Evaluating young children''s cognitive capacities through computer versus hand drawings

Young normal and handicapped children, aged 3 to 6 years, were taught to draw a scene of a house, garden and a sky with a computer drawing program that uses icons and is operated by a mouse. The drawings were rated by a team of experts on a 7-category scale. The children's computer- and hand-produced drawings were compared with one another and with results on cognitive, visual and fine motor tests. The computer drawing program made it possible for the children to accurately draw closed shapes, to get instant feedback on the adequacy of the drawing, and to make corrections with ease. It was hypothesized that these features would compensate for the young children's limitations in such cognitive skills, as memory, concentration, planning and accomplishment, as well as their weak motor skills. In addition, it was hypothesized that traditional cognitive ratings of hand drawings may underestimate young children's intellectual ability, because drawing by hand demands motor skills and memory, concentration and planning skills that are more developed than that actually shown by young children. To test the latter hypothesis, the children completed a training program in using a computer to make drawings. The results show that cognitive processes such as planning, analysis and synthesis can be investigated by means of a computer drawing program in a way not possible using traditional pencil and paper drawings. It can be said that the method used here made it possible to measure cognitive abilities "under the floor" of what is ordinarily possible by means of traditionally hand drawings.     

Family interaction and child psychopathology: A comparison of two observation strategies

We examined two systems of assessing family interactions that are in common usage: a home based observation of free parent-child interaction and a clinic based observation of a structured mother-child problem solving discussion. Participants were 18 depressed, 27 conduct disordered and 16 comparison children and their mothers. Results indicated that: 1) these observations may yield very different data about child, and to a lesser extent, parent behavior, 2) parental affect in the clinic was related to their level of aversive behaviour in the home, 3) levels of both aversive and positive behavior for children and their mothers were correlated within each setting, 4) accuracy of diagnostic classifications made on the basis of the observational data were highest for comparison and conduct disordered children, but lowest for depressed children observed in the clinic, and 5) the inclusion of data on mothers' behavior increased classification accuracy for conduct disordered children only.     

Chest pain without coronary artery disease: An exploratory comparison with panic disorder

Recent reports have indicated similarities between patients with persistent chest pain of nonorganic origin and patients with panic disorder. In order to explore this association further, we administered a structured interview and three self-report measures (State-Trait Inventory, Beck Depression Inventory, and SCL90-R) to three subject groups: (1) a sample with persistent chest pain (CP; n=14) who had been screened and found to have normal coronary arteries, (2) a sample of patients with panic disorder (PD; n=14), and (3) a sample of matched normals (n=14). CP patients were considered to be free of coronary artery disease (CAD) following normal cardiac catheterization and/or normal thallium stress tests and were not diagnosed initially with panic disorder. PD patients were diagnosed with a standardized psychiatric interview and were free of organic causes of panic. Using an exploratory data analytic approach, the results indicated that both CP and PD samples reported increased levels of state and trait anxiety (p <.0001), depression (p <.01), and somatization (p <.0001) compared with normals. CP patients differed from PD patients in their less frequent use of anxiolytic medication (p <.01) and lower levels of reported panic anxiety and phobic avoidance (p <.0001). These data suggest that persistent chest pain in the absence of CAD shares some features with panic disorder, yet differs from panic in key ways as well. The results are discussed in light of the role of anxiety in contributing to symptom labeling.This research was supported by Grant 86G-491 from the American Heart Association, Texas Affiliate, to J.G.B. H.T. is the recipient of USPHS Research Career Development Award K04-HL-0122246.     

Psychopathology subtypes and symptom correlates among former prisoners of war

Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma.     

Social adjustment in the offspring of parents with bipolar affective disorder

The social adjustment of the adolescent offspring of parents with bipolar affective disorder (n=41) was compared to that of the offspring of parents with nonaffective psychiatric disorders (n=22) and the offspring of normal controls (n=26). In addition, the relationship between social adjustment and cyclothymia in offspring was determined. Social adjustment was assessed using the Life Activities Inventory, a new measure developed to assess social functioning in adolescents and young adults. Cyclothymia was assessed with the General Behavior Inventory. As a group, the offspring of bipolar parents did not differ significantly from either control group on social adjustment. However, the cyclothymic offspring of bipolar parents exhibited significantly poorer social adjustment than the noncyclothymic offspring of bipolars and the offspring of psychiatric and normal controls. These findings suggest that poor social functioning in the adolescent offspring of parents with bipolar illness may be associated with the early manifestations of affective disorder. In addition, these data indicate that despite its subsyndromal intensity, cyclothymia can result in significant social impairment.This study was supported in part by National Institute of Mental Health (NIMH) Research Grant MH-39782 to Daniel N. Klein and NIMH Grants MH-33083 and MH-37195 to Richard A. Depue.     

The interview for antisocial behavior: Psychometric characteristics and concurrent validity with child psychiatric inpatients

The present study evaluated psychometric features and correlates of the Interview for Antisocial Behavior (IAB), a new measure designed to assess antisocial child behavior. Parents of 264 psychiatric inpatients (ages 6–13 years) completed the measure to evaluate antisocial behavior of their children. The investigation evaluated the relation of IAB scores to clinically derived diagnoses and to aggression and externalizing behaviors, as measured by different raters (parents, teachers), across different settings (home, school, hospital), and with different assessment methods (rating scales, behavioral role-play test). The results indicated that the IAB showed acceptable levels of internal consistency. A priori scores (severity, duration, total antisocial behavior) and factor analytically derived scales (Arguing/Fighting, Covert Antisocial Behaviors, Self-Injury) distinguished children with a DSM III diagnosis of conduct disorder, and scores on the IAB were more consistently related to other measures of aggression and externalizing behavior than to measures of internalizing behavior or overall severity of dysfunction. The implications of the results for use of the measure, particularly in relation to evaluation of the overt-covert dimension of antisocial behavior, are discussed.Completion of this research was facilitated by a Research Scientist Development Award (MH00353) and by grants (MH35408, MH39642) from the National Institute of Mental Health and the Rivendell Foundation.     

Integrating vocational interest inventory results and expressed choices

Though many studies have examined the predictive power of expressed choices versus that of measured interests, fewer have been concerned with the relationship between the degree to which choices and interests agree and later persistence in an expressed choice. This study explored that relationship, using longitudinal data for 7706 college students and 1372 employed persons. Four levels of congruence between expressed choice and measured interests were identified. Results indicated that persistence in an expressed choice increases systematically as congruence between choice and interests increases. Implications for counselors are noted.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

内侧前额皮层-伏隔核环路在决策冲动中的作用：基于动物模型的研究

注意缺陷多动障碍(attentiondeficit/hyperactivitydisorder,ADHD)行为控制不足与决策冲动密切相关,后者受内侧前额皮层(medial prefrontal cortex, mPFC)与伏隔核(nucleus accumbens, NAc)调节。为调查ADHD决策冲动与m PFC-NAc间功能耦合的关系,研究采用ADHD模型SHR (spontaneously hypertensive rat, SHR)大鼠,结合延迟折扣任务和在体电生理,研究发现,与对照Wistar (WIS)大鼠相比, SHR大鼠对延迟大奖赏的选择百分比降低; WIS大鼠m PFC-NAc的Theta频段相干值表现为延迟选择时显著大于立即选择时、首次选择时大于连续选择时、转换试次时大于连续试次时,而SHR大鼠在上述条件均低于WIS大鼠。回归分析发现m PFC-NAc的相干差值与延迟大奖赏选择率显著正相关。结果表明m PFC-NAc间功能联系减弱是ADHD决策冲动缺陷的重要环路基础,该缺陷与其深度信息加工以及策略转换能力受损有关,扩展了ADHD决策冲动的认知和神经机制的认识。     

Year of Zoom in a Year of Doom: Lessons Learned Delivering ERP Remotely During the COVID-19 Pandemic

In response to the COVID-19 pandemic and consequential shutdown measures, many mental health professionals started providing therapy to patients exclusively via telehealth. Our research center, which specializes in studying and treating obsessive-compulsive disorder (OCD), historically has provided in-person exposure and response prevention (ERP) to adults with OCD, but shifted to telehealth during the pandemic. Unlike in other modes of talk therapy, ERP’s emphasis on therapist-supervised exposures presented unique opportunities and challenges to delivering treatment entirely via a virtual platform. This paper provides case examples to illustrate lessons we learned delivering ERP exclusively via telehealth in New York from March 2020 through June 2021 and offers recommendations for future study and practice. Though we observed a number of drawbacks to fully remote ERP, we also discovered advantages to delivering ERP this way, meriting additional research attention.