Pediatric do-not-attempt-resuscitation orders and public schools: a national assessment of policies and laws

Some children living with life-shortening medical conditions may wish to attend school without the threat of having resuscitation attempted in the event of cardiopulmonary arrest on the school premises. Despite recent attention to in-school do-not-attempt-resuscitation (DNAR) orders, no assessment of state laws or school policies has yet been made. We therefore sought to survey a national sample of prominent school districts and situate their policies in the context of relevant state laws. Most (80%) school districts sampled did not have policies, regulations, or protocols for dealing with student DNARs. A similar majority (76%) either would not honor student DNARs or were uncertain about whether they could. Frequent contradictions between school policies and state laws also exist. Consequently, children living with life-shortening conditions who have DNARs may not have these orders honored if cardiopulmonary arrest were to occur on school premises. Coordinated efforts are needed to harmonize school district, state, and federal approaches in order to support children and families' right to have important medical decisions honored.     

The relationship of body image dissatisfaction to cigarette smoking in college students

This study examined the association of cigarette smoking status and body image dissatisfaction as measured by the Multidimensional Body-Self Relations Questionnaire (MBSRQ), in 1575 young adult college students, 18–24 years of age. Respondents were current cigarette smokers (N = 482) or never tobacco users (N = 1093). Smoking status was found to be significantly associated with 5 of the 10 MBSRQ subscales, with current smokers having lower scores on Fitness Orientation, Health Evaluation and Health Orientation (all p < 0.001) and higher scores on Appearance Orientation (p = 0.01) and Overweight Preoccupation (p = 0.03) compared with never tobacco users. Furthermore, among current smokers, a higher number of days smoked in the last 30 days were associated with lower scores on all MBSRQ subscales, except Self-Classified Weight. In terms of clinical implications, interventions for smoking cessation among college students might benefit from inclusion of components for addressing body image dissatisfaction and improving health beliefs.     

The Relative Contribution of Sibling Deviance and Peer Deviance in the Prediction of Substance Use Across Middle Childhood

This study investigated the quality of sibling relationships and sibling deviancy in a sample of children at-risk for substance use and antisocial behavior. Based on a history of empirical and theoretical models suggesting strong associations between children's development in the context of relationships and the emergence of delinquency and drug use, this research extends previous efforts by including sibling relationships in this developmental model, linking siblings with later substance use. Sibling relationship quality as well as peer deviance were examined using a multirater, multimethod assessment procedure. We tested 3 constructs (deviancy, warmth, and conflict) related to sibling behavior. Only sibling deviance and peer deviance directly predicted substance use. When both sibling deviance and peer deviance were examined as predictors of changes in substance use over time, only sibling deviance was significant. Implications for the development of substance use behavior in middle childhood are discussed.     

Competitive martial arts and aggressiveness: a 2-yr. longitudinal study among young boys

This study is a follow-up study of Reynes and Lorant's studies assessing the effect of one year of judo and karate training on aggressiveness scores among young boys. The data reported here were obtained after a second year of practice, 14 judoka, 9 karateka, and 20 control participants who filled out the Buss-Perry Aggression Questionnaire three times, 1 year apart. At the first assessment, all participants, born the same year, were 8 yr. old and at the third they were 10 yr. old. Analysis indicated that after two years of practice, karate training seemed to have neither positive nor negative effects on aggressiveness scores, while judo training seemed to have a negative effect on anger scores. However, the results suggested the importance of kata or meditation in training sessions on self-control acquisition for such young boys.     

Borderline personality disorder features predict negative outcomes 2 years later

In a sample of 351 young adults, the authors assessed whether borderline personality disorder (BPD) features prospectively predicted negative outcomes (poorer academic achievement and social maladjustment) over the subsequent 2 years, over and above gender and both Axis I and Axis II psychopathology. Borderline traits were significantly related to these outcomes, with impulsivity and affective instability the most highly associated. The present findings suggest that the impulsivity and affective instability associated with BPD leads to impairment in relating well with others, in meeting social role obligations, and in academic or occupational achievement. Therefore, these may be especially important features to target in interventions for BPD.     

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.     

MMPI-2 profile code types and measurement error

We studied simulated MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) code type stability and change expected with measurement error for 12 MMPI-2 well-defined mean code type profiles. Profile scores for the 2 scales defining the code type were systematically varied to represent target code type profiles at 9 different levels of T-score profile definition. We randomly generated samples of 50 simulated, estimated true score profiles at each level of profile definition for each code type around the estimated true scores for each scale at each level of profile definition. Two sets of simulated profiles were developed. The first simulation was based on the reported means, test-retest reliabilities, and the standard errors of measurement for the MMPI-2 normative group. The second simulation was based on the means, standard deviations, and estimated retest stability for a clinical group of psychiatric patients. We calculated frequencies and percentages of simulated profiles with the highest estimated true scores on the same 2 scales as the original code type profile. Percentages of simulated profiles with the same 2 highest scales as the original code type profiles increased from 27% to 37% for the 3-point level of definition, 37% to 49% for the 5-point definition, 46% to 61% for 7-point definition, 63% to 78% for 10-point definition, 78% to 89% for 13-point definition, 83% to 93% for 15-point definition, and greater than 90% for profile definition greater than 15 points.     

Interpersonal problems and outcome in outpatient psychotherapy: findings from a long-term longitudinal study in Germany

We used a comprehensive longitudinal data set from Germany to examine trajectories of symptom distress depending on interpersonal problems at study intake measured via the Inventory of Interpersonal Problems-64 (IIP-64; Horowitz, Strau, & Kordy, 1994). Participants (N=622) underwent mid- or long-term outpatient psychotherapy (either psychodynamically oriented psychotherapy, cognitive behavioral therapy, or analytic psychotherapy). Data comprises up to 5 assessments during a 2-year period and was analyzed via hierarchical linear modeling. In the analytic psychotherapy subgroup, initial symptom level was higher in submissive patients. Initial interpersonal problems were not predictive of the rate of symptom change during therapy. Only in psychodynamic treatments, low affiliation positively affected treatment outcome. Interpersonal problems at intake were not related to the number of utilized sessions and utilization rate across treatment subgroups. We discuss the findings and outline future research topics.     

What kind of memory supports visual marking?

In visual search tasks, if a set of items is presented for 1 s before another set of new items (containing the target) is added, search can be restricted to the new set. The process that eliminates old items from search is visual marking. This study investigates the kind of memory that distinguishes the old items from the new items during search. Using an accuracy paradigm in which perfect marking results in 100% accuracy and lack of marking results in near chance performance, the authors show that search can be restricted to new items not by visual short-term memory (VSTM) of old locations but by a limited capacity and slow-decaying VSTM of new locations and a high capacity and fast-decaying memory for asynchrony.     

Gratitude in intermediate affective terrain: links of grateful moods to individual differences and daily emotional experience

Two studies were conducted to explore gratitude in daily mood and the relationships among various affective manifestations of gratitude. In Study 1, spiritual transcendence and a variety of positive affective traits were related to higher mean levels of gratitude across 21 days. Study 2 replicated these findings and revealed that on days when people had more grateful moods than was typical for them, they also reported more frequent daily episodes of grateful emotions, more intense gratitude per episode, and more people to whom they were grateful than was typical for them. In addition, gratitude as an affective trait appeared to render participants' grateful moods somewhat resistant to the effects of discrete emotional episodes of gratitude.