Recall initiation strategies must be controlled in training studies that use immediate free recall tasks to measure the components of working memory capacity across time

There has been great interest in using working memory (WM) training regimens as an alternative treatment for ADHD, but it has recently been concluded that existing training regimens may not be optimally designed because they target the primary memory component but not the secondary component of WM capacity. This conclusion requires the ability to accurately measure changes in primary and secondary memory abilities over time. The immediate free recall task has been used in previous studies to measure these changes; however, one concern with these tasks is that the recall order required on training exercises may influence the recall strategy used during free recall, which may in turn influence the relative number of items recalled from primary and secondary memory. To address this issue, previous training studies have explicitly controlled recall strategy before and after training. However, the necessity of controlling for recall strategies has not been explicitly tested. The present study investigated the effects of forward-serial-order training on free recall performance under conditions in which recall strategy was not controlled using a sample of adolescents with ADHD. Unlike when recall order was controlled, the main findings showed selective improvement of the secondary memory component (as opposed to the primary memory component) when recall order was uncontrolled. This finding advances our understanding of WM training by highlighting the importance of controlling for recall strategies when free recall tasks are used to measure changes in the primary and secondary components of WM across time.     

Will the “Real Boy” Please Behave: Dosing Dilemmas for Parents of Boys with ADHD

The use of Ritalin and other stimulant drug treatments for attention-deficit hyperactivity disorder (ADHD) raises distinctive moral dilemmas for parents; these moral dilemmas have not been adequately addressed in the bioethics literature. This paper draws upon data from a qualitative empirical study to investigate parents' use of the moral ideal of authenticity as part of their narrative justifications for dosing decisions and actions. I show that therapeutic decisions and actions are embedded in valued cultural ideals about masculinity, self-actualization and success, as well as in moral conceptions of authenticity and personal freedom. I argue that this investigation of parents' moral justifications and dosing dilemmas raises questions about the validity of authenticity as a transcendent moral principle. Moreover, this study demonstrates that in order to be relevant, bioethical analysis of neurocognitive enhancement must engage with ground-up studies of moral principles and decision-making in context.     

ADHD Assessment

Abstract

This study examined effects of negative versus positive symptom formats on the assessment and subsequent classification of ADHD in children in public schools. Symptoms associated with the disorder based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) were presented to parents and teachers of referred children according to both types of formats. Informants were then asked to indicate whether the symptoms described the child's behavior over the last six months. Overall, the negatively phrased symptoms appeared to generate response bias which resulted in an increased percentage of children meeting the DSM-IV criteria for ADHD. Additionally, the decision reliability or classification agreement between the two formats was low, suggesting the possibility of confirmation bias in the assessment process. Implications for practice and future research are discussed.     

Ethical Challenges for Jewish Long Term Care Providers

ABSTRACT

This article discusses the particular ethical challenges and opportunities facing Jewish long term care providers. The discussion begins with background on Jewish healthcare ethics generally and then notes several problems in applying traditional principles in concrete situations today. Specific ethical dilemmas characterizing long term care are described, and their implications for practice within Jewish facilities are explicated. Finally, suggestions are offered regarding special contributions that can be made to both the Jewish community and the larger society by bringing the perspective of Jewish healthcare ethics to the arena of long term care provision and policy-making for aging citizens.     

Differences in High and Low Anxiety Sensitive Women's Responses to a Laboratory‐Based Cold Pressor Task

Anxiety sensitivity (AS) has been linked to a variety of disabling chronic health conditions, including pain‐related conditions. A recent study has found that healthy women with high AS reported significantly higher levels of sensory and affective pain on an experimental cold pressor task compared to women with low AS. However, this study found no differences between AS groups for pain tolerance or pain threshold. In the present study, which was designed to replicate and extend these findings, 90 undergraduate university women were selected for inclusion in 1 of 2 AS groups (high or low) based on their screening scores on a 16‐item measure of AS. Participants were tested individually on a lab‐based cold pressor task using a variety of self‐report and observer‐measured variables. Data analyses revealed that, as expected, the high AS participants reported significantly more fear in response to the cold pressor on a relevant item of the McGill Pain Questionnaire – Short Form (SF‐MPQ) than did the low AS participants. Also as expected, the high AS participants reported more pain in response to the cold pressor on the Present Pain Index (PPI) of the SF‐MPQ than did the low AS participants. High AS participants did not differ from low AS participants on other aspects of the cold pressor response (e.g. pain threshold, pain tolerance, pain recovery). These results support the role of pain‐related fear as a mediating variable between AS and increased perceived pain intensity.     

Vicarious Trauma in Social Workers: The Role of Trauma History,Social Support,and Years of Experience

Vicarious trauma, a disruption in schemas and worldview often accompanied by symptoms similar to those of posttraumatic stress disorder, occurs as a result of chronic secondary exposure to traumatic material. The aim of this study was to examine the role of personal trauma history, social support, and experience level in the development of vicarious trauma among licensed social workers in Maryland (N = 160). Results indicated an increase in social support and in experience level of social workers predicted less severe vicarious trauma. In addition, an interaction effect between trauma history and social support trending on significance indicated higher levels of social support might help protect those without a trauma history but not those with a trauma history against vicarious trauma. Research and clinical implications are discussed.     

Sticks and Stones May Break My Bones but Words Relate to Adult Physiology? Child Abuse Experience and Women's Sympathetic Nervous System Response while Self-Reporting Trauma

Child abuse predicts a wide range of long-lasting deleterious outcomes, including disruptions in the biological systems central to emotion arousal and regulation. However, little is known about the specific ways in which child abuse affects adulthood sympathetic reactivity and recovery. This study investigated the association between child abuse experience and adult skin conductance level and habituation in 85 at-risk women as they completed a self-report trauma questionnaire. Childhood emotional abuse was independently associated with blunted skin conductance habituation over the course of survey completion after controlling for other abuse subtypes and current trauma symptoms. These results suggest that women emotionally abused as children experience prolonged emotional arousal and poor physiological regulation of emotion in response to reminders of traumatic experiences.     

Yoga Practice May Buffer the Deleterious Effects of Abuse on Women's Self-Concept and Dysfunctional Coping

Women who experienced abuse as children or adults can suffer from symptoms such as dissociations, physiological regulation difficulties, and mood disturbances that might not respond to traditional interventions. Given the benefits of yoga, we hypothesized that yoga practice would ameliorate the negative impact of abuse on psychological functioning. Our findings suggest that frequent yoga practice might ameliorate the negative impact of abuse history on self-concept and coping skills. In addition, our findings suggest that women who incorporate yoga into other areas of life could get the greatest psychological benefits. Given the preliminary nature of this study, further research into the benefits of yoga on women who have child or adult abuse histories is warranted.     

Gender Differences in Reporting Psychological Abuse in a National Sample

Understanding the nature and impact of psychological abuse for males and females is crucial because it might be the precursor of other forms of violence. This study examines reported gender differences in psychologically abusive acts using a national sample of U.S. citizens. The data were collected anonymously from an online administration of the Measure of Psychological Abuse (MPAB). Other measures were included to assess outcomes that might occur due to psychological abuse. Results indicate that there are more similarities than differences in the gender reports of psychological abuse. Compared to males' reports, differences include female reports of certain behaviors leading to more negative emotional and behavioral impact and more negative outcomes due to being in a psychologically abusive relationship.     

Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse

Attention deficit disorder and attention deficit/hyperactivity disorders (ADD/ADHD) are found in approximately 5% to 10% of school-aged children. This study examined whether childhood physical abuse was associated with ADD/ADHD. Data were derived from a population-based sample of 13,054 adults from the 2005 Canadian Community Health Survey. We used logistical regression analysis in 2 models, both of which had ADD/ADHD as the criterion variable. There were 7 times higher odds of ADD/ADHD among those who reported they had been abused after controlling for several potential mediating factors, including age, race, gender, and 3 other types of adverse childhood experiences (parental divorce, parental addictions, and long-term parental unemployment) in comparison to those who were not abused. The results of this analysis show a strong link between childhood abuse and ADD/ADHD, an association that requires further study.