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.     

周围神经嵌压症诊治过程中的临床思维

运用自然辩证法培养良好的临床思维,指导周围神经嵌压症的诊治过程,有助于获得最佳诊治效果。诊断过程中需全面了解理论知识,学会科学观察,兼顾整体与局部的关系,通过合理分析与综合,可以做出确切诊断。治疗过程中需对有关医师的技术进行评价,采用控制论及系统论方法指导治疗,才能恢复周围神经的结构与功能。     

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.     

The Centrality of the Response Process in Construct Validity: An Illustration via the Rorschach Space Response

Recently, psychologists have emphasized the response process—that is, the psychological operations and behaviors that lead to test scores—when designing psychological tests, interpreting their results, and refining their validity. To illustrate the centrality of the response process in construct validity and test interpretation, we provide a historical, conceptual, and empirical review of the main uses of the background white space of the Rorschach cards, called space reversal (SR) and space integration (SI) in the Rorschach Performance Assessment System. We show how SR and SI's unique response processes result in different interpretations, and that reviewing their literatures with these distinct interpretations in mind produces the expected patterns of convergent and discriminant validity. That is, SR was uniquely related to measures of oppositionality; SI was uniquely related to measures of cognitive complexity; and both SR and SI were related to measures of creativity. Our review further suggests that the Comprehensive System use of a single space code for all uses of white space likely led to its lack of meta-analytic support as a measure of oppositionality (Mihura, Meyer, Dumitrascu, &; Bombel, 2013 *Mihura, J. L., Meyer, G. J., Dumitrascu, N., &; Bombel, G. (2013). The validity of individual Rorschach variables: Systematic reviews and meta-analyses of the Comprehensive System. Psychological Bulletin, 139, 548–605. doi:10.1037/a0029406[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). We close by discussing the use of the response process to improve test interpretation, develop better measures, and advance the design of research.     

Interval estimation for the intraclass correlation in dirichlet-multinomial data

When the underlying distribution is discrete with a limited number of categories, methods for interval estimation of the intraclass correlation which assume normality are theoretically inadequate for use. On the basis of large sample theory, this paper develops an asymptotic closed-form interval estimate of the intraclass correlation for the case where there is a natural score associated with each category. This paper employs Monte Carlo simulation to demonstrate that when the underlying intraclass correlation is large, the traditional interval estimator which assumes normality can be misleading. We find that when the number of classes is 20, the interval estimator proposed here can generally perform reasonably well in a variety of situations. This paper further notes that the proposed interval estimator is invariant with respect to a linear transformation. When the data are on a nominal scale, an extension of the proposed method to account for this case, as well as a discussion on the relationship between the intraclass correlation and a kappa-type measure defined here and on the limitation of the corresponding kappa-type estimator are given.The authors wish to thank the Editor, the Associate Editor, and the three referees for many valuable comments and suggestions to improve the clarity of this paper. The works for the first, the third, and the fourth authors were partially supported by grant #R01AR43025-01 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.