The Partners for Life Program: A Couples Approach to Cardiac Risk Reduction

Morbidity and mortality are reliably lower for the married compared with the unmarried across a variety of illnesses. What is less well understood is how a couple uses their relationship for recommended lifestyle changes associated with decreased risk for illness. Partners for Life compared a patient and partner approach to behavior change with a patient only approach on such factors as exercise, nutrition, and medication adherence. Ninety‐three patients and their spouses/partners consented to participate (26% of those eligible) and were randomized into either the individual or couples condition. However, only 80 couples, distributed across conditions, contributed data to the analyses, due to missing data and missing data points. For exercise, there was a significant effect of couples treatment on the increase in activity and a significant effect of couples treatment on the acceleration of treatment over time. In addition, there was an interaction between marital satisfaction and treatment condition such that patients who reported higher levels of marital distress in the individuals condition did not maintain their physical activity gains by the end of treatment, while both distressed and nondistressed patients in the couples treatment exhibited accelerating gains throughout treatment. In terms of medication adherence, patients in the couples treatment exhibited virtually no change in medication adherence over time, while patients in the individuals treatment showed a 9% relative decrease across time. There were no condition or time effects for nutritional outcomes. Finally, there was an interaction between baseline marital satisfaction and treatment condition such that patients in the individuals condition who reported lower levels of initial marital satisfaction showed deterioration in marital satisfaction, while non satisfied patients in the couples treatment showed improvement over time.     

Differential Item Functioning of the Symptoms of Major Depression by Race and Ethnicity: An Item Response Theory Analysis

This study examines the psychometric properties, and particularly differential item functioning (DIF) due to racial and ethnic group, of the criteria for a major depressive episode using a large sample (N?=?1,063) of outpatients seeking treatment for mood and anxiety disorders. DIF was evaluated using multiple group confirmatory factor analysis. Item thresholds fell along a continuum with the core features of depressed mood and anhedonia, along with fatigue, being endorsed at lower levels of depression, and change in appetite and suicidal ideation endorsed at more severe levels of depression. Item discriminations, reflecting an item’s ability to discriminate between lower and higher levels of depression, were highest for depressed mood and anhedonia, and lowest for change in appetite and suicidal ideation. When examining model fit among the racial groups we did not find differences in symptom functioning, providing support for the use of these symptoms across diverse groups. This is of particular importance given the paucity of studies examining this question using a semi-structured clinician administered instrument to a clinical sample.     

阅读困难可否补救? 两种理论驱动干预方案的比较(英文)

本研究是一个进行中的纵向实验的一部分,该实验旨在比较一个认知干预方案(PREP:PASS阅读促进方案)和一个主要关注语音、命名速度和意义成分的神经心理方案(DEST-RT:DEST补救工具)在阅读困难补救中的效能。从320位儿童构成的初始样本中,选择4组儿童,并一年级接受四周干预后,对他们在许多认知、语言、阅读和正字法测量上的表现进行比较:两个实验组共28名伴有阅读困难的儿童(每组n=14),平均年龄6岁6个月,分配到PREP和DEST-RT补救方案中,两组儿童基于年龄、性别、父母教育水平、非言语和言语能力进行匹配,同时也考虑他们的认知和语言表现剖面;一个阅读水平匹配组(RA-C,n=19),也存在阅读困难,不接受任何处理;一个实足年龄匹配组(CA-C,n=30)。结果表明,所有四组儿童在所有认知、语言、阅读和正字法测量上均随时间而改善;与CA-C和DEST-RT相比,PREP组在继时性加工上进步显著;在正字法选择,这一在单词加工中利用视觉-字形信息的正字法加工任务上,PREP组的表现也优于DEST-RT组;最后,在语音敏感性、字母数字的RAN、单词阅读(真词和假词)及段落理解等方面,PREP和DEST-RT的表现均显著优于CA-C和RA-C。讨论部分,则着重讨论设计理论驱动的低成本且能有效改善阅读表现的补救方案的必要性。