Defining Treatment Outcomes in Pediatric Obsessive-Compulsive Disorder Using a Self-Report Scale

This study examined benchmarks of treatment response and clinical remission on the Obsessive Compulsive Inventory–Child Version (OCI-CV) for youth with obsessive-compulsive disorder (OCD). Participants were 91 youth who enrolled in a randomized controlled trial that examined the benefit of augmenting cognitive behavior therapy (CBT) with either d-cycloserine or placebo. Youth completed the OCI-CV at baseline, Week 4 (prior to initiating exposure therapy), and posttreatment. Receiver operator curve (ROC) analyses examined optimal benchmarks for treatment response and clinical remission as identified by independent evaluators at the posttreatment assessment using the Clinical Global Impression (CGI) scales of Improvement (CGI-Improvement), Severity (CGI-Severity), and Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Optimal benchmarks for treatment response were a 20%–25% reduction in the OCI-CV total score. Meanwhile, optimal benchmarks for remission were a 55%–65% reduction in the OCI-CV total score and a posttreatment total score ≤ 6-8. OCI-CV benchmarks exhibited moderate agreement with the CY-BOCS for treatment response and clinical remission. Meanwhile, fair agreement was observed for response and remission with CGI scales. A lower pretreatment OCI-CV total score was associated with less agreement between classification approaches. Findings provide benchmarks for classifying treatment response and clinical remission in an efficient manner. Given the moderate agreement between the CY-BOCS and OCI-CV benchmarks, the OCI-CV may serve as a useful alternative when clinician-rated scales cannot be administered due to limited resources (e.g., time, training). Thus, evidence-based measurement can be incorporated to monitor therapeutic response and remission in clinical practice.     

Analogous activities: Tools for thinking comparatively in religious studies courses

This article discusses an experiential teaching method that uses secular activities that are simple, accessible, and analogous to religious practice in order to facilitate comparative religious study. These “analogous activities” – for example, social rituals, stillness, yoga, a social media fast, singing, nonviolent communication, and mindfulness meditation – provide a third point of reference that allows students to pivot between their understanding of religion and those of practitioners and scholars of religion. Experiential learning can be quite successful if deliberately sequenced to allow students to encounter a series of interpretive frameworks and structured with prompts and parameters that encourage reflection and critical analysis of their experience. In my course engaging in analogous activities not only impacted students' understanding of Asian religions, but also led them to question two previous assumptions: first, that religious beliefs were more important than religious practices, which is particularly problematic in regards to Asian religious traditions that place more emphasis on orthopraxy than orthodoxy, and second, that religion was something separate from one's everyday or lived reality.     

Can the criminal law ever be therapeutic?

This paper addresses the question of whether criminal law, especially in its sentencing and penological aspects, can be adjusted in its workings to incorporate the perspective of therapeutic jurisprudence. A conceptual framework developed by Wexler, Winick, and their colleagues is employed to provide a basis for reflection on the operation and impact of sentencing processes. Of considerable importance in this exercise is a mounting volume of evidence concerning the outcomes of work with adjudicated offenders, which illustrates the potential of psycho-educational, behavioral-cognitive skills-training, and therapeutic programs for reduction of recidivism. Such intervention programs are currently offered within the limits set by, but are not intrinsic components of, judicial decisions. The psycho-legal implications of these findings are discussed and some possibilities surveyed for tentative exploration of actively therapeutic departures within crimino-legal decision-making.     

Developmental Trends in False Memory Across Adolescence and Young Adulthood: A Comparison of DRM and Memory Conformity Paradigms

Little is known about the reliability of eyewitness memory among adolescents as most memory research has focused primarily on adults and young children. A number of studies recently have emerged outlining conditions where memory suggestibility increases from early childhood to adulthood. These developmental reversals are found in semantic association tasks such as the Deese–Roediger–McDermott (DRM) paradigm and have not yet been thoroughly investigated among adolescents. In the current study, we examined DRM performance among 11–21 year olds (N = 245). Extending the work comparing children and adults, false memory on the DRM task increased with age. False memory on the DRM task was not associated with false memory on a memory conformity task. The different memory processes involved with the tasks and the implications for legal psychology are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

Development and Validation of the State Moral Elevation Scale: Assessing State-Level Elevation Across Nonclinical and Clinical Samples

Journal of Happiness Studies - Research on moral elevation has steadily increased and identified several psychosocial benefits that bear relevance to both the general population and people with...     

Utrecht Gender Dysphoria Scale - Gender Spectrum (UGDS-GS): Construct validity among transgender,nonbinary, and LGBQ samples

Abstract

Background: Researchers combined both versions of the original Utrecht Gender Dysphoria Scale (UGDS) to create a single gender spectrum version (UGDS-GS) which measures dissatisfaction with gender identity and expression over time as well as comfort with affirmed gender identity.

Aim: This study examined the construct validity of the newly revised, UGDS-GS.

Method: Tests of measurement invariance were conducted in stages to assess measurement invariance of the UGDS-GS across three groups: cisgender, binary transgender, and nonbinary/genderqueer.

Results: Findings indicate that the UGDS-GS functions acceptably in all three gender groups (configural and metric invariance). Also, across binary transgender and nonbinary/genderqueer groups, the measure functions very similarly with all four types of invariance. Item level findings highlight the specificity of the measure to distinguish experiences of binary transgender and nonbinary/genderqueer persons differently from cisgender LGBQ individuals.

Conclusions: The UGDS-GS demonstrates a large degree of invariance across binary transgender, nonbinary/genderqueer, and cisgender LGBQ subgroups; and therefore, findings indicate this revision to be a substantial improvement. This 18-item self-report, Likert-type scale measure is a) inclusive of all gender identities and expressions (e.g., transfeminine spectrum, transmasculine spectrum, genderqueer, nonbinary, cisgender); b) appropriate for use longitudinally from adolescence to adulthood; and c) administered at any point in the social or medical transition process, if applicable, or in community-based research focused on gender dysphoria that examines cisgender and transgender persons.     

The Genderqueer Identity (GQI) Scale: Measurement and validation of four distinct subscales with trans and LGBQ clinical and community samples in two countries

ABSTRACT

Background: Non-binary gender measurement has grown out of a need for accurate representation in scholarship and public health services available to a diverse gender population.

Aims: The Genderqueer Identity Scale (GQI) was developed to allow for a multidimensional assessment of genderqueer identity, including non-binary identity, socially constructed versus essentialist gender, theoretical awareness of gender concepts, and gender fluidity. The GQI was designed to assess gender identity across a full spectrum of gender, at any age after mid-adolescence, and at various stages of gender identity development, including prior to, during, and after a gender transition, where applicable. Two of the GQI subscales focus on intrapersonal processes, while two focus on interpersonal processes.

Methods: The measure was piloted and refined across four distinct samples: a U.S. university based LGBT sample, consecutive clinical referrals at the Center of Expertise on Gender Dysphoria in Amsterdam, the Netherlands, a Dutch LGB community sample, and an online survey forum (LGBTQ).

Results: The first exploratory factor analysis identified minor potential adjustments, which were refined and retested. Researchers evaluated and cross-validated the hypothesized factor structure and determined that the three factor GQI subscales and the unidimensional Gender Fluidity measure yielded internally consistent and valid scores among transgender individuals seeking clinical treatment and LGB individuals within a community setting. The exploratory and confirmatory factor analyses provide evidence of good reliability, construct validity, and internal consistency of all four subscales.

Discussion: The subscales were appropriate across a spectrum of gender identities and can be taken in the same form over time and across gender transition statuses, making them suitable for clinical evaluation and community based longitudinal research with trans-identified or gender nonconforming persons. The development of the GQI fills critical gaps in gender-related measurement including the ability to assess multiple dimensions of gender identity, and to assess gender identity across time.     

Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force

Abstract

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient’s ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.