Willingness to Use ADHD Self-Management: Mixed Methods Study of Perceptions by Adolescents and Parents

Little is known about perceptions surrounding self-management for attention deficit hyperactivity disorder (ADHD), although such interventions appear commonly used and are considered essential components of the chronic care model. Our research is part of a mixed methods study that followed students at high and low risk for ADHD over 11 years. During the final study years, area-representative samples of 148 adolescents (54.8 % participation; 97 ADHD high-risk group; 51 low-risk peers) and 161 parents (59.4 % participation; 108 parents of high-risk adolescent; 53 parents of low-risk peer) completed a cross-sectional survey on community-identified self-management interventions for ADHD (activity outlets, sleep regulation, dietary restriction, homework help, family rules, and prayer). Respondents also answered open-ended questions addressing undesirable self-management effects, which were analyzed using grounded theory methods. High-risk adolescents expressed significantly lower willingness towards all self-management interventions than did adult respondents, except for increased activity outlets. They also reported lower receptivity towards sleep regulation and dietary restriction than did their low-risk peer group. No gender or race differences in self-management willingness were found, except for higher receptivity to prayer in African American respondents. Cost, perceived ineffectiveness, disruptions to routines, causation of interpersonal conflicts, and reduced future self-reliance were seen as potential undesirable effects. Findings suggest that activity-based ADHD interventions appear particularly acceptable across all demographic and risk groups, unlike sleep regulation and dietary approaches. Further research on self-care effectiveness is needed to incorporate adolescents’ viewpoints about ADHD self-management, as interventions may be acceptable to adults, but resisted by adolescents.     

Reducing Social Stress in Urban Adolescents with Peer Network Counseling

Increased social stress in the context of peer interactions is associated with multiple negative health outcomes, including substance use. Addressing social stress could provide protective effects for adolescents who are particularly vulnerable to peer-based issues such as loneliness and perceived isolation. Toward this end, we examined the efficacy of a 20-min substance use intervention named peer network counseling to reduce social stress with 119 urban adolescents. Adolescents presenting at primary care clinics were randomized into treatment or control conditions and followed for 6 months. Utilizing a repeated measures general linear model, we examined the effects of peer network counseling while controlling for race, gender, age, depression symptoms, and substance use (alcohol, marijuana). At 6 months the peer network counseling condition decreased social stress compared to controls (p?<?0.05). A linear mixed-effects moderation model revealed that peer network counseling temporarily moderated the effect of alcohol use, but not for marijuana or heavy alcohol use. Peer network counseling seems to reduce social stress, which suppresses alcohol use among peer network counseling participants in the short term. These promising findings appear to support the efficacy of peer network counseling in reducing social stress, which can moderate alcohol use among urban adolescents.     

Engagement in Group Psychotherapy Among Marginalized Individuals With Hepatitis C

This article examines an innovative psychoeducational group model at a community-based hepatitis C treatment program in Toronto, Canada. Group support is increasingly used as part of community-based, interdisciplinary approaches to addressing the complex psychosocial needs and barriers to care of individuals living with and/or undergoing treatment for hepatitis C. This article articulates the theoretical framework and details of one such group model. It also examines group engagement and outcomes using data collected over three group cycles. Psychotherapeutic engagement was higher than might be anticipated for a highly marginalized population. Specifically, group cohesion measures were equivalent or higher compared to norms for other support/psychotherapy groups. This study suggests that individuals with complex psychosocial issues have the ability to engage meaningfully in group therapy.     

Multidisciplinary Early Intervention for Preschoolers with Externalizing Behavior Problems and Language Impairment: Results from an Open Trial

Journal of Psychopathology and Behavioral Assessment - The purpose of the study was to a) examine school readiness (SR) outcomes in preschoolers with externalizing behavior problems (EBPs) and...     

To harvest,procure, or receive? Organ transplantation metaphors and the technological imaginary

Theoretical Medicine and Bioethics - One must technologize bodies to conceive of organ transplantation. Organs must be envisioned as replaceable parts, serving mechanical functions for the workings...     

Age and sex differences in object control skills by children ages 5 to 14

Object control skills provide children the tools to be physically active-a major societal priority. At the fundamental movement level, object control skills form the foundation of further sports skill development. The purpose of this study was to examine children's (ages 5 to 14 years, Grades K-8) development of four key object control skills: catching, throwing, kicking, and striking. 186 children were tested on selected items from the Object Control Subtest of the Test of Gross Motor Development-2, using a cross-sectional and correlational design. As anticipated, significant differences were found for age on all four skills. These improvements were characterized by early, rapid gains at ages 9 to 10, beyond which development occurred at a slower rate for catching, throwing, and kicking; striking development continued at a steady rate to age 14 years. Contrary to previous findings, no overall sex differences were found for catching or kicking. Overall sex differences favoring boys were observed for throwing and striking. Implications for evolutionary contributions to throwing and striking were discussed.     

Simulations of dolphin kick swimming using smoothed particle hydrodynamics

In competitive human swimming the submerged dolphin kick stroke (underwater undulatory swimming) is utilized after dives and turns. The optimal dolphin kick has a balance between minimizing drag and maximizing thrust while also minimizing the physical exertion required of the swimmer. In this study laser scans of athletes are used to provide realistic swimmer geometries in a single anatomical pose. These are rigged and animated to closely match side-on video footage. Smoothed Particle Hydrodynamics (SPH) fluid simulations are performed to evaluate variants of this swimming stroke technique. This computational approach provides full temporal and spatial information about the flow moving around the deforming swimmer model. The effects of changes in ankle flexibility and stroke frequency are investigated through a parametric study. The results suggest that the net streamwise force on the swimmer is relatively insensitive to ankle flexibility but is strongly dependent on kick frequency.     

Legal briefing: The unbefriended: making healthcare decisions for patients without surrogates (Part 2)

This issue's "Legal Briefing" column continues coverage of recent legal developments involving medical decision making for unbefriended patients. These patients have neither decision-making capacity nor a reasonably available surrogate to make healthcare decisions on their behalf. This topic has been the subject of recent articles in JCE. It has been the subject of major policy reports. Indeed, caring for the unbefriended has even been described as the "single greatest category of problems" encountered in bioethics consultation. Moreover, the scope of the problem continues to expand, especially with rapid growth in the elderly population and with an increased prevalence of dementia. Unfortunately, most U.S.jurisdictions have failed to adopt effective healthcare decision-making systems or procedures for the unbefriended. "Existing mechanisms to address the issue of decision making for the unbefriended are scant and not uniform." Most providers are "muddling through on an ad hoc basis." Still, over the past several months, a number of state legislatures have finally addressed the issue. These developments and a survey of the current landscape are grouped into the following 14 categories. The first two categories define the problem of medical decision making for the unbefriended.The remaining 12 describe different solutions to the problem. The first six categories were covered in Part 1 of this article; the last eight categories are covered in this issue (Part 2). 1. Who are the unbefriended? 2. Risks and problems of the unbefriended. 3. Prevention: advance care planning, diligent searching, and careful capacity assessment. 4. Decision-making mechanisms and standards. 5. Emergency exception to informed consent. 6. Expanded default surrogate lists: close friends. 7. Private guardians. 8. Volunteer guardians. 9. Public guardians. 10. Temporary and emergency guardians. 11. Attending physicians. 12. Other clinicians, individuals, and entities. 13. Institutional committees. 14. External committees.     

How daydreaming relates to life satisfaction, loneliness, and social support: the importance of gender and daydream content

Daydreaming appears to have a complex relationship with life satisfaction and happiness. Here we demonstrate that the facets of daydreaming that predict life satisfaction differ between men and women (Study 1; N=421), that the content of daydreams tends to be social others (Study 2; N=17,556), and that who we daydream about influences the relation between daydreaming and happiness variables like life satisfaction, loneliness, and perceived social support (Study 3; N=361). Specifically, daydreaming about people not close to us predicts more loneliness and less perceived social support, whereas daydreaming about close others predicts greater life satisfaction. Importantly, these patterns hold even when actual social network depth and breadth are statistically controlled, although these associations tend to be small in magnitude. Individual differences and the content of daydreams are thus important to consider when examining how happiness relates to spontaneous thoughts.     

Family Intervention to Prevent Depression and Substance Use Among Adolescents of Depressed Parents

Parental depression places offspring at elevated risk for multiple, co-occurring problems. The purpose of this study was to develop and preliminarily evaluate Project Hope, a family intervention for the prevention of both depression and substance use among adolescent-aged children (M?=?13.9?years) of depressed parents. The program was created by blending two empirically supported interventions: one for depression and another for substance use. Thirty families were randomly assigned to either Project Hope (n?=?16) or a wait-list control condition (n?=?14). Pretests, posttests (n?=?29), and 5-month follow-ups (n?=?28) were conducted separately with parents and youth via phone interviews. Questions asked about the family depression experience, family interactions, family management, coping, adolescent substance use beliefs and refusal skills, adolescent depression, and adolescent substance use. Project Hope was fully developed, manualized, and implemented with a small sample of targeted families. Engagement in the program was relatively high. Preliminary outcome analyses were conducted using 2 (Group) ×3 (Time) analyses of covariance. Results provided some evidence for significant improvements among intervention compared to control participants in indicators of the family depression experience, family management, and coping, and a statistically significant decrease from pretest to posttest in alcohol quantity for intervention compared to control youth. Next steps for this program of research are discussed.