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     

“The Dead”

Gabriel Conroy, central to James Joyce's novella, The Dead, keys the reader's experience of the evening portrayed. A third-person narration allows for distance, but Gabriel's closely depicted thought processes and actions, and his insistent self-consciousness, shape the story. As such they invite psychoanalytic interpretation and reward it. Gabriel's shocking discovery and reaction to it can be seen to be informed by rendered psychodynamics and a credible internalized past. Joyce and Freud, actual contemporaries, can be seen as contemporaneous in imagination as well.     

The Factor Structure of the Beavers Interactional Scales

Confirmatory factor analysis and regression analyses of the Beavers Interactional Scales did not appear to support the model offered by its developers, namely, several specified family attributes contributing respectively to two global factors of Family Competence and Family Style. Moreover, regression analysis indicated that only three of 12 items predicted raters' assessments of Global Family Health, and one of seven items predicted Global Family Style. Individuals interested in the family dynamic centripetal/centrifugal might best think of that as a unitary entity and rate it accordingly.     

Der “dritte Weg” der “neo-eurasischen” Zeitschrift “Elementy” -- zurück ins Dritte Reich?

Studies in East European Thought - Articulated in the twenties, the doctrines of the exiled Russian ‘Evrazijstvo’ movement are undergoing a renaissance in Russia today. As the...     

Adjusting To a New Racial Climate: Maintenance of Personal Integrity

This paper will focus on the writer’s experience as a native New Yorker relocating to Montgomery, Alabama. The writer will share how he adjusted and coped with overt discrimination and racism in the context of the high school in which he attended there-a majority white high school on the “other” side of town. The writer will share how he employed the following coping mechanisms as methods of adjusting to his new environment: translating emotional experiences into words (relaxation and talk therapy), involvement with other black positive peers, careful assessment before acting, withdrawal and avoidance, and consuming African-American literature.     

Neural correlates of a default response in a delayed go/no-go task

Working memory, the ability to temporarily retain task-relevant information across a delay, is frequently investigated using delayed matching-to-sample (DMTS) or delayed Go/No-Go tasks (DGNG). In DMTS tasks, sample cues instruct the animal which type of response has to be executed at the end of a delay. Typically, performance decreases with increasing delay duration, indicating that working memory fades across a delay. However, no such performance decrease has been found when the sample cues exist of present vs. absent stimuli, suggesting that pigeons do not rely on working memory, but seem to respond by default in those trials. We trained 3 pigeons in a DGNG task and found a similar default response pattern: The diverging slopes of the retention functions on correct Go and No-Go trials suggested that pigeons by default omitted their response following No-Go stimuli, but actively retained task-relevant information across the delay for successful responses on Go trials. We conducted single-cell recordings in the avian nidopallium caudolaterale, a structure comparable to the mammalian prefrontal cortex. On Go trials, many neurons displayed sustained elevated activity during the delay preceding the response, replicating previous findings and suggesting that task-relevant information was neurally represented and maintained across the delay. However, the same units did not show enhanced delay activity preceding correct response suppressions in No-Go trials. This activation-inactivation pattern presumably constitutes a neural correlate of the default response strategy observed in the DGNG task.     

Reflections on <Emphasis Type="Italic">The Passion of the Christ</Emphasis>

The purpose of this article is to offer pastoral reflections on the movie by Mel Gibson entitled The Passion of the Christ.     

Gender Role Stereotyping of Parents in Children’s Picture Books: The Invisible Father

Previous studies reveal the reinforcement of gender stereotypes by picture books children read during the formative years. In these books, boys tend to be portrayed as active leaders, and girls as passive followers. Women and girls are under-represented. Men often exhibit career skills, and women perform traditional tasks in the home. Even when careers are nontraditional, personality characteristics and other qualities and behaviors are often stereotypical. Previous researchers emphasized the narrowly defined roles of women and children in picture books. In this study, we focused on the representation of mothers and fathers, and examined whether men are stereotyped as relatively absent or inept parents. A content analysis of the gender roles exhibited in 200 prominent childrens picture books demonstrated that fathers are largely under-represented, and, when they do appear, they are withdrawn and ineffectual parents. Further research could establish whether seriously deficient models of fatherhood in childrens literature affect the incidence of present, caring fathers in society.     

A Comparison of Results and Acceptability of Functional Behavioral Assessment Procedures with a Group of Middle School Students with Emotional/Behavioral Disorders (E/BD)

There is currently controversy over the validity and applicability of functional behavioral assessment (FBA) procedures with students with emotional/behavioral disorders (E/BD). A set of FBA procedures, including teacher and student interviews and direct classroom observations, were carried out with eight students with disabilities (7 classified E/BD, one classified LD). Results indicated that when all three methods (teacher/student interviews, classroom observations) yielded a ranking for a function they agreed 64% of those occasions. For those situations in which there was overall disagreement there was agreement between teacher interview and classroom observations most of the time. Social validity data indicated that both students and teachers felt that the assessment procedures were a useful and productive process.     

Working Memory and Learning in Early Alzheimer’s Disease

Cognitive deficits associated with early Alzheimers disease (AD) have been recently operationalised in terms of an acquisition deficit and the research supporting this view is presented. However, there is still debate concerning the nature of this deficit and how underlying cognitive processes may be detrimentally affecting the ability to acquire new information in early AD. This review argues that the pattern of cognitive deficits contributing to the acquisition impairment in early AD patients may be readily interpreted within the context of a working memory model. Isolating the component processes of working memory that underlie the acquisition deficit in early AD patients will aid in the design of clinical applications that are focussed at enhancing the ability to acquire new information in everyday life.