Implementation of Effective Treatments of Preschool Behavior Problems in a Clinic Setting

Epidemiological data indicate that nearly 20% of preschool aged children have significant behavioral problems. Parents typically consult their child’s primary care provider, who frequently refers to child psychologists for treatment regarding these difficulties. Psychologists skilled in providing effective services for young children are in short supply, limiting accessibility, and parents often are reluctant to follow up with a mental health specialist, suggesting low acceptability. The Behavior Consultation Clinic is a structured clinic for preschool children designed to address these issues of effectiveness, accessibility and acceptability. A retrospective review of 550 patients seen over a 5-year period found that half were seen for one therapy session. Review of the remaining patients found that slightly more than half showed improvement (32% successful discharge with improvement, 24% premature discharge with improvement) with a typical range of two to seven half-hour sessions, about a quarter did not improve, and the remaining patients were referred to a higher level of service. These data indicate that a structured, brief clinic that focuses on the needs of preschool children utilizing evidence-based approaches can be effective, acceptable, and accessible. The Behavior Consultation Clinic also serves as a training clinic for psychology interns and pediatric medical residents.     

Validating a “spurning scale” for nurses in Hong Kong

Based on a model on spumed helpers’ reactions, a spurning scale for nurses was constructed with items to assess the extent to which practicing nurses experience recurrent rejection of their help by patients and colleagues. Three approaches were employed to examine the validity of the scale: the relationship of the spurning scores with job satisfaction and turnover scores; the relationships of the spurning scores with burnout scores; and the relationships of the spurning scores with scores indicative of stress arising from interactions with one's patients, colleagues, and supervisor. Practicing nurses in Hong Kong (N = 212) who were enrolled in a refresher program of studies responded to a questionnaire containing the variables of interest. The results offered promising evidence for the validity of the scale.     

Homosexuality: Coming out of the confusion

The author asserts that earlier theoretical assumptions contribute to the conceptual confusion about homosexuality in much contemporary psychoanalytic research. Bergeret's article, recently published in this Journal , is exemplary of this confusion. The author refutes his contention that homosexuality is not 'true' sexuality but merely a defensive, narcissistic fixation away from, or a nearly psychotic denial of, heterosexuality. He then clarifies specific areas of conceptual confusion regarding homosexuality still prevalent in psychoanalytic discourse that derive from earlier theoretical premises. These areas of confusion include manifest versus latent homosexuality, narcissism and bisexuality, oedipal dynamics and development, and transference and technique.     

A Pilot Study of Acute Stress Symptoms in Parents and Youth Following Diagnosis of Type I Diabetes

The primary aims of this exploratory study were to determine the rate of occurrence of acute stress disorder (ASD) in children newly diagnosed with Type 1 diabetes and their parents, to examine relationships with demographic and psychosocial factors, and to examine the relationships between ASD symptom clusters and early adherence behavior (clinic attendance). The sample consisted of 102 parents of children ages 0–17 years and 40 youth ages 11–17 who were evaluated within three days of diabetes diagnosis. Eighteen percent of parents and 17% of youth reported subthreshold symptoms of ASD. Acute stress symptoms and demographic variables predicted clinic attendance, with a differential pattern evident in the responses of youth and their parents. These findings reinforce the importance of screening symptoms of ASD in youth with newly diagnosed diabetes and their parents to assist in identifying families who may be in need of additional support.     

Does it really matter whether students' contributions are spoken versus typed in an intelligent tutoring system with natural language?

There is the question of whether learning differs when students speak versus type their responses when interacting with intelligent tutoring systems with natural language dialogues. Theoretical bases exist for three contrasting hypotheses. The speech facilitation hypothesis predicts that spoken input will increase learning, whereas the text facilitation hypothesis predicts typed input will be superior. The modality equivalence hypothesis claims that learning gains will be equivalent. Previous experiments that tested these hypotheses were confounded by automated speech recognition systems with substantial error rates that were detected by learners. We addressed this concern in two experiments via a Wizard of Oz procedure, where a human intercepted the learner's speech and transcribed the utterances before submitting them to the tutor. The overall pattern of the results supported the following conclusions: (1) learning gains associated with spoken and typed input were on par and quantitatively higher than a no-intervention control, (2) participants' evaluations of the session were not influenced by modality, and (3) there were no modality effects associated with differences in prior knowledge and typing proficiency. Although the results generally support the modality equivalence hypothesis, highly motivated learners reported lower cognitive load and demonstrated increased learning when typing compared with speaking. We discuss the implications of our findings for intelligent tutoring systems that can support typed and spoken input.     

The hippocampus: hub of brain network communication for memory

A complex brain network, centered on the hippocampus, supports episodic memories throughout their lifetimes. Classically, upon memory encoding during active behavior, hippocampal activity is dominated by theta oscillations (6-10Hz). During inactivity, hippocampal neurons burst synchronously, constituting sharp waves, which can propagate to other structures, theoretically supporting memory consolidation. This 'two-stage' model has been updated by new data from high-density electrophysiological recordings in animals that shed light on how information is encoded and exchanged between hippocampus, neocortex and subcortical structures such as the striatum. Cell assemblies (tightly related groups of cells) discharge together and synchronize across brain structures orchestrated by theta, sharp waves and slow oscillations, to encode information. This evolving dynamical schema is key to extending our understanding of memory processes.     

Counseling Canadian Indigenous Peoples: The Therapeutic Alliance and Outcome

The aim of this study was to determine whether client therapeutic alliance ratings and client symptom severity were predictors of counseling outcomes among Canadian Indigenous clients. Participants included 179 Canadian Indigenous clients who completed an outcome measure at the 1st and last sessions and an alliance measure at both the 2nd and 3rd sessions. Results indicated that higher client alliance ratings at Sessions 2 and 3 and baseline client symptom severity were significant predictors of outcome. El objetivo de este estudio fue determinar si las valoraciones del cliente de la alianza terapéutica y la severidad de los síntomas del cliente fueron indicadores de los resultados de la consejería entre clientes indígenas canadienses. Los participantes incluyeron 179 clientes indígenas canadienses que completaron una medida de resultados en la primera y última sesión, además de una medida de la alianza en la segunda y tercera sesión. Los resultados indicaron que unas valoraciones del cliente más altas de la alianza en las sesiones 2 y 3 y la severidad preliminar de los síntomas del cliente fueron indicadores significativos del resultado.     

Who uses more strategies? Linking mathematics anxiety to adults’ strategy variability and performance on fraction magnitude tasks

Adults use a variety of strategies to reason about fraction magnitudes, and this variability is adaptive. In two studies, we examined the relationships between mathematics anxiety, working memory, strategy variability and performance on two fraction tasks: fraction magnitude comparison and estimation. Adults with higher mathematics anxiety had lower accuracy on the comparison task and greater percentage absolute error (PAE) on the estimation task. Unexpectedly, mathematics anxiety was not related to variable strategy use. However, variable strategy use was linked to more accurate magnitude comparisons, especially among adults with lower working memory performance or those who use mathematics less frequently, as well as lower PAE on the estimation task. These findings shed light on the role of strategy variability in fraction problem solving and demonstrate a link between mathematics anxiety and fraction magnitude reasoning, a key predictor of general mathematics achievement.