Fabricated Illness: Working within the Family System to Find a Pathway to Health

The term medically unexplained symptoms refers to a clinical presentation where the child's symptoms and impairment cannot be explained by any known organic pathology, and may include conversion disorders, somatoform pain disorders, factitious disorder, and factitious disorder by proxy. In this case study, we present our treatment of a 9‐year‐old girl with a 2‐year history of medically unexplained abdominal cramping and vaginal discharge. During the 9 months that we worked with this family, we were never able to clarify in our own minds the source of the child's symptoms—that is, who was responsible for their induction or who was the instigator or maintainer of the exaggerated symptoms. Nor did we come to fully understand the function of the symptoms in the family system. Our case report does not answer either of these questions. Instead, we describe how we worked with the family despite the ongoing ambiguities as to why the symptoms were occurring and who was inducing them. The functional outcome was disappearance of symptoms, return to full school attendance, and improved parenting behavior.     

Stuttering severity and educational attainment

Purpose

This study investigated the relationship between self-reported stuttering severity ratings and educational attainment.

Method

Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering severity on a 9-point scale for a range of speaking situations. These included: (1) talking with a family member, (2) talking with a familiar person, not a family member, (3) talking in a group of people, (4) talking with a stranger, (5) talking with an authority figure such as a work manager or teacher, (6) talking on the telephone, (7) ordering food or drink, and (8) giving their name and address.

Results

There was a significant negative relationship between highest educational achievement and mean self-reported stuttering severity rating for the eight situations.

Conclusions

Future research is needed to investigate how this result should be addressed in educational institutions.Educational objectives: The reader will be able to: (1) describe the negative effects of stuttering through childhood to adulthood; (2) identify some of the negative consequences associated with stuttering on peer and teacher relationships, and academic performance at school; and (3) summarise the relationship between stuttering severity and educational attainment.     

Correction to: A New Social Picture Task to Assess Interpretation Bias Related to Social Fears in Adolescents

Research on Child and Adolescent Psychopathology -     

Coping with COVID-19: Longitudinal Impact of the Pandemic on Adjustment and Links with Coping for Adolescents with and without ADHD

Research on Child and Adolescent Psychopathology - Understanding factors that foster resilience and buffer against the negative psychological impact of COVID-19 is critical to inform efforts to...     

Longitudinal Association of Sluggish Cognitive Tempo with Depression in Adolescents and the Possible Role of Peer Victimization

Research on Child and Adolescent Psychopathology - It is unknown whether sluggish cognitive tempo (SCT) is prospectively associated with depression in adolescence, and possible processes linking...     

Jandu Yani U (for all families): Tailored Triple P Training and Support Promote Empowerment in Remote Aboriginal Communities

Journal of Child and Family Studies - To enhance the accessibility and acceptability of evidence-based parenting programs in Indigenous communities, there is a need to build a confident and skilled...     

The Association Between Sluggish Cognitive Tempo and Academic Functioning in Youth with Attention-Deficit/Hyperactivity Disorder (ADHD)

The purpose of the study was to evaluate the relation between Sluggish Cognitive Tempo (SCT) and academic functioning in a sample of 52 adolescents (40 males, 12 females) with Attention-Deficit/Hyperactivity Disorder (ADHD; M _age?=?13.75). This study builds on prior work by utilizing an empirically-based and psychometrically validated measure of SCT, collecting ratings of SCT from both parents and teachers, and examining associations with multiple domains of academic functioning from both the parent and teacher perspective as well as grade point average (GPA). Both SCT and DSM-IV symptoms of inattention were significantly correlated with domains of academic functioning. Multiple regression analyses demonstrated that the parent-rated SCT Slow subscale predicted overall academic functioning, organizational skills impairment, and homework problems above and beyond ADHD symptoms and child and demographic characteristics known to be associated with academics, including intelligence, academic achievement, and family income. The teacher-rated SCT Low Initiation/Persistence subscale also predicted homework problems and was the only SCT variable to predict school grades above and beyond ADHD symptoms and relevant covariates. Both the SCT Slow and Low Initiation/Persistence subscales include items related to youth seeming apathetic, unmotivated, and lacking initiative, behaviors that are strongly related to ADHD symptoms of inattention but not currently captured by the DSM-IV. Implications of these findings towards supporting the external validity of the SCT construct are discussed along with potential implications for intervention.     

Social and Academic Impairment in Youth with ADHD, Predominately Inattentive Type and Sluggish Cognitive Tempo

Sluggish cognitive tempo (SCT) was originally identified as a construct that characterized the inattention problems of some children with attention deficit disorder (ADD). Research has indicated that using SCT symptoms to identify a subset of youth with attention-deficit/hyperactivity disorder, predominately inattentive type (ADHD-IT) may elucidate distinct patterns of impairment and thereby improve the external validity of ADHD subtypes. The objective of the current study was to investigate whether youth with clinically-assessed ADHD-IT and high levels of SCT exhibit unique social and academic impairments. In a clinic-referred sample of youth (N?=?209; 23 % female) aged 6 to 17 years, participants who met criteria for three different groups were identified: ADHD, Combined Type (ADHD-CT; n?=?80), ADHD-IT with low SCT symptoms (n?=?74), and ADHD-IT with high SCT symptoms (n?=?55). These groups were compared on indicators of social and academic functioning while considering the effects of co-occurring internalizing and disruptive behavior disorders. Youth with ADHD-IT high in SCT exhibited uniquely elevated withdrawal, as well as low leadership and low peer-directed relational and overt aggression, which were not accounted for by co-occurring disorders. This high-SCT group was also the only group to have more homework problems than the ADHD-CT group, but only when other disruptive behavior disorders were absent. The distinctiveness of the high-SCT group, which was primarily evident in social as opposed to academic functioning, provides partial support for the external validity and clinical utility of SCT.     

Observer Effects without Demand Characteristics: An Inductive Investigation of Video Monitoring and Performance

Purpose

The purpose of these two studies was to explore the relationship between video monitoring and quantity of performance in the absence of demand characteristics.

Design/methodology/approach

Data were gathered via two experiments involving business students working on a motor task. Participants were randomly assigned to the monitored and unmonitored conditions. Experiment 1 (n = 75) was inductive while Experiment 2 (n = 139) was partially inductive.

Findings

Experiment 1 showed that monitored participants’ performance was lower than that of unmonitored participants. Further, monitoring reduced outliers, increased interquartile variance, and normalized the distribution. Experiment 2 replicated the effect of monitoring on performance controlling for cognitive ability and emotions, demonstrated that negative emotions interacted with monitoring condition, and suggested that differences in performance were not due to cheating or variation in task-related strategies. We offer a grounded theory of video monitoring proposing that different implicit decision rules are activated when people are monitored as compared to when they are not monitored.

Implications

Future research needs to determine the extent to which our results extend to similar settings in the workplace and to other forms of observation. At this time, we believe organizations should carefully consider the consequences of electronic monitoring. Controlling expectations in the lab or workplace does not necessarily eliminate the independent effect of monitoring. Therefore, researchers must beware misinterpretation of effect sizes and overlooking the role of observation in their data.

Originality/value

These studies demonstrate that video monitoring can create observer effects in the absence of demand characteristics. Our inductive approach revealed the nature of the effects beyond mean differences and served as the basis for developing a testable theory of monitoring that goes beyond what was previously known.