Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.     

Fluency versus conscious recollection in the word completion performance of amnesic patients

To examine the relative contribution of fluency and recollection to the word completion performance of amnesics, we administered a task in which patients were told specifically not to utilize previously presented words during stem completion (an Exclusion condition). This condition was contrasted with a standard word completion task in which patients were encouraged simply to complete the stem with the first word that came to mind (an Inclusion condition). Since the exclusion condition necessitated controlled respecification of the initial presentation, it was hypothesized that amnesics would be less able than controls to exclude study list items. Consistent with this hypothesis, the results indicated that the amnesics' performance, unlike that of the alcoholic controls, did not significantly differ as a function of task condition. To examine whether amnesics' conscious recollection could be enhanced, Experiment 2 presented the study list five times. The amnesics now were able to exclude a significant number of items from the study list; however, they still did so considerably less frequently than alcoholic controls. For the alcoholic controls, increasing the number of study trials had little additional effect on their exclusion performance, but it significantly enhanced their inclusion performance. Taken together, these findings suggest that for control subjects, word completion performance is likely mediated by a combination of fluency and recollection, while for amnesic patients, performance is almost exclusively based on the fluency with which an item comes to mind.     

Parent attributions of emotion to their children and the cues children use in perceiving their own emotions

A number of studies have demonstrated stable individual differences in the cues that generate emotions and other feeling states. These differences are assumed to arise from the cues parents use to identify their children's emotional states. As children learn about their own emotional states, they come to rely on these same cues. To test one implication of their view, the facial expressions of children (N=41) were manipulated and their feelings assessed. Some children reported emotions consistent with their expressions, while others reported emotions appropriate to the situation. In a separate procedure, their mothers were asked to identify the emotional states of children whose expressions were inconsistent with an account of their circumstances. Mothers who paid more attention to their children's expressive behavior had children who were more responsive to their own expressive behavior. In contrast, the mothers who were more responsive to situational cues had children whose emotions arose from the situational cues as well.The authors would like to thank numerous teachers and administrators of the Worcester Public School system in Worcester, Massachusetts, for their assistance.     

INCREASING APPOINTMENT KEEPING BY REDUCING THE CALL-APPOINTMENT INTERVAL

We examined the effect of reducing the interval between a patient's call for an appointment and the appointment itself. In Experiment 1, patients calling a family planning unit of a public health department were assigned appointments within either 1 or 3 weeks of their call. Data on patient “shows” and “no-shows” were recorded weekly for 6 weeks. Show rates for those in the 1-week appointment group were significantly higher than those in the 3-week group. In Experiment 2, patients were assigned to appointment dates either the next operating clinic day (next-day group) or 2 weeks from the call date (2-week group). Show rates for those in the next-day group were significantly better than show rates for patients in the 2-week group. Clinic productivity, time spent with patients, and consumer satisfaction were also assessed. Implications for appointment scheduling are discussed.     

Rehearsal strategy as a function of recall expectation

The subjects were divided into three groups with respect to their expectations concerning a recall task given after the final trial of the usual STM distractor procedure. Group 1 were told only that they would have to recall during each trial's recall interval, thus did not expect to have to recall again. Group 2 were told that they would have to recall all the words presented in the experiment at the end of the last trial, in addition to the trial-by-trial recall. Group 3 were told only that they would have to recall after all words had been presented and they sat passively through the presentation trials. In addition to their recall expectations, half of the subjects in each group received a 2-s presentation and half received a 5-s presentation interval. It was found that the length of the presentation interval had an effect on the number of words recalled at the end of all trials, but recall expectancy did not. However, expectancy did determine the rehearsal strategies of subjects and hence the serial positions from which items were recalled.     

Predictors of conflict over the household division of labor among women employed full-time

This empirical study examined predictors of conflict over the household division of labor among a group of 319 middle class, less traditional married women in order to examine the degree to which equity factors predicted conflict. Forty of the women were either African American, Hispanic, Native American, or Asian. An analysis of covariance indicated that there were no differences by race/ethnicity. The study explored the following: (1) the degree to which equity factors predict conflicts over household labor, (2) which equity factors best account for conflict, (3) the degree to which particular equity factors mediate the relationship of conflict with other variables, (4) whether equity factors are more compelling in predicting conflicts than practical or status variables, and (5) whether women's perceptions of the reasons for conflict put more emphasis on equity than on other issues. Results indicated that while both equity and practical factors predicted conflict, equity factors were more statistically significant. The best overall model of conflict suggested that it was predicted by lower satisfaction with the division of labor (which, in turn, was contingent upon time differentials between spouses and the time a womans' spouse spent on traditional women's tasks), a larger number of household members, a woman's younger age, and performing a greater number of overall household tasks. Equity is important to such women and constitutes a basis for making arguments about justice. However, these employed women devote twelve hours more per week to household labor than their partners and are relatively satisfied with the division. Chaeftz's theory of gender equity identifies where this sample of employed women may be located in the process of change.Thanks to Diane Blohowiak for statistical assistance and to Susan Jacquet, Laura Thieme, Annette Tierrien, and Mark Hoven Stohs for assistance with data gathering. Special thanks to the reviewers.     

The Impact of Procedural Justice on Opinions of Public Policy: Solid Waste Management as an Example1

This study assessed the applicability of Tyler and Lind's (1992) relational model of authority to the context of local government policies on solid waste management. Tests of the hypothesized relations proposed by Tyler and Lind, accomplished through structural equation modeling, revealed that our data supported the relations between the various constructs of the model. Perceptions of both process control and relational process were found to be positively related to procedural fairness judgments, while procedural fairness judgments were weakly related to evaluations of government entities. Contrary to our expectations, a similar structural equation model test of an extension of the Tyler and Lind model showed that the model constructs were unrelated to respondents' opinions of public policies. The results also indicated that respondents living in communities with different infrastructures and political climates differed slightly in their perceptions of procedural justice and related constructs, but did not differ in their endorsement of the various solid waste management policies.     

Counseling and screening for cystic fibrosis in patients with congenital bilateral absence of the vas deferens: Patient perceptions

Congenital bilateral absence of the vas deferens (CBAVD) occurs in approximately 1.3% of infertile males and is thought to be, in most cases, a primarily genital form of cystic fibrosis (CF). Fourteen males with CBAVD considering microsurgical sperm aspiration from the epididymis (MESA) and in vitro fertilization were seen for genetic counseling and screening for CF. To retrospectively evaluate these patients' perceptions of the counseling and screening information, we conducted structured telephone interviews to assess their recall of information about CF and its impact on their health concerns and reproductive plans. We found that, as the health implications of CF are abstract and not as important to patients as the diagnosis of CBAVD itself, patients tend to view their CF status primarily in terms of their reproductive potential. Retrospective analysis afforded us an opportunity to identify the psychosocial issues of most concern to this unique patient population.