Externalizing psychopathology in adulthood: a dimensional-spectrum conceptualization and its implications for DSM-V

Mental disorders involving antisocial behavior and substance use are genetically linked and vary continuously. The authors present a review and integrative conceptualization of these observations in terms of a dimensional and hierarchically organized externalizing spectrum. As a foundation for this conceptualization, the authors introduce a quantitative, model-based approach to comparing categorical and continuous conceptions of psychopathology and apply this approach in an empirical study of patterns of comorbidity among externalizing disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders. The authors present evidence that comorbidity among externalizing disorders is best modeled by an underlying normally distributed continuum of risk for multiple disorders within the externalizing spectrum. The authors conclude by discussing implications of the externalizing spectrum conceptualization for classification of disorders in the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders.     

Limitations in verbal fluency following heavy burdens of early childhood diarrhea in Brazilian shantytown children.

The effects of heavy burdens of diarrhea in the first 2 years of life on specific executive control function like verbal fluency are not well understood. In previous studies, we have shown associations of early childhood diarrhea (ECD) with nonverbal intelligence and school functioning. Therefore, we postulated that ECD might affect early neuropsychological development leading to long-term deficits in normal cognitive development. Based on our extensive 14-year prospective cohort studies of early childhood diarrheal illnesses in a Brazilian shantytown community, we examined ECD correlations between specific impairments of higher mental function and executive skills in shantytown children 5-10 years later (now at 6-12) years of age. Specifically we examined whether heavy diarrheal illnesses correlate with reduced performance on selected tests of executive function. Our study, for the first time, suggests a disproportional impairment in semantic but not phonetic fluency in a subset of children with heavy burdens of diarrhea in their first 2 years of life even when controlling for maternal education, breastfeeding, and child schooling. Similar semantic decrements have been associated with impaired recovery from brain injury. These exploratory studies suggest the importance of verbal fluency tests to assess executive functioning in children challenged by poor nutrition and diarrhea in early life. In addition, our unique findings show the potential influences of early childhood diarrhea on language development that is so critical to productive adulthood and potentially set a foundation for new neuropsychological approaches, which assess early burdens of enteric illnesses on childhood development.     

Effects on Volunteering of the September 11, 2001, Attacks: An Archival Analysis1

Data from a national online organization that matches volunteers with service organizations places volunteers were analyzed to answer questions regarding the impact of the September 11, 2001, attacks on volunteering in the United States. Results showed that: (a) following September 11, there was a dramatic increase in the number of people who offered to volunteering, and the increase lasted for about 3 weeks; (b) the greatest increase in volunteering occurred for crisis‐related organizations, but volunteering increased significantly for all kinds of charities and service organizations; and (c) the demographic correlates of volunteering changed little in the wake of the attacks. The results are discussed in the context of psychological theories of the factors that motivate prosocial actions.     

Maternal and Paternal Depressive Symptoms and Child Maladjustment: The Mediating Role of Parental Behavior

This study examined parental behaviors as mediators in links between depressive symptoms in mothers and fathers and child adjustment problems. Participants were 4,184 parents and 6,048 10- to 15-year-olds enrolled in the 1998 and 2000 cycles of the Canadian National Longitudinal Survey of Children and Youth. Mothers and fathers self-reported symptoms of depression at Times 1 and 2 and their children assessed parental nurturance, rejection, and monitoring and self-reported internalizing and externalizing problems and prosocial behavior at Time 2. Hierarchical linear modeling showed evidence of mediation involving all three domains of parental behavior. Findings supported the hypothesis that the quality of the child's rearing environment is one mechanism that carries risk to children of depressed parents. Interventions for parents whose symptoms of depression interfere with parenting responsibilities could help reduce the risk of some childhood disorders.     

The role of child adrenocortical functioning in pathways between interparental conflict and child maladjustment

This study examined the interplay between interparental conflict and child cortisol reactivity to interparental conflict in predicting child maladjustment in a sample of 178 families and their kindergarten children. Consistent with the allostatic load hypothesis (McEwen & Stellar, 1993), results indicated that interparental conflict was indirectly related to child maladjustment through its association with individual differences in child cortisol reactivity. Analyses indicated that the multimethod assessment of interparental conflict was associated with lower levels of child cortisol reactivity to a simulated phone conflict between parents. Diminished cortisol reactivity, in turn, predicted increases in parental reports of child externalizing symptoms over a 2-year period. Associations between interparental conflict, child cortisol reactivity, and child externalizing symptoms remained robust even after demographic factors and other family processes were taken into account.     

Test-induced priming of false memories

Of interest was whether prior testing of related words primes false memories in the Deese/Roediger-McDermott (DRM) paradigm. After studying lists of related words, subjects made old-new judgments about zero, three, or six related items before being tested on critical nonpresented lures. When the recognition test was self-paced, prior testing of list items led to faster false recognition judgments, but did not increase the rate of false alarms to lures from studied lists. Critically, this pattern changed when decision making at test was speeded. When forced to respond quickly—presumably precluding the use of monitoring processes—clear test-induced priming effects were observed in the rate of false memories. The results are consistent with an activation-monitoring explanation of false memories and support that retrieving veridical memories can be a source of memory error.     

Model stability of the 15-item Geriatric Depression Scale across cognitive impairment and severe depression

The 15-item Geriatric Depression Scale (GDS) is used in a wide variety of clinical and research settings. The study's purpose was to further establish the validity of the 15-item GDS by exploring the underlying factor structure in a healthy, nondemented sample of older adults and then analyzing whether this factor structure remained stable across a sample of demented individuals and a sample of individuals with a history of depression 6 months after discharge from an inpatient psychiatric setting. A 2-factor model fit the data best in the exploratory analyses. The 2 factors, Life Satisfaction and General Depressive Affect, found in the nondemented sample (r = .39) remained stable across cognitive impairment (r = .12) but merged into a 1-factor model in the psychiatric sample (r = .93). The results indicate that nondepressed older adults with poor life satisfaction may be identified as depressed on screening instruments such as the 15-item GDS.     

Use them or lose them: Are manipulatives needed to assess numeracy and geometry performance in preschool?

In two studies, we investigated whether using three-dimensional (3D) manipulatives during assessment aided performance on a variety of preschool mathematics tasks compared to pictorial representations. On measures of children's understanding of counting and cardinality (n = 103), there was no difference in performance between manipulatives and pictures, with Bayes factors suggesting moderate evidence in favor of the null hypothesis. On a measure of children's shape identification (n = 93), there was no difference in performance between objects and pictures, with Bayes factors suggesting moderate evidence in favor of the null hypothesis. These results suggest flexibility in the materials that can be used during assessment. Pictures, or 2D renderings of 3D objects, which can be easily printed and reproduced, may be sufficient for assessing counting and shape knowledge without the need for more cumbersome concrete manipulatives.     

Testing the dopamine overdose hypothesis in action control: A study in people with Parkinson's disease

Prior work on patients with Parkinson's disease (PD) has shown that the administration of dopaminergic medication in the early to intermediate stages of PD benefits (motor) functions associated with the dopamine-depleted dorsal striatal circuitry but may ‘overdose’ and interfere with (cognitive) functions associated with the relatively intact ventral striatal circuitry. The present study aimed to elucidate this so-called dopamine overdose hypothesis for the action control domain. Using a within-subject design in a sample of 13 people with PD, we evaluated the effect of dopaminergic medication on two cognitive processes underlying goal-directed behaviour, namely action selection and initiation through event binding and conflict adaptation. We also investigated whether individual differences in the magnitude of medication effects were associated across these processes. Results showed no indications that dopaminergic medication affects action selection and initiation or conflict adaptation in PD patients. Additionally, we observed no correlations between both cognitive processes nor between individual differences in medication effects. Our findings do not support the notion that dopaminergic medication modulates action control processes, suggesting that the dopamine overdose hypothesis may only apply to a specific set of cognitive processes and should potentially be refined.     

Use of didactic training and feedback to improve quality and acceptability of progress notes written by direct-care staff on a psychiatric inpatient unit

Writing progress notes represent a critical activity of practicing clinicians in a variety of settings. They provide a way for medical practitioners, insurance companies, and others to communicate in a timely fashion regarding ongoing clinical care. Previous research showed that intervention components like didactic training, using note templates, and feedback improved the quality of progress notes. At least two questions remain despite several studies already addressing progress note writing. First, previous research most often used multiple intervention components to improve progress notes. Thus, the relative impact of two common components of interventions, such as didactic training and feedback, is unclear. Second, previous research has not evaluated the acceptability of improved progress notes for the practitioners that actually utilize them. Thus, the purpose of the current study evaluated the components of didactic training and feedback on improved progress note writing for four direct staff employed by a psychiatric inpatient unit. A second purpose of this study was to evaluate the acceptability of the training procedures by both (a) the direct-care staff participating in this study and (b) four members of the psychiatric treatment team that used direct-care staff progress notes to inform their clinical care. Results showed that feedback was necessary to improve the accuracy of progress notes for three of four participants. The direct-care staff reported the training procedures as acceptable and the treatment team noted improvements in the quality of the progress notes after intervention. These data will be discussed in terms of ways to arrange effective training programs to improve direct-care staff's progress notes.