Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review.     

Multifactorial assessment of reading disability: identifying the best predictors

A multifactorial diagnostic assessment battery was evaluated using data obtained from 105 reading-disabled children and their matched controls (total N = 210). A stepwise discriminant function analysis selected five nonreading measures from among 16 as the best diagnostic predictors of reading disability. These measures included WISC-R Information and Digit Span, self-reported family histories of reading problems, and tests of symbol-processing speed and letter fluency.     

Formula: see text]Executive functions in extremely low birth weight and late-preterm preschoolers: Effects on working memory and response inhibition

Executive function (EF) refers to fundamental capacities that underlie more complex cognition and have ecological relevance across the individual's lifespan. However, emerging executive functions have rarely been studied in young preterm children (age 3) whose critical final stages of fetal development are interrupted by their early birth. We administered four novel touch-screen computerized measures of working memory and inhibition to 369 participants born between 2004 and 2006 (52 Extremely Low Birth Weight [ELBW]; 196 late preterm; 121 term-born). ELBW performed worse than term-born on simple and complex working memory and inhibition tasks and had the highest percentage of incomplete performance on a continuous performance test. The latter finding indicates developmental immaturity and the ELBW group's most at-risk preterm status. Additionally, late-preterm participants performed worse compared with term-born on measures of complex working memory but did not differ from those term-born on response inhibition measures. These results are consistent with a recent literature that identifies often subtle but detectable neurocognitive deficits in late-preterm children. Our results support the development and standardization of computerized touch-screen measures to assess EF subcomponent abilities during the formative preschool period. Such measures may be useful to monitor the developmental trajectory of critical executive function abilities in preterm children, and their use is necessary for timely recognition of deficit and application of appropriate interventional strategies.     

Partnering for Success Symptom Monitoring Outcomes: Cognitive Behavioral Therapy Plus for Children and Youth in Child Welfare

Journal of Child and Family Studies - A substantial proportion of children and youth in the child welfare system have mental health concerns that warrant attention. While these youth are more...     

The Experience of Genetic Counselors Working with Patients Facing the Decision of Pregnancy Termination after 24 Weeks Gestation

Prenatal genetic counselors are health care professionals who counsel women making reproductive decisions which include decisions such as terminating pregnancies due to fetal anomalies. Little is known about the experiences and practices of prenatal genetic counselors working with women who have the option of termination after 24 weeks gestation. In this national survey of 168 genetic counselors who have practiced prenatal genetic counseling, we asked about their general practice patterns, including indications for which termination is offered and types of abortion care services that are coordinated by genetic counselors. We report respondents’ self-assessments of level of understanding of federal abortion law and abortion procedures. Seventy-six percent of respondents have offered and counseled on termination after 24 weeks and 93% of respondents believe it is the responsibility of the counselor to discuss this option with patients. However, one-third report that they have some or no understanding of the procedures and three-quarters report that they have some or no understanding of federal abortion law. The results of this study provide insight into knowledge and experiences of genetic counselors working with these patients, allowing for improved genetic counselor training and continuing education to provide better guidance and develop more effective means of assisting patients.     

Emotion recognition in children with Fetal Alcohol Spectrum Disorders

There is a limited amount of research that examines social-emotional functioning in children with Fetal Alcohol Spectrum Disorder (FASD), and the majority of it relies on parent and teacher reports of social impairments. Because these provide broad measures of social function, they fail to elucidate the underlying specific skills with which this group of children has difficulty. The current study examines emotion-recognition abilities in children with FASD, as it plays a central role in social interaction. Participants were 22 children with diagnosed FASD (ages 8–14), and age- and gender-matched typically developing controls. Tasks included measures of emotion recognition from three nonlinguistic modalities: facial expressions, emotional tone of voice, and body positioning and movement. Participant’s parents completed measures of adaptive and behavioral function that were related to children’s performance on aspects of emotion recognition. Overall, the results show that children with FASD have more difficulties with emotion recognition than typically developing age-matched peers, but these difficulties may not be clinically significant (e.g., smaller effect size) or may be specific to the age of the individual exhibiting the emotion (i.e., child vs. adult). These results are discussed in the context of previous studies.     

Associations between insecure attachment and sexual experiences

Associations between insecure attachment and sexual experiences were tested in a sample of 328 college students. Variations in adult attachment previously have been shown to relate to sexual behaviors, with the current study extending earlier work by examining different sexual outcomes and by testing factors that may account for these relations. Avoidant attachment was expected to relate to engagement in casual sex (i.e., a greater number of sexual partners and lower percentage of partners within committed relationships), with less restrictive sexual beliefs mediating the relations. In contrast, anxious attachment was expected to relate to more unwanted but consensual sexual experiences, and to more negative affect about sexual experiences, with low self‐esteem mediating the relations. Results showed some support for the hypotheses. Avoidant attachment was related to the type (but not number) of sexual partners, with sexual beliefs mediating the relations. A greater number of unwanted but consensual sexual experiences related to anxious and avoidant attachment for women and to avoidant attachment for men. Anxiety related to negative affect for women and men, and self‐esteem served as a partial mediator of these relations.     

Emotional reactions and regulatory responses to negative and positive events: Associations with attachment and gender

In two studies, we examined inter-individual variability in responses to both negative and positive events. In the first study, participants (119 college students) reported on negative and positive events from their own lives. The second was an experiment in which participants (133 college students) were given either negative or positive feedback about their personality. With negative events, more insecure individuals, especially anxiously attached, evidenced more intense negative emotional reactions and greater processing of (i.e., ruminating on) negative experiences. With positive events, securely attached individuals and less anxiously attached engaged in greater processing of positive experiences (maximized), whereas more insecure individuals tended to minimize positive experiences. Gender differences for emotion regulation were moderated by either attachment or event type. Findings for negative events generally coincide with prior research, and those for positive events provide new evidence that attachment style could affect how people react to positive events and emotions.     

Type A behavior pattern, inhibited power motivation, and activity inhibition

The constructs of the Type A behavior pattern and the Inhibited Power Motive Syndrome (IPMS) have many features in common. The empirical relation between the two constructs was investigated in this study with 45 employed, male medical and surgical patients. Four different measures of the Type A pattern were examined. Results showed that, of the four measures, the Structured Interview and the Hostility Scale were related significantly to the IPMS. Systolic blood pressure reactivity was also related significantly to the IPMS. These relations could be ascribed largely to activity inhibition alone. The contribution of activity inhibition to an understanding of the biological and psychological substrates of the Type A behavior pattern is discussed.