Evaluating the Impact of Genetic Counseling and Testing with Signal Detection Methods

One measure of the impact of genetic counseling and testing (GCT) is the extent to which it fosters behavioral change that is consistent with mutation status. We describe and illustrate how two different signal detection methods, receiver operating characteristic (ROC) analysis and recursive partitioning, can be used in this context to evaluate the impact of GCT. We analyzed real screening behavior data obtained in the 12 months following GCT for Hereditary Nonpolyposis Colon Cancer (HNPCC) using these two different signal detection approaches. Each approach demonstrated that GCT had an impact on behavioral outcomes, and was effective in fostering behavioral outcomes appropriate to mutation status. The ROC approach demonstrated that GCT was effective because mutation positive and mutation negative individuals could be distinguished on the basis of the number of recommended screening behaviors. The recursive partitioning approach demonstrated that GCT was effective because there were generally high rates of adherence to screening guidelines among subjects. The recursive partitioning technique also identified four subgroups of subjects, each with distinct characteristics, for which tailored interventions could be developed to increase rates of adherence to screening guidelines. Signal detection methods are easily implemented and are useful techniques for evaluating the impact of GCT.     

A rapid assessment of skills in young children with autism

Educational interventions based on the principles of behavior analysis are highly effective for establishing skills in young children with autism. As a first step in program development, the child's current skill level is determined by evaluating performance on tasks drawn from a preestablished curriculum. However, few specific guidelines have been delineated for conducting these skills assessments or interpreting the results. In this study, we evaluated an efficient methodology for conducting skills assessments. Six children who had been diagnosed with autism participated. The relative efficacy of two assessment packages--one containing several reinforcement procedures and one containing several potentially effective prompts--was evaluated across two to three skills for each child using multiple baseline and reversal designs. Results suggested that the methodology was useful for matching targeted skills to appropriate interventions.     

Effect of relation availability on the interpretation and access of familiar noun-noun compounds

Two experiments investigate whether relations that link the constituents of compounds during compound formation (e.g., teapot is formed by combining tea and pot using the relation head noun FOR modifier) also influence the processing of familiar compounds. Although there is evidence for the use of such relations in forming compounds, whether such relations affect the processing of familiar compounds is unknown. The data show clear effects of repetition and relational priming for written words on both a sense-nonsense task and a lexical decision task. These results indicate that the relation linking the constituents of familiar compounds is important to their access and use.     

Collateral effects of response blocking during the treatment of stereotypic behavior

The collateral effects of response blocking were evaluated while treating stereotypic behavior in a woman diagnosed with autism. Blocking stereotypic behavior (head and tooth capping) was associated with decreases in leisure-item interaction and increases in another stereotypic response (hand wringing). Results suggested that the reduction in item interaction was due to adventitious punishment. Prompts to access an alternative source of reinforcement attenuated the side effects somewhat, but results suggested that the undesirable effects of response blocking may be fairly durable.     

Parental Influence on Children with Attention-Deficit/Hyperactivity Disorder: I. Relationships Between Parent Behaviors and Child Peer Status

We examined associations between children’s peer relationships and (a) their parents’ social competence as well as (b) their parents’ behaviors during the children’s peer interactions. Participants were families of 124 children ages 6–10 (68% male), 62 with ADHD and 62 age- and sex-matched comparison youth. Children’s peer relationships were assessed via parent and teacher report, and sociometric nominations in a lab-based playgroup. Parental characteristics were assessed via parent self-report and observations of behavior during their child’s playgroup. After statistical control of relevant covariates, parents of children with ADHD reported poorer social skills of their own, arranged fewer playdates for their children, and displayed more criticism during their child’s peer interaction than did parents of comparison youth. Parents’ socialization with other parents and facilitation of the child’s peer interactions predicted their children having good peer relationships as reported by teachers and peers, whereas parental corrective feedback to the child and praise predicted poor peer relationships. Parents’ ratings of their child’s social skills were positively associated with ratings of their own social skills, but negatively associated with criticism and facilitation of the child’s peer interactions. Relationships between parental behaviors and peer relationships were stronger for youth with ADHD than for comparison youth. The relevance of findings to interventions is discussed.     

Neurocognitive Function and Suicide in U.S. Army Soldiers

This prospective cohort study used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers to examine associations between neurocognitive functioning and subsequent suicidal events among Regular Army enlisted soldiers during the years 2004–2009. Cases were all soldiers who completed the Army's Automated Neuropsychological Assessment Metrics (ANAM) computerized testing battery prior to documented suicide attempt (n = 607), ideation (n = 955), or death (n = 57). Controls were an equal‐probability sample of 9,893 person‐months from other soldiers. Exploratory factor analysis of five ANAM tests identified a general neurocognitive factor that excluded the mathematic processing test (MTH). When examined separately in logistic regression analyses that controlled for sociodemographics and prior mental health diagnosis, both the general neurocognitive factor (logit [β] = ?.197 to ?.521; p < .01) and MTH (β = ?.024 to ?.064; p < .05) were associated with all outcomes. When both predictors were examined simultaneously, the general neurocognitive factor continued to be associated with all outcomes (β = ?.164 to ?.417; p < .05) and MTH continued to be associated with suicide attempt (β = ?.015; p = .046) and ideation (β = ?.014; p = .018). These small but robust associations suggest that future research must continue to examine the extent to which objective neurocognitive tests may enhance understanding and prediction of suicide risk.     

Multidimensional Perfectionism and Anxiety: Differences Among Individuals With Perfectionism and Tests of a Coping‐Mediation Model

This study examined the relationship between adaptive and maladaptive perfectionism, anxiety, and coping processes in a sample of 329 undergraduate students. Specifically, participants with adaptive perfectionism had the lowest levels of anxiety, followed by participants with nonperfectionism, and participants with maladaptive perfectionism had the highest levels. Various coping processes mediating the relationship between maladaptive perfectionism and anxiety are discussed.     

Children’s Acceptance of Others with Disability: The Influence of a Disability-Simulation Program

Elementary school is a transitional and impressionable period for any child. In inclusive classroom settings, children with disabilities may experience the challenges of acceptance and integration into peer relationships. The experience of children with disabilities in such classrooms can be positive if their classmates are accepting and open. One way to encourage these attitudes is by increasing awareness through disability-simulation. This study evaluates an existing school program, whose goal is to increase acceptance of others with disability. We surveyed students to assess the influence of the program. An adapted acceptance scale was distributed to students before and after participation in the program. Our hypothesis was that student acceptance would increase after participating in the program. Additionally, we hypothesized that physical, visual, and auditory disabilities would be easier for students to understand, making acceptance scores for these disabilities higher than those for a learning disability. We report changes in acceptance using group means. Our results reveal that post-survey responses showed higher acceptance than pre-survey responses, especially for auditory disabilities. Other significant findings include differences in attitudes between the two schools and differences based on prior experience with someone with a disability. By evaluating the effectiveness of this type of program (whose efficacy has been controversial in the literature), this study can provide teachers, administrators, genetic counselors, and parents with a better idea of how to address children’s attitudes towards peers. In our study, the effectiveness of promoting understanding through disability-simulation has proven its worth to improve children’s acceptance.     

Mothers' and Fathers' Internal State Language with Their Young Children: An Examination of Gender Differences During an Emotions Task

The current study examined gender differences in mothers' and fathers' internal state language (ISL), children's use of ISL, and whether ISL was related to parents' ratings of the children's social skills. Fifty‐seven (28 boys, 29 girls) toddler/preschool children (M age = 32.5 months, SD = 5.38 months) were observed separately with their mothers and fathers in their homes while they discussed pictures of children's facial expressions of emotions. Parents completed a questionnaire concerning their child's social–emotional behaviours (i.e. BASC‐2). Parents used more ISL with sons compared with daughters, and sons used more ISL with mothers than with fathers. No overall differences were found between mothers' and fathers' ISL. Children's social skills as rated by mothers were predicted by mothers' ISL comments, whereas children's social skills as rated by fathers were predicted by children's age and fathers' ISL clarifications. Implications and limitations of the study are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

Mindfulness and its relationship to emotional regulation

Research on the effectiveness and mechanisms of mindfulness training applied in psychotherapy is still in its infancy (Erisman & Roemer, 2010). For instance, little is known about the extent and processes through which mindfulness practice improves emotion regulation. This experience sampling study assessed the relationship between mindfulness, emotion differentiation, emotion lability, and emotional difficulties. Young adult participants reported their current emotional experiences 6 times per day during 1 week on a PalmPilot device. Based on these reports of emotions, indices of emotional differentiation and emotion lability were composed for negative and positive emotions. Mindfulness was associated with greater emotion differentiation and less emotional difficulties (i.e., emotion lability and self-reported emotion dysregulation). Mediational models indicated that the relationship between mindfulness and emotion lability was mediated by emotion differentiation. Furthermore, emotion regulation mediated the relationship between mindfulness and both negative emotion lability and positive emotion differentiation. This experience sampling study indicates that self-reported levels of mindfulness are related to higher levels of differentiation of one's discrete emotional experiences in a manner reflective of effective emotion regulation.