The Use of the Devereux Scales of Mental Disorders in the Assessment of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder

The present study was designed to gather validity data on the Devereux Scales of Mental Disorders (DSMD) for distinguishing among children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 32), Conduct Disorder (CD; N = 34), or no clinical diagnosis (NC; N = 65). Three types of indicators were compared: (a) DSMD scale, composite, and total scores, (b) the number of ADHD or CD-related items endorsed, and (c) diagnostic efficiency statistics (e.g., sensitivity, positive and negative predictive power). The clinical groups did not differ significantly from each other, but both were significantly higher than the NC group on all DSMD scales. Moreover, there were significant differences between the ADHD and the CD groups on the number of respective ADHD and CD-related items endorsed. A cut-off of seven to eight items yielded the best discrimination between the two diagnostic groups. Diagnostic efficiency statistics indicate that the DSMD may be effective at differentiating between similar disruptive behavior disorders.     

Quality control and the practice of clinical psychology

Because of current health care reforms, quality control, accountability, and cost-effectiveness have become important issues in the practice of clinical psychology. It is imperative that practicing clinicians begin to evaluate their services to assess whether they demonstrate high quality and cost-effectiveness, as well as a continued commitment to qualify improvement. Deming's (1986) approach to quality control is discussed as a useful strategy for improving effectiveness in the practice of clinical psychology. This approach emphasizes the process of identification of the client population, improvements through incremental processes, and evaluation of outcomes. Organizational Behavior Management (OBM) techniques are also reviewed as useful ways in which to supplement and improve on Deming's approach to quality control. Science and quality control are discussed as being inherently coherent. The scientist—practitioner model dictates that services provided to clients should be rigorously evaluated. Various procedures for evaluating the quality of services provided in clinical practice are discussed.     

共情的认知神经研究回顾

共情是指个体对他人情绪和想法的感受及理解,它在人类个体和社会的发展中起到了重要作用。近年来,脑成像技术为研究共情的神经基础提供了有力的技术支持,发现了共情的关键功能脑区。基础与临床的实验证据表明,更好地理解共情的神经机制对于孤独症、反社会人格等精神障碍有重要的意义。该文对相关的研究进行了综述并对未来可能的研究方向提出了展望     

Threat interpretation bias as a vulnerability factor in childhood anxiety disorders

The present study examined threat interpretation biases in children 7-12 years of age with separation, social and generalised anxiety disorders (N=15), non-anxious offspring at risk due to parental anxiety (N=16) and non-anxious controls of non-anxious parents (N=14). Children provided interpretations of ambiguous situations to assess cognitive, emotional and behavioural responses. In comparison with non-anxious control children and at-risk children who did not differ from each other, anxious children reported stronger negative emotion and less ability to influence ambiguous situations. These results suggest that threat interpretation bias may be a cognitive factor associated with ongoing childhood anxiety but not a vulnerability factor associated with parental anxiety.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

Enhanced Cognitive Behavior Therapy: A Single Treatment for All Eating Disorders

Eating disorders are serious mental illnesses affecting a significant proportion of women and a smaller number of men. Approximately half of those with an eating disorder (ED) will not meet the criteria for anorexia or bulimia nervosa, and will be diagnosed with an eating disorder not otherwise specified (EDNOS). Until recently, there were no recommended treatments for EDNOS. This article provides an overview of enhanced cognitive behavior therapy, a validated treatment for all forms of EDs.     

Self-Reported Cognitive Inconsistency in Older Adults

ABSTRACT

Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70–91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.     

Processing of musical structure by high-functioning adolescents with autism spectrum disorders

Enhanced pitch perception and memory have been cited as evidence of a local processing bias in autism spectrum disorders (ASD). This bias is argued to account for enhanced perceptual functioning (Mottron &; Burack, 2001 Mottron, L. and Burack, J. A. 2001. “Enhanced perceptual functioning in the development of autism”. In The development of autism: Perspectives from theory to research, Edited by: Burack, J. A., Charman, T., Yirmiya, N. and Zelazo, P. R. 131–147. Mahwah, NJ: Lawrence Erlbaum.  [Google Scholar]; Mottron, Dawson, Soulières, Hubert, &; Burack, 2006 Mottron, L., Dawson, M., Soulières, I., Hubert, B. and Burack, J. 2006. Enhanced perceptual functioning in autism: An update, and eight principles of autistic perception. Journal of Autism and Developmental Disorders, 36(1): 27–43. doi:10.1007/s10803-005-0040-7[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and central coherence theories of ASD (Frith, 1989 Frith, U. 1989. Autism: Explaining the enigma, Oxford: United Kingdom: Blackwell.  [Google Scholar]; Happé &; Frith, 2006 Happé, F. and Frith, U. 2006. The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36(1): 5–25. doi:10.1007/s10803-005-0039-0[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). A local processing bias confers a different cognitive style to individuals with ASD (Happé, 1999 Happé, F. 1999. Autism: Cognitive deficit or cognitive style?. Trends in Cognitive Sciences, 3(6): 216–222. doi:10.1016/S1364-6613(99)01318-2[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), which accounts in part for their good visuospatial and visuoconstructive skills. Here, we present analogues in the auditory domain, audiotemporal or audioconstructive processing, which we assess using a novel experimental task: a musical puzzle. This task evaluates the ability of individuals with ASD to process temporal sequences of musical events as well as various elements of musical structure and thus indexes their ability to employ a global processing style. Musical structures created and replicated by children and adolescents with ASD (10–19 years old) and typically developing children and adolescents (7–17 years old) were found to be similar in global coherence. Presenting a musical template for reference increased accuracy equally for both groups, with performance associated to performance IQ and short-term auditory memory. The overall pattern of performance was similar for both groups; some puzzles were easier than others and this was the case for both groups. Task performance was further found to be correlated with the ability to perceive musical emotions, more so for typically developing participants. Findings are discussed in light of the empathizing-systemizing theory of ASD (Baron-Cohen, 2009 Baron-Cohen, S. 2009. Autism: The Empathizing-Systemizing (E-S) Theory. Annals of the New York Academy of Sciences, 1156: 68–80. doi:10.1111/j.1749-6632.2009.04467.x[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) and the importance of describing the strengths of individuals with ASD (Happé, 1999 Happé, F. 1999. Autism: Cognitive deficit or cognitive style?. Trends in Cognitive Sciences, 3(6): 216–222. doi:10.1016/S1364-6613(99)01318-2[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Heaton, 2009 Heaton, P. 2009. Assessing musical skills in autistic children who are not savants. Philosophical Transactions of the Royal Society Biological Sciences, 364: 1443–1447. doi:10.1098/rstb.2008.0327[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]).     

Complementary assessments of executive function in preterm and full-term preschoolers

Executive functions (EFs) are interrelated cognitive processes that have been studied in relation to behavior, attention, academic achievement, and developmental disorders. Studies of EF skills assessed through parent report and performance-based measures show correlations between them ranging from none to modest. Few studies have examined the relationship between EF skills measured through parent report and performance-based measures in relation to adaptive function. The present study included preschool children born preterm as a population at high risk for EF impairments. Preschool children (N = 149) completed a battery of EF tasks that assess working memory, response inhibition, idea generation, and attention shifting or cognitive flexibility. Parents reported on children’s EF and adaptive skills. Preterm children showed more parent-rated and performance-based EF impairments than did full-term children. The combined use of either parent report or performance-based measures resulted in the identification of a large number of children at risk for EF impairment, especially in the preterm group. Both parent report and performance-based EF measures were associated with children’s adaptive function. EF skills are measurable in young child'ren, and we suggest that EF skills may serve as targets for intervention to improve functional outcomes. We recommend the use of both parent report and performance-based measures to characterize children’s EF profiles and to customize treatment.     

Trait Anger and Axis I Disorders: Implications for REBT

Anger has a prominent role in basic theories of emotion. And while many psychiatric disorders can be conceived of as emotional disorders (e.g., depressive disorders, anxiety disorders), there are no disorders for which anger is the cardinal feature. We analyzed diagnostic data on 1,687 (as later) psychiatric outpatients and looked at the co-occurrence of high trait anger (as assessed by criterion 8 of Borderline Personality Disorder) and Axis I disorders, and Borderline and Antisocial Personality Disorders. The purpose was to examine whether dysfunctional anger met criteria necessary to be considered a valid diagnostic category. Results showed that high trait anger was not fully accounted for by any particular Axis I diagnosis, or any set of Axis I diagnoses, or by the combination of Axis I diagnoses and Borderline and Antisocial PDs. Trait anger also accounted for significant amounts of unique variance in several indicators of psychiatric impairment and psychosocial functioning. We describe the anger disorder diagnoses of Eckhardt and Deffenbacher (Anger disorders: Definition, diagnosis and treatment. Taylor & Francis, Bristol, PA, 1995), and discuss the implications of those diagnoses for the practice of REBT and CBT.