Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Parenting stress in parents of children with attention-deficit hyperactivity disorder and parents of children with learning disabilities

Parenting a child with ADHD can challenge parenting resources and coping. Increasingly, researchers are examining the relationship between the behavior of the child with ADHD and family functioning. While studies have shown inceased parenting stress in parents of children with ADHD, these studies have compared children with ADHD to non-disabled children. This study compares reports of parenting stress among mothers of children with ADHD, mothers of children with learning disabilities and mothers of non-referred children. Results showed that parenting stress was highest for mothers of children with ADHD. Increased parenting stress was associated with child characteristics and, in particular, with externalizing behavior problems.     

Visual slow brain potentials in children with attention deficit disorder

Using a two-stimulus reaction time paradigm, with two separate reward conditions (contingent and noncontingent), we compared slow wave brain potentials (ERPs) in 144 children with attention deficit disorder (ADD) and 30 normal control children. This article reviews the findings during the 900 msec visual warning stimulus. As we had expected, based on ERP work of Forth and Hare (1989) and Raine, Venables and Williams (1990), and on previous work from our own laboratory, the group differences were found in the negative slow wave portions of the ERP complex during the contingent reward condition but not during the noncontingent condition. Aggressive hyperactive subjects with attention deficit disorder (ADDHA) were discriminated from nonaggressive subjects (including control subjects) during the contingent reward condition in the following ways: (1) greater fronto-central negativity (640–900 msec slow wave) and (2) greater right parietal than left parietal negativity (430–750 msec slow wave). All ADD subgroups, when compared to control (CONTR) subjects, showed greater slow wave negativity (700–900 msec) at the midline occipital electrode site during the contingent reward condition. This could be explained in part as an IQ effect on ERPs reflecting the IQ difference between the ADD subgroups and the controls. These slow wave findings seem to relate to attentional problems of these children. They are discussed in terms of a psychobiological model of inhibition/disinhibition and appetitive activation.     

An investigation of the sampling distributions of item discrimination indices

The sampling properties of four item discrimination indices (biserialr, Cook's indexB, theU–L 27 per cent index, and DeltaP) were investigated in order to ascertain their sampling properties when small samples drawn from actual test data rather than constructed data were employed. The empirical results indicated that the mean index values approximated the population values and that values of the standard deviations computed from large sample formulas were good approximations to the standard deviations of the observed distributions based on samples of size 120 or less. Goodness of fit tests comparing the observed distributions with the corresponding distribution of the product-moment correlation coefficient based upon a bivariate normal population indicated that this correlational model was inappropriate for the data. The lack of adequate mathematical models for the sampling distributions of item discrimination indices suggests that one should avoid indices whose only real reason for existence was the simplification of computational procedures.This research reported herein was performed pursuant to a contract (OE-2-10-071) with the United States Office of Education, Department of Health, Education and Welfare.     

Compassion: An east‐west comparison

Compassion is an emotion that occupies a central position in Mahāyāna Buddhist philosophy while it is often a neglected subject in contemporary western philosophy. This essay is a comparison between an Eastern view of compassion based upon Mahāyāna Buddhist perspectives and a western view of the same emotion. Certain principles found in Mahāyāna Buddhist philosophy such as the Bodhisattva Ideal, and suffering (dukkha) to name two, are explored for the information they contain about compassion. An essay by Lawrence Blum is taken as representative of a Western view (but not exclusively) and it is analyzed for its shortcomings in light of the Buddhist view. The conclusion briefly describes the value of understanding an eastern view on compassion as a means of filling the void one finds in western medical ethics discourse which focuses so heavily, and redundantly, upon issues such as patient autonomy and paternalism.     

Event-related brain potentials elicited by rhyming and non-rhyming pictures differentiate subgroups of reading disabled adolescents

Event-related brain potentials were recorded while disabled adolescent subjects read and judged whether two sequentially presented pictures had names that rhymed. Subjects with relatively good phonetic skills displayed an N400 priming effect, i.e., a significant reduction in the amplitude of the negative peak, occurring approximately 400 msec post-stimulus, for pictures with names that rhymed with preceding pictures as compared with pictures that had names that did not rhyme with the prime. No such effect was evident for subjects with relatively poor phonetic skills. This lack of an N400 priming effect provides evidence for a reduction in neural capacity and/or activation during phonological processing in the subjects with poor phonological skills. Demonstrating the N400 priming effect to be stronger in one group of reading disabled subjects, compared to another, supports the position that specific subtypes of reading disability exist. In addition to the stronger N400 priming effect, the phonetically stronger group also exhibited an enhanced negativity, from 700 to 1,000 msec after target stimulus onset, compared to phonetically inferior subjects. This finding replicates earlier work and possibly reflects a higher level of confidence in the group with better phonetic skills.     

Practice-based competencies for accreditation of and training in graduate programs in genetic counseling

In January 1996, the American Board of Genetic Counseling (ABGC) adopted 27 practice-based competencies as a standard for assessing the training of graduate students in genetic counseling. These competencies were identified and refined through a collective, narrative process that took place from January through November 1994, and included directors of graduate programs in genetic counseling, ABGC board members and expert consultants. These competencies now form the basis of the document Requirements for Graduate Programs in Genetic Counseling Seeking Accreditation by the American Board of Genetic Counseling (American Board of Genetic Counseling, 1996). The competencies are organized into four domains and are presented and discussed in this article.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January, 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).     

A case-based approach to the development of practice-based competencies for accreditation of and training in graduate programs in genetic counseling

The American Board of Genetic Counseling (ABGC) sponsored a consensus development conference with participation from directors of graduate programs in genetic counseling, board members, and expert consultants. Using a collective, narrative, and case-based approach, 27 competencies were identified as embedded in the practice of genetic counseling. These competencies were organized into four domains of skills: Communication; Critical Thinking; Interpersonal, Counseling, and Psychosocial Assessment; and Professional Ethics and Values. The adoption of a competency framework for accreditation has a variety of implications for curriculum design and implementation. We report here the process by which a set of practice-based genetic counseling competencies have been derived; and in an accompanying article, the competencies themselves are provided. We also discuss the application of the competencies to graduate program accreditation as well as some of the implications competency-based standards may have for education and the genetic counseling profession. These guidelines may also serve as a basis for the continuing education of practicing genetic counselors and a performance evaluation tool in the workplace.The Consortium includes Directors of established graduate programs in genetic counseling and members of the ABGC Board of Directors who participated in the Consensus Development Conference held in January 1994: Diane Baker (University of Michigan/ABGC); Bonnie Baty (ABGC); Joan Burns (University of Wisconsin); Debra Collins (ABGC); Virginia Corson (ABGC); Beth Fine (Northwestern University/ABGC); Elizabeth Gettig (University of Pittsburgh); Verle Headings (Howard University); Jacqueline Hecht (University of Texas); Carl Huether (University of Cincinnati); Bonnie LeRoy (University of Minnesota); Joan Marks (Sarah Lawrence College); Anne Matthews (University of Colorado); Roberta Palmour (McGill University); Lorna Phelps (Medical College of Virginia); Kimberly Quaid (Indiana University); Joan Scott (ABGC); Ann Smith (ABGC); Helen Travers (ABGC); Judith Tsipis (Brandeis University); Ann Walker (University of California-Irvine/ABGC); Jon Weil (University of California-Berkeley); S. Robert Young (University of South Carolina); Randi Zinberg (Mount Sinai School of Medicine, New York).