How Couple- and Parenting-Focused Programs Affect Child Behavioral Problems: A Randomized Controlled Trial

The significance of enhancing parenting skills to reduce child maladjustment is well-established and supports the important role of evidence-based parenting programs. However, the notion that parenting should be the exclusive focus for enhancing child behavior is necessarily limiting. Evidence is growing that relationship-oriented treatments may be another powerful approach to improve child adjustment, albeit the underlying effects in couple- versus parenting-focused programs have been subject to limited study. The aim of this RCT was to compare the treatment effects of (1) a couple-focused program (the Couples Coping Enhancement Training) to (2) a parenting training (Triple P) and (3) a control group on children’s behavioral problems in 150 couples. The parents’ perceptions of relationship quality, parenting behavior, and child’s behavioral problems were assessed by means of questionnaires completed prior to and 2 weeks after the end of the treatment. Multi-group path analyses revealed that in mothers’ perception the couple-focused program reduced child behavioral problems by enhancing the relationship quality whereas improved parenting mediated the benefits in the parenting training. In fathers’ evaluations the couple-focused program reduced dysfunctional parenting which largely accounted for the benefits in child adjustment. The dearth of research on child outcomes in couple-focused intervention studies is a striking gap that should be overcome. It is a promising field because of its evident potential to foster the health of many children.     

Trust or Distrust Toward Healthcare Services: Breast Screening in the North and South of Italy

This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy ranging in age between 48 and 69 years, and proposes a free mammogram every two years. The effectiveness of cancer early detections has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the case of breast cancer. A diagnosis of this form of cancer at its early phases in 97% of cases allows women to survive at least five years after it. However, the different level of trust women feel for healthcare structures is the discriminating element between the North and South of Italy for their access to the screening program. This topic will be thoroughly analyzed by presenting the results of research aimed at evaluating the meaning given to the outcomes of a first exploratory study, this second study also offers the opportunity to share our results within the social context that has generated them. The outcomes of the present research have been presented to a group of “privileged witnesses” living in the South (Naples and its surroundings): 12 women aging from 49 to 65, and 5 healthcare workers (one doctor, 25 two nurses, and two Local Health Authority supervisors); they took part in three Focus Groups for an in-depth look of the theme in question. The analyses of the groups' debates, carried out by means of a software for text analysis (T-LAB), confirmed the results of the previous research: the diffidence and lack of synergy between institutions and healthcare workers are the causes of southern women's lack of participation to the breast cancer screening program. In particular, the comparison between women's and workers' viewpoints shows a different emotional connotation about the possibility to improve participation to the screening: the workers' optimism countervails women's distrust and pessimism.     

The relationship between childhood adversity,psychiatric disorder and clinical severity: results from a multi-centre study

Although several studies have shown a clear association between childhood adversities and later development of a number of psychiatric disorders, a number of recent reports have cast doubts regarding the aetiological role played by abuse, neglect and loss, arguing that they are neither necessary nor sufficient to account for the development of subsequent psychopathology. In this study, we aimed to investigate the associations and predictive power of childhood adversities on later onset of Axis-I &-II psychiatric conditions and the impact on severity of psychiatric presentation in a large sample of patients. This cross-sectional multi-centre study evaluated patients (N = 1136) recruited in fourteen NHS psychotherapy departments in the UK. Patients were assessed using a number of rater-based questionnaires and self-rated measures. Multiple regression analyses showed that childhood experiences of loss and physical abuse were predictive of severe personality disorder and borderline personality disorder, but not of other less severe PD and Axis-I diagnoses. Sexual abuse predicted later onset of Post-traumatic Stress Disorder. In addition, we found that childhood abusive experiences were strongly associated with severity of psychiatric distress, interpersonal problems and global functioning. Having experienced two or more childhood adversities significantly increased severity of psychiatric distress, interpersonal malfunctioning and CORE scores.     

Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder

Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change—including moderate and low decreasing—as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first 4 weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility.     

Inhibition in motor imagery: a novel action mode switching paradigm

Motor imagery requires that actual movements are prevented (i.e., inhibited) from execution. To investigate at what level inhibition takes place in motor imagery, we developed a novel action mode switching paradigm. Participants imagined (indicating only start and end) and executed movements from start buttons to target buttons, and we analyzed trial sequence effects. Trial sequences depended on current action mode (imagination or execution), previous action mode (pure blocks/same mode, mixed blocks/same mode, or mixed blocks/other mode), and movement sequence (action repetition, hand repetition, or hand alternation). Results provided evidence for global inhibition (indicated by switch benefits in execution-imagination (E-I)-sequences in comparison to I-I-sequences), effector-specific inhibition (indicated by hand repetition costs after an imagination trial), and target inhibition (indicated by target repetition benefits in I-I-sequences). No evidence for subthreshold motor activation or action-specific inhibition (inhibition of the movement of an effector to a specific target) was obtained. Two (global inhibition and effector-specific inhibition) of the three observed mechanisms are active inhibition mechanisms. In conclusion, motor imagery is not simply a weaker form of execution, which often is implied in views focusing on similarities between imagination and execution.     

The gender effect in 3D-Mental-rotation performance with familiar and gender-stereotyped objects – a study with elementary school children

The study examined the influence of gender-stereotyped stimuli rotated in depth on children’s mental-rotation performance. Participants included 321 elementary school children who completed three-dimensional mental-rotation tasks with either male- or female-stereotyped stimuli (M-MRT-3D/F-MRT-3D). Results suggest that in-depth tasks are very difficult for second graders. No gender effect was found in the mental-rotation performance of 7- to 9-year-old children; however, task understanding indicates gender differences. For fourth graders, a significant interaction of gender and stimulus type could be demonstrated. Furthermore, results indicate that fourth-grade boys tend to guess more often in tasks with stimuli consistent to the respective own gender. In addition, regression analyses showed that next to grade and perceptual speed, the perceived level of stimulus familiarity predicted performance. Considering a possible link between dimensionality and familiarity, the influence of the gender-stereotyped stimuli on children’s confidence and task understanding as well as on transformational processes and strategy efficiency is discussed.     

Age differences in personality traits across cultures: self‐report and observer perspectives

Using self‐report measures, longitudinal studies in the US and cross‐sectional studies from many cultures suggest that the broad factors of Neuroticism, Extraversion, and Openness to Experience decline from adolescence to adulthood, whereas Agreeableness and Conscientiousness increase. Data are inconsistent on the rate of change during adulthood, and on the generalizability of self‐report findings to informant ratings. We analysed cross‐sectional data from self‐reports and informant ratings on the Revised NEO Personality Inventory in Czech (N = 705) and Russian (N = 800) samples. Some curvilinear effects were found, chiefly in the Czech sample; informant data generally replicated self‐reports, although the effects were weaker. Although many of the details are not yet clear, there appear to be pan‐cultural trends in personality development that are consistent with the hypothesis of intrinsic maturation. Copyright © 2004 John Wiley & Sons, Ltd.     

Impaired awareness of movement disorders in Parkinson’s disease

Background

This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson’s disease (PD) and motor fluctuations (dyskinesias, wearing off, on–off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits by comparing the on and off states using motor scales and an extensive battery of tests to assess cognitive and behavioral functioning.

Methods

PD patients were compared on three different scales that we have devised to measure awareness of movement disorders: Global Awareness of Movement (GAM) Disorders, dyskinesia/hypo-bradykinesia rating scales.

Results

Data showed that PD patients had greater awareness and psychological suffering in the off state than in the on state. In particular, they were troubled by motor disabilities related to hypokinesias and had mood-related symptoms and a perception of disability in activities of daily living. Interestingly, patients only showed a selective reduction of awareness of movement disorders associated with executive functions and related to dyskinesias in the on state, compared to a preserved awareness of hypokinesias in the off state. On the contrary, no association with executive functions was found in the off state.

Conclusion

Our findings suggest that the dopaminergic overstimulation of mesocorticolimbic pathways may cause a dysfunction of prefrontal–subcortical connections related to the impaired insight.     

On Minimizing Guessing Effects on Multiple‐Choice Items: Superiority of a two solutions and three distractors item format to a one solution and five distractors item format

Multiple‐choice response formats are troublesome, as an item is often scored as solved simply because the examinee may be lucky at guessing the correct option. Instead of pertinent Item Response Theory models, which take guessing effects into account, this paper considers a psycho‐technological approach to re‐conceptualizing multiple‐choice response formats. The free‐response format is compared with two different multiple‐choice formats: a traditional format with a single correct response option and five distractors (‘1 of 6’), and another with five response options, three of them being distractors and two of them being correct (‘2 of 5’). For the latter format, an item is scored as mastered only if both correct response options and none of the distractors are marked. After the exclusion of a few items, the Rasch model analyses revealed appropriate fit for 188 items altogether. The resulting item‐difficulty parameters were used for comparison. The multiple‐choice format ‘1 of 6’ differs significantly from the multiple‐choice format ‘2 of 5’, while the latter does not differ significantly from the free‐response format. The lower difficulty of items ‘1 of 6’ suggests guessing effects.     

Neural and genetic foundations of face recognition and prosopagnosia

Faces are of essential importance for human social life. They provide valuable information about the identity, expression, gaze, health, and age of a person. Recent face‐processing models assume highly interconnected neural structures between different temporal, occipital, and frontal brain areas with several feedback loops. A selective deficit in the visual learning and recognition of faces is known as prosopagnosia, which can be found both in acquired and congenital form. Recently, a hereditary sub‐type of congenital prosopagnosia with a very high prevalence rate of 2.5% has been identified. Recent research results show that hereditary prosopagnosia is a clearly circumscribed face‐processing deficit with a characteristic set of clinical symptoms. Comparing face processing of people of prosopagnosia with that of controls can help to develop a more conclusive and integrated model of face processing. Here, we provide a summary of the current state of face processing research. We also describe the different types of prosopagnosia and present the set of typical symptoms found in the hereditary type. Finally, we will discuss the implications for future face recognition research.