Axis I anxiety and mental health disorders among stuttering adolescents

PurposeThe purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.MethodParticipants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12–14 years; n = 20) and older adolescents (15–17 years; n = 17).ResultsThirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate–severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15–17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12–14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.DiscussionThese results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.Educational Objectives: The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.     

If We Build It … Will They Come? – Establishing a Cancer Genetics Services Clinic for an Underserved Predominantly Latina Cohort

Background: Cancer genetic counseling and testing is a standard of care option for appropriate families and can identify individuals at increased risk prior to diagnosis, when prevention or detection strategies are most effective. Despite documented efficacy of cancer risk reduction in high-risk individuals, underserved and minority individuals have a disproportionate cancer burden and limited access to genetic counseling. Methods: A needs assessment survey documented gaps in knowledge and interest in prevention. Satellite clinics were established at two indigent healthcare systems. Cancer genetics CME lectures were conducted and referral guidelines disseminated to clinicians who referred patients for counseling. Results: An increase in clinician knowledge was demonstrated post-CME and reflected by quality referrals. Eighty-eight percent of patients kept their appointments. In the predominantly Latina⁶ (n=77) clinic population, 71.4% were affected with cancer, and 17 mutation positive families were identified. Preliminary data shows a positive impact on patients' motivation and behavior. The majority has expressed satisfaction and reduction in anxiety. Conclusions: This study demonstrates feasibility and acceptability of cancer genetics services in this population, suggesting the potential to reduce cancer morbidity in underserved, high-risk families.“Latino” is the most common census term for individuals of Spanish, Mexican, Central and South American, Cuban, or Puerto Rican descent, referring to ethnicity, and is generally considered a more ethnically/culturally based term for individuals of the aforementioned groups. As this cohort is female the feminine noun “Latina” is used     

A Survey of Patients’ Experiences with the Cancer Genetic Counseling Process: Recommendations for Cancer Genetics Programs

In order to promote ongoing quality improvement of not only the Penn State Cancer Genetics Program, but also other cancer risk assessment programs throughout the country, we developed, piloted and conducted a survey to explore patient expectations, experiences, and satisfaction with the cancer genetic counseling process. The comprehensive survey was mailed to 340 eligible patients, 156 (45.9%) of whom returned the completed survey within the allotted time. Responses to closed-ended questions were tallied and open-ended questions were content analyzed. Major findings show that: (1) Patients were seeking cancer-related information and support throughout the cancer risk assessment process and were interested in participating in available research studies; (2) The setting in which patients are seen for cancer risk assessment may pose potential emotional ramifications; (3) Misperceptions regarding insurance discrimination and lack of insurance coverage persist; (4) Patients view the genetic counselor as responsible for updating them about new discoveries. Specific recommendations for cancer genetics programs are included.     

Understanding and Improving the Validity of Self-Report of Parenting

Although researchers using parental self-report data have questioned its validity (Holden, 2001) and called for more work in this area (Krevans & Gibbs, 1996; Locke & Prinz, 2002), methodological concerns regarding self-report about parenting practices have not been addressed adequately. The susceptibility of parental report to systematic distortions suggests a need for research on ways to improve self-report. This paper attempts to synthesize research findings from other fields (e.g., survey methodology) about ways to improve the validity of self-report, and to discuss the implications for self-report of parenting behaviors. Methods for improving self-report are presented for each of the 5 major tasks in responding to a question: (1) understanding the question, (2) recalling relevant behavior, (3) inference and estimation, (4) mapping the answer onto the response format, and (5) “editing” the answer for reasons of social desirability. Self-administered interviewing, audio-computer-assisted interviewing, pretesting, conversational interviewing, and the decompositional item may be among the best candidates for use in parental self-report. Recommendations are offered with respect to strategies that might prove useful in improving parental assessment of parenting, and to research efforts to evaluate the utility and potential costs of these strategies.     

Psychometric properties of the Situational Inventory of Body-Image Dysphoria-Short form in a Spanish sample

The primary objective of this study was to translate and validate Situational Inventory of Body-Image Dysphoria-Short form (SIBID-S) in a Spanish population. The scale consists of 20 items to assess the frequency of dysphoric body-image emotions in certain situational contexts, using a five-point rating scale. The questionnaire was administered to 214 women between the ages of 14 and 29 years, from primary and secondary schools and a university. Principal components analysis indicated a one-factor structure for the entire sample and both younger (<18) and older (≥18) participants. Internal consistency was high (0.94), and the test–retest reliability over 1 month ranged between 0.89 and 0.93. The SIBID-S showed good convergent validity in relation to other pertinent measures of body image, eating pathology, and self-esteem. Moreover, the SIBID-S was differentiated low-risk, subclinical eating disturbed, and clinical eating disordered patients. Results support the potential utility of the SIBID-S in the Spanish female population, including a younger group than previously studied, as well as its usefulness in the assessment of body image among females varying in degrees of eating pathology.     

Functional analysis and treatment of aggression maintained by preferred conversational topics

After an initial functional analysis of a participant's aggression showed unclear outcomes, we conducted preference and reinforcer assessments to identify preferred forms of attention that may maintain problem behavior. Next, we conducted an extended functional analysis that included a modified attention condition. Results showed that the participant's aggression was maintained by access to preferred conversational topics. A function-based intervention decreased aggression and increased an appropriate communicative response.     

First graders' literacy and self-regulation gains: The effect of individualizing student instruction

We examined the effect of individualizing student instruction (ISI; N = 445 students, 46 classrooms) on first graders' self-regulation gains compared to a business-as-usual control group. Self-regulation, conceptualized as a constellation of executive skills, was positively associated with academic development. We hypothesized that the ISI intervention's emphasis on teacher planning and organization, classroom management, and the opportunity for students to work independently and in small groups would promote students' self-regulation. We found no main effect of ISI on self-regulation gains. However, for students with weaker initial self-regulation, ISI was associated with greater self-regulation gains compared to peers in control classrooms. The ISI effect on self-regulation was greater when the intervention was more fully implemented.     

A Bayesian-optimal principle for learner-friendly adaptation in learning games

Adaptive learning games should provide opportunities for the student to learn as well as motivate playing until goals have been reached. In this paper, we give a mathematically rigorous treatment of the problem in the framework of Bayesian decision theory. To quantify the opportunities for learning, we assume that the learning tasks that yield the most information about the current skills of the student, while being desirable for measurement in their own right, would also be among those that are efficient for learning. Indeed, optimization of the expected information gain appears to naturally avoid tasks that are exceedingly demanding or exceedingly easy as their results are predictable and thus uninformative. Still, tasks that are efficient for learning may be experienced as too challenging, and the resulting failures can lower motivation. Therefore, in addition to quantifying the expected informational benefit for learning of any prospective task to be presented next, we also model the expected motivational cost of its presentation, measured simply as the estimated probability of failure in our example model. We propose a “learner-friendly” adaptation algorithm that chooses the learning tasks by optimizing the expected benefit divided by the expected cost. We apply this algorithm to a Rasch-like student model implemented within a real-world application and present initial results of a pilot experiment.     

Visual‐motor and executive functions in children born preterm: The Bender Visual Motor Gestalt Test revisited

Böhm, B., Lundequist, A. & Smedler, A.‐C. (2010). Visual‐motor and executive functions in children born preterm: The Bender Visual Motor Gestalt Test revisited. Scandinavian Journal of Psychology, 51, 376–384. Visual‐motor development and executive functions were investigated with the Bender Test at age 5½ years in 175 children born preterm and 125 full‐term controls, within the longitudinal Stockholm Neonatal Project. Assessment also included WPPSI‐R and NEPSY neuropsychological battery for ages 4–7 ( Korkman, 1990 ). Bender protocols were scored according to Brannigan & Decker (2003) , Koppitz (1963) and a complementary neuropsychological scoring system (ABC), aimed at executive functions and developed for this study. Bender results by all three scoring systems were strongly related to overall cognitive level (Performance IQ), in both groups. The preterm group displayed inferior visual‐motor skills compared to controls also when controlling for IQ. The largest group differences were found on the ABC scoring, which shared unique variance with NEPSY tests of executive function. Multiple regression analyses showed that hyperactive behavior and inattention increased the risk for visual‐motor deficits in children born preterm, whereas no added risk was seen among hyperactive term children. Gender differences favoring girls were strongest within the preterm group, presumably reflecting the specific vulnerability of preterm boys. The results indicate that preterm children develop a different neurobehavioral organization from children born at term, and that the Bender test with a neuropsychological scoring is a useful tool in developmental screening around school start.     

On the Speed Sensitivity Parameter in the Lognormal Model for Response Times and Implications for High-Stakes Measurement Practice

In high-stakes testing, often multiple test forms are used and a common time limit is enforced. Test fairness requires that ability estimates must not depend on the administration of a specific test form. Such a requirement may be violated if speededness differs between test forms. The impact of not taking speed sensitivity into account on the comparability of test forms regarding speededness and ability estimation was investigated. The lognormal measurement model for response times by van der Linden was compared with its extension by Klein Entink, van der Linden, and Fox, which includes a speed sensitivity parameter. An empirical data example was used to show that the extended model can fit the data better than the model without speed sensitivity parameters. A simulation was conducted, which showed that test forms with different average speed sensitivity yielded substantial different ability estimates for slow test takers, especially for test takers with high ability. Therefore, the use of the extended lognormal model for response times is recommended for the calibration of item pools in high-stakes testing situations. Limitations to the proposed approach and further research questions are discussed.