Rasch analysis of the Hospital Anxiety and Depression Scale in spinal cord injury

Purpose: The purpose of this study was to evaluate the psychometric properties of the Hospital Anxiety and Depression Scale (HADS), applied among persons with spinal cord injury (SCI), using Rasch analysis. Methods: A cross-sectional multicenter study was conducted and the data of 102 people with SCI were analyzed. Rasch analyses were performed to assess dimensionality, overall and individual item fit, response scale structure, targeting, and differential item functioning. Results: The anxiety and depression subscales showed unidimensionality, that is, model and item fit. The two subscales are reliable (r = .72, 0.82) in SCI. No disordered structure of the response scales or differential item functioning in age, gender, education, relationship status, level of spinal lesion were found. Stepwise deletion of the misfitting items did not produce a total score that fulfilled the statistical criteria for unidimensionality. Conclusions: The results of the Rasch analyses support the use of the anxiety and depression subscales among people with SCI. However, further research is needed to confirm these findings and examine sensitivity to change of the HADS in SCI, which would support its use in longitudinal observational and intervention studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Using the Interactive Systems Framework to Support a Quality Improvement Approach to Dissemination of Evidence-Based Strategies to Promote Early Detection of Breast Cancer: Planning a Comprehensive Dynamic Trial

Dissemination efforts must optimize interventions for new settings and populations. As such, dissemination research should incorporate principles of quality improvement. Comprehensive Dynamic Trial (CDT) designs examine how information gained during dissemination may be used to modify interventions and improve performance. Although CDT may offer distinct advantages over static designs, organizing the many necessary roles and activities is a significant challenge. In this article, we discuss use of the Interactive Systems Framework for Dissemination and Implementation to systematically implement a CDT. Specifically, we describe “Bronx ACCESS”, a program designed to disseminate evidence‐based strategies to promote adherence to mammography guidelines. In Bronx ACCESS, the Intervention Delivery System will elicit information needed to adapt strategies to specific settings and circumstances. The Intervention Synthesis and Translation System will use this information to test changes to strategies through “embedded experiments”. The Intervention Support System will build local capacities found to be necessary for intervention institutionalization. Simulation modeling will be used to integrate findings across systems. Results will inform on‐going policy debate about interventions needed to promote population‐level screening. More generally, this project is intended to advance understanding of research paradigms necessary to study dissemination. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Sentence processing in Lewy body spectrum disorder: the role of working memory

Prior work has related sentence processing to executive deficits in non-demented patients with Parkinson's disease (PD). We extended this investigation to patients with dementia with Lewy bodies (DLB) and PD dementia (PDD) by examining grammatical and working memory components of sentence processing in the full range of patients with Lewy body spectrum disorder (LBSD). Thirty-three patients with LBSD were given a two-alternative, forced-choice sentence-picture matching task. Sentence type, working memory, and grammatical structure were systematically manipulated in the sentences. We found that patients with PDD and DLB were significantly impaired relative to non-demented PD patients and healthy controls. The deficit in PDD/DLB was most pronounced for sentences lengthened by the strategic placement of an additional prepositional phrase and for sentences with an additional proposition due to a center-embedded clause. However, there was no effect for subject-relative versus object-relative grammatical structure. An MRI voxel-based morphometry analysis in a subset of patients showed significant gray matter thinning in the frontal lobe bilaterally, and this extended to temporal, parietal and occipital regions. A regression analysis related sentence processing difficulty in LBSD to frontal neocortex, including inferior prefrontal, premotor, and dorsolateral prefrontal regions, as well as right superior temporal cortex. These findings are consistent with the hypothesis that patients with PDD and DLB have difficulty processing sentences with increased working memory demands and that this deficit is related in part to their frontal disease.     

A gender difference in the false recall of negative words: women DRM more than men

Gender differences in susceptibility to associative memory illusions in the Deese/Roediger-McDermott paradigm were investigated using negative and neutral word lists. Women (n=50) and men (n=50) studied 20 lists of 12 words that were associates of a non-presented critical lure. Ten lists were associates of negatively valenced lures (e.g., cry, evil) and ten were associates of neutral lures (e.g., chair, slow). When asked to recall the words after each list, women falsely recalled more negative lures than men, but there was no gender difference in the false recall of neutral lures. These findings suggest that women reflect on associations within negative lists to a greater degree than men and are thereby more likely to generate the negative critical lures.     

Shared cognitive processes underlying past and future thinking: the impact of imagery and concurrent task demands on event specificity

Recent literature has argued that whereas remembering the past and imagining the future make use of shared cognitive substrates, simulating future events places heavier demands on executive resources. These propositions were explored in 3 experiments comparing the impact of imagery and concurrent task demands on speed and accuracy of past event retrieval and future event simulation. Results provide support for the suggestion that both past and future episodes can be constructed through 2 mechanisms: a noneffortful "direct" pathway and a controlled, effortful "generative" pathway. However, limited evidence emerged for the suggestion that simulating of future, compared with retrieving past, episodes places heavier demands on executive resources; only under certain conditions did it emerge as a more error prone and lengthier process. The findings are discussed in terms of how retrieval and simulation make use of the same cognitive substrates in subtly different ways.     

Mother-child interaction and resilience in children with early developmental risk

Although prenatal and genetic factors make strong contributions to the emergence of intellectual disability (ID), children's early environment may have the potential to alter developmental trajectories and to foster resilience in children with early risk. The present study examined mother-child interaction and the promotion of competence in 50 children with early developmental delays. Three related but distinct aspects of mother-child interaction were considered: maternal technical scaffolding, maternal positive sensitivity, and mother-child dyadic pleasure. Children were classified as exhibiting undifferentiated delays at age 3, based upon performance on developmental assessments and the absence of known genetic syndromes. Mother-child interaction was assessed at age 4 through observational ratings of structured laboratory tasks, and through naturalistic home observations. ID was identified at age 5 using the dual criteria of clinically significant delays in cognitive functioning and adaptive behavior. Maternal technical scaffolding and dyadic pleasure each uniquely predicted reduced likelihood of later ID, beyond the contributions of children's early developmental level and behavioral functioning. Follow-up analyses suggested that mother-child interaction was primarily important to resilience in the area of adaptive behavior, with scaffolding and dyadic pleasure differentially associated with particular subdomains. Implications for theories of intellectual disability and for family-based early intervention and prevention efforts are discussed.     

Effects of the Helping Early Literacy with Practice Strategies (HELPS) Reading Fluency Program with Latino English Language Learners: A Preliminary Evaluation

The Helping Early Literacy with Practice Strategies (HELPS) Program was developed by integrating 8 evidence-based fluency-building instructional strategies into a structured program that can be feasibly implemented by educators. The HELPS Program has been shown in previous research to significantly improve elementary-aged students’ reading abilities, but the effects of HELPS have not been evaluated with an important and increasing sub-population of U.S. students, English language learners (ELLs). As such, the purpose of this control group comparison study was to evaluate HELPS with Latino ELLs. Findings showed that ELLs who received HELPS scored significantly higher than the control group on standardized measures of fluency and comprehension. Although this study represents an initial attempt to understand the effects of HELPS with ELLs, the findings have implications for educators and researchers who work with ELLs.     

Measuring Attitudes Toward Acceptable and Unacceptable Parenting Practices

This study investigated the properties of a new rating instrument, the Parenting Questionnaire (PQ), designed to measure attitudes about acceptable and unacceptable parenting practices. In Study 1, subject matter experts representing culturally diverse psychologists, parents, and college students were consulted to identify 110 items receiving high endorsement. In Study 2, items were administered to 1,398 undergraduate students to examine their factor structure and the effects of ethnicity and gender differences on PQ factors. In Study 3, test–retest reliability (N = 92) and convergent validity (N = 142) of the PQ factors were examined. Exploratory factor analysis revealed three factors (total of 63 items) with high internal consistencies that accounted for a moderate amount of total variance (R ² = .38). The factors were Critical Feedback (26 items), Supportive Feedback (26 items), and Physical Discipline (11 items). Significant ethnicity and gender differences were found on the three PQ factors, as well as a significant interaction between ethnicity and gender on the Supportive Feedback factor. PQ factor scores demonstrated good temporal stability, internal consistency, and convergent validity. Overall findings suggest that the PQ is a reliable, stable, and valid measure of attitudes toward parenting with three distinct factors. Future research directions with parents are discussed.     

Calibrating for Comorbidity: Clinical Decision-Making in Youth Depression and Anxiety

Comorbidity in clinical youth populations is more the rule than the exception, yet few established guidelines exist to help practicing clinicians manage complex diagnostic profiles. The current paper reviews efforts within the treatment development literature to handle comorbidity in depressed and anxious children and adolescents, including single-target, modular-based, and transdiagnostic interventions. Two case studies are presented to describe how comorbid anxiety and depression are managed within two different evidence-based single-target interventions. A third case is presented to introduce a novel individual behavioral activation therapy (IBAT) designed to address co-occurring depression and anxiety by targeting a single maintaining mechanism (avoidance) that underlies both disorders. Implications for clinical decision-making (assessing complex clinical profiles in practice, prioritizing treatment goals, selecting interventions from a broad evidence base) are discussed.