Training Pediatric Psychologists for Perinatal Behavioral Health Services in a Pediatric Hospital

Although pediatric hospitals specialize in providing care to children and adolescents, at The Children’s Hospital of Philadelphia (CHOP), our team has been providing behavioral health services for two unique parent populations—parents with a child in the Newborn Infant Intensive Care Unit and pregnant women carrying fetuses with specific birth defects and receiving prenatal care in the Center for Fetal Diagnosis and Treatment. A new training program was developed to expand the scope of pediatric psychologists’ practice to include perinatal behavioral health services, specifically for these two unique parent populations served at CHOP. The program includes direct service provision for adult mental health concerns, as well as education and support to help families cope with the existing medical conditions. This article describes the training program and its implementation as a model of training for other pediatric hospitals. The roles of psychologists embedded in these units and hospital privileges are discussed.     

Facets of career decision-making difficulties

The present research investigated the relations among the measured and the expressed career decision-making difficulties in a sample of 299 young adults who intended to apply to college or university. As hypothesised, the correlations between career decision-making difficulties, as measured by the Career Decision-Making Difficulties Questionnaire (CDDQ), and the expressed difficulties were generally high (median = 0.64), but varied among the 10 difficulty categories (range 0.35-0.82). Both measured and expressed difficulties correlated negatively with the students' career decision-making self-efficacy (-0.63 and -0.65, respectively). The correlations between the CDDQ and both dimensions of the Vocational Decision Style Indicator were negative but low (-0.25 for the introvert vs. extrovert dimension and -0.35 for the thinking vs. feeling dimension). The correlations between the students' scholastic aptitude test scores and both measured and expressed difficulties were negligible (-0.03 and -0.08, respectively). Participants with more crystallised career plans reported lower career decision-making difficulties, higher career decision-making self-efficacy, and a higher 'thinking' (as opposed to 'feeling') vocational decision-making style. The theoretical and practical implications of these findings are discussed.     

A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff

The mental health challenges of some vocations present a challenge for current intervention models. Bibliotherapy focused on transdiagnostic processes that might both prevent and alleviate a range of mental health distress could be an effective and practical approach. K-12 school personnel (N = 236; 91% female; 30-60 years old) responding to a wellness-oriented program announcement were randomized to receive an Acceptance and Commitment Therapy (ACT) self-help volume or to a waitlist. Three-fourths were above clinical cutoffs in general mental health, depression, anxiety, or stress. Participants read the book for two months, completed exercises and quizzes, and after post assessment were followed for 10 weeks; waitlist participants were then also given the book with two months to complete it. Overall, participants showed significant improvement in psychological health. Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression, anxiety and stress. Follow up general mental health, depression, and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility.     

Contextual dependencies in predictive learning

Two experiments assessed contextual dependencies in a predictive-learning task. Subjects learned to associate each of four pictorial stimuli with the occurrence or non-occurrence of a specific outcome. Each of these stimuli, the intentional stimuli, was presented against one of two different visual (Experiment 1) or auditory (Experiment 2) context stimuli. These context stimuli were incidental: subjects were not explicitly instructed to pay any attention to them and each of them in isolation was not predictive of the outcome. During acquisition and testing, subjects expressed the expected relationship between intentional stimulus and outcome by an appropriate key press. At test, intentional stimuli were presented either with the same contextual stimulus as also present during acquisition (same trials), or with the other one (switched trials). The response latency was slower on switched trials than on same trials in each experiment, a result extending previous findings on the effect of environmental contextual stimuli on task performance. Results are discussed in the framework of contextual occasion setting and habituation to contextual stimuli.     

Behavioral Problems and Reading Difficulties Among Language Minority and Monolingual Urban Elementary School Students

This study examined the potentially compounding effect of language minority (LM) status on problem behaviors among urban second and third grade-level poor readers. Univariate analyses showed that a disproportionate percentage of both LM and English monolingual (L1) poor readers already displayed clinically significant levels of anxiety, social problems, and oppositional behaviors in the classroom. Analyses of variance, however, demonstrated that LM status was not an additive risk factor for reading difficulties, behavior problems, or lowered self-concept in this sample. No differences were observed between LM and L1 students on a wide range of reading measures, on their teachers’ ratings of internalizing and externalizing problem behaviors in the classroom, or on self-ratings of self-efficacy and social competence. Implications for intervention for all urban students with reading difficulties are discussed.     

Neuropsychological, learning and psychosocial profile of primary school aged children with the velo-cardio-facial syndrome (22q11 deletion): evidence for a nonverbal learning disability?

In this exploratory study, the neuropsychological and learning profile of nine primary school age children with velo-cardio-facial syndrome (VCFS) was studied by systematic neuropsychological testing. In five out of nine children, the following profile was found: a VIQ-PIQ discrepancy (in favor of the VIQ), significantly better scores (.05 level) for reading (decoding) and spelling compared to arithmetic, deficient tactile-perceptual skills (difficulties mainly on the left side of the body), weak but not deficient visual-perceptual abilities, deficient visual-spatial skills, extremely poor psychomotor skills (gross motor skills more deficient than fine motor skills), problems with processing of new and complex material, poor visual attention, good auditory memory and relatively good language skills. These findings correspond to the pattern of neuropsychological assets and deficits that has been described for the syndrome of nonverbal learning disabilities (NLD) (Rourke, 1987, 1988, 1989, 1995). The psychosocial profile of all nine children with VCFS also correspond to that of children with NLD. Further studies on the relationship between cognitive function, behavior, psychiatric disorder and abnormalities in brain anatomy in young people with VCFS will be needed. In clinical practice, it is worthwhile exploring in greater depth the neuropsychological functions of children with VCFS to rule out NLD, since they may benefit from specific remediation following the learning principles of the NLD-treatment.     

Fairness,Self‐Interest,and Cooperation in a Real‐Life Conflict1

Effects of procedural fairness and self‐interest on cooperation vs. hardness in an urban planning conflict were examined in a questionnaire study. The self‐interest perspective posits that people seek to maximize their outcomes and, therefore, cooperate only when they can gain advantages or avoid disadvantages by doing so, while fairness models of cooperation view cooperative actions as based mainly on justice motives. The data give strong support for the fairness hypothesis, showing that self‐interest accounts only for hard strategies, whereas justice motives explain a considerable part of cooperation. The impact of the results on further research on social conflicts and their settlement, as well as the elaboration of models of fairness in the social psychology of conflicts are discussed.