BALANCING SOCIAL ACCEPTABILITY WITH TREATMENT EFFECTIVENESS OF AN INTRUSIVE PROCEDURE: A CASE REPORT

The debate over social acceptability of intrusive procedures has led some school districts to adopt policies allowing punishment for only the most extreme forms of destructive behavior. We investigated the effectiveness of selectively implementing punishment for only the most severe topographies of aggression and property destruction, while less extreme behaviors were ignored. Results indicated that severe behaviors were reduced to near-zero levels only when both severe and less severe behaviors were similarly punished.     

Cognitive sequelae of repeated head injury in a population of intravenous drug users

The relationship between closed head injury and performance on neuropsychological (NP) tests was investigated in a group of intravenous drug users (IVDUs). Subjects with repeated head traumas involving loss of consciousness (LOC) performed worse than both a control group without LOC and reference group with only a single episode of LOC. There were no significant differences between the last two groups. Performance on tests of memory, attention, and motor performance was significantly worse in the group with repeated head injury. The average time since the last episode of LOC was more than 11 years. We conclude from these findings that a single episode of LOC does not result in significant cognitive impairment in this population. Two or more episodes, however, are more likely to produce chronic cognitive impairment.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

The Relations Among Maternal Depression,Maternal Criticism,and Adolescents’ Externalizing and Internalizing Symptoms

This study examined the relations between maternal criticism and externalizing and internalizing symptoms in adolescents who varied in their risk for psychopathology. Both maternal-effects and child-effects models were examined. The sample consisted of 194 adolescents (mean age = 11.8~years) and their mothers; 146 mothers had a history of depressive disorders and 48 did not. When adolescents were in 6th and 8th grade, maternal criticism was measured with the five-minute speech sample and adolescents symptoms were assessed with the Child Behavior Checklist. Maternal criticism was significantly associated with both adolescents externalizing and internalizing symptoms, beyond the contribution of the chronicity/severity of mothers depression history. Maternal criticism did not mediate the relation between maternal depression and adolescent symptoms. In contrast, adolescent externalizing behaviors mediated the relation between chronicity/severity of maternal depression history and maternal criticism in 6th grade. Prospective analyses showed that adolescents externalizing symptoms in 6th grade significantly predicted maternal criticism in 8th grade, controlling for maternal depression history and prior maternal criticism. Results are discussed in terms of the importance of examining child-effects models in studies of maternal criticism.     

The role of posttraumatic fear and social support in the relationship between trauma severity and posttraumatic growth among adolescent survivors of the Yaan earthquake

Middle school students in Lushan county (N = 315) were assessed 6 months after the Yaan earthquake using a trauma severity questionnaire, a posttraumatic fear questionnaire, a social support questionnaire and a posttraumatic growth inventory to examine the effects of posttraumatic fear and social support in the relationship between trauma severity and posttraumatic growth (PTG). The results showed that posttraumatic fear mediated the relationship between trauma severity and PTG, and social support moderated the relationship between posttraumatic fear and PTG. These findings suggested that trauma severity could be positively associated with PTG in a direct way or in an indirect way through posttraumatic fear. Moreover, posttraumatic fear had a positive relation to PTG under the condition of high social support level, whereas the relation was non‐significant when the level of social support was low. These results were discussed in terms of their implications for adolescents after trauma.     

Stage of Chronicity and Cognitive Correlates of Pain-Related Disability

The present research examined the functional relations between the different dimensions of catastrophic thinking and pain-related disability, as a function of stage of chronicity. In the present study, 150 patients with chronic pain were grouped to form 3 different levels of chronicity: Group A (6 months to 2 years, n = 44); Group B (2-4 years, n = 55); and Group C (more than 4 years, n = 51). The 3 subscales of the Pain Catastrophizing Scale (Rumination, Magnification, Helplessness) were used as predictors of disability. Disability was assessed with the Pain Disability Index and pain was assessed with the McGill Pain Questionnaire. For Group A, regression analysis revealed that none of the PCS subscales predicted disability beyond the variance accounted for by sex, age and pain. Rumination was a significant predictor of disability in Group B, and both rumination and helplessness predicted disability in Group C. These findings provide preliminary evidence that stage of chronicity is an important moderator of psychological vulnerability for pain-related disability. Discussion addresses how the impact of pain management programs might be increased by tailoring interventions to specific patient needs.     

The impact of event vividness,event severity,and prior paranormal belief on attributions towards a depicted remarkable coincidence experience: Two studies examining the misattribution hypothesis

Two studies examine the impact event vividness, event severity, and prior paranormal belief has on causal attributions for a depicted remarkable coincidence experience. In Study 1, respondents (n = 179) read a hypothetical vignette in which a fictional character accurately predicts a plane crash 1 day before it occurs. The crash was described in either vivid or pallid terms with the final outcome being either severe (fatal) or non‐severe (non‐fatal). Respondents completed 29 causal attribution items, one attribution confidence item, nine scenario perception items, a popular paranormal belief scale, and a standard demographics questionnaire. Principal axis factoring reduced the 29 attribution items to four attribution factors which were then subjected to a 2 (event vividness) × 2 (event severity) × 2 (paranormal belief) MANCOVA controlling for respondent gender. As expected, paranormal believers attributed the accurate crash prediction less to coincidence and more to both paranormal and transcendental knowing than did paranormal sceptics. Furthermore, paranormal (psychokinesis) believers deemed the prediction more reflective of paranormal knowing to both (1) a vivid/non‐fatal and (2) a pallid/fatal crash depiction. Vividness, severity, and paranormal belief types had no impact on attribution confidence. In Study 2, respondents (also n = 179) generated data that were a moderately good fit to the previous factor structure and replicated several differences across attributional pairings albeit for paranormal non‐believers only. Corresponding effects for event severity and paranormal belief were not replicated. Findings are discussed in terms of their support for the paranormal misattribution hypothesis and the impact of availability biases in the form of both vividness and severity effects. Methodological issues and future research ideas are also discussed.     

The Hospital Anxiety and Depression Scale: a pilot study to examine its latent structure and the link between psychological state and symptom severity in transient ischaemic attack patients

Transient ischaemic attack (TIA) is often associated with anxiety and depression, which may precipitate secondary stroke and interfere with treatment. The Hospital Anxiety and Depression Scale (HADS) is widely used to assess these states and to inform the management of any associated psychological problems, but there is considerable debate about what it actually measures. The HADS scores from a range of different clinical groups have been reviewed in order to assess its psychometric properties, but so far, no research has examined either its latent structure when used with TIA patients, or the association between symptom severity and the test’s validity. The aims of this study, therefore, were to investigate: (a) the underlying structure of the HADS when used with TIA patients; and (b) the impact of symptom severity on the validity of the HADS. The HADS and a functional capacity measure were administered by post to a sample of 542 confirmed TIA patients. Exploratory factor analysis was conducted on the HADS scores to establish its underlying structure for this clinical group, and then, sub-sample correlations were undertaken between the anxiety/depression scores for different levels of functional capacity. Two factors emerged, with 13 of the 14 HADS items loading significantly on both, suggesting there is a common affective state underlying the standard anxiety and depression scales. Further data-exploration indicated that convergence between these affective states increased as functional capacity deteriorated. The results suggest firstly that the HADS measures general subjective distress when used with TIA patients, and secondly that the higher reported symptom severity in this clinical group may be associated with reduced affective differentiation. As the ability to retain clear affective discrimination is associated with health and well-being, this could provide a focus for post-TIA rehabilitation.     

Arch structure is associated with unique joint work,relative joint contributions and stiffness during landing

To examine lower extremity joint contributions to a landing task in high-(HA) and low-arched (LA) female athletes by quantifying vertical stiffness, joint work and relative joint contributions to landing.MethodsTwenty healthy female recreational athletes (10 HA and 10 LA) performed five barefoot drop landings from a height of 30 cm. Three-dimensional kinematics (240 Hz) and ground reaction forces (960 Hz) were recorded simultaneously. Vertical stiffness, joint work values and relative joint work values were calculated using Visual 3D and MatLab.ResultsHA athletes had significantly greater vertical stiffness compared to LA athletes (p = 0.013). Though no differences in ankle joint work were observed (p = 0.252), HA athletes had smaller magnitudes of knee (p = 0.046), hip (p = 0.019) and total lower extremity joint work values (p = 0.016) compared to LA athletes. HA athletes had greater relative contributions of the ankle (p = 0.032) and smaller relative contributions of the hip (p = 0.049) compared to LA athletes. No differences in relative contributions of the knee were observed (p = 0.255).ConclusionsThese findings demonstrate that aberrant foot structure is associated with unique contributions of lower extremity joints to load attenuation during landing. These data may provide insight into the unique injury mechanisms associated with arch height in female athletes.