Contingency Management for Attendance to Group Substance Abuse Treatment Administered by Clinicians in Community Clinics

Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were enrolled in the clinics when the CM treatment phase was in effect attended a significantly greater percentage of therapy sessions than patients who were enrolled in treatment when CM was not in effect. This study is one of the first to investigate CM in community settings implemented entirely by community clinicians, and results suggest that CM is effective in improving therapy attendance.     

希望会成为失望吗?——图宾根1961年开讲词

文章从人类学一存在论视角重新界定了"希望"的具体内涵.希望会成为失望,而且会成为深痛的失望.因为第一,希望不是确信,希望与可失望性直接有关,本身包含有麻烦、迂回、挫折、失败等因素;第二,希望是一种向前开放状态,希望不是与既定的现存事物相联系,而是与为来的尚未存在的事物相联系.稳固的希望包含着事物的类本质,故通过对趋势-潜势的忠实观察而得到校准,并且依照自由王国的目标内容而成为尺度本身.对于一种政治制度来说,事先把握了的希望与原理,即人道的社会主义乃是检验其成绩的最可靠的标尺.     

Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample

To examine Swanson, Nolan, and Pelham-IV (SNAP-IV) psychometric properties, parent (N = 1,613) and teacher (N = 1,205) data were collected from a random elementary school student sample in a longitudinal attention deficit hyperactivity disorder (ADHD) detection study. SNAP-IV reliability was acceptable. Factor structure indicated two ADHD factors and an oppositional defiant disorder (ODD) factor. Parent and teacher scores varied by gender and poverty status (d = .49-.56) but not age; only teacher scores varied by race (d = .25-.55). Screening and diagnostic utility was evaluated with likelihood ratios (LRs) and posttest probabilities. Parent SNAP-IV scores above 1.2 increased probability of concern (LR > 10) and above 1.8, of ADHD diagnosis (LR > 3). Teacher hyperactivity/impulsivity scores above 1.2 and inattention scores above 1.8 increased probabilities of concern only (LR = 4.2 and >5, respectively). Higher teacher scores for African American children and race differences in measurement models require future study.     

The Implementation of Modified Parent-Child Interaction Therapy for Youth with Separation Anxiety Disorder

Separation Anxiety Disorder (SAD) is the most prevalent anxiety disorder experienced by children, and yet empirical treatment studies of SAD in young children are virtually nonexistent. This paper will describe the development and implementation of an innovative treatment for SAD in young children. First, we will highlight the rationale for developing interventions specifically for SAD in young children. Second, we will describe an existing empirically supported treatment, Parent-Child Interaction Therapy (PCIT; Brinkmeyer, M. Y., & Eyberg, S.M., (2003)), that may have particular applicability to very young children with SAD and their parents. We present how results from 10 pilot participants were utilized to modify PCIT to better address the needs of children with SAD and their families. The benefits and challenges of implementing this modified version of PCIT are reviewed, along with potential directions for future research in this area.     

Predicting Treatment and Follow-up Attrition in Parent–Child Interaction Therapy

Predictors of attrition from individual parent–child interaction therapy were examined for 99 families of preschoolers with disruptive behavior disorders. Seventy-one percent of treatment dropouts were identified by lower SES, more maternal negative talk, and less maternal total praise at pretreatment. Following PCIT, families were randomly assigned to an Assessment-Only or Maintenance Treatment condition. Higher maternal distress predicted 63% of dropouts in the Assessment-Only condition. Lower maternal intellectual functioning predicted 83% of dropouts from Maintenance Treatment. Findings highlight a continuing need for evidence-based retention strategies at various phases of engagement in PCIT. This study was funded by the National Institute of Mental Health (RO1 MH60632). We thank the members of the UF Child Study Laboratory for their contributions to this study.     

Knowledge about a common source can promote visual- haptic integration

The brain integrates object information from multiple sensory systems to form a unique representation of our environment. Temporal synchrony and spatial coincidence are important factors for multisensory integration, indicating that the multisensory signals come from a common source. Spatial separations can lead to a decline of visual-haptic integration (Gepshtein et al, 2005 Journal of Vision 5 1013-1023). Here we tested whether prior knowledge that two signals arise from the same object can promote integration even when the signals are spatially discrepant. In one condition, participants had direct view of the object they touched. In a second condition, mirrors were used to create a spatial separation between the seen and the felt object. Participants saw the mirror and their hand in the mirror exploring the object and thus knew that they were seeing and touching the same object. To determine the visual-haptic interaction we created a conflict between the seen and the felt shape using an optically distorting lens that made a rectangle look like a square. Participants judged the shape of the probe by selecting a comparison object matching in shape. We found a mutual biasing effect of shape information from vision and touch, independent of whether participants directly looked at the object they touched or whether the seen and the felt object information was spatially separated with the aid of a mirror. This finding suggests that prior knowledge about object identity can promote integration, even when information from vision and touch is provided at spatially discrepant locations.     

医学专业精神及医疗保密：美国历史及现状中的冲突

讨论卫生部门宣传和加强强制汇报的法律的努力、强制性汇报的规定与医学专业精神及个人自主性之间的冲突、私人医生避免遵守这些规则的策略、病人和倡议者设法避免强制性登记和检测的策略,以及医生/病人和公共卫生官员达成的妥协。最后对公共卫生政策提出建议,认识到强制性汇报存在的问题和卫生政策透明度的重要性。