Assessing Child and Adolescent Pragmatic Language Competencies: Toward Evidence-Based Assessments

Using language appropriately and effectively in social contexts requires pragmatic language competencies (PLCs). Increasingly, deficits in PLCs are linked to child and adolescent disorders, including autism spectrum, externalizing, and internalizing disorders. As the role of PLCs expands in diagnosis and treatment of developmental psychopathology, psychologists and educators will need to appraise and select clinical and research PLC instruments for use in assessments and/or studies. To assist in this appraisal, 24 PLC instruments, containing 1,082 items, are assessed by addressing four questions: (1) Can PLC domains targeted by assessment items be reliably identified?, (2) What are the core PLC domains that emerge across the 24 instruments?, (3) Do PLC questionnaires and tests assess similar PLC domains?, and (4) Do the instruments achieve content, structural, diagnostic, and ecological validity? Results indicate that test and questionnaire items can be reliably categorized into PLC domains, that PLC domains featured in questionnaires and tests significantly differ, and that PLC instruments need empirical confirmation of their dimensional structure, content validity across all developmental age bands, and ecological validity. Progress in building a better evidence base for PLC assessments should be a priority in future research.     

心率变异性在心身疾病和情绪障碍研究中的应用

心率变异性的频谱成分可单独反映交感神经和副交感神经活动的影响。高频（HF）是由迷走神经单独介导；低频（LF）受迷走神经和交感神经共同调制，但主要反映交感神经的活动性 。此指标可对高血压、冠心病和月经前期烦躁等心身障碍进行评价。该文还探讨了它用于情绪研究的价值，并认为在不同情绪体验期间的自主神经活动有多种搭配模式，正常人与情绪障碍者之间以及情绪障碍（抑郁、焦虑、恐怖、强迫）患者在自主神经活动方面可能存在显著差别     

A Greek-Language Inventory of Fears: Psychometric Properties and Factor Structure of Self-Reports of Fears on the Hellenic Fear Survey Schedule

The structure of fearfulness and the psychometric properties of a Greek-language version of the Fear Survey Schedule were studied in a sample of normal Greek adults. Overall summary scores were higher for women than for men, had satisfactory temporal stability and internal consistency, and were useful in discriminating levels of phobic anxiety independent of levels of depression as assessed by a concurrent self-report measure. However, the temporal stabilities of responses for many items were inadequate for the reliable identification of levels of fear of specific events and objects. A factor analysis yielded five components that were conceptually similar to those obtained abroad. Subscales based on component items were psychometrically reliable. In comparison with American subjects, Greek subjects rated similar items as most fearful, but reported higher levels of fears of these items, reflecting either higher levels of fears, greater disclosure, or cultural differences in the meaning of fear ratings.     

Disorders of Eating in the Elderly

The most common eating disorder in the elderly in both community and hospital settings is food refusal. This may lead to weight loss and malnutrition with all the adverse consequences on independence and function. The management of disorders of eating in the elderly is a diagnostic and therapeutic challenge, requiring the combined skills of the medical and nursing staff. The causes are often multifactorial and require careful and repeated assessment of the patient's social, psychological, and medical history. Approach to treatment involves these factors, as well as ethical and cultural considerations. Eating is the most basic biological drive for survival in nature. In human societies there are additional cultural and social aspects that may override this instinct, as in the case of hunger strikes for political motives. In the elderly, food is one of the major sources of possible pleasure and it is the challenge for health providers to try and give this enjoyment to their patients for as long as possible.     

Sleep and psychopathology

This article examines the relationship between sleep disturbance and psychopathology. Epidemiological, cross-sectional, and longitudinal data suggest a high rate of comorbidity between sleep disturbance and psychopathology, particularly between insomnia, anxiety, and depression. Between 50% and 80% of psychiatric patients complain of sleep disturbances during the acute phase of their illness. Conversely, among treatment-seeking individuals with a primary complaint of insomnia and randomly selected community samples, approximately one third display a concurrent psychopathology, one third exhibit psychological symptoms that do not necessarily exceed the threshold for a psychiatric disorder, and another third present insomnia as a functionally autonomous disorder. There is a positive relationship between severity of sleep disturbances and concurrent psychopathology, but unequivocal evidence of a cause-and-effect relationship is still lacking. However, longitudinal data suggest that anxiety and stressful life events often precede acute sleep difficulties, whereas persistent insomnia may be a risk factor for subsequent development of depression. Implications for the prevention and treatment of coexisting sleep disturbance and psychopathology are discussed.     

Predictors and moderators of improved social-emotional functioning in mothers with substance use disorders and their young children enrolled in a relationship-based case management program

Mothers with substance use disorders (SUDs) typically have trauma histories and psychosocial difficulties that lead to poor social-emotional functioning and disrupted mother–child relationships. This 12-month study explored associations of family adverse circumstances and services (case management, therapeutic, and community-based) received by 57-mothers with SUDs and their infants (less than 24-months-old) with changes in social-emotional functioning. All mothers were enrolled in a relationship-based case management program (Parent–Child Assistance Program [PCAP]) that emphasized connecting mothers to appropriate community services. A subset of mothers was additionally provided a trauma-focused psychotherapeutic intervention (infant–parent psychotherapy [IPP]). Dyads in both treatment groups improved in overall social-emotional functioning as assessed by the Functional Emotional Assessment Scale (FEAS). A combined-sample regression analysis revealed that improved FEAS scores were significantly predicted by the number of community services received but not by PCAP case management hours (IPP was not included in this analysis). More adverse circumstances were associated with less improvement in social-emotional functioning in the children; but among the mothers trauma level did not predict FEAS scores. We also found a moderating effect of trauma: Dyads with relatively more adversity showed a significantly greater association of community services received with improvement in FEAS scores than did those with relatively less adversity.     

Schizotypal traits are not related to multisensory integration or audiovisual speech perception

Multisensory integration, the binding of sensory information from different sensory modalities, may contribute to perceptual symptomatology in schizophrenia, including hallucinations and aberrant speech perception. Differences in multisensory integration and temporal processing, an important component of multisensory integration, are consistently found in schizophrenia. Evidence is emerging that these differences extend across the schizophrenia spectrum, including individuals in the general population with higher schizotypal traits. In the current study, we investigated the relationship between schizotypal traits and perceptual functioning, using audiovisual speech-in-noise, McGurk, and ternary synchrony judgment tasks. We measured schizotypal traits using the Schizotypal Personality Questionnaire (SPQ), hypothesizing that higher scores on Unusual Perceptual Experiences and Odd Speech subscales would be associated with decreased multisensory integration, increased susceptibility to distracting auditory speech, and less precise temporal processing. Surprisingly, these measures were not associated with the predicted subscales, suggesting that these perceptual differences may not be present across the schizophrenia spectrum.     

Does culture shape face perception in autism? Cross‐cultural evidence of the own‐race advantage from the UK and Japan

Autism spectrum disorders (ASD) are associated with face perception atypicalities, and atypical experience with faces has been proposed as an underlying explanation. Studying the own‐race advantage (ORA) for face recognition can reveal the effect of experience on face perception in ASD, although the small number of studies in the area present mixed findings. This study probed the ORA in ASD by comparing two cultural groups simultaneously for the first time. Children with ASD in the UK (N = 16) and Japan (N = 26) were compared with age‐ and ability‐matched typically developing (TD) children in the UK (N = 16) and Japan (N = 26). Participants completed a two‐alternative forced‐choice task, whereby they had to recognize a just seen face from a foil which was manipulated in one of four ways (IC: identity change; EE: easy eyes; HE: hard eyes; HM: hard mouth). Face stimuli were Asian and Caucasian, and thus the same stimuli were own and other race depending on the cultural group. The ASD groups in the UK and Japan did not show impaired face recognition abilities, or impairments with recognizing faces depending on manipulations to the eye region, and importantly they showed an ORA. There was considerable heterogeneity in the presence of the ORA in ASD and TD and also across cultures. Children in Japan had higher accuracy than children in the UK, and TD children in Japan did not show an ORA. This cross‐cultural study challenges the view that atypical experiences with faces lead to a reduced/absent ORA in ASD.     

Objective and subjective bulimic episodes in the classification of bulimic-type eating disorders: Another nail in the coffin of a problematic distinction

We sought to further explore the validity of the distinction between objective bulimic episodes (OBEs) and subjective bulimic episodes (SBEs) in the study of bulimic-type eating disorders. Drawing on data obtained at the second, interview phase of a large-scale epidemiological study, we identified mutually exclusive subgroups of women with bulimic-type eating disorders who engaged in regular OBEs but not SBEs (n = 37) or regular SBEs but not OBEs (n = 52). These subgroups were compared on a wide range of outcomes, including socio-demographic characteristics, current levels of eating disorder psychopathology, general psychological distress and impairment in role functioning, current and lifetime impairment in quality of life specifically associated with an eating problem, (self)-recognition of an eating problem, health service utilization and use of psychotropic medication. The only difference between groups was that participants who reported regular OBEs were heavier than those who reported regular SBEs. The findings converge with those of previous research in suggesting that bulimic-type eating disorders characterized by regular SBEs, but not OBEs, do not differ in any clinically meaningful way from those characterized by regular OBEs, but not SBEs. Inclusion of bulimic-type eating disorders characterized by regular SBEs as a provisional category requiring further research in DSM-V appears warranted.