A Meta-Analysis of Behavioral Interventions for Adolescents and Adults with Autism Spectrum Disorders

Evaluation of evidence-based treatments is important for adolescents and adults with autism spectrum disorders (ASD) given the increasing number of interventions available and the prevalence of ASD. In this study, we sought to evaluate the effectiveness of behavioral interventions for this population by conducting a meta-analysis of published single-case research studies. A new metric for calculating effect size in single-case research, nonoverlap of all pairs, was utilized. In addition, the certainty of evidence, a system to evaluate research methodology, was applied to the reviewed articles. Forty-three articles were identified in the study. Results suggested that the behavioral interventions in the areas of academic skills, adaptive skills, problem behavior, phobic avoidance, social skills, and vocational skills have medium-to-strong effect sizes. Medium-to-high confidence in findings was noted for 81 % of the studies in the meta-analysis; however, three-fourths of the reviewed studies did not include treatment integrity, which may affect the ability to draw conclusions about the effectiveness of the interventions. Overall, the evidence is promising for the use of behavioral interventions for this population; however, additional research and dissemination are needed to fill the gap between research and practice in order for practitioners to meet the increasing demand as individuals with ASD age.     

Consumer Preferences for the Predictive Genetic Test for Alzheimer Disease

The purpose of this study was to assess consumer preferences for predictive genetic testing for Alzheimer disease in the United States. A rating conjoint analysis was conducted using an anonymous online survey distributed by Qualtrics® to a general population panel in April 2011 in the United States. The study design included three attributes: Accuracy (40 %, 80 %, and 100 %), Treatment Availability (Cure is available/Drug for symptom relief but no cure), and Anonymity (Anonymous/Not anonymous). A total of 12 scenarios were used to elicit people’s preference, assessed by an 11-point scale. The respondents also indicated their highest willingness-to-pay (WTP) for each scenario through open-ended questions. A total of 295 responses were collected over 4 days. The most important attribute for the aggregate model was Accuracy, contributing 64.73 % to the preference rating. Treatment Availability and Anonymity contributed 20.72 % and 14.59 %, respectively, to the preference rating. The median WTP for the highest-rating scenario (Accuracy 100 %, a cure is available, test result is anonymous) was $100 (mean?=?$276). The median WTP for the lowest-rating scenario (40 % accuracy, no cure but drugs for symptom relief, not anonymous) was zero (mean?=?$34). The results of this study highlight attributes people find important when making the hypothetical decision to obtain an AD genetic test. These results should be of interests to policy makers, genetic test developers and health care providers.     

Callous-Unemotional Traits and the Treatment of Conduct Problems in Childhood and Adolescence: A Comprehensive Review

The treatment of conduct problems among children and adolescents with callous-unemotional (CU) traits has been subject to much speculation; however, treatment outcome research has been surprisingly limited and findings have been mixed. This review examines the research to date in this field as it pertains to two key questions. First, are CU traits associated with clinical outcomes and processes in the family based treatment of child and adolescent conduct problems? Second, can family based intervention produce change in CU traits? Using a systematic search strategy, we identified 16 treatment outcomes studies that can be brought to bear on these questions. These studies provide strong evidence of unique associations between CU traits and risk for poor treatment outcomes, while at the same time indicating that social-learning-based parent training is capable of producing lasting improvement in CU traits, particularly when delivered early in childhood. We discuss the potential for this emerging evidence base to inform the planning and delivery of treatments for clinic-referred children with CU traits, and detail an ongoing program of translational research into the development of novel interventions for this high-risk subgroup.     

Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic mental health condition that often results in substantial impairments throughout life. Although evidence-based pharmacological and psychosocial treatments exist for ADHD, effects of these treatments are acute, do not typically generalize into non-treated settings, rarely sustain over time, and insufficiently affect key areas of functional impairment (i.e., family, social, and academic functioning) and executive functioning. The limitations of current evidence-based treatments may be due to the inability of these treatments to address underlying neurocognitive deficits that are related to the symptoms of ADHD and associated areas of functional impairment. Although efforts have been made to directly target the underlying neurocognitive deficits of ADHD, extant neurocognitive interventions have shown limited efficacy, possibly due to misspecification of training targets and inadequate potency. We argue herein that despite these limitations, next-generation neurocognitive training programs that more precisely and potently target neurocognitive deficits may lead to optimal outcomes when used in combination with specific skill-based psychosocial treatments for ADHD. We discuss the rationale for such a combined treatment approach, prominent examples of this combined treatment approach for other mental health disorders, and potential combined treatment approaches for pediatric ADHD. Finally, we conclude with directions for future research necessary to develop a combined neurocognitive + skill-based treatment for youth with ADHD.     

The Psychometric Equivalence of the Personal Wellbeing Index School-Children for Indigenous and Non-Indigenous Australian Adolescents

Despite increasing research interest in the subjective wellbeing (SWB) of Indigenous Australians, SWB measures used in these studies have not been validated for use in this population. Until the measurement equivalence of scales used in this population are demonstrated, inferences regarding potential differences in SWB across Indigenous and non-Indigenous groups cannot be validly inferred. To rectify this, the present study examines the psychometric equivalence of the Personal Wellbeing Index—School Children (PWI-SC) for use among samples of Indigenous and non-Indigenous Australian adolescents using multiple-group confirmatory factor analysis. The Indigenous sample comprised 1,378 adolescents enrolled in the Australian Federal Government’s Youth Connections Program. A sample of 6,401 non-Indigenous adolescents also enrolled in the Youth Connections Program represented a second comparative group. Finally, the third comparative group comprised a convenience sample of 983 Victorian high-school students. The results demonstrated strict factorial invariance between all three adolescent groups, suggesting that the PWI-SC measures the same underlying construct in each sample. These findings support quantitative comparisons between Indigenous and non-Indigenous SWB data as valid. The implications of this research are discussed.     

Emotional Environments: Selective Permeability,Political Affordances and Normative Settings

Topoi - I begin this article with an increasingly accepted claim: that emotions lend differential weight to states of affairs, helping us conceptually carve the world and make rational decisions. I...     

Minding the ($500,000) Gap: Accounting for the Gender-Driven Gap in Executive Severance Agreements

Journal of Business and Psychology - As the number of women in leadership positions continues to rise, it is important to closely examine the gender pay gap at the executive level. Prior studies...     

Content Hungry: How the Nutrition of Food Media Influences Social Media Engagement

What motivates people to consume and engage with food media on social networks? We adopt an evolutionary lens to suggest that the valence of people’s affective state varies by the implied caloric density of food media, which has a direct impact on social media engagement. First, we analyze a catalog of Buzzfeed’s Tasty videos based on nutritional content derived from the dish’s ingredients and find that visualizing caloric density (i.e., calories per serving) positively influences likes, comments, and shares on Facebook. We then replicate this phenomenon in an experiment, providing preliminary evidence for the role of affect as an explanatory mechanism. We conclude by isolating the role of affect with a classic misattribution task, which attenuates the elevated engagement resulting from exposure to calorie-dense food media. These findings contribute to the dialogue on the antecedents of social media engagement and offer implications for content developers, advertisers, consumer health advocates, and policymakers.     

The Sex-Based Harassment Inventory: A Gender Status Threat Measure of Sex-Based Harassment Intentions

Sex Roles - We introduce a new inventory measuring sex-based harassment intentions and threat perceptions grounded in gender status threat theories (Berdahl, 2007; Stephan et al., 2016). In Study 1...     

Measuring Productivity in Primary Care Behavioral Health: A Delphi Study

High productivity by behavioral health consultants (BHC) is a defining aspect of the primary care behavioral health (PCBH) model to maximize access to care and is often measured by patient volume. Studies of productivity in health care settings suggest a single productivity target may not be optimal. We used a Delphi method to obtain expert consensus on an operational definition of high productivity by BHCs in the PCBH model. Clinicians, managers, and researchers in PCBH were recruited to participate in a multi-round survey using a modified Delphi technique and develop consensus on PCBH productivity metrics. Ten participants completed all three survey rounds and rated 28 metrics. After three rounds, two direct metrics (average number of billable BHC visits each day; number of patients seen per day) received at least 80% consensus as “Essential”, two received at least 50%, and five received less than 50%. One influencer (level of integration at the practice) received at least 80% consensus as “Very Much” influential, 19 received at least 50%, and eight items received less than 50%. Several themes arose from participant comments. PCBH productivity can be interpreted as being high volume. Numerous practice factors influence how productive a BHC may be. Future studies should determine the feasibility of our metrics in clinical practice, establish productivity expectations based on patient needs and clinic resources, and identify patient-, clinician-, or practice-level moderators of productivity.