Occupational Therapy Student Experiences and Transformations During Fieldwork in Mental Health Settings

The purpose of this study is to better understand the transformative experiences of occupational therapy students during fieldwork. In occupational therapy education, fieldwork provides students with an in-depth experience in the field. Thirty-one students submitted narratives following completion of Level II fieldwork in a mental health setting. Concepts from transformative learning theory guided the analysis. The themes that emerged were: (1) understanding clients with mental illness; (2) understanding occupation and occupational therapy; (3) feeling like a professional; and (4) changing as a person. The results highlight the importance of understanding the transformative process and fieldwork in mental health settings.     

The Home-Based Occupational Therapy Intervention in the Alzheimer's Disease Multiple Intervention Trial (ADMIT)

There is no way to prevent functional declines related to Alzheimer's Disease (AD). The use of occupational therapy (OT) has been shown to be successful in managing some aspects of AD. We added home-based OT to evidence-based best practice for AD with the aim of delaying functional decline in people with AD. OT was delivered in the home to a caregiver dyad including the person with AD and her/his caregiver. This article describes the OT intervention for the AD Multiple Intervention Trial, a parallel randomized controlled trial. We include baseline data on the 180 caregiver dyads.     

Self-Cutting and Suicidal Ideation among Adolescents: Gender Differences in the Causes and Correlates of Self-Injury

In recent years, non-suicidal self-injury (NSSI) among adolescents has been identified as alarmingly common place. Some studies have suggested that more than one in eight adolescents have engaged in self-cutting or other self-injuring behaviors. Even more of a concern is that self-injury often foreshadows suicide or suicide attempts. With self-cutting common in middle and high schools, understanding the antecedents and correlates of such behavior may help counselors and others public health officials identify troubled students and initiate preventative measures. This study utilizes data from 2,639 high school students from the Delaware Youth Risk Behavior Survey to investigate the gender differences in NSSI and suicidal ideation. Overall, 13% reported engaging in NSSI within the past year, with females reporting significantly higher rates (17%) of NSSI than males (9%). Results indicate that there are significant gender differences in NSSI and suicidal thoughts based upon previous victimization experiences, reported substance use, depression, health behaviors, and sexual orientation.     

Negative processing biases predict subsequent depressive symptoms

This study investigated the possible relationship between negative processing biases and subsequent depression. The Scrambled Sentences Test (SST), a measure of processing bias, was administered to a large sample of undergraduates. Participants also completed self-report measures of thought suppression tendencies, current level of depression, and lifetime worst-depression symptoms. High scores on the SST, reflecting a negative processing bias, predicted depression symptoms measured 4 to 6 weeks later, even after controlling for concurrent and past depression. The SST was administered both with and without cognitive load to all participants. The SST with load predicted subsequent depression for both men and women. The SST without load predicted depression for women only. The SST difference score, a measure of the change in scores between the no-load and load conditions, was a significant predictor of subsequent depression for men but not women. Among men, the combination of high thought suppression with either high SST-load scores or high SST difference scores proved to be a particularly strong indicator of vulnerability to subsequent depression.     

Birth of an Abstraction: A Dynamical Systems Account of the Discovery of an Elsewhere Principle in a Category Learning Task

Human participants and recurrent (“connectionist”) neural networks were both trained on a categorization system abstractly similar to natural language systems involving irregular (“strong”) classes and a default class. Both the humans and the networks exhibited staged learning and a generalization pattern reminiscent of the Elsewhere Condition (Kiparsky, 1973). Previous connectionist accounts of related phenomena have often been vague about the nature of the networks’ encoding systems. We analyzed our network using dynamical systems theory, revealing topological and geometric properties that can be directly compared with the mechanisms of non‐connectionist, rule‐based accounts. The results reveal that the networks “contain” structures related to mechanisms posited by rule‐based models, partly vindicating the insights of these models. On the other hand, they support the one mechanism (OM), as opposed to the more than one mechanism (MOM), view of symbolic abstraction by showing how the appearance of MOM behavior can arise emergently from one underlying set of principles. The key new contribution of this study is to show that dynamical systems theory can allow us to explicitly characterize the relationship between the two perspectives in implemented models.     

The Contribution of Executive Skills to Reading Comprehension

Although word recognition deficits (WRD) are a known cause of reading comprehension deficits (RCD), other contributions to RCD, including executive function (EF), have not been fully explored. We examined the contribution of EF (working memory and planning), along with attention, decoding, fluency, and vocabulary to reading comprehension in 60 children (including 16 WRD and 10 RCD), ages 9–15 years. After controlling for commonly accepted contributors to reading comprehension (i.e., attention, decoding skills, fluency, and vocabulary), EF continued to make a significant contribution to reading comprehension but not to word recognition skills. These findings highlight the need for consideration of the role of EF in RCD.     

Physicians' Silent Decisions: Because Patient Autonomy Does Not Always Come First

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time.