Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.     

Commentary: A Patient's Perspective on Predictive Testing for Alzheimer Disease

Commentary

Commentary: A Patient's Perspective on Predictive Testing for Alzheimer Disease     

Remembering Alexandra Symonds

The American Journal of Psychoanalysis -     

The Therapeutic Factors Inventory: Development of a Scale

Although Yalom's (1995) framework of the therapeutic factors facilitating outcome in group has been accepted by group specialists, no empirically based instrument assesses all of these factors. The Therapeutic Factors Inventory (TFI), with 11 scales based on the therapeutic factors, has been designed to fill this gap. This article summarizes the development and preliminary reliability testing of the TFI. Each scale of the instrument demonstrated high internal consistency; however, one scale obtained unacceptably low test-retest reliability. Further validity testing is needed. Implications of these findings are discussed.     

A short duration group treatment of smoking behavior by stimulus saturation

Two saturation procedures of different lengths were administered to Ss who desired to quit smoking. Ss chain-smoked for either 20 hr (group E₁) or 10 hr (E₂). Total abstinence was the main dependent measure. Both groups experienced relatively equal success on a short-term basis. Long-term abstinence was noted for group E₁ only. Sixty per cent of the E₁ Ss were not smoking 4 months after treatment.     

Adolescent identity formation: a Swedish study of identity status using the EOM-EIS-II

The aim of this study was to examine ego identity status among Swedish adolescents using the EOM-EIS-II. Identity status scores and distributions were examined for 222 (108 female, 114 male) Swedish high school students. Identity status differences were found between genders. There was a greater likelihood of female adolescents being categorized as moratoriums than were males, and there was a greater likelihood of males being categorized as diffusions than were females. Statistically significant differences were found between genders on the following subscales: moratorium, foreclosure, and diffusion. No statistically significant differences were found between females and males on the identity achievement subscale. To achieve a preliminary construct validation of the results from the EOM-EIS-II, four of the 222 participants were also assessed using Marcia's identity status interview. A fairly good accordance between the interview assessment of identity status and the EOM-EIS-II assessment were found. Interview results showed differences between the interviewers on each subscale (IA, M, F, and D). The same differences were detected on three of four subscales when assessing these individuals' identity statuses using the EOM-EIS-II.     

Diagnosing agoraphobia in the context of panic disorder: examining the effect of DSM-IV criteria on diagnostic decision-making

A diagnostic and statistical manual (DSM)-IV diagnosis of agoraphobia in the context of panic disorder (PD) is based on three nosologically sufficient criteria: (1) avoidance, (2) use of companions, and (3) endurance of situations despite distress. Therefore, an agoraphobia diagnosis can be made across an extremely broad range of cases including when there are no avoidance behaviors (e.g., the patient endures the situation). It was hypothesized that clinicians do not weight these criteria equally and that the DSMs individual, sufficient criteria lead to poor inter-rater reliability. Clinicians (N=48) rated hypothetical patients with symptom profiles emphasizing each of these three criteria. Consistent with expectation, clinicians differentially weighted these criteria. Avoidance was relatively more apt to produce a diagnosis when only one criterion was emphasized in clinical vignettes. Inter-rater reliability was poor in instances when only one sufficient criterion was highlighted. Knowledge concerning DSM criteria resulted in a greater rate of agoraphobia endorsement, but knowledge did not account for the overall pattern of findings.     

Explicit and implicit attitudes towards food and physical activity in childhood obesity

This study investigated differences in the explicit and implicit attitudes towards food and physical activities between children with obesity (n=38) and a matched control group (n=38). The implicit attitude was assessed using the Extrinsic Affective Simon Task (EAST; J. Exp. Psychol. (50) (2003) 77), a modified version of the Implicit Association Test (IAT; J. Personality Social Psychol. (74) (1999) 1464). It was expected that both groups would report a positive explicit attitude towards healthy food and intense physical activities, and a negative explicit attitude towards unhealthy food and sedentary activities. Of particular interest was the hypothesis that children with obesity would have a more positive implicit attitude towards unhealthy food and sedentary activities than the control group. Results revealed no differences between groups in the explicit attitude towards food and physical activity. Children and adolescents with obesity had a more pronounced positive implicit attitude towards food in general. The relevance of these findings in terms of prevention, treatment and further research is discussed.     

Infants' understanding of object-directed action

When and in what ways do infants recognize humans as intentional actors? An important aspect of this larger question concerns when infants recognize specific human actions (e.g. a reach) as object-directed (i.e. as acting toward goal-objects). In two studies using a visual habituation technique, 12-month-old infants were tested to assess their recognition that an adult's reach is directed toward its target object. Infants in the experimental condition were habituated to a display in which an actor reached over a wall-like barrier with an arcing arm movement, to pick up a ball. After habituation infants saw two test displays, for which the barrier was removed. In the direct test event the actor reached directly for the ball, the arm tracing a visually new path, but the action consistent with attempting to reach for the object as directly as possible. In the indirect test event the actor traced the old path, reaching over in an arc, even though the wall was no longer present. This arm movement was identical to that in habituation but no longer displayed a reach going directly to its object. In a control condition infants saw the same movements but in a situation with no goal-object. In the experimental conditions, with a goal object present, infants looked longer at the indirect test event in comparison to the direct test event. In the control conditions infants looked equally at both indirect and direct test events. We conclude that sensitivity to human object-directed action is established by 12-month-olds and compare these results to recent findings by [Gergely, G., Nadasdy, Z., Csibra, G., & Biro S. (1995). Taking the intentional stance at 12 months of age. Cognition, 56, 165-193] and [Woodward, A. (1998). Infants selectively encode the goal object of an actor's reach. Cognition, 69, 1-34].