Primary and Secondary Caregiver Reports of Quality of Life in Pediatric Asthma: Are they Comparable?

This study aimed to compare primary and secondary caregiver QOL within families of children with asthma and determine the potential importance of including secondary caregiver QOL in clinical and research settings. Participants included 118 families of children with asthma that had primary and secondary caregivers. Families completed measures in a single research session. Caregivers reported on QOL, psychological functioning, and family burden; children completed a measure of QOL. Child lung function was determined from objective spirometry. Adherence to prescribed controller medication was measured for 6 weeks following the research visit. Primary caregiver QOL was significantly lower than secondary caregiver QOL (Mean overall QOL of 5.85 versus 6.17, p < .05). Better medication adherence was associated with higher primary caregiver QOL (ρ = .22, p = .02); secondary caregiver QOL, not primary caregiver QOL, was positively associated with child QOL (ρ = .20, p = .03). Families with discrepant QOL scores between caregivers (difference in scores of at least .50) were characterized by more family burden and primary caregiver psychological symptoms. Differences in QOL scores between caregivers may be a reflection of primary caregivers’ greater investment in daily asthma management. In families reporting low burden and few psychological difficulties in the primary caregiver, QOL assessments from either caregiver may may be informative and representative of how parents are adapting to child asthma. In families experiencing high levels of burden or more primary caregiver psychological difficulties, QOL reports from secondary caregivers may not be as clinically meaningful.     

Skills of Cognitive Therapy (SoCT): a new measure of patients' comprehension and use

The authors describe the development and psychometric properties of a new measure called the Skills of Cognitive Therapy (SoCT) in depressed adults and their cognitive therapists. The 8-item SoCT assesses patients' understanding and use of basic cognitive therapy (CT) skills rated from the perspectives of both observers (SoCT-O; therapists in this report) and patients (SoCT-P). Ratings of patients' skill usage are made on 5-point Likert-type scales ranging from 1 (never) to 5 (always or when needed). Higher scores reflect greater patient skill in applying cognitive therapy principles and coping strategies. To develop this scale, a 33-item pool was used, rated by both patients and their therapists at the middle and end of CT (Ns = 359-416), and evaluated the reliability and concurrent and predictive validity of both versions of the scale. The SoCT has excellent internal consistency reliability and moderate correlations between the observer and patient versions. It is important to note that the SoCT showed good predictive validity for response when collected at the midpoint of acute phase CT. Considering both patients' self-ratings and clinicians' SoCT ratings, the odds ratio for responding to CT was 2.6. The practical utility of the SoCT is discussed, as well as its theoretical importance in research of patient CT skills (e.g., acquisition, comprehension, and generalization) as putative moderators or mechanisms of symptom change in the therapy.     

Prediction and judgment as indicators of sensitivity to covariation of continuous variables

The present study used both judgments of strength of relationship and measures of the ability to predict one variable from another to assess subjects’ sensitivity to the covariation of two continuous variables. In addition, one group of subjects judged strength of relationship after merely observing the presentation of 60 pairs of two-digit numbers, and a second group made strength judgments after being actively engaged in predicting one member of a pair when given the other. The prediction and judgment data provide different pictures of subjects’ sensitivity to covariation. The subjects were quite poor at estimating strength of relationship but, by some measures, good at predicting one variable from another. Judgments were not strongly influenced by whether subjects had previously engaged in overt prediction. The implications of these results for the literature on covariation estimation are discussed.     

Expectancies About the Effects of Alcohol on the Self and on Others as Determinants of Alcohol Policy Attitudes1

The present study brings together 2 separate lines of research in the alcohol field: alcohol expectancies and policy attitudes. Expectancies concerning the short- and long-term effects of drinking (e.g., aggression), were predicted to be stronger determinants of support for alcohol availability control when the target person was another, compared to when discussing effects of one's own drinking. In a population-based survey conducted in 1992, 804 current drinkers were asked about self and other alcohol expectancies, as well as attitudes toward various alcohol policies. Results showed a distinct self-other discrepancy, with people more likely to expect alcohol to have a greater effect over others than over themselves. Further, it was found that these other-expectancies were among the strongest predictors of favoring tighter alcohol controls. These findings lend support to findings of a self-other bias in social psychology, and provide insight as to the structure of public opinion on alcohol policy.     

Thinking about Morality and Moral Thinking: Is There a Distinction?

ABSTRACT A recent exchange with Shaffer (this issue) reveals several points of agreement underscoring the utility of our subject-based approach to understanding moral thought. Shaffer's latest reply raises the interesting question of whether thinking about morality, the focus of our study, constitutes moral thinking. Our response underscores how Shaffer's approach to studying moral thought differs from our own. More important, we emphasize how disagreements over what constitutes moral thinking can and should be settled empirically.