Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial

This study examined the individual and combined effects of two nonpharmacological treatments for attention deficit/hyperactivity disorder (ADHD): Cogmed working memory training (CWMT) for adolescents and behavioral parent training (BPT) for mothers. Ninety-one adolescents (ages 11–15) and their mothers were randomized to one of four CWMT and BPT treatment and active control (placebo) group combinations of 5-week interventions. At pre- and posttest, mothers and teachers completed rating forms, and adolescents completed neuropsychological measures of working memory (WM). Individual intervention effects showed that treatment CWMT significantly improved WM spans, whereas there were no significant differences for treatment or control BPT on reports of parent-related outcomes. Combined treatment effects indicated an overall pattern of greatest improvements for the control CWMT/treatment BPT group, as compared to the other three groups, on adolescent WM deficit, behavioral regulation problems, and global executive deficit. Most significant effects for outcomes were main effects of improvements over time. A combination of CWMT and BPT did not result in increased treatment gains. However, potential effects of combined treatment may have been masked by greater perceived benefits arising from lack of struggle in the nonadaptive, CWMT active control condition. Future combined intervention research should focus on specific, theoretically driven WM deficits among individuals with ADHD, should include possible adaptations to the standard CWMT program, should examine effectiveness of cognitive treatments combined with contextual interventions and should utilize appropriate control groups to fully understand the unique and combined effects of interventions.     

The value of dignity in and for bioethics: rethinking the terms of the debate

The discussion of the nature and value of dignity in and for bioethics concerns not only the importance of the concept but also the aims of bioethics itself. Here, I challenge the claim that the concept of dignity is useless by challenging the implicit conception of usefulness involved. I argue that the conception of usefulness that both opponents and proponents of dignity in bioethics adopt is rooted in a narrow understanding of the role of normative theory in practical ethical thinking. I then offer an alternate understanding of the nature and value of dignity. I begin by recognizing that claims that one’s dignity has been violated point to an important difference between “respect for autonomy” and “respect for persons.” I then suggest three different conceptions of how dignity can be normatively guiding for bioethics, and conclude that, ultimately, understanding dignity as the cornerstone of a reflective perspective that frames moral reflection and deliberation is valuable for doing bioethics well.     

Attainment and behavioral disturbance at 9 years: The influence of early and late life stress events

This paper presents data from a small-scale longitudinal study that examines the importance of life-stress events in early and late childhood for later attainment and behavioral disturbance. The study sample consists of 59 children, all of whom when first contacted lived in families with low incomes, of low social status, and little education. Therefore, all of the children can be considered disadvantaged, and the influence of life stress events can be assessed uncontaminated by differences in socio-economic status. At age 9 years, 21 of these children were assessed as disturbed, whereas 38 were not. The results presented suggest that life stress events in early childhood: (1) are of little importance in explaining variations in the behavior of either group of children; and (2) help to explain variations in the attainment of the disturbed, but not the other children. However, life-stress events in late childhood are (1) of considerable importance in explaining variations in the behavior of both the disturbed and other children; but (2) of little importance in explaining variations in the attainments of either group of children. The findings are discussed with reference to child, parent, and other factors that may act to protect vulnerable children against life event stress.     

Police perspectives on responding to mentally ill people in crisis: perceptions of program effectiveness

In this study, we sampled sworn police officers from three law enforcement agencies (n=452), each of which had different system responses to mentally ill people in crisis. One department relies on field assistance from a mobile mental health crisis team, a second has a team of officers specially trained in crisis intervention and management of mentally ill people in crisis, and a third has a team of in-house social workers to assist in responding to calls. Calls involving mentally ill people in crisis appear to be frequent and are perceived by most of the officers to pose a significant problem for the department; however, most officers reported feeling well prepared to handle these calls. Generally, officers from the jurisdiction with a specialized team of officers rated their program as being highly effective in meeting the needs of mentally ill people in crisis, keeping mentally ill people out of jail, minimizing the amount of time officers spend on these calls, and maintaining community safety. Officers from departments relying on a mobile crisis unit (MCU) and on police-based social workers both rated their programs as being moderately effective on each of these dimensions except for minimizing officer time on these calls where the MCU had significantly lower ratings. © 1998 John Wiley & Sons, Ltd.     

Parallel process in supervision

This paper addresses the concept of parallel process and its application in clinical supervision. Parallels between therapy and supervision are examined as well as some of the key issues surrounding the use of parallel process as a supervisory intervention. Although there is a need for more investigation to explain and support this concept further, the authors would argue that parallel process interventions in supervision can enhance the supervisory process and the task of teaching and learning for both the supervisee and supervisor. A case example is provided to demonstrate the parallel process in supervision and its potential as a facilitative intervention.     

Direct comparison of auditory implicit memory tests

In this experiment, we examined the degree to which four implicit tests and two explicit tests, all involving auditory presentation, were sensitive to the perceptual characteristics of the stimuli presented during study. Presenting stimuli visually decreased priming in all the implicit memory tests, relative to auditory presentation. However, changing voice between study and test decreased priming only in the implicit memory tests requiring identification of words degraded by noise or by low-pass filtering, but not in those tests requiring generation from word portions (stems and fragments). Modality effects without voice effects were observed in cued recall, but the opposite pattern of results (voice effects without modality effects) was obtained in recognition. The primary new finding is the demonstration that auditory memory tests, both explicit and implicit, differ in their sensitivity to the perceptual information encoded during study.     

Free will perceptions,religious coping,and other mental health outcomes in caregivers of individuals with dementia

Caring for a person with dementia often results in depression, anxiety, and reduced quality of life (QoL). Pinpointing beliefs and practices that reduce this distress is imperative. The current study tested the hypotheses that greater free will perceptions and religious coping would be associated with greater QoL and other mental health indicators in a sample of 107 dementia caregivers. The results of regression and content analyses supported the expectation that free will and religious coping would be associated with greater QoL. Relationships also emerged among free will perceptions, religious coping, anxiety, and depression. Clinical implications are discussed.     

Error detection in text: do feedback and familiarity help?

In the present study, the authors examined the extent to which familiarity and feedback (auditory and/or articulatory) might be beneficial to proofreading. Participants proofread unfamiliar and familiar (repeated) passages while (a) concurrently reading either aloud or silently, (b) concurrently listening to the passages being read to them, or (c) reading without either auditory or articulatory feedback. Errors were one-letter changes that transformed function words into contextually inappropriate words. Familiarity improved reading times largely irrespective of feedback, and it enhanced error detection only when auditory feedback was available to participants. Proofreaders' enhanced error detection in familiar text reflected a change in their sensitivity to errors rather than any change in the placement of the response criterion for reporting errors. These findings suggest that familiarity can produce two kinds of functional fluency, one involving speed of processing, which is largely independent of feedback, and the other concerned with accuracy of processing, which relies on feedback.