Auditory information is beneficial for adults with Down syndrome in a continuous bimanual task

Much recent research using discrete unimanual tasks has indicated that individuals with Down syndrome (DS) have more difficulty performing verbal-motor tasks as compared to visual-motor tasks (see Perceptual-Motor Behavior in Down Syndrome, Human Kinetics, Champaign, IL, 2000, p. 305 for a review). In continuous tasks, however, individuals with DS perform better when movement is guided by auditory information compared to visual information (Downs Syndr.: Res. Prac. 4 (1996) 25; J. Sport Exercise Psy. 22 (2000) S90). The aim of the present study was to investigate if there are any differences for adults with DS between visual, auditory and verbal guidance in a continuous bimanual task. Ten adults with DS, 10 adults without DS and 10 typically developing children drew lines bimanually towards the body (down) and away from the body (up) following three different guidance conditions: visual (flashing line), auditory (high tone, low tone), and verbal (“up”, “down”). All participants produced mostly in-phase movements and were close to the 1000 ms target time for all guidance conditions. The adults with DS, however, displayed greater variability in their movement time, movement amplitude and bimanual coordination than adults without DS. For all groups, the left hand was slower and more variable in producing the lateral movements than the right hand. The results regarding guidance information suggest that auditory information is beneficial for repetitive bimanual tasks for adults with DS. Possible mechanisms that cause these results will be discussed.     

Early abuse, psychiatric diagnoses and irritable bowel syndrome

In a population of 71 (57 female, 14 male) IBS patients seeking psychological treatment, we found expected levels of childhood sexual and physical abuse (57.7%) and expected levels of current Axis I psychiatric disorders (54.9%). Moreover, we found those who had been victims of early abuse had higher current Beck Depression Inventory scores. However, contrary to expectations, there were no significant associations between early abuse and current psychiatric disorder in this population, suggesting that those individuals with psychological distress are not exactly the same group with a history of abuse.     

Differentiating overreporting and extreme distress: MMPI-2 use with compensation-seeking veterans with PTSD

This purpose of this study was to examine overreporting on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in compensation-seeking veterans with posttraumatic stress disorder (PTSD). A sample of veterans tested during a V.A. hospital compensation and pension exam were given the MMPI-2 and measures of PTSD, depression, and combat exposure. Veteran's MMPI-2s were only included in the analyses if their profile was extremely exaggerated, as measured by an F scale T score above 80, did not elevate the MMPI-2 VRIN and TRIN scales, and had a primary diagnosis of PTSD (n = 127). Using the Infrequency-Psychopathology, F(p), scale to distinguish overreporting from distress, it was found that 98 veterans elevated profiles due to distress, whereas 29 elevated due to overreporting, F(p) below and above 7, respectively. Differences between groups on MMPI-2 clinical scales and the other measures were assessed. Implications of these findings for assessing veteran response style and using the MMPI-2 with a PTSD population are discussed.     

Not all narrative shifts function equally

Readers of narratives keep track of narrative events and the information associated with these events. Does some of this associated information help structure the processing of and memory for the narrative? In three experiments, we examined the role of basic event building blocks (character, time, and location) in event indexing during text comprehension. These three experiments dealt with perceived coherence, perceived cohesion, and on-line processing, respectively. The results indicated that characters are more likely to serve as event indexes. Although the findings with respect to indexing were similar in all three experiments, interesting differences emerged as a function of the level of text comprehension examined (coherence, cohesion, or on-line processing).     

High levels of contextual interference enhance handwriting skill acquisition

The authors conducted 3 experiments to examine whether introducing high levels of contextual interference is useful in handwriting skill acquisition. For all experiments, elementary school students (Ns = 44, 50, and 78, respectively) were randomly assigned to 1 of 2 practice schedules-blocked or random practice-in the acquisition phase. In the blocked condition, each of 3 letters (h, a, and y) or (in Experiment 1) symbols was handwritten 24 times consecutively. In the random condition, each letter (or symbol) was practiced 24 times, but in an intermixed, unsystematic sequence. Overall, the results showed that the random practice schedule leads to enhanced retention and transfer performance of handwriting skill acquisition.     

Therapist Self-Efficacy in Delivering Cognitive Processing Therapy in a Randomized Controlled Implementation Trial

Efforts to improve the implementation of evidence-based treatments (EBT) have recently made important strides. One such example is understanding the vital role that weekly consultation plays as therapists learn to deliver an EBT. Because mechanism-based research can further support EBT implementation, the present study sought to examine the potential relationship between therapist self-efficacy in relation to treatment fidelity and outcomes.We examined therapist self-efficacy ratings from 80 therapists working with 188 patients. These data were collected as part of a randomized controlled implementation trial testing cognitive processing therapy (CPT). Across post-workshop training conditions, we ran multilevel models to assess (1) changes in therapist self-efficacy, (2) therapist self-efficacy in relation to treatment fidelity, and (3) therapist-self-efficacy in relation to patient PTSD symptom outcomes.We found that therapist self-efficacy significantly improved over the course of 6 months of CPT training. Baseline therapist self-efficacy was differentially associated with client outcomes based on post-workshop training condition. Specifically, therapists with low self-efficacy that did not receive post-workshop consultation tended to have poorer outcomes than therapists with low self-efficacy that received consultation. In the present sample, therapist self-efficacy was not related to treatment fidelity.As this was the first study to examine therapist self-efficacy in the implementation of an evidence-based treatment, our findings suggest that self-efficacy may be an important implementation factor in treatment outcomes and worthy of ongoing research.     

A Novel Approach to the Assessment of Fidelity to a Cognitive Behavioral Therapy for PTSD Using Clinical Worksheets: A Proof of Concept With Cognitive Processing Therapy

Fidelity monitoring is a critical indicator of psychotherapy quality and is central to successful implementation. A major barrier to fidelity in routine care is the lack of feasible, scalable, and valid measurement strategies. A reliable, low-burden fidelity assessment would promote sustained implementation of cognitive behavioral therapies (CBTs). The current study examined fidelity measurement for cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) using clinical worksheets. External raters evaluated patient worksheets done as a part of treatment, both guided by the therapist and completed independently as homework. Results demonstrated that fidelity ratings from CPT session worksheets were feasible and efficient. Notably, they were strongly correlated with observer ratings of the fidelity of CPT strategies that were present on the worksheets. Agreement among ratings conducted by individuals with a range of experience with CPT was acceptable to high. There was not a main effect of therapist-guided, in-session worksheet ratings on PTSD symptom change. However, patient competence in completing worksheets independently was associated with greater PTSD symptom decline and in-session, therapist-guided worksheet completion was associated with larger symptom decreases among patients with high levels of competence. With further research and refinement, rating of worksheets may be an efficient way to examine therapist and patient skill in key CPT elements, and their interactions, compared to the gold standard of observer ratings of therapy video-recordings. Additional research is needed to determine if worksheets are an accurate and scalable alternative to gold standard observer ratings in settings in which time and resources are limited.     

Does teaching an omnibus mand preclude the development of specifying mands?

When problem behavior is controlled by a synthesized reinforcement contingency, a simple omnibus mand that yields access to all reinforcers simultaneously has been shown to effectively replace problem behavior. The question arises as to whether teaching an omnibus mand will preclude the acquisition of specifying mands for each of the combined reinforcers. In this study, after 3 students diagnosed with autism acquired an omnibus mand (“My way, please”) that yielded all identified reinforcers simultaneously, specifying mands (e.g., “All done,” “May I have my toys?” “Play with me”) were taught to yield each individual reinforcer (e.g., escape, tangibles, attention). Problem behavior was immediately eliminated for all children, and the omnibus mand was acquired quickly. Teaching an omnibus mand did not preclude acquisition of specifying mands for any learner and instead allowed for the acquisition of specifying mands once problem behavior had been effectively reduced.     

Feasibility of Biological Sample Collection among a High-Risk Maternal Population for Child Maltreatment-Qualitative Pilot Findings

Little is known on the feasibility of biological sample collection among at-risk parents for child maltreatment participating in evidence-based parenting intervention studies evaluating behavioral outcomes. This study explored acceptability and feasibility of collecting biospecimen samples among 12 high-risk mothers. Data were taken from semi-structured baseline interviews among participants who provided salivary, hair and buccal swab samples for a pilot study examining biobehavioral stress responses to an evidence-based parenting program. Content analysis results suggest that while uncomfortable, biospecimen collection will not impede research participation. Providers should highlight connections between biology and behaviors to motivate parents and increase engagement in parenting programs.