Using Cognitive Mapping to Understand Problems Experienced by Family Caregivers of Persons with Severe Physical Disabilities

Individuals who provide ongoing care for family members who have a chronic disease or disability are likely to encounter a wide array of problems that can compromise their own health and their ability to function effectively in a caregiving role. Structured focus group meetings were conducted to elicit a comprehensive list of the problems that caregivers experienced during their first year of providing care to a person with a severe physical disability. A separate group of caregivers (N = 60) individually sorted problems into piles based on their similarity and assigned relative importance to each problem. The aggregated data were analyzed with multidimensional scaling and hierarchical cluster analysis. Results indicated that caregivers cognitively organize problems along three dimensions: I. Centeredness–caregiver versus patient-oriented; II. Relationship Demands–physical versus emotional; and III. Caregiver Burden–time versus emotional. Additionally, 6 clusters of substantively similar problems were identified and prioritized in terms of personal relevance: Basic Needs (lowest); Perceived Constraints; Caregiver Challenges; Patient Resentment; Patient Withdrawal; and Patient Intrapsychic Adjustment (highest). Further examination of the organization of problems identified by caregivers should provide important insights about the experience of caregivers and how more targeted interventions can be developed to address their specific needs.     

Time pressure and group performance: Exploring underlying processes in the Attentional Focus Model

The Attentional Focus Model (Karau & Kelly, 1992) predicts that time pressure should lead group members to focus on a restricted range of task-relevant cues and to adopt task completion as their major interaction objective. Although this prediction has been supported in several studies (e.g., Karau & Kelly, 1992; Kelly, Jackson, & Hutson-Comeaux, 1997; Kelly & Karau, 1999; Parks & Cowlin, 1995), the exact processes that underlie information restriction have not been specified. We propose that two processes are involved. Specifically, the restriction of information may occur because time pressure affects the way in which information is initially encoded or attended to before a group enters its decision-making phase, or because group members filter out what they judge to be less important information during group discussion and decision making. We assessed both of these processes within a decision-making experiment where time pressure was manipulated prior to learning information that would be used to perform a task. Recall of information learned prior to group discussion did not differ by time pressure condition, arguing against an encoding process. In contrast, interaction data demonstrated information restriction by group members, arguing for a filtering process. Thought listings collected 1 min into the group discussion in some groups also supported a filtering process, as did questionnaire data. Implications of these findings for the Attentional Focus Model and for effective group decision making are discussed.     

Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms

The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms (p < .01) and global severity (p < .002), as well as self-reported ADHD symptoms (p < .0001) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety (p's < .04), lower IE-rated depression (p < .01), and a trend to have lower self-reported depression (p = .06). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) (p < .02). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.     

Hope,Social Support,and Postpartum Depression: Disentangling the Mediating Effects of Negative Affectivity

We examined the potentially mediating effects of negative affectivity (NA) on the hope–depression relationship among a sample of postpartum women. We also assessed the social support reported by these women and examined the possible mediating effects of NA on the social support–postpartum depression relationship. Correlational analyses of data obtained from women (N = 98) who had given birth in the previous 6 months revealed that NA did not mediate either hope or social support in the prediction of postpartum depression. Hope accounted for a significant degree of variance in postpartum depression. These data suggest that hope has palliative effects among women following childbirth and these effects are not nullified or explained by emotional predispositions.     

Peer Perceptions and Liking of Children with Anxiety Disorders

Examined three aspects of childhood anxiety and peer liking: (1) whether or not children can detect anxiety in age-mates, (2) the degree to which peer-reported anxiety, self-reported anxiety, and presence of anxiety disorders are associated with peer liking, and (3) whether or not self-reported anxiety and presence of anxiety disorders are associated with peer liking after controlling for peer-reported anxiety. Peer raters (9.5–12.5 years) rated videotaped speech samples of target children with anxiety disorders (AD; 9.5–13 years) and target children without anxiety disorders (NAD; 9.5–13 years). Peer-rated anxiety was positively correlated with target children’s self-reported anxiety and was higher among children with AD and children with social phobia (SP). Peer liking was inversely related to peer-reported anxiety and was lower for target children with SP. Target children with SP were liked less regardless of how anxious peers perceived them to be. Peer rater and target child demographics did not moderate the relationship between peer-rated anxiety and peer liking.     

Teaching Spelling Through Prompting and Review Procedures Using Computer-Based Instruction

Computer-based instruction (CBI) was used to teach 3 sets of 20 spelling words to two 6th graders in a multiple baseline design. The CBI presented a voice recording of each spelling word and prompted the students to type the word. If they spelled the word incorrectly, a training procedure was initiated that included prompt fading and systematic review practice. Results showed that three to ten 15-min training sessions were needed for participants to score 100% on each word set. During a subsequent maintenance phase, one participant received 2 re-training sessions on word Set 2 due to low performance but no other training was provided. Average performance was 93% across all word sets during the final three sessions of the maintenance phase and 79% on a 3-week follow-up test. Kristin H. Mayfield, now at iLearn, Inc., Marietta, GA, USA.     

The effect of mechanical context on attentional cost in unimanual coordination

The purpose of this study was to address the attentional cost of sensorimotor coordination by determining if changes to the mechanical context of movement would influence the ability to attend and respond to an alternate stimulus. Nine right-handed participants performed rhythmic pronation and supination movements of the forearm in time with an auditory metronome. A secondary task, consisting of a pedal response to visual probe stimuli, was employed to infer the attentional cost of the coordination task. When the axis-of-rotation (AOR) was placed below the long axis of the forearm, the average time to react (RT) to the probe stimuli was greater for the supinate-on-the-beat condition than for the pronate-on-the-beat condition. Conversely, with the AOR above the forearm, RT for the pronate-on-the-beat pattern was greater than that for the supinate-on-the-beat pattern. Thus, changing the mechanical context of an upper limb coordination task altered the central processing cost required to maintain pattern stability. This finding provides further evidence that the attentional resources required to produce a particular movement are determined by the ease with which the action is executed by the sensorimotor system.