Prevention of nonadherence to nonsteroidal anti-inflammatory medications for newly diagnosed patients with juvenile rheumatoid arthritis.

Adherence to medications for chronic pediatric diseases decreases overtime. This randomized controlled trial evaluated a clinic-based, nurse-administered educational and behavioral intervention to prevent the anticipated drop in adherence to nonsteroidal medications among newly diagnosed patients with juvenile rheumatoid arthritis. Thirty-four participants completed the study (mean age = 8.44 years, SD = 3.96), including 19 in the experimental group and 15 in the standard-treatment (education) control group. There were significant group and Group x Time effects for adherence (assessed with an electronic monitor over a 13-month period) favoring the experimental group. In contrast, the groups did not differ significantly in disease activity or functional limitations. Factors that may have prevented detection of differences in these health parameters are dicussed.     

Brief report: An extension of the sequential alternating treatment design using reversals with subjects not available concurrently

This brief report proposes an extension of the traditional Alternating Treatments Design that would be acceptable to use in hospital and residential settings where subjects are often not concurrently available. Concerns about the inability of traditional designs to work in these special situations and the emergence of a “scientist–practitioner split” are discussed. An example of how the Extended Alternating Treatments Design might be used is provided.     

Does working memory training promote the use of strategies on untrained working memory tasks?

Adaptive computerized training has been associated with significant enhancements in untrained working memory tasks, but the nature of the cognitive changes that underpin these improvements are not yet fully understood. Here, we investigate the possibility that training stimulates the use of memory-related strategies. In a randomized controlled trial, participants completed four tests of working memory before receiving adaptive working memory training, nonadaptive working memory training with low memory loads, or no training. Open-ended interviews about strategy use were conducted after the administration of untrained working memory tasks at two time points. Those in the adaptive and nonadaptive groups completed the assessments before (T1) and after (T2) 10 training sessions. The no-training group completed the same set of tasks at T1 and T2, without any training between assessment points. Adaptive training was associated with selective improvements in untrained tests of working memory, accompanied by a significant increase in the use of a grouping strategy for visuospatial short-term memory and verbal working memory tasks. These results indicate that training-related improvements in working memory may be mediated by implicit and spontaneous changes in the use of strategies to subsegment sequences of information into groups for recall when the tasks used at test overlap with those used during training.     

The Incremental Validity of Self-Report and Performance-Based Methods for Assessing Hostility to Predict Cardiovascular Disease in Physicians

We evaluated the utility of an integrative, multimethod approach for assessing hostility-related constructs to predict premature cardiovascular disease (CVD) and premature coronary heart disease (CHD) using participants from the Johns Hopkins Precursors Study, which was designed to identify risk factors for heart disease. Participants were assessed at baseline while in medical school from 1946 to 1962 (M age = 24.6) and have been followed annually since then. Baseline assessment included individually administered Rorschach protocols (N = 416) scored for aggressive imagery (i.e., Aggressive Content, Aggressive Past) and self-reports of 3 possible anger responses to stress. Cox regression analyses predicting morbidity or mortality by age 55 revealed a significant interaction effect; high levels of Aggressive Content with high self-reported hostility predicted an increased rate of premature CVD and CHD, and incrementally predicted the rate of these events after controlling for the significant covariates of smoking (CVD and CHD) and cholesterol (CHD) that were also assessed at baseline. The hostility and anger measures, as well as other baseline covariates, were not predictors of CVD risk factors assessed at midlife during follow-up. Overall, this integrative model of hostility illustrates the potential value of multimethod assessment to areas of health psychology and preventive medicine.     

The Role of the Father in Anorexia

The literature on anorexia often overlooks the important role of the father in the complex etiology of the illness. This paper examines the father's role and how it impacts on the psychological development of his anorectic daughter. Premorbid and comorbid personality components such as dependency, perfectionism, and high achievement, are shown to be influenced by the father. His role is again significant at the onset of adolescence, when his daughter needs his affirmation as she struggles to make the transition from childhood to womanhood. Socialization of the sexes is implicated in hindering the father/daughter relationship, as is the father's fear of sexual attraction to his developing daughter. The effect of a patriarchal society on the development of anorexia in girls is also explored. The nature of the society we live in is thought to further complicate the anorectic girl's relationship with her father.     

Impact of age-relevant goals on future thinking in younger and older adults

This study investigated how personal goals influence age differences in episodic future thinking. Research suggests that personal goals change with age and like autobiographical memory, future thinking is thought to be organised and impacted by personal goals. It was hypothesised that cueing older adults with age-relevant goals should modulate age differences in episodic details and may also influence phenomenological characteristics of imagined scenarios. Healthy younger and older adults completed the Future Thinking Interview [Addis, D. R., Wong, A. T., & Schacter, D. L. (2008). Age-related changes in the episodic simulation of future events. Psychological Science, 19(1), 33–41. doi:10.1111/j.1467-9280.2008.02043.x] adapted to activate age-appropriate goals. Narratives were scored with an established protocol to obtain objective measures of episodic and semantic details. Subjective features such as emotionality and personal significance showed age differences as a function of goal domain while other features (e.g., vividness) were unaffected. However, consistent with prior reports, older adults produced fewer episodic details than younger adults and this was not modulated by goal domain. The results do not indicate that goal activation affects level of episodic detail. With respect to phenomenological aspects of future thinking, however, younger adults show more sensitivity to goal activation, compared with older adults.     

Adaptive training leads to sustained enhancement of poor working memory in children

Working memory plays a crucial role in supporting learning, with poor progress in reading and mathematics characterizing children with low memory skills. This study investigated whether these problems can be overcome by a training program designed to boost working memory. Children with low working memory skills were assessed on measures of working memory, IQ and academic attainment before and after training on either adaptive or non‐adaptive versions of the program. Adaptive training that taxed working memory to its limits was associated with substantial and sustained gains in working memory, with age‐appropriate levels achieved by the majority of children. Mathematical ability also improved significantly 6 months following adaptive training. These findings indicate that common impairments in working memory and associated learning difficulties may be overcome with this behavioral treatment.