INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

Conversational time patterns and mutual influence in parent-child interactions: A time series approach

Mutual influencing processes are assumed to be the basic building blocks in establishing parentchild bonding and in influencing cognitive and language behavior. A study by Jasnow and Feldstein (1986) revealed that, within the temporal domain of speech, preverbal (9-month-old) infants and their mothers exhibit a pattern of mutual influence (attunement) in their average durations of switching pauses. The general purpose of this research was to extend those findings to children with higher verbal functioning. In addition, parent and child genders, nature of the interaction, and specific aspects of parents' personalities, expressiveness, and instrumentality were considered. Each parent interacted with their 4-or 5-year-old son or daughter in each of two conversations—unstructured (social conversation) and structured (task activity). Conversations were processed by an automated computer system yielding objective measure of turns, vocalizations, pauses, and switching-pause durations. To examine interspeaker influence or attunement of temporal speech patterns, influence coefficients were computer for each speaker on a turn-by-turn basis using time series regression. Analysis of these coefficients revealed that: (1) Mutual influence is most evident with switching-pause duration. (2) Structure in the conversation (as defined by the task or parental instrumentality) seems to facilitate attunement for vocalization and switching pause duration. (3) Attunement with girls seems to occur equally well with both parents, while boys exhibit a style of temporal patterning influence which suggests greater identification with the father. (4) Expressiveness seems to facilitate attunement to the child's switching-pause duration.     

On differentiating embarrassment from shame

Four experiments were conducted to demonstrate that embarrassment and shame are distinct emotions that result from violations of different types of internalized standards. Embarrassment results from violating one's particular persona; shame results from violating a shared, objective ideal. Subjects vividly imagined themselves in situations and indicated their emotional reactions. In Experiment I, we demonstrate that people differentiate between embarrassment and shame systematically (F(1,27) = 74.4, p < 0.001). In Experiments 2 and 3, we demonstrate that embarrassment results from violating a persona (n = 34, p < 0.001; n = 23, p < 0.001), and shame results from violating an objective ideal (n = 34, p < 0.001; n = 23, p < 0.001). In Experiment 4, we demonstrate that it is the type of standard that is violated (n = 30, p < 0.001), not whether or not the violation was intentional, that determines whether one experiences embarrassment or shame. We argue that both shame and embarrassment play an important role in maintaining personal identity.     

Computational and reasoning abilities in arithmetic: Cross-generational change in China and the United States

A Chinese advantage over Americans was found for economically relevant computational and reasoning abilities in arithmetic for groups of 6th- and 12th-grade students matched or equated on general intelligence. No cross-national difference for computational or reasoning abilities was found for samples of older (60- to 80-year-old) Chinese and American adults equated on general intelligence. The pattern of change in arithmetical competencies across cohorts suggests that the Chinese advantage in 6th and 12th grade is due to a cross-generational decline in competencies in the United States and a cross-generational improvement in China.     

The Future of Psychology in Medicaid's Health Delivery System for People with Disabilities

State Medicaid programs are rapidly converting fee-for-service health delivery systems to managed care for people with disabilities. In theory, managed care models of health delivery will substantially improve the quality of care for people with disabilities, but in reality, few successful models exist. This period of transition holds both opportunities and challenges for psychologists in medical settings. Because Medicaid reforms for people with disabilities may herald similar reforms for both the public and the private sectors, psychology's response will determine its role in the future of health care delivery for this population. Changes in training and increased attention to outcomes research, innovations in practice, and advocacy will be the keys to success.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.     

Inhibitory control over no-longer-relevant information: Adult age differences

Hartman and Hasher (1991) used a garden-path task in which younger and older adults generated the final word for each of a series of high-cloze sentences. Under instructions to remember the final word, the experiment included critical sentences for which the generated word was replaced by a new, to-be-remembered target. Using an implicit priming task, the first experiment replicated a basic finding: Younger adults showed priming only for the target words, whereas older adults showed priming for both the generated and target words. Two experiments explored boundary conditions. One showed that an additional sentence that interpreted the new target word enabled older adults to narrow access to only the target word. The provision of additional time following the introduction of the new target word did not. Specific information, not more time, is required for inefficient inhibitory mechanisms to clear the recent past from memory.     

The Development of the Toddler Behavior Screening Inventory

The purpose of the present study was to develop the Toddler Behavior Screening Inventory (TBSI) for rapidly assessing maternal reports of toddler behavior problems. The TBSI is a 40-item measure intended for use by pediatricians, psychologists, and other child-care professionals. A group of mothers (n = 312) rated the initial 93-item TBSI in terms of behavior frequency and parental perception of the behavior as problematic. Following item elimination, 40 items were retained due to being both frequent and problematic at all toddler age levels. Data were obtained with a new sample of mothers (n = 581) and showed the TBSI to possess good reliability and validity.     

Associations Between Clinic-Referred Boys and Their Fathers on Childhood Inattention-Overactivity and Aggression Dimensions

The question asked in this study of 70 clinically referred 6- to 12-year-old boys with behavior problems was whether or not childhood inattention-overactivity and aggression are transmitted specifically from biological fathers to sons. Fathers' self-reported childhood inattention-overactivity on a retrospectively valid measure was exclusively associated with parents' ratings of their sons' current attention problems on the Mothers' Operational Measure for Sub-grouping (MOMS), the Revised Child Behavior Checklist (RCBCL), and an approximated DSM-IV inattention dimension. Fathers' self-reported childhood aggression was not associated with ratings of their sons' aggression on the MOMS or DADS (a parallel instrument for fathers), nor on DSM-III oppositional or conduct disorder dimensions, but it was exclusively associated with RCBCL ratings of sons' aggressive and delinquent behavior. None of the nonspecific correlations (father inattention-overactivity with son aggression or father aggression with son inattention-overactivity) was significant.