At home with Down syndrome and gender

I argue that there is an important analogy between sex selection and selective abortion of fetuses diagnosed with Down syndrome. There are surprising parallels between the social construction of Down syndrome as a disability and the deeply entrenched institutionalization of sexual difference in many societies. Prevailing concepts of gender and mental retardation exert a powerful influence in constructing the sexual identities and life plans of people with Down syndrome, and also affect their families' lives.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Family Processes and Treatment Outcome in the MTA: Negative/Ineffective Parenting Practices in Relation to Multimodal Treatment

To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.     

Parenting and Family Stress Treatment Outcomes in Attention Deficit Hyperactivity Disorder (ADHD): An Empirical Analysis in the MTA Study

Parenting and family stress treatment outcomes in the MTA study were examined. Male and female (579), 7–9-year-old children with combined type Attention Deficit Hyperactivity Disorder (ADHD), were recruited at six sites around the United States and Canada, and randomly assigned to one of four groups: intensive, multi-faceted behavior therapy program alone (Beh); carefully titrated and monitored medication management strategy alone (MedMgt); a well-integrated combination of the two (Comb); or a community comparison group (CC). Treatment occurred over 14 months, and assessments were taken at baseline, 3, 9, and 14 months. Parenting behavior and family stress were assessed using parent-report and child-report inventories. Results showed that Beh alone, MedMgt alone, and Comb produced significantly greater decreases in a parent-rated measure of negative parenting, Negative/Ineffective Discipline, than did standard community treatment. The three MTA treatments did not differ significantly from each other on this domain. No differences were noted among the four groups on positive parenting or on family stress variables. Results are discussed in terms of the theoretical and empirically documented importance of negative parenting in the symptoms, comorbidities and long-term outcomes of ADHD.     

Effects of antecedent order and semantic context on Chinese pronoun resolution

Three reading time experiments were conducted in order to examine the relative contributions of order of antecedents and semantic context to the resolution of temporarily ambiguous Chinese pronouns. These pronouns were ambiguous because each of them was preceded by two antecedents, both of which were likely candidates for coreference. The identity of the pronoun was revealed by subsequent disambiguating information that constrained the pronoun to one particular interpretation. Experiment 1 showed that reading of the disambiguating phrase was slower when the phrase confined the pronoun to the second rather than to the first antecedent. Experiment 2 produced the same effect of antecedent order (first vs. second antecedent) regardless of whether the target antecedent was an action-performing or an action-receiving entity. In Experiment 3, the order effect was eliminated by a biasing modifier inserted immediately before the pronoun. These results indicate that in a semantically neutral environment, the first-appearing antecedent is the preferred candidate for coreferencing the ambiguous Chinese pronoun. The interaction between order of antecedents and semantic context (in the form of preposed biasing modifiers) suggests that the initial comprehension of Chinese pronouns depends as much on contextual as on structural factors.     

Measurement properties of the Center for Epidemiologic Studies-Depression Scale in a homeless population

The measurement properties of the Center for Epidemiologic Studies--Depression Scale (CES-D; L. S. Radloff, 1977) were evaluated in a probability sample of homeless adults residing in a large and demographically diverse community. The findings from this investigation suggest that the CES-D is a reliable measure of depressive symptoms among homeless adults and that the factor structure of the scale replicates the factor structure found in the general population. Change in the CES-D scores was associated with change in residential status, with participants who had made a transition from homelessness to regular domicile, reporting significantly lower levels of depressive symptomatology. This result indicates the scale's sensitivity to current depressive mood, as affected by significant life events encountered by homeless persons.     

Between-individual comparisons in performance evaluation: a perspective from prospect theory

This article examines how between-individual comparisons influence performance evaluations in rating tasks. The authors demonstrated a systematic change in the perceived difference across ratees as a result of changing the way performance information is expressed. Study 1 found that perceived performance difference between 2 individuals was greater when their objective performance levels were presented with small numbers (e.g., absence rates of 2% vs. 5%) than when they were presented with large numbers (e.g., attendance rates of 98% vs. 95%). Extending this finding to situations involving trade-offs between multiple performance attributes across ratees, Study 2 showed that the relative preference for 1 ratee over another actually reversed when the presentation format of the performance information changed. The authors draw upon prospect theory to offer a theoretical framework describing the between-individual comparison aspect of performance evaluation.     

Constraints on view combination: effects of self-occlusion and differences among familiar and novel views

The use of multiple familiar views of objects to facilitate recognition of novel views has been addressed in a number of behavioral studies, but the results have not been conclusive. The present study was a comprehensive examination of view combination for different types of novel views (internal or external to the studied views) and different objects (amoeboid objects and objects composed of geons; objects with and without self-occlusion across rotation). The authors found that the advantage gained from the study of 2 views was more than the generalization from each of the studied views presented alone. This facilitation occurred only for internal views but not external views. In addition, the benefits from the study of 2 views diminished when (a) the studied views did not share the same visible features and when (b) the studied views were separated by a small angular difference.     

Whole-word phonological representations of disyllabic words in the Chinese lexicon: data from acquired dyslexia

This study addresses the issue of the existence of whole-word phonological representations of disyllabic and multisyllabic words in the Chinese mental lexicon. A Cantonese brain-injured dyslexic individual with semantic deficits, YKM, was assessed on his abilities to read aloud and to comprehend disyllabic words containing homographic heterophonous characters, the pronunciation of which can only be disambiguated in word context. Superior performance on reading to comprehension was found. YKM could produce the target phonological forms without understanding the words. The dissociation is taken as evidence for whole-word representations for these words at the phonological level. The claim is consistent with previous account for discrepancy of the frequencies of tonal errors between reading aloud and object naming in Cantonese reported of another case study of similar deficits. Theoretical arguments for whole-word form representations for all multisyllabic Chinese words are also discussed.     

The collaborative assessment and management of suicidality versus treatment as usual: a retrospective study with suicidal outpatients

The Collaborative Assessment and Management of Suicidality (CAMS) is a novel clinical approach used to identify, assess, and manage suicidal outpatients (Jobes & Drozd, 2004). The results of a retrospective study evaluating the impact of CAMS versus treatment as usual (TAU) on suicidal outpatients are presented. Patients in the CAMS treatment group (n = 25) resolved their suicidality significantly more quickly than TAU patients (n = 30). CAMS was also significantly associated with decreased medical health care utilization in the 6 months after the start of suicide-related mental health treatment. These results provide promising preliminary support for the effectiveness of CAMS and a foundation for prospective research.