Midi-level measurement of social anxiety in psychiatric and non-psychiatric samples

This paper reports the development and assessment of midi-level behavioral measures of social anxiety in the context of two experiments, one studying an analog student sample, the other a psychiatric sample. Judgments on nine categories of clinically practical midi-level behaviors (e.g. Facial Expression, Orienting, Sense of Timing), based on a review of the literature on human ethology and on pilot research, were compared to global judgments of social anxiety and social skill and to physiological arousal. Intraclass correlations exceeded 0.80 for judgments of the global and midi-level behavioral ratings on both samples. Results of correlational analyses indicated that while there were several significant predictors of global skill and anxiety among the midis, the magnitude of the relationship between midis and globals was stronger for the patient than the student sample. Further analyses based on S's heart rate (HR) reactivity suggested that while global ratings did not significantly predict H R in a high social anxiety situation, one midi-level behavioral rating (self-manipulations) did. The clinical utility of the newly developed measures is discussed with particular attention to their practicality for behavior therapy.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.     

An Ethical Framework for the Design,Development, Implementation,and Assessment of Drones Used in Public Healthcare

Science and Engineering Ethics - The use of drones in public healthcare is suggested as a means to improve efficiency under constrained resources and personnel. This paper begins by framing drones...     

Using high-probability foods to increase the acceptance of low-probability foods

Studies have evaluated a range of interventions to treat food selectivity in children with autism and related developmental disabilities. The high-probability instructional sequence is one intervention with variable results in this area. We evaluated the effectiveness of a high-probability sequence using 3 presentations of a preferred food on increasing acceptance in a child with autism who refused a few specific foods. The high-probability sequence increased acceptance of 3 foods. We then systematically faded the intervention for 2 foods.     

EFFECTS OF A SIGNALED DELAY TO REINFORCEMENT IN THE PREVIOUS AND UPCOMING RATIOS ON BETWEEN-RATIO PAUSING IN FIXED-RATIO SCHEDULES

Domestic hens responded under multiple fixed‐ratio fixed‐ratio schedules with equal fixed ratios. One component provided immediate reinforcement and the other provided reinforcement after a delay, signaled by the offset of the key light. The components were presented quasirandomly so that all four possible transitions occurred in each session. The delay was varied over 0, 4, 8, 16, and 32 s with fixed‐ratio 5 schedules, and over 0, 8 and 32 s with fixed‐ratio 1, 15 and 40 schedules. Main effects of fixed‐ratio value and delay duration were detected on between‐ratio pauses. Pauses were longer when the multiple‐schedule stimulus correlated with a delayed‐reinforcer component was presented, with the longest pauses occurring at the transition from a component with an immediate reinforcer to one with a delayed reinforcer. Pause durations were shortest during immediate components. Overall, both the presence or absence of a delay in the upcoming component, and the presence or absence of a delay in the preceding component affected pause length, but the upcoming delay had the larger effect. Thus changes in delay had similar effects to past reports of the effects of changes in response force, response requirement, and reinforcer magnitude in multiple fixed‐ratio fixed‐ratio schedules.     

Initial development of a brief measure of psychological distress

This paper addresses the preliminary development, construct validity, and psychometric properties of a brief self-report measure of psychological distress. 40 items were originally generated by doctoral level psychologists for use in the preliminary clinical sample. Inpatients from a psychiatric unit (N = 125) completed the items, and a principal-components analysis with a direct oblimin rotation was used to evaluate construct validity. The study indicated a four-factor solution, using the constructs of Depression, Hopelessness, Anxiety, and Anger, with good estimates of reliability. After evaluation of factor structure, item analyses, and reliability estimates, a redacted 19-item scale was identified.     

Family Functioning and the Course of Adolescent Bipolar Disorder

The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age = 14.48 ± 1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents’ depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents’ manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.     

Teacher Acquisition of Functional Analysis Methods Using Pyramidal Training

Pyramidal training involves an experienced professional training a subset of individuals who, in turn, train additional individuals. Pyramidal training is effective for training a variety of behavior-analytic skills with direct-care staff, parents, and teachers. As teachers’ roles in behavioral assessment increase, pyramidal training may be useful to improve the procedural fidelity with which teachers conduct functional analyses. In the current study, previously trained teachers taught six other teachers (trainees) to conduct standard functional analysis conditions in a pyramidal training model. All trainees quickly acquired the skills necessary to conduct attention, escape, play, and tangible conditions during analog role-plays. Trainees also implemented functional analysis conditions with fidelity in their classrooms with students. Using a pyramidal training model may help to disseminate behavior-analytic procedures.     

Using facial muscular movements to understand young children's emotion regulation and concurrent neural activation

Individual differences in young children's frustration responses set the stage for myriad developmental outcomes and represent an area of intense empirical interest. Emotion regulation is hypothesized to comprise the interplay of complex behaviors, such as facial expressions, and activation of concurrent underlying neural systems. At present, however, the literature has mostly examined children's observed emotion regulation behaviors and assumed underlying brain activation through separate investigations, resulting in theoretical gaps in our understanding of how children regulate emotion in vivo. Our goal was to elucidate links between young children's emotion regulation‐related neural activation, facial muscular movements, and parent‐rated temperamental emotion regulation. Sixty‐five children (age 3–7) completed a frustration‐inducing computer task while lateral prefrontal cortex (LPFC) activation and concurrent facial expressions were recorded. Negative facial expressions with eye constriction were inversely associated with both parent‐rated temperamental emotion regulation and concurrent LPFC activation. Moreover, we found evidence that positive expressions with eye constriction during frustration may be associated with stronger LPFC activation. Results suggest a correspondence between facial expressions and LPFC activation that may explicate how children regulate emotion in real time.