Psychometric Properties and Responsiveness to Change of 15‐ and 28‐Item Versions of the SCORE: A Family Assessment Questionnaire

The SCORE (Systemic Clinical Outcome and Routine Evaluation) is a 40‐item questionnaire for completion by family members 12 years and older to assess outcome in systemic therapy. This study aimed to investigate psychometric properties of two short versions of the SCORE and their responsiveness to therapeutic change. Data were collected at 19 centers from 701 families at baseline and from 433 of these 3–5 months later. Results confirmed the three‐factor structure (strengths, difficulties, and communication) of the 15‐ and 28‐item versions of the SCORE. Both instruments had good internal consistency and test–retest reliability. They also showed construct and criterion validity, correlating with measures of parent, child, and family adjustment, and discriminating between clinical and nonclinical cases. Total and factor scales of the SCORE‐15 and ‐28 were responsive to change over 3–5 months of therapy. The SCORE‐15 and SCORE‐28 are brief psychometrically robust family assessment instruments which may be used to evaluate systemic therapy.     

Impulsive behaviour in interpersonal encounters: Associations with quarrelsomeness and agreeableness

Associations between impulsivity and interpersonal behaviours have rarely been examined, even though impulsivity may disrupt the flow of social interactions. For example, it is unknown to what extent the commonly used Barratt Impulsiveness Scale (BIS‐11) predicts impulsive behaviour in social situations, and how behaving impulsively during interpersonal encounters might influence levels of quarrelsomeness and agreeableness. In this study, 48 healthy working individuals completed the BIS‐11 and recorded their behaviour in social situations using event‐contingent recording. Record forms included items representing quarrelsome, agreeable, and impulsive behaviours. BIS‐11 motor impulsiveness scores predicted impulsive behaviour in social situations. Impulsive behaviour was associated, in different interactions, with both agreeableness and quarrelsomeness. Behaving impulsively in specific interactions was negatively associated with agreeableness in participants with higher BIS‐11 motor impulsiveness and positively associated with agreeableness in participants with lower BIS‐11 motor impulsiveness. Impulsive quarrelsome behaviour may cause interpersonal problems. Impulsive agreeable behaviour may have positive effects in individuals with low trait impulsivity. The idea that there are between‐person differences in the effects of state impulsivity on the flow of social interaction deserves further study.     

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.     

Establishing the feasibility of direct observation in the assessment of tics in children with chronic tic disorders

Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods.     

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.