactivity/impulsivity as separate but correlated latent constructs and (b) hierarchical general factor models with a general factor for all symptoms and separate specific factors for inattention and hyperactivity/impulsivity. Participants were 751 adults with ADHD. Two models with correlated factors and two general factor models of ADHD symptoms were tested. Results: The general factor model provided a better fit of the data than the correlated models. The general factor model with one general and three (inattention, motoric, and verbal hyperactivity/impulsivity) specific factors best accounted for the adults' symptoms. Conclusion: These results suggest a unitary component to ADHD symptoms as well as dimensional specific factors. The replication of a general factor in adults suggests continuity of symptom presentation from childhood into adulthood. Clinical implications are discussed.     

Caregiver Demand and Parent Distress in Juvenile Rheumatic Disease: The Mediating Effect of Parent Attitude Toward Illness

Parents of youth with juvenile rheumatic diseases (JRD) often take on illness management responsibilities that can become burdensome, potentially resulting in poor parent adjustment outcomes. However, not all caregivers will experience increased distress as a result of variability in stress appraisals. The current study examined the role of parent illness attitudes in the relation between perceived caregiver demand and parental distress. Youth (N = 70) ages 7–18 years diagnosed with a JRD and their parents were recruited from a pediatric rheumatology clinic. Parents completed measures of caregiver demand, parental distress, and illness attitudes. Hierarchical regression revealed a relationship between caregiver demand and parental distress. A significant relationship was also found between caregiver demand and parent illness attitudes, as well as parent illness attitudes and parental distress. Thus, parent illness attitudes mediated the relationship between caregiver demand and parental distress. Techniques aimed at altering negative illness attitudes may help parents cope with their caregiving responsibilities.     

Representational momentum and the flash‐lag effect

Representational momentum (RM) is a distortion where the final orientation of a moving object is misremembered as further along its trajectory. Experiments reported here examine RM when an additional object was flashed just as the moving object disappeared. When the task was to judge the flashed object, participants reported that the flash appeared to lag behind (flash‐lag effect; FLE). When the task was to judge the moving object, larger forward distortions for the moving object were found when the flash was present, despite previous evidence that the FLE depends on the moving object's continued presence. The results suggest that some part of the FLE depends upon what precedes the flash. In addition, equivalent RM was observed for implied and smoothly animated events, a possible limit to the velocity effect for RM was found, and larger positive distortions were found for downward rotations.     

Typhoid Pollyanna: The effect of category valence on retrieval order of positive and negative category members

Previous research suggests that people process pleasant information more efficiently than unpleasant information. This phenomenon has been illustrated in a variety of contexts and paradigms, and is frequently referred to as the Pollyanna principle. One important aspect of the Pollyanna principle is that people tend to retrieve pleasant members of a category from semantic memory prior to unpleasant members of the same category. However, we propose that the retrieval advantage of favourably viewed category members holds only for positive categories and that prototypicality of category members might be a better predictor of ease of retrieval than favourability. These possibilities were tested in two studies. In Study 1, favourability effects on retrieval order were observed for positive categories but not for neutral or negative categories. In Study 2, prototypical category members were retrieved before less prototypical category members for both positive and negative categories. These results suggest that the Pollyanna principle might be the result of a confound between favourability and prototypicality for members of favourable categories.     

Bilingual Generation Effect: Variations in Participant Bilingual Type and List Type

Slamecka and Katsaiti (1987, Experiment 1) reported that there is no generation effect with bilingual materials under intentional learning instructions. In contrast, O'Neill, Roy, and Tremblay (1993, Experiment 1) demonstrated a bilingual generation effect when an incidental learning set was induced. In the present experiment, the possibility that another procedural variation between the two studies accounts for the disparate findings was examined. A 2-stimuli (read bilingual translations, generate bilingual translations) list was compared with a 3-stimuli (read bilingual translations, generate bilingual translations, read unilingual repetitions) list, in accordance with the procedures used in the earlier experiments. Under incidental learning conditions, for both list types, a strong generation effect was found. Participant type—coordinate or compound bilingualism—was also varied. The generation effect was much larger for compound bilinguals than for coordinate bilinguals, presumably because of a greater difference in the allocation of attention to read than to generate items by compound bilinguals.