The Psychosocial Impact of Undergoing Prophylactic Total Gastrectomy (PTG) to Manage the Risk of Hereditary Diffuse Gastric Cancer (HDGC)

Individuals identified as at high risk of developing Hereditary Diffuse Gastric Cancer (HDGC) are advised to undergo prophylactic surgery - have their stomach removed - in their early twenties. Research with (older) cancer patients who undergo gastrectomy for curative reasons suggests that gastric resection has a number of physical and psychosocial sequelae. Because it is difficult to extrapolate the findings of studies of older cancer patients to younger healthy patients who are considering prophylactic total gastrectomy (PTG), the aim of this qualitative interview study was to determine the psychosocial implications of undergoing prophylactic surgery to manage genetic risk. Fourteen men and 13 women from the UK’s Familial Gastric Cancer study who had undergone PTG were invited to participate in qualitative interviews. Most reported that undergoing surgery and convalescence was easier than anticipated. There was evidence that age affected experiences of PTG, with younger patients tending to report faster recovery times and more transient aftereffects. All saw the benefits of risk reduction as outweighing the costs of surgery. Surgery was described as having a range of physical impacts (disrupted appetite, weight loss, fatigue, GI symptoms) that had related psychological, social and economic implications. Those considering PTG need to be aware that its impact on quality of life is difficult to predict and negative sequelae may be ongoing for some individuals.     

Relating print and speech: the effects of letter names and word position on reading and spelling performance

From an early age, children can go beyond rote memorization to form links between print and speech that are based on letter names in the initial positions of words (Treiman & Rodriguez, 1999; Treiman, Sotak, & Bowman, 2001). For example, children's knowledge of the name of the letter t helps them learn that the novel word TM is pronounced as team. Four experiments were carried out to determine whether letter names at the ends of words are equally useful. Four- and five-year-olds derived little benefit from such information in reading (Experiments 1 and 3) or spelling (Experiment 2), although adults did (Experiment 4). For young children, word-final information appears to have less influence on reading and spelling performance than does word-initial information. The results help delineate the circumstances under which children can go beyond a logographic approach in learning about print.     

Variability and detection of invariant structure

Two experiments investigated learning of nonadjacent dependencies by adults and 18–month–olds. Each learner was exposed to three–element strings (e.g., pel–kicey–jic) produced by one of two artificial languages. Both languages contained the same adjacent dependencies, so learners could distinguish the languages only by acquiring dependencies between the first and third elements (the nonadjacent dependencies). The size of the pool from which the middle elements were drawn was systematically varied to investigate whether increasing variability (in the form of decreasing predictability between adjacent elements) would lead to better detection of nonadjacent dependencies. Infants and adults acquired nonadjacent dependencies only when adjacent dependencies were least predictable. The results point to conditions that might lead learners to focus on nonadjacent versus adjacent dependencies and are important for suggesting how learning might be dynamically guided by statistical structure.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

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.     

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.     

The cognitive foundations of reading and arithmetic skills in 7- to 10-year-olds

A range of possible predictors of arithmetic and reading were assessed in a large sample (N=162) of children between ages 7 years 5 months and 10 years 4 months. A confirmatory factor analysis of the predictors revealed a good fit to a model consisting of four latent variables (verbal ability, nonverbal ability, search speed, and phonological memory) and two manifest variables (digit comparison and phoneme deletion). A path analysis showed that digit comparison and verbal ability were unique predictors of variations in arithmetic skills, whereas phoneme deletion and verbal ability were unique predictors of variations in reading skills. These results confirm earlier findings that phoneme deletion ability appears to be a critical foundation for learning to read (decode). In addition, variations in the speed of accessing numerical quantity information appear to be a critical foundation for the development of arithmetic skills.     

The social context of imitation in infancy

Infants increasingly generalize deferred imitation across environmental contexts between 6 and 18 months of age. In three experiments with 126 6-, 9-, 12-, 15-, and 18-month-olds, we examined the role of the social context in deferred imitation. One experimenter demonstrated target actions on a hand puppet, and a second experimenter tested imitation 24h later. When the second experimenter was novel, infants did not exhibit deferred imitation at any age; when infants were preexposed to the second experimenter, all of them did. Imitating immediately after the demonstration also facilitated deferred imitation in a novel social context at all ages but 6 months. Infants' pervasive failure to exhibit deferred imitation in a novel social context may reflect evolutionary selection pressures that favored conservative behavior in social animals.     

Perceptions of Dating Violence Following a Sexualor Nonsexual Betrayal of Trust: Effects of Gender, Sexism, Acceptance of Rape Myths, and Vengeance Motivation

College womens (N = 220) and mens (N = 208) perceptions of violence following a betrayal by a romantic partner were studied in an independent groups design that varied gender of the participant, type of betrayal (sexual or nonsexual), and gender of the betrayed individual. Participants read one of four brief vignettes in which the betrayed person slapped his/her partner and made his/her lip bleed. Justification of this action was rated on 10 items. Factor analysis of these items indicated the presence of three factors for men and four for women. Both men and women indicated that hitting the partner, getting even, and being angry were more justifiable following a sexual betrayal. The hitting of a male partner by a betrayed woman was perceived as more justified than the hitting of a female partner by a betrayed man. In absolute terms, hitting and getting even by both women and men were generally viewed as unjustifiable, whereas being angry was viewed as justifiable. For both women and men, scores on the Vengeance Scale (Stuckless & Goranson, 1992) and Rape Myth Acceptance Scale (Lonsway & Fitzgerald, 1995) were related to getting even. For men, the Hostile Sexism Scale (Glick & Fiske, 2001) was related to getting even or being angry and breaking up. Results indicated that perceptions of reactions to betrayal are related to type of betrayal and to the dispositional characteristics of the perceiver.