Perceived stigma of caregivers: Psychometric evaluation for Devaluation of Consumer Families Scale

Background/Objective: The Devaluation of Consumer Families Scale (DCFS) is commonly used to measure perceived stigma towards family members of people with mental illness. However, its factorial structure has never been confirmed using confirmatory factor analysis (CFA). This study aimed to test the psychometric properties of the DCFS Taiwan version (DCFS-TW). Method: Family caregivers (N=511) completed the DCFS-TW (97 completed the DCFS again after 2 to 4 weeks) and other instruments. CFA, test-retest reliability, internal consistency, concurrent validity, and known-group validity were analyzed. Results: The three-factor structure of the DCFS-TW performed better than the one-factor structure. Test-retest reliability (r = .66) and internal consistency were satisfactory (α = .85); concurrent validity (absolute r = .20 to .58) was acceptable; known-group validity was supported by the significantly different DCFS-TW scores in clinical characteristics (had been vs. had not been hospitalized; had been vs. had not been compulsorily admitted). Conclusions: The DCFS-TW has decent psychometric properties and is suitable for health professionals to measure perceived stigma towards family members of people with mental illness.     

Chronic Pain and Neuropsychological Functioning

This review article examines the effect of chronic pain on neuropsychological functioning. Primary attention is given to studies that include patient groups without a history of traumatic brain injury (TBI) or neurologic disorders. Numerous studies were identified that demonstrate neuropsychological impairment in patients with chronic pain, particularly on measures assessing attentional capacity, processing speed, and psychomotor speed. Despite suggestive findings, further studies are needed to clarify the variables that mediate the impact of pain on neuropsychological functioning and the unique role of various symptoms often associated with chronic pain.     

Inhibition and shifting in children with learning deficits in arithmetic and reading

The executive functions of inhibition and shifting were studied in arithmetic-disabled children, reading-disabled children, reading plus arithmetic-disabled children, and controls (N = 74). Measures involved the rapid naming of objects, digits, letters, or quantities with or without additional task requirements that reflected inhibition or shifting. Also, the Making Trails task, reflecting shifting, was administered. For tasks without executive demands, arithmetic-disabled children were slower in the naming of digits and quantities, whereas reading-disabled children were slower in the naming of digits and letters. For the executive tasks, arithmetic-disabled children as well as reading plus arithmetic-disabled children were impaired on the Making Trails task and on an object naming task that required both inhibition and shifting. Reading-disabled children exhibited no problems in executive functioning. Furthermore, it was shown that reading plus arithmetic-disabled children experienced the combination of problems that characterize children with a single learning deficit.     

Which Executive Functioning Deficits Are Associated With AD/HD,ODD/CD and Comorbid AD/HD+ODD/CD?

This study investigated (1) whether attention deficit/hyperactivity disorder (AD/HD) is associated with executive functioning (EF) deficits while controlling for oppositional defiant disorder/conduct disorder (ODD/CD), (2) whether ODD/CD is associated with EF deficits while controlling for AD/HD, and (3)~whether a combination of AD/HD and ODD/CD is associated with EF deficits (and the possibility that there is no association between EF deficits and AD/HD or ODD/CD in isolation). Subjects were 99~children ages 6–12 years. Three putative domains of EF were investigated using well-validated tests: verbal fluency, working memory, and planning. Independent of ODD/CD, AD/HD was associated with deficits in planning and working memory, but not in verbal fluency. Only teacher rated AD/HD, but not parent rated AD/HD, significantly contributed to the prediction of EF task performance. No EF deficits were associated with ODD/CD. The presence of comorbid AD/HD accounts for the EF deficits in children with comorbid AD/HD+ODD/CD. These results suggest that EF deficits are unique to AD/HD and support the model proposed by R. A. Barkley (1997).     

On the possibility and desirability of constructing a neutral conception of disability

Disagreement about the properattitude toward disability proliferates. Yetlittle attention has been paid to an importantmeta-question, namely, whether ``disability' isan essentially contested concept. If so, recentdebates between bioethicists and the disabilitymovement leadership cannot be resolved. Inthis essay I identify some of the presumptionsthat make their encounters so contentious. Much more must happen, I argue, for anydiscussions about disability policy andpolitics to be productive. Progress depends onconstructing a neutral conception ofdisability, one that neither devaluesdisability nor implies that persons withdisabilities are inadequate. So, first, I clearaway the conceptual underbrush that makes usthink our idea of disability must bevalue-laden. Second, I sketch someconstituents of, and constraints upon, aneutral notion of disability. This revised version was published online in June 2006 with corrections to the Cover Date.     

The Relationship Between the Child and Adolescent Functional Assessment Scale (CAFAS) and Indicators of Functioning

We investigated the relationship between scores on the Child and Adolescent Functional Assessment Scale (CAFAS) and several indicators of functioning assessed in the national evaluation of the demonstration grants funded by the Center for Mental Health Services System of Care Initiative. The sample included 3187 youths, ranging in age from 4 to 23, with serious emotional disturbance (SED) who were evaluated at intake. At 6 month post-intake, 873 of these youths were re-evaluated. As predicted, higher CAFAS scores were associated with previous psychiatric hospitalization, more serious psychiatric diagnoses, and more restrictive living arrangements. Youths in residential inpatient settings were significantly more impaired than youths living in their own home or in regular foster care. Below average school performance, poor attendance, and contact with law enforcement personnel were also associated with greater impairment. Youth's total CAFAS scores decreased significantly from intake to 6 months. These results indicate that the CAFAS is a measure of functioning which has both statistical and clinical significance.     

Predictors of Family Functioning Among Clergy and Spouses: Influences of Social Context and Perceptions of Work-Related Stressors

We wished to identify predictors of family functioning from models including perceptions of stresses associated with mobility, financial compensation, intrusiveness to family boundaries, expectations on time demands, and the lack of social support. Data were collected from 136 randomly selected couples from six denominations in which husbands were clergy. Participants completed a survey that included the Clergy Family Life Inventory which assessed perceptions of five work-related stressors and the Self Report Measure of Family Functioning scale which measured 12 dimensions of family functioning. Separate regression models were tested for husbands and wives and these analyses indicated that no single stressor seemed influential for all 12 dimensions of family functioning. However, for both husbands and wives, family boundary intrusiveness, lack of social support, and mobility stresses influenced their competence in numerous areas of family functioning. In addition, husbands and wives experienced similar effects of stress among several dimensions of family functioning (e.g. enmeshment, family organization, democratic family atmosphere expressiveness).     

The Influence of Perceived Versus Aerobic Fitness on Psychological Health and Physiological Stress Responsivity

This study sought to evaluate the association between perceived and aerobic physical fitness and both psychological functioning and physiological stress responsivity. Sixty nonsymptomatic participants (30 males, 30 females) participated in the experiment. Participants completed a series of personality and mood questionnaires as well as a laboratory procedure measuring cardiovascular responses (i.e., heart rate and blood pressure) while performing stressful laboratory tasks (i.e., the Stroop Color Naming Test and a sham IQ test). Aerobic fitness (i.e., VO ₂ max using the Bruce protocol) as well as perceived fitness were also determined. Results suggest that perceived fitness was generally associated with positive personality and mood variables while aerobic fitness was not. Overall results support the view that perception of fitness may be as important or perhaps even more important than aerobic fitness in its association with psychological but perhaps not physical functioning.     

Training the supervisor: Integrating a family of origin approach

The replication of intergenerational patterns is considered here within the supervisor-family therapist-and family system, and the proposal of integrating a family of origin approach into the training of supervisors is presented. To become aware of the relation of one's own family of origin issues and their potential impact within the supervision and treatment can effectively improve intervention approaches, benefitting the supervisor, the therapist and the family in treatment. Being considerate of the training needs and levels of supervisors is an important component when integrating family of origin work into the training.