Quality care in residential placement for children and youth with developmental disabilities

There is a growing concern for quality care in residential placements outside of the natural family for children and youth with developmental disabilities. Ideally, children with developmental disabilities should remain with their natural parent or parents of parents with appropriate supports until the age when children typically leave home. In reality, parents of children and youth with development disabilities are not always able or willing to care for their children at home, and alternate residential placements must be found. This paper will discuss some of the issues surrounding the provision of quality care in out-of-home residential placements for children and youth with developmental disabilities.     

Evaluation of behavioral measures of risk taking propensity with inner city adolescents

The current study examined the utility of behavioral measures of risk-taking propensity in the assessment of self-reported real-world risk-taking behaviors using a sample of 51 high-school-aged inner-city adolescents. Results indicated that performance on one behavioral measure, the balloon analogue risk task, accounted for unique variance in self-reported delinquency/safety risk behaviors as well as substance use risk behaviors, above and beyond that provided with demographics and self-report measures of risk-related constructs (i.e., impulsivity and sensation seeking). These results are discussed in relation to the potential utility of using a multimethod assessment approach for better understanding risk-taking vulnerability among adolescents.     

Transitions to and from asymmetrical gait patterns

Asymmetrical gait patterns such as the gallop provide insight into the complexity of human locomotion. The nature of spontaneous (e.g., walk-run), quasi-spontaneous (e.g., gallop-walk), and intentional (e.g., walk-gallop) transitions was analyzed in 2 ways in the present study. In Analysis 1, the authors used step-wise regression to associate 10 physical characteristics with gait transitions. Transition predictability was moderate; thigh length best predicted 3 of 6 transitions. In Analysis 2, the dynamic characteristics of transitions (order parameters, phase shifts, multistability, and critical fluctuations) were described; those characteristics existed for all transition types. The results of the analyses suggest that intentional transitions are less biomechanically predictable than are spontaneous transitions and that transitions between gait pairs (e.g., walk-gallop and gallop-walk), regardless of velocity direction, have more in common than do transitions requiring specific intention.     

Memory and identity

Among the many topics covered in Sven Bernecker’s impressive study of memory is the relation between memory and personal identity. Bernecker uses his grammatical taxonomy of memory and causal account to defend the claim that memory does not logically presuppose personal identity and hence that circularity objections to memory-based accounts of personal identity are misplaced. In my comment I investigate these claims, suggesting that the relation between personal identity and memory is more complicated than Bernecker’s analysis suggests. In particular, I argue (1) that while he shows that some memories do not presuppose personal identity he fails to show that those that are appealed to in memory-based accounts of personal identity do not, and (2) that the features of his view that allow him to define memory without reference to personal identity also obscure important features of memory that must be part of a complete account.     

The Coming-Out Process and Its Adaptational and Health-Related Associations Among Gay, Lesbian, and Bisexual Youths: Stipulation and Exploration of a Model

A model is proposed and explored that links the coming-out process to the psychological functioning (i.e., self-esteem and distress) and sexual behaviors of gay, lesbian, and bisexual youths recruited from gay-focused community-based and college organizations in New York City. The coming-out process is multidimensional, consisting, as defined here, of involvement in gay/lesbian activities, attitudes toward homosexuality, comfort with homosexuality, self-disclosure of sexual identity to others, and sexual identity. The coming-out dimensions were related to self-esteem, distress, and unprotected sexual behaviors. In addition, the relations between the coming-out dimensions and unprotected sexual behaviors were explained by psychological functioning. In particular, limited involvement in gay/lesbian activities was associated with more unprotected sex. Negative attitudes toward homosexuality were related directly to more unprotected sex, and they were related indirectly to more unprotected sex by means of increasing emotional distress. These and other findings have implications for designing preventive interventions to increase the youths' psychological functioning and reduce their unprotected sexual behaviors.     

THE STORY OF THE MIND: PSYCHOLOGICAL AND BIOLOGICAL EXPLANATIONS OF HUMAN BEHAVIOR

Abstract. Persons have a curious dual nature. On the one hand, they are subjects, whose actions must be explained in terms of beliefs, desires, plans, and goals. At the same time, however, they also are physical objects, whose actions must be explicable in terms of physical laws. So far no satisfying account of this duality has been offered. Both Cartesian dualism and the modern materialist alternatives (reductionist and antireductionist) have failed to capture the full range of our experience of persons. I argue that an exciting new approach to this difficulty can be found by considering developments in clinical psychology. The clinical debate between those endorsing biological models of mental illness and those endorsing psychodynamic models mirrors broader debates in the philosophy of mind. The possible resolution of this debate through the development of integrated psychobiological models suggests a promising way to reconcile the dual nature of persons in a far more appealing way than any yet proposed.     

Timing of HIV Interventions on Reductions in Sexual Risk Among Adolescents

Examined the effectiveness of an HIV intervention program among 151 adolescents ages 13 to 24 years who were randomly assigned to (a) seven sessions of 1.5 hr each (10.5 hr); (b) three sessions of 3.5 hr each (10.5 hr); or (c) a no-intervention condition. Using cognitive-behavioral intervention strategies, social skills and HIV-related beliefs, perceptions, and norms were targeted in both the three- and seven-session, small-group intervention conditions. Regression analysis indicated that over 3 months, the number of unprotected risk acts and the number of sexual partners were lower in the seven-session condition compared to the other conditions. Factors mediating risk acts changed in a complex manner: For example, perceived vulnerability increased for those with initially lower vulnerability scores among youths in the seven-session condition compared to others. Self-approval of condom use was also higher for those with initially low scores in the seven-session compared to the three-session condition. Self-efficacy for risk avoidance and condom use was significantly higher in the three-session condition for those with initially low scores compared to other groups. On the role-play measure, those with higher baseline scores in the low-pressure situation improved significantly only in the three-session intervention; in the high-pressure situation, the participants reported significantly higher scores in the seven-session intervention, and those with higher scores improved the most. Results suggest the importance of multisession HIV intervention programs to be delivered with fidelity in community settings.     

Description of a Behavioral Intervention to Reduce Substance Use and Related Risk and Increase Positive Parenting among Urban Mothers with Alcohol and Other Drug Problems

The abuse of alcohol and other substances by mothers raising adolescent children has serious adverse effects on family functioning and youth outcomes, and on mothers’ own health and adaptation. Mothers who are also HIV-infected face additional challenges. In the present report, we describe a multi-session intervention conducted in individual sessions for mothers with alcohol and other substance use problems who are raising adolescent children. We outline the primary components of the intervention and include case studies and examples of exercises and tools. We found that engagement with the intervention and high rates of attendance were facilitated by tapping into mothers’ desires to improve their relationships with their adolescent children, the use of a harm reduction approach toward substance use, and intensive outreach. We also discuss lessons learned in the course of implementing and evaluating the intervention.     

Empathic Access: The Missing Ingredient in Personal Identity

Abstract

Philosophical discussions of personal identity depend upon thought experiments which describe psychological vicissitudes and question whether the original person survives in the person resulting from the described change. These cases are meant to determine the types of psychological change compatible with personal continuation. Two main accounts of identity try to capture this distinction; psychological continuity theories and narrative theories. I argue that neither fully succeeds since both overlook the importance of a relationship I call “empathic access.” I define empathic access and discuss its role in a complete account of personal identity.