Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

An Evaluation of the Effects of Diagnostic Composition on Individual Treatment Outcome Within Transdiagnostic Cognitive–Behavioral Group Therapy for Anxiety

Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179–186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89–97; Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97). Transdiagnostic group treatment packages focus on the common aspects inherent across the anxiety disorders such as behavioral and cognitive avoidance, and faulty cognitive appraisals of threat potential or meaning (Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230). Although research supports the overall efficacy of transdiagnostic cognitive behavior therapy (CBT) for anxiety disorders (Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice and Training, 45, 214–226), the effect of diagnostically mixed group composition on individual outcomes is less clear. This study investigated the relationship between group composition and treatment outcome within diagnostically heterogeneous groups with the purpose of determining if diagnostic heterogeneity differentially impacted treatment outcome for 84 individuals during a 12-week transdiagnostic cognitive–behavioral group anxiety treatment program (Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guilford). The diagnostic makeup of the treatment group was examined at the beginning of treatment and at the end of treatment, and the results indicated that the diagnostic makeup of the treatment group had no significant impact on individual treatment outcome. These findings have direct implications for the delivery of transdiagnostic treatments, and are discussed in terms of their global implications for the transdiagnostic approach to the treatment of anxiety disorders.     

Treatment, Age, and Time-Related Predictors of Behavioral Outcome in Pediatric Brain Tumor Survivors

The research has shown that children surviving cancer are at risk for long-term emotional and behavioral problems secondary to the cumulative effects of cranial irradiation and chemotherapy. The purpose of this study was to investigate the emotional and behavioral outcome of children diagnosed with brain tumor and treated with cranial irradiation and chemotherapy by looking at the association between treatment, time, age, and cognitive-related variables on externalizing and internalizing behaviors at 3 years posttreatment. Fifty-four brain tumor survivors were administered a neuropsychological test battery, whereas the parents filled out the CBCL and Conners' Parent Rating Scale. The results indicate that chemotherapy treatment with vincristine, cytoxan, cisplantinum, and/or VP16 was related to poorer internalizing and externalizing behavioral outcome, especially attention, social withdrawal, and anxious–depressive symptomatology. Age at time of diagnosis or treatment, time since discontinuation of treatment, type and/or total dose of radiation therapy was not significantly correlated with any of the behavioral outcome scales. Verbal memory and learning deficits accounted for a significant portion of the variance in social withdrawal, whereas lower scores in overall intellectual functioning and verbal fluency was related to disturbances in attention, inhibition, and social functioning. The findings suggest that children treated with 1 or a combination of any of the aforementioned chemotherapy agents who exhibit declines in intellectual functioning and memory are at increased risk for long-term behavioral problems 3 years after treatment cessation. These findings support the importance for early psychotherapeutic and supportive intervention services immediately after treatment cessation, with the goal of circumventing these potentially debilitating emotional problems.     

Parental Monitoring,Association with Externalized Behavior,and Academic Outcomes in Urban African‐American Youth: A Moderated Mediation Analysis

African‐American adolescents exposed to neighborhood disadvantage are at increased risk for engaging in problem behavior and academic underachievement. It is critical to identify the mechanisms that reduce problem behavior and promote better academic outcomes in this population. Based on social disorganization and socioecological theories, the current prospective study examined pathways from parental monitoring to academic outcomes via externalizing behavior at different levels of neighborhood disadvantage. A moderated mediation model employing maximum likelihood was conducted on 339 African‐American students from 9th to 11th grade (49.3% females) with a mean age of 14.8 years (SD ± 0.35). The results indicated that parental monitoring predicted low externalizing behavior, and low externalizing behavior predicted better academic outcomes after controlling for externalizing behavior in 9th grade, intervention status, and gender. Mediation was supported, as the index of mediation was significant. Conversely, neighborhood disadvantage did not moderate the path from parental monitoring to externalizing behavior. Implications for intervention at both community and individual levels and study limitations are discussed.     

Gender Differences in Problem Solving: Expectancy and Problem Context

In this study, we investigated gender differences in problem solving as a function of problem context and expectations for success. Subjects were 90 women and 56 men from introductory psychology classes who were administered a set of mathematical problems varying in gender context under male-expectancy, female-expectancy, and neutral-expectancy conditions. No significant gender differences or interaction of gender with problem context were found. However, significant effects of problem context and expectancy were found. Both male and female subjects made higher scores on female-context problems and lower scores in the female-expectancy condition. When mathematics aptitude was used as a covariate, an interaction of gender with expectancy was found. Men in the female-expectancy condition made significantly lower scores than either men or women in the male-expectancy condition.     

The Strengths and Limitations of Case Record Reviews in Examining Family Preservation Outcome Formulation and Treatment Planning

Much debate has centered on what are reasonable outcomes of the short-term intensive family preservation services (IFPS). However, little attention has been given to how therapists actually formulate outcomes in their practices. The files of 98 families who used IFPS were reviewed to determine how therapists formulated outcomes and whether formulated outcomes varied by service sector (child welfare or mental health) and child age. It was found that formulated outcomes in mental health were more likely than those in child welfare to have a child focus and an interpersonal locus. Variation in outcome formulation in child welfare by child age was found, with outcomes of younger children more likely to be parent-focused than were outcomes of older children. The issues pointed out by these findings are discussed. Since case records are a potential data source for researchers, the paper concludes with a discussion of the strengths and limitations of case record reviews for research purposes.