Symptoms of Meares-Irlen/Visual Stress Syndrome in subjects diagnosed with Chronic Fatigue Syndrome

Several diagnostic symptoms of the visual-processing deficit Meares-Irlen/Visual Stress Syndrome are remarkably similar to symptom manifestations reported by individuals with chronic fatigue syndrome (CFS). We surveyed the specific incidences of nine widely-recognised symptoms of visual stress (VS) in a group of subjects (n = 20) previously diagnosed with CFS. The presence of each symptom of VS in the CFS group was compared to its respective presence in both an age and sex matched healthy comparison group (n = 46), and an age and sex matched group comprised of individuals (n = 14) diagnosed with VS. Results showed the frequencies of all nine VS symptoms in the CFS-diagnosed group to be significantly higher (p = .032 – p < .0005) than in the comparison group, with only two symptoms being statistically less frequent in the CFS group than in the VS-diagnosed group. The average number of VS symptoms reported by the CFS group was also significantly higher than the comparison group, yet not significantly different from the VS group. Thus, the occurrence of VS symptoms in subjects diagnosed with CFS appears to be far greater than previously reported, which in turn may indicate the interplay of some yet to be identified underlying factor(s) common to both conditions.     

Associations between attachment‐related symptoms and later psychological problems among international adoptees: Results from the FinAdo study

We examined the associations between attachment‐related symptoms (symptoms of reactive attachment disorder (RAD), symptoms of disinhibited social engagement disorder (DSED), and clinging) and later psychological problems among international adoptees. The study population comprised internationally adopted children (591 boys and 768 girls, 6–15 years) from the ongoing Finnish Adoption (FinAdo) study. Data were gathered with self‐administered questionnaires both from adoptive parents and from adoptees aged over 9 years. Attachment‐related symptoms were measured using of a short (8‐item) questionnaire and later behavioral/emotional problems were assessed using the Child Behavior Checklist (CBCL) and the Five to Fifteen (FTF) scale for attention‐deficit/hyperactivity disorder (ADHD) symptoms. RAD and DSED symptom subscales were associated with an increased risk of emotional and behavioral problems and ADHD. Especially the mixed type of attachment‐related symptoms was strongly associated with later emotional and behavioral problems.     

Theoretical frameworks for working with harder to reach families: lines,curlicues, and spirals: comment on Donovan and Pocock

This article comments on the Donovan and Pocock articles appearing in this issue, both of which address the evolution of theory and practice in family therapy. An emphasis is placed on the importance of integration and a shared philosophy of theory and practice in our current political and economic managed care climate, in which it is critically important to embrace the integrated and chaotic whole of what is happening in theory and in practice.     

An Optimized Design of Choice Experiments: A New Approach for Studying Decision Behavior in Choice Task Experiments

In this paper, we present a new approach for the optimal experimental design problem of generating diagnostic choice tasks, where the respondent's decision strategy can be unambiguously deduced from the observed choice. In this new approach, we applied a genetic algorithm that creates a one‐to‐one correspondence between a set of predefined decision strategies and the alternatives of the choice task; it also manipulates the characteristics of the choice tasks. In addition, this new approach takes into account the measurement errors that can occur when the preferences of the decision makers are being measured. The proposed genetic algorithm is capable of generating diagnostic choice tasks even when the search space of possible choice tasks is very large. As proof‐of‐concept, we used this novel approach to generate respondent‐specific choice tasks with either low or high context‐based complexity that we operationalize by the similarity of alternatives and the conflict between alternatives. We find in an experiment that an increase in the similarity of the alternatives and an increase in the number of conflicts within the choice task lead to an increased use of non‐compensatory strategies and a decreased use of compensatory decision strategies. In contrast, the size of the choice tasks, measured by the number of attributes and alternatives, only weakly influences the strategy selection. Copyright © 2014 John Wiley & Sons, Ltd.     

Couple and Family Treatments: Study Quality and Level of Evidence

This paper examines the application of the guidelines for evidence‐based treatments in family therapy developed by Sexton and collaborators to a set of treatment models. These guidelines classify the models using criteria that take into account the distinctive features of couple and family treatments. A two‐step approach was taken: (1) The quality of each of the studies supporting the treatment models was assessed according to a list of ad hoc core criteria; (2) the level of evidence of each treatment model was determined using the guidelines. To reflect the stages of empirical validation present in the literature, nine models were selected: three models each with high, moderate, and low levels of empirical validation, determined by the number of randomized clinical trials (RCTs). The quality ratings highlighted the strengths and limitations of each of the studies that provided evidence backing the treatment models. The classification by level of evidence indicated that four of the models were level III, “evidence‐based” treatments; one was a level II, “evidence‐informed treatment with promising preliminary evidence‐based results”; and four were level I, “evidence‐informed” treatments. Using the guidelines helped identify treatments that are solid in terms of not only the number of RCTs but also the quality of the evidence supporting the efficacy of a given treatment. From a research perspective, this analysis highlighted areas to be addressed before some models can move up to a higher level of evidence. From a clinical perspective, the guidelines can help identify the models whose studies have produced clinically relevant results.     

Judgment of infant cry: The roles of acoustic characteristics and sociodemographic characteristics

Adult judgments of infant cry are determined by both acoustic properties of the cry and listener sociodemographic characteristics. The main purpose of this research was to investigate how these two sources shape adult judgments of infant cry. We systematically manipulated both the acoustic properties of infant cries and contrasted listener sociodemographic characteristics. Then, we asked participants to listen to several acoustic manipulations of infant cries and to judge the level of distress the infant was expressing and the level of distress participants felt when listening. Finally, as a contrasting condition, participants estimated the age of the crying infant. Using tree‐based models, we found that judgments of the level of distress the infant was expressing as well as the level of distress listeners felt are mainly accounted for by select acoustic properties of infant cry (proportion of sound/pause, fundamental frequency, and number of utterances), whereas age estimates of a crying infant are determined mainly by listener sociodemographic characteristics (gender and parental status). Implications for understanding infant cry and its effects as well as early caregiver‐infant interactions are discussed.     

Sustained Implementation of Evidence‐based Programs in Disadvantaged Communities: A Conceptual Framework of Supporting Factors

This paper presents a review of the empirical literature for studies evaluating factors that facilitate and create barriers to sustained program implementation in disadvantaged communities. It outlines study methodology and sustainment outcomes and proposes a conceptual model that involves implementation sustainment support for providers delivering evidence‐based health and family services in disadvantaged communities. Sustained program implementation in the community setting is a significant issue as only 43% of studies reported successfully sustained programs. The review identified 18 factors that facilitate success and create barriers to program sustainment. The factors are synthesized into three themes; program characteristics, workplace capacity, and process and interaction factors. The majority of factors map onto commonly cited sustainability influences in implementation science. However, there was an additional focus for studies included in this review on the importance of factors such as program burden, program familiarity and perceived competence in program skills, workplace support for the program, staff mobility and turnover, supervision and peer support, and ongoing technical assistance. The need to use a conceptual framework and develop measures to guide and evaluate capacity building in EBP implementation and sustainment in low‐resource community settings is highlighted.