Interrater agreement on behavioral executive function measures in adolescents with Attention Deficit Hyperactivity Disorder

Background/ObjectiveThough most children with Attention Deficit Hyperactivity Disorder (ADHD) show difficulties in behavioral measures of executive functions (EF), few studies have examined interrater agreement in these measures.Objective: To analyze the agreement between parents, teachers and self-reports of behavioral EF in adolescents with ADHD and controls. Method: A sample of 118 adolescents (75 with ADHD and 43 controls) was rated by parents, teachers and the adolescents themselves using the Comprehensive Executive Function Inventory. The intraclass correlation coefficient (ICC) and Bland and Altman methods were used to evaluate agreement. Results: The ICC between parents, teachers and self-report was poor or moderate in the group with ADHD; in the control group the agreement was fair to good. The Bland and Altman graphs show that, in the control group, most of the scores are below to the clinical cut-off point, while in the group with ADHD they are above. Conclusions: Agreement between all raters was low. Parents, teachers and adolescents agreed on the absence of deficits in behavioral EF in the control group, and on the presence of deficits in the group with ADHD, although they did not agree on the frequency of these deficits.     

Question answering from structured knowledge sources

We present an implemented approach for domain-restricted question answering from structured knowledge sources, based on robust semantic analysis in a hybrid NLP system architecture. We perform question interpretation and answer extraction in an architecture that builds on a lexical-conceptual structure for question interpretation, which is interfaced with domain-specific concepts and properties in a structured knowledge base. Question interpretation involves a limited amount of domain-specific inferences, and accounts for higher-level quantificational questions. Question interpretation and answer extraction are modular components that interact in clearly defined ways. We derive so-called proto queries from the linguistic representations, which provide partial constraints for answer extraction from the underlying knowledge sources. The search queries we construct from proto queries effectively compute minimal spanning trees from the underlying knowledge sources. Our approach naturally extends to multilingual question answering, and has been developed as a prototype system for two application domains: the domain of Nobel prize winners, and the domain of Language Technology, on the basis of the large ontology underlying the information portal LT World.     

Does Mother Know Best? An Actor–Partner Model of College‐Age Women's Human Papillomavirus Vaccination Behavior

This study examined the associations of perceived threat, perceived efficacy, and parent–child communication with the extent to which college‐age women received the human papillomavirus (HPV) vaccine. Daughters and their mothers completed a survey about the HPV vaccine (N = 182 dyads). The results showed that mothers' perceived self‐efficacy to talk to their daughters and mothers' response efficacy of the vaccine were indirectly related to mother–daughter communication about HPV. Further, mother–daughter communication mediated the relation between mothers' intention to talk to their daughters and daughters' HPV vaccination behavior. This study demonstrates the importance of the social context of health behavior and the role of communication in understanding maternal influence on the HPV vaccination behavior of young adult women.     

Prediction of end-of-life fears in COPD – hoping for the best but preparing for the worst

Objective: The diagnosis of a life-threatening illness can trigger end-of-life fears. Early studies show that end-of-life fears play an important role in chronic obstructive pulmonary disease (COPD). However, predictors of these fears have not yet been identified. This study investigated the relevance of socio-demographic variables, illness severity, psychological distress and disease-specific anxieties as predictors of end-of-life fears in COPD.

Design: A total of 131 COPD patients participated at two time points. Regression and mediation analyses, as well as cross-lagged panel analyses were conducted.

Main outcome measures: The participants completed questionnaires assessing end-of-life fears (Multidimensional Orientation toward Dying and Death Inventory), psychological distress (Hospital Anxiety and Depression Scale), and disease-specific anxieties (COPD Anxiety Questionnaire). Pulmonary function and a 6-min walk test served as measures of illness severity.

Results: Illness severity was not predictive of end-of-life fears. However, gender and psychological distress explained incremental variance. When disease-specific anxieties were included as additional predictors, psychological distress was no longer significant. Cross-lagged panel analyses mostly supported these results. Moreover, disease-specific anxieties mediated the association between psychological distress and end-of-life fears.

Conclusion: Administration and intensity of end-of-life care (especially concerning end-of-life fears) in COPD patients should be based not only on illness severity, but rather on psychological distress and disease-specific anxieties.     

Juror decision making: A case of attitude change mediated by authoritarianism

For a jury to reach a unanimous decision, certain individuals must change their attitudes with regard to the defendant's guilt during deliberations. Because these changers are the key to the group decision-making process, they were carefully scrutinized to ascertain demographic or personality characteristics which might be mediating their behavior. In three experiments, two using college students as subjects and one using Philadelphia Court of Common Pleas jury pool members, it was found that authoritarians changed their attitude with regard to the defendant's guilt more than equalitarians. Further, most of these “changers” were aware they had changed their attitude. There was no generalizable evidence for the proposition that authoritarians are more likely to favor a guilty verdict.     

Therapieabbrüche in der stationären Psychotherapie

This article focuses on the patients’ view of the causes and consequences of premature therapy termination in inpatient psychosomatic setting. In this study, drop-out patients and non-drop-out patients were questioned in semi-structured phone interviews (n=62). The causes of early termination are seen in this study to be connected with an internal, somatic concept of disease, discontent with treatment, and social interaction problems in the hospital. In 80% of the examined cases more than two causes were reported. Consequently, early termination of treatment can be considered as an outcome of multifactorial influences. Furthermore, a group of “inner drop-outs” has been identified within the non-drop-out patients. Despite high discontent, these patients remained in treatment because they often feared possible negative consequences of early treatment termination. Both drop-outs and inner drop-outs scored lower in outcome analysis than the remaining patients. This study points to problem areas that can help identify potential drop-out patients.     

Der Arztbrief

The right of inspection in the hospital documents, the hospital discharge report for example, is often refused to patients in in-patient psychotherapeutic treatment (psychiatry, psychosomatic and psychotherapeutic medicine) with reference to the protection of the patients themselves, their doctors or relatives. Within a systemic therapy approach patients of an acute psychosomatic care unit in a hospital the patients could inspect the report of their hospital treatment including all ?objective” and ?subjective” data of their hospital stay. The conversation with patients and their relatives about this report and modifications of the details and addresses of the report in case of patients’ objections is considered as a psychotherapeutic tool (narrative of doctor and patient) in order to improve the transparency of the diagnostic and therapeutic process and the insights in the psychosomatic mechanisms of the patient’s disease. We discuss our organisation of cocreating the hospital discharge report and our experiences with this type of patient-doctor-communication.     

Excessive self-focused attention and defensiveness among psychiatric patients: a vicious cycle?

The contribution of defensive coping to the phenomenon of excessive self-focused attention was studied in 20 depressed or anxious psychiatric outpatients comprising the negative affect group, 20 patients with psychotic disorders, and a control group of 21 patients of an orthopaedic clinic. Self-focused attention was assessed using the Self-reflectiveness and Internal State Awareness subfactors of the Private Self-consciousness Scale. In accordance with other research on self-focused attention, the negative affect group obtained higher scores on the Self-reflectiveness scale than the control group (t39=2.40, p<.03). To examine the relationship between self-focus and defensiveness, Weinberger, Schwartz, and Davidson's approach was employed, using median splits of short forms of the Taylor Manifest Anxiety Scale and the Marlowe-Crowne scale to differentiate among four groups of subjects. The highest self-reflectiveness was found for those participants who were high in both defensiveness and anxiety. This group scored higher than the nondefensive high anxious group (t30= -2.31, p<.03). The heightened self-focused attention might result from automatically instigated states of self-focused attention and paradoxical effects of defensive efforts to avoid self-focus.     

Effectiveness of an empirically supported treatment for social phobia in the field

This study examined the effectiveness of individual exposure combined with cognitive restructuring for social phobia in a clinical setting as well as the influence of sample restriction criteria on the effect size. Participants were 217 unselected patients with a primary diagnosis of social phobia who were treated by 57 therapists in four outpatient clinics of the Christoph-Dornier-Foundation of Clinical Psychology in Germany. Results 6 weeks after the end of therapy showed highly significant reductions in social phobic fears and avoidance as well as in general anxiety and symptoms of depression. However, patients who dropped out during therapy reported a significantly higher degree of depression. Results did not differ between the four outpatient clinics and are comparable with the average effect-sizes reported by meta-analytic studies of controlled efficacy research, using selected patients. Also, restricting the sample according to the selection criteria often applied in research settings did not result in higher effect sizes for the applied outcome measures. We conclude that individual cognitive behavioural therapy for social phobia can be transported from research settings to the field of mental health.