Is the Association of ADHD with Socio-Economic Disadvantage Explained by Child Comorbid Externalizing Problems or Parent ADHD?

It has been unclear whether an associations of child ADHD with socio-economic disadvantage (SES) could be accounted for by (a) parental ADHD explaining both low SES and child ADHD, and/or (b) the joint overlap of ODD or CD with low SES and ADHD. Study 1 used a community-recruited case-control sample with detailed evaluation of SES indicators, child ADHD, child externalizing, and parent ADHD symptoms (n = 931 children, 521 ADHD, 577 boys, 354 girls) in a path modeling analysis with latent variables. Study 2 evaluated ADHD and externalizing behavior in a regression model using a poverty index for SES, in 70,927 children (48.2% female) aged 5–17 years from the US 2011–2012 National Survey of Children’s Health (NSCH). In Study 1, lower SES was related to the ADHD latent variable, β = ?.18, p < .001; 95%CI [?.25,-.12]. This effect held when parent ADHD and child ODD and CD were in the model, β = ?.11, p < .01, 95% CI [?.09,-.03], equivalent to OR = 1.50, 95% CI[1.12–2.04]). In Study 2, these results replicated. Adjusting only for age and sex, children from families who were below 200% of the federal poverty line were more likely to have moderate or severe ADHD than no ADHD, versus children above that line, OR = 2.13, 95% CI[1.79,2.54], p < .001. The effect held after adjusting for disruptive/externalizing problems, OR = 1.61, p < .01, 95%CI [1.32,1.96]. The effect size for comparable models was similar across both studies, lending higher confidence to the results. It is concluded that the SES association with child ADHD is not explained by artifact and requires a mechanistic explanation.     

Markov Decision Process Measurement Model

Within-task actions can provide additional information on student competencies but are challenging to model. This paper explores the potential of using a cognitive model for decision making, the Markov decision process, to provide a mapping between within-task actions and latent traits of interest. Psychometric properties of the model are explored, and simulation studies report on parameter recovery within the context of a simple strategy game. The model is then applied to empirical data from an educational game. Estimates from the model are found to correlate more strongly with posttest results than a partial-credit IRT model based on outcome data alone.     

Leadership Perspectives on Integrating Psychologists into Specialty Care Clinics: An Evolving Paradigm

Integration of health psychologists into specialty care is a shift in the tertiary care construct that addresses all aspects of a patient’s presentation, including psychiatric/social history, psychological well-being, and behavioral contributions to the disease process, assuring both optimal health outcomes and cost-effectiveness in a financially challenging healthcare environment. In this paper, we discuss leadership perspectives (physician and psychologists) on the factors involved in integrating a health psychologist into a busy tertiary care environment. Ultimately, we hope that this information provides a primer on how to frame a proposal for an integrated health psychologist emphasizing the elements important to senior medical leadership and administration. First, we briefly discuss the current payer framework, providing support for integration emphasizing costs and other metrics. Second, we introduce organizational structure models and strategies for integration. Lastly, we will discuss the unique skillset psychologists possess, and additional skills necessary, to be effective in the changing landscape of healthcare. We think this information is important both for leaders attempting to integrate a health psychologist into specialty care and for the early career health psychologist embarking on his/her first senior staff position.     

Using computer‐assisted instruction to increase the eye gaze of children with autism

Many children diagnosed with autism spectrum disorders have difficulty making appropriate eye contact and engaging in joint attention. The current study evaluated a computer‐assisted instruction package (pairing visual stimuli with vocal stimuli) as a novel treatment to improve the eye gaze accuracy in 3 elementary school children with autism. The researchers measured the latency from a recorded verbal stimulus to the students making eye contact with pictures of familiar individuals displayed on a computer screen, and the duration for which eye gaze on the stimulus was maintained. An automated infrared camera system for measuring eye gaze was utilized that eliminated the need for an instructor to make subjective judgments regarding participants' eye gaze. For all three participants, duration of eye contact increased, and latency to responding decreased following exposure to the computer‐assisted instruction. The implications of these findings for the treatment of individuals with autism are discussed, along with suggestions for future research on the topic.     

Foster Parents’ Knowledge of Child Trauma: An Exploratory Study

To promote trauma-informed professional supports and services to maltreated youth, it is imperative that researchers explore foster parents’ knowledge of child trauma. However, there is a dearth in the literature related to this topic. This exploratory study utilizes a convenience sample (N = 219) of foster parents in one southeastern state. Variables of interest include actual and perceived knowledge about child trauma. After a terse review of background literature, this paper will explicate key results, discuss these findings, and identify salient practice and policy implications derived from this study. The paper will conclude by delineating apposite areas for future research.     

Stopping the Nonadherence Cycle: The Clinical and Theoretical Basis for Dialectical Behavior Therapy Adapted for Adolescents With Chronic Medical Illness (DBT-CMI)

Most adolescents with chronic illness do not adhere to their regimen. A novel transdiagnostic adaptation of dialectical behavior therapy (dialectical behavior therapy for chronic medical conditions; DBT-CMI) is presented to improve medical adherence in adolescents. The authors describe the approach of DBT-CMI and the model’s conceptualization of nonadherence, with specific focus on the core concepts of non-adherence across illness in adolescence.DBT-CMI has been piloted in two disease groups with preliminary benefit. DBT-CMI lends itself theoretically as a transdiagnostic approach due to specific skills that target core concepts of nonadherence in adolescence. Future research is warranted on the applicability of DBT-CMI across other pediatric medical conditions to replicate findings and examine long-term outcomes.     

Compunction,Second-Personal Morality,and Moral Reasons

In The Second-Person Standpoint and subsequent essays, Stephen Darwall develops an account of morality that is “second-personal” in virtue of holding that what we are morally obligated to do is what others can legitimately demand that we do, i.e., what they can hold us accountable for doing through moral reactive attitudes like blame. Similarly, what it would be wrong for us to do is what others can legitimately demand that we abstain from doing. As part of this account, Darwall argues for the proposition that we have a distinctive “second-personal reason” to fulfill all of our obligations and to avoid all wrong-actions, an “authority-regarding” reason that derives from the legitimate demands the “moral community” makes of us. I show that Darwall offers an insufficient case for this proposition. My criticism of this aspect of Darwall’s account turns in part on the fact that we have compunction-based or “compunctive” reasons to fulfill all of our obligations and to avoid all wrong actions, a type of reason that Darwall seemingly overlooks.     

Pretending to be authentic: challenges for students when reflective writing about their childhood for assessment

Critical reflection potentially allows social work and human service (SWHS) students to understand how past experiences can shape their future practice. This study of 20 Australian undergraduate SWHS students with a history of childhood adversity found reflective writing for this purpose was not a useful pedagogical practice. Rather than developing skills in critical reflection students found the task performative, linked to academic requirements, where they needed to display emotional containment. Consequently, SWHS academics need to examine reflective writing about childhood adversity for assessment as this process may not enable students to build skills in critical reflection that drive professional development.     

A Comparison of Wages by Gender and Region of Origin for Newly Arrived Refugees in the USA

The resettlement model supported by the US government aims to help recently arrived refugees achieve economic self-reliance within the first 90 to 180 days of arrival. In addition to the challenges they face in adapting to their new locations, however, refugees enter a US labor market characterized by preexisting wage disparities based on race and gender. Meanwhile, recent changes in US refugee and immigration policies have infused debates over nationalism, Islamophobia, and the economics of resettlement. In this context, it is critical to assess whether refugees face wage discrimination that may affect their ability to become economically self-reliant. Drawing on the International Rescue Committee’s administrative data on refugee resettlement, we examine the extent to which starting wages for newly arrived refugees differ by region of origin and gender. The study found consistent gender pay gaps among the majority of new arrivals. The study also identified lower wages for refugees arriving from sub-Saharan Africa, Latin America, and the Caribbean compared to other regions. These trends suggest a need for more consistent agency monitoring of employment placement, and the development of strategies to ensure more equitable employment outcomes for refugees.