The purpose of this study was to determine relationships between acculturation level, generational status, and gender with acculturative stress. Acculturation level was determined by the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) and acculturative stress was determined by the Societal, Attitudinal, Familial and Environmental Acculturative Stress Scale-Children's Version (SAFE-C). Subjects included 1268 Hispanic children ages 11-15. In order to validate the usefulness of the ARSMA-II with this sample, analyses were conducted between acculturation level and generational status. The Pearson product moment correlation (r=.44) and the ANOVA between the mean acculturation score and generational status were significant. However, the mean acculturation score from this study was considerably lower than the ARSMA-II score; therefore, new acculturation levels were developed to establish local adolescent norms for the ARSMA-II. All analyses involving acculturation levels were conducted using both the ARSMA-II and new acculturation levels because 300 subjects were reclassified with the new norms. Significant results were similar using both acculturation levels; however, there were more between group differences using the new acculturation levels. It was hypothesized that as acculturation level increased toward the Anglo culture, acculturative stress would decrease. The one-way ANOVA confirmed this relationship. It was also hypothesized that as generational status increased, acculturative stress would decrease. A one-way ANOVA also supported this hypothesis. In order to replicate previous findings on gender, a one-way ANOVA was conducted with acculturative stress and acculturation level. Results for both were non-significant. Overall findings indicate that generational status and acculturation level have a significant impact on acculturative stress in Hispanic children; however, gender does not seem to be a factor. Findings emphasize the importance of addressing cultural issues in the assessment, intervention, and treatment of acculturating Hispanic children. Furthermore, the ARSMA-II appears to be a useful instrument in assessing acculturation level in young adolescent Hispanics though new ...
The current study examined the effects of acculturative processes on the self-report of behavioral problems in Hispanic children ages 11-14. Acculturation was measured by the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II) (ã Sage Publications, Thousand Oaks, CA, www.sagepub.com) (Cuellar, Arnold, and Maldonado, 1995) and the self-report of behavioral symptoms was assessed using the Youth Self-Report (ã T.M. Achenbach, Burlington, VT, www.aseba.com) (Achenbach, 1991). It was hypothesized that while both the linear and orthogonal categories of acculturation would account for a significant proportion of the variance in behavior problems in this age group, the orthogonal model would account for a larger proportion of variance due to its multidimensional nature. As well, it was hypothesized that the experimental Marginalization scales of the ARSMA-II would be predictive of behavioral problems. Multivariate analysis of variance was used to test these hypotheses and results were non-significant for the linear, orthogonal, and marginalization categories. The effects of the ethnic/cultural homogeneity of the region from which the sample was drawn, the buffering of social support, and the developmental aspects of ethnic identity are discussed as factors which may have influenced the potential impact of acculturative stress on psychological and behavioral functioning.
This study was conducted to examine the sequelae of cardiovascular conditioning on locus of control, short-term mood, and psychological well-being. A pre-post test design, with control group, was used to measure the effects of a one month program of aerobic conditioning on adult volunteers. This study also sought to examine ways in which fitness changes covaried with psychological changes, and to describe patterns of change taking place during aerobic conditioning.
In the present study, an anger management treatment program was compared to a pseudo-social skills training program (self-help group) and waiting list control group to determine its effectiveness in reducing irritable/angry behavior in head injured subjects. Subjects consisted of 28 adults with previous head injury trauma who had difficulty with excessive irritability and anger. Subjects averaged 35.4 years of age and had an average of 8.9 years post head injury. Treatment consisted of 10 group sessions over a five week period. Anger management training was designed to teach subjects self management skills aimed at reducing the frequency of angry acting out behavior. Training methods included role playing, relaxation training, assertiveness training and cognitive restructuring. The pseudo-social skills training group was a self-help group designed to encourage discussion of irritability problems without teaching specific coping techniques. To assure some degree of homogeneity in cognitive abilities among subjects, minimum eligibility scores were required on five subtests of the Wechsler Adult Intelligence Scale - Revised and the Peabody Picture Vocabulary Test. Dependent measures were pre and posttreatment scores obtained from five categories of the Katz Adjustment Scale - Relative form: belligerence, negativity, general psychopathology, social obstreperousness, and social role functioning. In addition, pre and posttreatment recordings of observed angry/irritable behavior in the subjects were obtained from a significant other. Results failed to reveal statistically significant differences on the dependent measures between the three study groups. In addition, analysis failed to reveal any significant variables that predicted outcome. It is evident that much more organized research is needed to further investigate the possibilities of treatment for various problems encountered by those with head injuries.
This study investigated the relationship among anxiety, depression, and sleep disturbances and the treatment of these three disorders through neurotherapy. Research suggests that these conditions commonly co-occur in the general population and that central nervous system (CNS) arousal may play a primary role in the development and maintenance of these disorders. Several recent studies suggested that neurotherapy, a biofeedback-based treatment for CNS dysregulation, might be an effective treatment for comorbid conditions, particularly the ones of interest here, depression, anxiety, and sleep disturbances. This investigation used a clinical case-series design to assess pre/post neurotherapy changes on objective measures of anxiety, depression, and sleep and to determine whether changes in anxiety and depression then predict improvements in sleep quality. Data for 23 participants (10 males) were obtained from files of adults (Mage = 40.22 years, SD = 16.20) who received at least 15 neurotherapy sessions (M = 47.83 sessions, SD = 22.23) the University of North Texas Neurotherapy Lab. Matched pair t-tests revealed that symptoms of sleep disturbance, depression, and anxiety showed significant improvements following neurotherapy. Neurotherapy treatment effect sizes generally ranged from moderate to large (d = .414 - .849). Multiple regression analysis found that changes in self-reported anxiety symptoms, but not depressive symptoms, predicted observed improvements in sleep quality (adjusted R2 = .26). Last, the implications and limitations were discussed in relation to neurotherapy practice and the associated research.
The present study investigates the predictive accuracy of a key approach to interpretation of the verbal-spatialcognitive (VSC) and sensorimotor (SM) factors of the McCarron-Dial System (MDS). The subjects include 99 brain damaged and 30 normal adults. The following research questions are addressed: (a) Does the neuropsychological key classify brain damaged and non-brain damaged subjects at a level significantly above chance? (b) Among the brain damaged subjects, does the neuropsychological key identify right brain damage, left brain damage and diffuse brain damage at an accuracy level significantly above chance? (c) Is the neuropsychological key approach superior to the empirical model derived from discriminant function analysis in predictive accuracy? The neuropsychological key correctly classifies 90% of the cases as brain damaged and 90% of the cases as non-brain damaged, for a total of 89.9% predictive accuracy. The obtained Kappa coefficient of .74 is statistically significant. The key accurately classifies 71.4% of the brain damaged group as right damage, 70% as left damage, and 93.8% as diffuse damage, for a total predictive accuracy of 7 9.5%. The Kappa coefficient of .68 is statistically significant. Chi square analysis of the difference between the key approach and multiple discriminant function analysis reveals that no significant difference is present between the accuracy of the two approaches in differentiating between brain damaged and non-brain damaged, or in differentiating among left, right and diffuse brain damage. The results support the validity of a neuropsychological key approach to interpretation of the McCarron-Dial System, although cross-validation is indicated to confirm the stability of these results. Differences in sex, educational level and racial composition of the comparison groups may have affected the results obtained. Refinement of the key in future research and the addition of test instruments assessing memory, auditory processing, attention and emotional/behavioral variables are recommended.
Dementia is prevalent among elderly people. As the world population ages, it is projected that the number of people affected by dementia may triple in the next 50 years. Over the last two decades, research has focused on identifying potentially modifiable risk factors in development and progression of dementia, such as vitamin B12 and folate. Results concerning the effects of low folate and vitamin B12 on cognitive performance are mixed. The main objective of the present study was to investigate the effects of vitamin deficiency on cognitive functioning in a clinical sample of elderly individuals with cognitive problems using a comprehensive neuropsychological assessment. A retrospective chart-review was performed on the 102 records of patients from the Geriatrics Clinic at the University of North Texas Health Science Center who presented with cognitive deficits. Charts were reviewed to obtain data on vitamin supplementation, vitamin status, history of chronic conditions and other biochemical data. The available database was used to obtain data on neuropsychological assessment. The study demonstrated mild association between vitamin B12 and folate status and cognitive deficits. There appeared to be a higher cut-off level that is above the traditionally used levels for vitamin B12 and folate deficiency concentrations at which cognitive deficits became more pronounced. Clinical applications, limitations and suggestions for future research were discussed.
The influence of autonomic activation in response to controllable versus noncontrollable stress, anger imagery induction, and relaxation imagery was studied among 80 participants between the ages of 18 and 34. Participants differed in level of trait hostility as assessed by the Irritability Subscale of The Buss-Durkee Hostility Inventory (Buss & Durkee,1957) and the Ho scale of the Cook-Medley Hostility Inventory (Cook & Medley, 1954). Groups were further subdivided with regards to either having a positive family history of cardiovascular disease or having no significant history. Results were obtained through analyses of electrocardiograph R-R intervals which produced an index of autonomic nervous system activation. Findings supported hypotheses involving the relations between autonomic balance and stress and hostility for the female and male populations. Among both populations, parasympathetic regulation was diminished during anger induction for individuals with high levels of trait hostility and having a family history of cardiovascular disease. Similar results were obtained for men during relaxation imagery induction.
Metopic synostosis is a condition in which the metopic suture of the human cranium fuses prematurely and may be related to poor behavioral inhibition leading to behaviors commonly associated with Attention-Deficit Hyperactivity Disorder (ADHD). The purpose of this project was to examine the behavior patterns among children with a history of metopic synostosis. It was hypothesized that children with a history of metopic synostosis would exhibit many of the same behavioral patterns associated with ADHD. It was also hypothesized that children with a history of simple synostosis not involving the metopic suture would not evidence this type of behavioral pattern. In order to test these hypotheses, the behavior of three groups of children was compared including (1) children who had a history of metopic synostosis (M= 7.63 years, SD = 1.92 years), (2) children who had a history of simple craniosynostosis not involving the metopic suture (M= 7.54 years, SD = 1.88 years), and (3) a group of children diagnosed with ADHD (M=7.78 year, SD = 1.87 years). It was found using the Home and School versions of the Attention Deficit Disorders Evaluation Scale (ADDES) that children with a history of metopic synostosis demonstrate significantly more behavioral disturbances than children with a history of simple craniosynostosis not involving the metopic suture. Using the BASC Teacher Rating Form it was found that children with a history of metopic synostosis have a behavior pattern similar to children diagnosed with ADHD and a dissimilar behavior pattern compared to children who have a history of craniosynostosis not involving the metopic suture. Using the BASC Parent Rating Form it was found that children with a history of metopic synostosis have a behavior pattern dissimilar to children diagnosed with ADHD and a dissimilar behavior pattern compared to children who have a history of craniosynostosis not involving ...
Although most people have experienced word-finding difficulty at one time or another, there are no clinical instruments able to reliably distinguish normal age-related effects from pathology in word-finding impairment. Two experiments were conducted to establish a modified version of the Boston Naming Test (BNT) that includes latency times, the Boston Naming Test of Latencies (BNT-L), in order to improve the instrument's sensitivity to mild to moderate word-finding impairment. Experiment 1: Latency times on the 60-item BNT (Goodglass et al., 2001) for 235 healthy adults' ages 18-89 years were collected on a representative sample. Qualitative features of the BNT items, statistical analyses, IRT, and demographic considerations of age, gender, education, vocabulary, race and culture, helped create a reduced BNT-L version with 15 of the most discriminating items. Statistically sound and sophisticated normative tables are provided that adjust for unseen covariates. Response latencies did not indicate earlier age-related decline in an optimally healthy sample. Experiment 2: Twenty-three patients referred for neuropsychological testing were administered the BNT-L. Patients referred for evaluation of mild cognitive impairment or possible dementia produced significantly different response BNT-L latencies from the healthy sample whereas patients referred for mild brain injury evaluation did not. Normal word-finding problems were discussed in terms of serial stage models of lexical access, as well as in terms of automatic and controlled cognitive processes in younger and older adults. Statistical process for creating a psychometric instrument using latencies is illustrated.
Individuals are living longer now than they have in the past. As a result, there is an increased incidence in illnesses that are more prevalent in later life. One group of illnesses that is more prevalent is age related dementia. Alzheimer's disease (AD) and vascular dementia (VaD) are two common types of dementia found in the older adult population. Recent research suggests that these two types of dementia may both have a vascular component that is instrumental in their development. Not only may this vascular component be present in both these illnesses, but also it may be related to a more severe cognitive decline in the aging process. Results indicate that both cardiovascular disease and general and spousal social support in middle age are all three independent significant predictors of mild cognitive impairment and other non-normative cognitive impairment in later life. However, results do not indicate that social support moderates the relationship between cardiovascular disease and cognition.
The effects of cranial electrotherapy stimulation (CES) on human EEG and brain current density were evaluated by quantitative electroencephalography (qEEG) and low resolution brain electromagnetic tomography (LORETA). A total of 72 research subjects were provided with a single session of CES, 38 were provided with 0.5 Hz CES while 34 were provided with 100 Hz CES. The qEEG paired t-tests revealed that in both frequencies of CES there was a significant (.05) increase in alpha relative power with concomitant decreases in delta and beta relative power. The 0.5 Hz CES decreased a wider frequency range of delta activity, while the 100 Hz CES decreased a wider frequency range of beta activity; suggesting some difference may exist in the EEG response to different frequencies of CES. The changes found in qEEG relative power were consistent with the affective and cognitive effects of CES reported in the literature, such as increased relaxation and decreased anxiety. Statistically significant changes for qEEG values other than relative power, such as coherence, amplitude asymmetry, phase lag and power ratios were also found. The LORETA paired t-tests found statistically significant (.05) increases in cortical and subcortical theta and alpha frequency current density with concomitant decreases in delta and beta current density. The effects of CES on current density varied by frequency, but did not show a differential in response based on proximity to the contacts, or structures within the brain. Statistically significant changes in current density were found in all 2394 gray matter voxels represented by LORETA, indicating a whole brain response to the CES stimulus. The qEEG and LORETA findings revealed that a single 20-minute session of CES does have a significant effect on the cortical and subcortical activity of the human brain resulting in activity consistent with decreased anxiety and increased relaxation.
The objective of the present study was to investigate Amen's formulations of subtypes of AD/HD initially identified by brain imaging techniques, through the use of behavioral checklist data. And in testing Amen's theory of six separate subtypes of AD/HD, to identify and differentiate the subtypes based on symptom presentation. Data was obtained through retrospective chart reviews (N=161) of children between the ages of 5 and 12 who met the criteria for the major symptoms observed in AD/HD and were referred for a previous comprehensive AD/HD evaluation. Data from behavioral checklist (CBCL and DBRS-IV) were matched to Amen's Subtype Symptom Checklist and each subject was given a percentage score for six subtype symptoms. Cluster analysis reliably found six clusters and each subject was labeled according to their symptom presentation. The clusters found were labeled as AD/HD - Combined Type, AD/HD - Predominately Inattentive Type, AD/HD - Predominately Hyperactive-Impulsive Type, Ad/HD - Combined Type with Obsessive-Compulsive features, AD/HD - Combined Type with Obsessive/Compulsive and Conduct Disorder features and Undifferentiated AD/HD. However, the present study did not find evidence of subtypes that corresponded to Amen's Temporal Lobe ADD or Limbic ADD. Discriminant function analysis of the six clusters found that the variables in the model (symptom percentage scores) significantly discriminated the subtype classification. Also, 76% of all cases were correctly classified according to their symptom presentation. Potential limitations of the sample and the data used for interpretation were discussed. Limitations of the study warrant further investigation making use of multi-modal assessment tools which relate well with brain imaging techniques, such as neuropsychological measures of attention and concentration, laboratory based measures of activity, continuous performance tests measuring inattention and impulsivity, and QEEG data measuring brain wave information. A multi-modal approach to investigating symptom subtypes of AD/HD would likely provide increased reliability and validity of ...
Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients who relied on dramatized coping strategies were less likely to be successful in treatment. Breathing activity and pain acknowledgement were positive coping techniques highly predictive of successful outcome in this study. The use of computers for assessment and other recommendations for future research were discussed.
It is apparent from the historical perspective regarding the theories of cognitive development and the cognitive functioning of individuals with visual impairments, that sight plays a major role in the development of certain cognitive processes. However, the affects of visual impairment on cognitive development remain to be at issue. Since sight seems to be highly integral in cognitive development beginning in the early stages of physical development, about the sixth month of life, and then begins to diminish in importance as verbal communication develops around eighteen months, then it should stand to reason that significant visual impairment or blindness occurring prior to this time would adversely impact an individual's cognitive development. Conversely, the occurrence of visual impairment or blindness after this critical period of development would have less of an impact. Cognitive theorists have proposed that visually impaired or blind persons may have developed different cognitive pathways to acquire, process, and accommodate sensory information. As a result, visually impaired or blind (VI/B) persons may "think differently" than sighted individuals. The present study was designed to address these issues as they relate to cognitive and neuropsychological development at various stages of growth and to examine possible differences in neuropsychological functioning dependent on the level of visual functioning a person retains; e.g. both the issues of age at onset and degree of impairment. It was also designed to study the possible interaction effects of degree of impairment with the age of onset. Findings indicated that the only differences in cognitive functioning appear to be related to age of onset and not the level of visual impairment. The findings further suggested that congenitally blind individuals have indeed developed alternate methods of cognitively processing nonverbal, abstract, or complex information, especially information involving a high degree of spatial orientation. Implications of this study may influence ...
The presence of cognitive deficits in obstructive sleep apnea (OSA) is well-documented. Specifically, short- and long-term memory, attention/vigilance, and executive function (e.g. processing speed, mental flexibility, and problem solving) are affected. Cognitive deficits in aging occur in similar areas (i.e., memory and processing speed). Given that a greater percentage of older adults experience sleep-disordered breathing as compared to middle-aged adults, it is possible that OSA may account for some of the deficits typically attributed to aging. This study investigated this hypothesis by comparing middle-aged and older adults with and without OSA on computer-based measures of cognitive performance. No effect of OSA or an interaction between OSA and age on cognitive function was found; an effect of age on processing speed, distinguishing stimuli rapidly, attention, spatial ability/mental flexibility, and both working memory and short-term visual memory was found. This study also explored whether or not cognitive function may be improved in persons with OSA by re-assessing those participants one month after treatment. An effect of treatment on improvements on processing speed, distinguishing stimuli rapidly, mental flexibility, and short term memory was found. Overall, findings reflect the ability of treatment to improve cognitive function among OSA patients, regardless of lack of deficits when compared to those without OSA.
This study is a comparison of four treatments involving education and imagery relaxation for the amelioration of dysmenorrhea. Treatment was presented to 76 subjects by videotape during a one-hour session. A six month follow-up was performed using one of the original instruments, the Symptom Severity Scale (Cox & Meyer, 1978) and a questionnaire designed for the study. Analysis of the test instruments indicated a significant treatment effect for the educational group. The second most effective treatment was a combined treatment utilizing imagery relaxation and education, although this group did not produce significant results. The no-treatment control group was more effective in diminishing symptoms than the fourth group, imagery relaxation alone. The lack of effectiveness of the imagery relaxation treatment was hypothesized to be due to lack of reinforcement of the technique. The educational treatment modality offered the individual an opportunity to learn about many different etiological facets of dysmenorrhea, including biological, learning, and cognitive factors. The presentation also introduced the individual to several different treatment modalities in order to provide an armamentarium of effective methods for diminishing or eliminating dysmenorrhea. These results suggest that there is a need for education about dysmenorrhea before menarche, in order to prepare, prevent, treat, and cope with this syndrome.
The purpose of this study was to confirm the original factor structure of the Wide Range Assessment of Memory and Learning (WRAML) utilizing a non-clinical adolescent population. Additional analysis examined the relationship between SAT-M scores and spatial relations ability. Exploratory analyses were conducted to determine ethnic and gender differences on the WRAML and subtests from the DAT. Sixty-four academically talented adolescents completed the WRAML and the mechanical reasoning and spatial relations subtests from the Differential Aptitude Test (DAT). The confirmatory factor analysis found the data obtained to not be a good fit for the factor structure of the WRAML (Sheslow & Adams, 1990). Additional confirmatory analyses were conducted which examined data fit of a three factor model found by reanalyzing the standardization data (Burton et al., 1996; Wasserman & Cambias, 1991) as well as two null models. The data failed to fit any of these three models. No support was found for the second hypothesis that predicted a positive relationship between SAT-M scores and spatial relations ability. Ethnic and gender differences on the WRAML and two DAT subtests were examined and discussed. Limitations of this study were reviewed which may have accounted for the overall lack of results.
The purpose of this study was twofold: to determine the construct validities of comparable AD/HD instruments that were developed according to our current, DSM-IV classification system for AD/HD; and to identify potential +neurocognitive and socioemotional markers for AD/HD. The sample consisted of 145 children ages 8 to 11 years of age who were diagnosed with Attention Deficit Hyperactivity Disorder (AD/HD), or Central Auditory Processing Disorder (CAPD). Children were administered a battery of neurocognitive tests and completed a self-report measure of personality. Parents completed several, AD/HD instruments pertaining to their children. The AD/HD instruments used in this study were the Attention Deficit Disorder Evaluation Scale-Home Version (ADDES), Attention Deficit Hyperactivity Disorder Test (ADHDT), and the Attention Problems and Hyperactivity scales from the BASC-Monitor (BASC-M). Of interest was how each AD/HD instrument compared to the DSM-IV, particularly in terms of the cross-consistency of AD/HD subtype classifications. The findings showed that the AD/HD instruments classified participants differently from the initial, DSM-IV entry diagnosis. Rates of agreement were better for some of the AD/HD instruments than for others yet there was little overall consistency. The neurocognitive measures used in the study were the Cognitive Assessment System-Basic Battery scales. The socioemotional measures used in the study were two parent-report scales from the BASC-M (Internalizing Problems and Adaptive Skills), and the child report scales from the BASC-Self Report of Personality. Results showed that the neurocognitive measures were relatively insensitive to AD/HD symptomatology while a nearly opposite trend was observed on the socioemotional measures. For the most part, participants classified as the ADHD-Combined Type (ADHD-CT), (regardless of which AD/HD instrument was used) had the most significant impairment in areas of social functioning and emotional symptoms across parent and self-reports.
The present study explored whether use of Spanish language sayings, or dichos, improved group climate within multi-ethnic chronic pain groups. Use of this form of figurative language fits within psychological theory identifying use of metaphor as a means of promoting change and creating new meaning. Further, metaphor use is consistent with the broader aims of experiential therapy. Group climate was measured by group members' self reports using the Group Climate Questionnaire-Short Form. A pilot study involving Latino Americans in medical and non-medical contexts aided in categorizing dichos as high versus low-relevance. It was anticipated that clients would rate high-relevance sessions as involving greater engagement, and less conflict and avoidance than low-relevance groups. Participants were recruited from four multidisciplinary pain management clinics offering similar programs. Once every four to six weeks, group leaders were provided with a list of either high or low-relevance dichos, and were blind to the existence of dichos categories. Three hierarchical regression analyses were employed to determine whether dichos relevance, characterized as low, mixed or highly relevant, contributed to variance in group conflict, avoidance and engagement. Dichos familiarity was the last variable entered into the regression equation, with gender, ethnicity and acculturation score entered in sequential fashion. Consistent with predictions, low-relevance groups yielded higher conflict scores than all groups combined. Also, high-relevance groups predicted lower avoidance when compared to all groups. In contrast to hypotheses, high-relevance groups predicted lower ratings of group engagement when compared to all groups. Post-hoc analysis indicated the mixed-relevance groups yielded significantly higher engagement scores than the low and high-relevance groups. Implications of these findings are discussed in relation to impact on approaches to group therapy with Latino American clients, and within the chronic pain population. Limitations of the study and recommendations for future research are offered.
The present study contributes to the widening body of spirituality research by conceptualizing it as a state-trait construct. A new measure of spirituality, the State-Trait Spirituality Inventory (STSI), was created and validated according to psychometric methods of test construction. In its current form, the STSI contains seven state spirituality items and six trait spirituality items. A thorough review of the literature identified common themes in spirituality definitions and assisted in developing definitions of trait and state spirituality. Internal consistency for the trait scale was .88 and for the state scale, .68. Good test-retest reliability was found with coefficients of .84 for trait spirituality and .81 for state spirituality. Results from a preliminary undergraduate sample as well as from the validation sample yielded a two-factor solution. In general, items determined by expert panels as trait items loaded on one factor and items deemed to be state items loaded on the second factor. Multitrait multimethod analysis yielded mixed findings for convergent, divergent, and concurrent validity for the spirituality and religiosity traits. Methods consisted of paper-and-pencil cognitive and behavioral measures. Cognitive measures were more likely to support convergent/divergent validity than were behavioral measures. A major emphasis in the study was to determine whether state and/or trait spirituality were able to predict current health status and provide evidence for predictive validity. Positive relationships were identified between trait spirituality and the mental health measures of the Short Form-36® (SF-36). In contrast, it was negatively related to the Role-Physical scale. State spirituality was inversely related to the Physical Component scale. These findings are discussed within the context of minimal research using the SF-36 and spirituality measures. The MTMM analysis was limited by available spirituality and religiosity measures that contain only cognitive or behavioral items. Suggestions for future research are offered.
Alzheimer’s Dementia (AD) is among the most common diseases in the Geriatric population, and its prevalence is expected to quadruple by 2047.Vascular Dementia (VaD) is the second most frequent cause of dementia, with studies indicating VaD accounts for 10-20% of dementia cases across the globe. A diagnostic model differentiating AD and VaD would be clinically and scientifically valuable, considering the treatment approaches for these conditions are different. Although there are differences between AD and VaD on their neuropsychological profiles, a diagnostic model that successfully differentiates AD and VaD on neuropsychological testing has not been developed, despite previous attempts. Our study addresses this gap in the literature by examining two diagnostic models used to predict the conversion of AD from mild cognitive impairment, and a third model was proposed to differentiate AD from VaD. We conducted ROC Analyses using the variables LM II Standard Score, Animals Total, and CDRS Sum based on a previous diagnostic model. The sensitivity and specificity for the diagnosis of mild VaD were calculated for all possible scores of each test measure. The Animals Total cutoff score of 7 achieved excellent sensitivity and specificity, receiving 96% and 92%, respectively. In this sample, patients who could name at least seven animals under 60 seconds were highly likely to be diagnosed with VaD. LM II Scaled Score also achieved statistical significance (p <0.001) and a cutoff score of 4 received 96% sensitivity and 77% specificity. Patients who achieved an LM II Scaled Score of 4 or higher were highly likely to be diagnosed with VaD.
The purpose of the study was to explore perceptual-motor differences between blind and sighted adults from a neuropsychological perspective, and to analyze differences within the blind group. Perceptual-motor abilities were examined using the Comprehensive Vocational Evaluation System (CVES), a vocational rehabilitation and neuropsychological battery designed for use with blind populations. The data were processed using Analysis of Covariance. Results showed that sighted persons had better motor abilities, while persons with blindness were more skilled at haptic identification of shape and texture. Analysis within the blind group showed that texture identification skills are better when blindness occurs earlier in life and to the extent that the blindness is total. Later onset blindness and the retention of some functional vision may not lead to a refocusing of attentional states necessary to develop haptic images. New neural connections may develop in persons with congenital/total blindness, a hypothesis in line with recent neuroradiological findings that occipital lobe activation occurs when congenitally blind individuals engage in tactile processing tasks. One implication of the findings is that teaching individuals who retain some functional vision to read Braille is probably counterproductive. These individuals would be better served by learning to use a CCTV and large print books. Future researchers should examine blindness from a multivariate perspective, examining subsets of blind groups based on age at onset, visual status, and other pertinent variables. Other implications are discussed and recommendations for future research are provided.
Pain has been described as the most complex human experience and most frequent reason patients seek medical treatment. Few people fail to experience the pain associated with disease, injury, or medical/surgical procedures. However, the impact of unemployment that results from chronic pain suffering has not been widely researched. To present a comprehensive view of the effect unemployment has upon the chronic pain experience, this study focused upon stress philosophy, chronic pain, employment, and coping effectiveness. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and a Personal Data Questionnaire (PDQ) were administered to 96 persons (four groups of 24 subjects) representing either unemployed or employed and either chronic or non-chronic (acute) pain populations.
Behavior analysts who study verbal behavior theorize that people derive relationships between stimuli - forming stimulus classes such that psychological functions transfer among stimuli and therefore affect behavior. Verbal processes are thought to play a role in cancer patients' behavioral flexibility. The current study examined if an analogue intervention produced changes in relations between health-relevant stimuli from pre- to post-test in patient and student samples. A matching-to-sample (MTS) task required participants to form three 4-member classes that included health, treatment, or neutral terms. Participants next listened to either an acceptance-based or a control-based rationale and therapy exercise, or a distracter task. Then, they were re-exposed to the MTS task. Latencies and accuracies for learning each class as well as between condition differences were examined. Finally, changes in ratings of stimuli from pre to post analogues were measured. Differences in stimuli ratings were seen in the student sample, reflecting transfer of function and some reduction in responsiveness to stimuli following intervention, but overall no learning performances are found. Discussion explores the consistency of the findings with acceptance and commitment therapy (ACT) theory in light of the seemingly lack of findings.
For the past quarter century, the public has been educated and warned about the dangers of smoking, and both smokers and health researchers have been in search of cost-effective, smoking cessation programs that will lead to long-term cessation. This study used a randomized experimental design to investigate the effectiveness of adding Web-based support materials to a nationally sponsored self-help smoking intervention. There was no significant increase in abstinence rates nor progression through the stages of change by those participants who had access to the Web site. However, there were some overall significant trends that suggested these self-help interventions were successful at decreasing daily rates of smoking and nicotine dependency, as well as tended to encourage repeated quit attempts. Although Web-based supports did not appear to increase the effectiveness of the nationally sponsored self-help intervention, this study demonstrated overall 12 week follow-up abstinence rates of 30-32%--greater than what might be expected, given average success rates of other self-help interventions. This study also supports the notion that women may face additional barriers to smoking cessation. Limitations and implications for future research are discussed.
The present study was conducted to explore the effectiveness of a worksite stress management program delivered via electronic mail (e-mail). One hundred and thirty-seven employed adults (36 males, 102 females; mean age = 29.46) from several diverse businesses consented to participate. The volunteers completed Cohen's Perceived Stress Scale, the Daily Hassles Scale, the Daily Work Hassles Scale, the TCU Self-Ratings Scales, and a demographic and opinion questionnaire. Individuals in the treatment group received e-mail messages twice weekly and had access to a website for three months about a variety of cognitive-behavioral techniques for managing worksite stress. A MANCOVA of post-intervention stress levels indicated that individuals who received the stress management messages perceived the same amount of stressors and hassles as individuals who did not receive the messages [F (5, 86) = 0.95, p = .45]. However, a MANCOVA of post-intervention perceived mood states revealed a tendency for individuals in the treatment group to be less depressed, anxious, and angry than individuals in the control group [F (3, 92) = 2.44, p = .07]. Demographic variables did not influence the outcome variables and pre- and post-test absenteeism and illness rates were similar for treatment and control groups. Coping skill usage was similar in amount and frequency, but differed in quality between the groups. The findings of the present study indicate that health promotion programs can be feasibly and effectively delivered via e-mail in the worksite.
Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean levels of endorsement for apathy varied by diagnosis. Further research is warranted to investigate this relationship and the GDS endorsement patterns for caregivers regarding their impression of the demented individual.
The financial cost for health care and lost productivity due to chronic pain has been estimated at over $70 billion per year. Researchers have attempted to discover the psychosocial and personality factors that discriminate between people who learn to cope well with chronic pain and those who have difficulty adjusting. The purpose of the present study was to examine the effects of perceived locus of control and dispositional optimism on chronic pain treatment outcomes. Subjects reported significantly lower post-treatment pain levels as compared with pre-treatment levels (M = 0.66, SD = 1.58), t(45) = 2.85, p = .007 (two-tailed), but decreased pain was not associated with scores on the internality dimension of the Pain Locus of Control Scale (PLOC) or on the Life Orientation Test-Revised (LOT-R) (a measure of dispositional optimism). Overall, participants' increased coping ability was associated with scores on the LOT-R, but not with scores on the internality dimension of the PLOC. Subjects with the lowest pre-treatment scores on the LOT-R demonstrated significantly greater increases in post-treatment coping ability than those with the highest scores (F(2,40) = 3.93, p < .03). Participants with the highest pre-treatment scores on both the PLOC internality dimension and the LOT-R demonstrated greater post-treatment coping ability (F(2,32) = 4.65, p < .02), but not less post-treatment pain than other subjects. Participants' post-treatment LOT-R scores were significantly higher than their pre-treatment scores (M = 2.09, SD = 3.96), t(46) = 3.61, p = .001 (two-tailed), but post-treatment PLOC internality scores were not significantly higher than pre-treatment scores. Implications of these results are discussed.
Positive psychology has led a movement that concentrates on positive characteristics. The current study examined the relationship between positive emotions, negative emotions, flourishing, languishing, and cardiovascular functioning. The study uses guided imagery to help participants recall a negative emotional event and positive emotional event in a counterbalanced order. The reverse order allowed us to examine the differential contributions of stress buffering versus facilitated recovery effects to higher levels of heart rate variability (HRV). The study also examined the relationship between mental health categories and known cardiovascular disease risk. Univariate analysis of variance revealed that positive emotions can serve as a stress buffer and dampen cardiovascular responses to a negative event. Also, analysis revealed a trend for the prediction that positive emotions can facilitate cardiovascular recovery following a negative event. Exploratory analysis did not reveal differences between a facilitated recovery group and a buffering group for cardiovascular measures. Future studies should include tighter control to help compare the differential influences of stress facilitation and stress buffering on cardiovascular functioning. The results from the study indicate that it is still too early to tell whether mental health buffers those individuals from developing CVD, and to answer whether languishing increases the risk of CVD. Longitudinal studies of young individuals without a prior history of any risk of CVD and who are flourishing or languishing might help provide answers to these questions.
This two-part study investigates the effectiveness of neurofeedback training for reducing behavioral problems commonly observed in abused/neglected children, and compares its efficacy to other treatment interventions with this population. Neuro-developmental sequelae of early relationship trauma are explored as an etiological framework for understanding disturbed affect-regulation, which appears central to the behavioral and emotional difficulties commonly experienced by this pediatric population. It is suggested that neurofeedback teaches children to self-regulate brain rhythmicity mechanisms, which in turn affects global improvements in behavior and mood. The pilot study utilizes records of 20 children removed from their biological homes by Child Protective Services. Children were assessed prior to treatment using the Child Behavior Checklist (CBCL) and the Test of Variables of Attention (TOVA), and again after 30 sessions of individualized, qEEG-guided neurofeedback training. A t-test analysis of pre- and post-scores was computed, and indicated significant improvements following treatment. A meta-analysis of existing literature on treatment interventions with abused/neglected children provides individual and aggregate effect sizes for 33 outcome studies with this clinical population, and contextualizes the results of the present pilot study within other empirically validated treatment modalities. Establishment of an overall effect size for treatment for this pediatric population provides a needed method of comparing research results across studies when control groups may not be ethical or feasible.
C-reactive protein (CRP) is a protein found in the blood that is synthesized by the liver and has been extensively studied due to its role in inflammatory and atherosclerotic processes. The importance of this biomarker in its role in vascular risk factors is increased with several lines of evidence pointing to its association with cognitive decline. The association between CRP and depression has been increasingly analyzed by various cross-sectional studies. The research between CRP and depressive symptoms in older women has yet to generate consistent trends. In the present study, a series of regression analyses was used to explore the association between CRP and both cognitive function and depressive symptomatology among a group of rural-dwelling women. Associations were evaluated through the use of data from Project FRONTIER, a rural-based research looking at both physical and cognitive aspects of health in rural-dwelling adults and elders. Comparisons were made between Mexican American women and a group of non-Hispanic Caucasian women. CRP was a significant independent predictor of total depression (beta = -.11, t = -1.99, p =.048). CRP was also a significant independent predictor of symptoms associated with meaningless within depression (beta = -.16, t = -2.94, p =.004). Contrary to prediction, CRP was not a significant independent predictor of overall cognitive function or performance in five specific cognitive domains. There is still needed evaluation on racial/ethnic differences present in regard to the impact of varied health factors on mental health within a culturally rich, rural cohort. It is recommended that future studies utilize standardized measurement of cognitive function to facilitate a more thorough understanding and comparison of change in this particular population.
Child maltreatment affects 900 thousand children in the U.S. every year and impacts all areas of daily functioning. Behavioral parent training (BPT) programs have effectively taught parenting and demonstrated externally valid outcomes (i.e., lower recidivism rates). Skill maintenance assessments for BPTs have mixed results. The Behavior Management and Parenting Services (BMAPS) program has shown effective skill training for court-mandated families. This study assessed skill maintenance and performance factors that may have impaired parents using an ABAB single-case research design in Phase 1 & external validity with a survey in Phase 2. Results for Phase 1 found that most BMAPS parents acquired all parenting tools to criteria, dropped below criteria at the 3 month probe, then fully demonstrated their regained skills after a brief review. Psychological and classroom factors do not appear to have systematically influenced performance at any time, although homework completion was associated with better scores at the end of class. Phase 2 results found a 91% reunification rate and a 0% recidivism rate over 1-3 years. All limitations aside, it appears that the BMAPS program is able to effectively train skills to criteria and these skills can be sustained with a booster session. The vast majority of parents we contacted were reunified with their children and none were involved with additional charges of child maltreatment.
Spinal cord injury (SCI) is an acute and devastating event that results in significant and permanent life changes for the individuals who are injured, as well as their families and friends. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with SCI. Measurement of depression in this population has a variety of methodological issues, including inconsistent assessments used (self-report versus clinical interviews), varying definitions of depression, inclusion and exclusion of physical symptoms in the assessment process, and use of measures that do not represent DSM-IV criteria for major depressive disorder. The primary goal of this study was to evaluate the Quick Inventory of Depressive Symptomatology - Self-Report (QIDS-SR) and provide descriptive analyses of this measure with persons with SCI. Results showed that somatic symptoms were more frequently endorsed than psychological symptoms in this population. Additionally, scores on the QIDS-SR were significantly associated with a depression diagnosis in the patient's medical chart. However, QIDS-SR scores were not found to be correlated inversely with quality of life scores as predicted. The QIDS-SR was shown to have good internal consistency and convergent validity with patients with SCI. However, it failed to demonstrate construct validity. The QIDS-SR has the potential to be a valid measure with this population and further analysis of the psychometric properties with patients with SCI is warranted.
The Luria-Nebraska Neuropsychological Battery (LNNB) was published in 1980 as an attempt to provide clinicians with a standardized version of the neuropsychological assessment and diagnostic procedures proposed by A. R. Luria and A, L. Christensen. Research on the LNNB included a series of factor analyses for each of eleven clinical scales. The analyses were completed on the combined scores obtained from a sample of normal, brain-damaged, and psychiatric populations. A second version of the LNNB was published in 1985 as a largely parallel version of Form I, but included changes in stimulus materials, administration procedures, and scoring procedures. The present study completed factor analyses on same eleven clinical scales using data generated with the newer LNNB Form II. The statistical procedures and criteria employed in the present investigation were identical to those used earlier on Form I to allow for comparisons between the two resulting sets of factor structures. The patient populations were different, however, in that all subjects in the current study were receiving inpatient care in a private psychiatric hospital which specializes in long-term treatment. Despite the changes in materials and procedures and the difference in subject parameters, the factors identified in the present investigation are similar to those seen in the Form I studies. However, two trends were observed when comparing the two sets of factor structures. First, in the present study several items were excluded from the statistical procedures because they were performed perfectly by almost everyone and the resulting scores lacked statistical variance. Second, more homogenous factors were obtained with the Form II analysis. That is, some of the complex LNNB Form I factors were reduced to two or more simpler factors. The results of the study lend support to Luna's conceptual model of higher cortical function and to the reliability of the LNNB as ...
Shared characteristics and predictors of psychological distress are beginning to be identified in research on women seeking genetic testing for BRCA1 and BRCA2 gene mutations. This study further explored patterns of psychological distress for 51 community women waiting to receive such genetic test results. There was no significant relationship between psychological distress and family cancer history, personal cancer history, social support networks, and family environment. Women in this sample tended to rely more on females and relatives for support than males and friends. Social support satisfaction was not related to gender or number of relatives providing support. Thirty-four of the 36 women classified on the family environment type were from Personal Growth-Oriented families. Comparisons with normal and distressed family means revealed increased cohesion and expressiveness with decreased conflict, indicative of supportive family environments. Limitations and implications are discussed.
Previous research indicates that women prefer orgasms triggered by penile-vaginal intercourse (PVI) as compared to those triggered by direct manual stimulation of the clitoris. However, for reasons that are not well understood, most women are unable to reach PVI orgasms as often as they desire. In addition, it is unclear why many women prefer PVI orgasms to those triggered by direct clitoral stimulation. This study developed a more precise measure of PVI orgasm frequency and evaluated key predictors of this frequency, including duration of intercourse, physical and psychological health, and partner traits with implications for either mating quality or relationship quality. The present study also measured PVI orgasm importance and investigated why it is important for many women. The sample consisted of 835 adult women with experience in PVI. Mean PVI orgasm frequency was 50%, with 39.4% of women never or rarely having PVI orgasms, 37.1% sometimes having PVI orgasms, and 23.5% almost always or always having PVI orgasms. As a median response, women believed that PVI orgasm was “very important” and perceived importance was correlated with orgasm frequency (r = .31, p < .001), as were reasons for importance. Duration of intercourse showed a linear relationship with PVI orgasm frequency, but this finding was qualified for women at the low and high extremes of the orgasm frequency distribution. Body esteem, anxiety during intercourse, exercise, and general pain predicted PVI orgasm frequency. Sensitive male traits, although valued by women even more highly than alpha male traits, showed notably weaker relationships with PVI orgasm than did male alpha traits. This is consistent with evolutionary theories of orgasm, and it supports the view that the female orgasm may function to favor some males over others in terms of sire choice. Clinical and theoretical implications of the present findings are discussed.
Research evidence is suggestive of a strength model of self-control, also known as ego depletion, in social psychological literature. Engaging in an initial task of self-control depletes a limited resource, resulting in less self-control on a subsequent, unrelated task. The strength model of self-control has been applied to many practical, everyday situations, such as eating behaviors among dieters. Newer studies suggest that blood glucose is the resource consumed during acts of self-control. Consuming glucose seems to "replete" individuals who have been depleted, improving performance and self-control. The current study aimed to examine the effects of ego-depletion on restrained eaters. The hypothesis was that restrained eaters who were depleted by a task of self-control would exhibit more disinhibition on a taste-test task than would restrained eaters who were not depleted. However, if the participants were given glucose following the depletion task, then their self-control would be "repleted" and they would exhibit similar control to that of the non-depleted participants. Contrary to expectations there were no differences between the groups in terms of total amount of cookies consumed. These results are inconsistent with a glucose model of self-control. Suggestions for future research and implications of the findings are discussed.
As the leading cause of death in the United States, coronary heart disease (CHD) is a growing public health problem, despite the fact that many risk factors for the disease are preventable, especially if addressed early in life. The purpose of the current study was to examine the effects of loss-framed versus gain-framed versus information-only health messages on both intention to attend and actual attendance at an appointment to get screened for CHD risk factors (i.e., hypertension, diabetes, and dyslipidemia). It was hypothesized that a population of young adults would be more likely to view screening for CHD risk factors as a low-risk, health-affirming behavior as opposed to a risky, illness-detecting behavior and would thus be more strongly influenced by gain-framed messages than loss-framed messages. Additional goals included the exploration of the extensively researched individual health beliefs of perceived threat (as defined by the health belief model) and health locus of control as they relate to message frames. One hundred forty-three undergraduate students were randomly assigned to either the loss-framed, gain-framed, or information-only control conditions. Framing manipulation checks revealed that participants failed to discern differences in the tone and emphasis of the experimental pamphlets. As a result, no tests of framing effects could be conducted. Sixteen (11.2%) of the 143 participants who participated in Part 1 of the experiment participated in Part 2 (i.e., attended a risk factor screening appointment). Multiple regression analysis revealed risk index, age, and powerful others health locus of control as significant predictors of screening intention. Gender was the only demographic or health related variable that was significantly related to screening outcome, such that women were more likely to get screened than men. Limitations and recommendations are discussed.
Learning of a positive diagnosis of HIV may be one of the most challenging and stressful events in life. The memory of this event is emotionally laden, and even years later evokes an emotional response. Similarly, many people living with HIV (PLH) have memories of the first time they were treated differently because of their diagnosis. While research frequently examines the subjective of stress, few studies have examined biological markers of stress in people living with HIV. Heart Rate Variability offers a non-invasive measure of stress. Beyond serving as a biological marker for stress, changes in HRV are also associated with emotional functioning. Research demonstrates decreased HRV levels in patients with Depression, Anxiety, and PTSD. We conducted a repeated measures MANOVA to examine effects of stress induction on HRV in individuals with high and low levels of HIV-related stigma. We found that the high stigma group was significantly different from the low stigma group in regard to changes in participants’ HRV, Wilks’ λ = .50, F (1, 51) = 11.63, p < .001. A hierarchical linear regression examined the relationship between HRV and other measures of stress (Heart Rate and Blood Pressure). We found that systolic blood pressure and heart rate in the stress condition were predictive of HRV (adjusted R2=.29, F (5,46) =4.07, p<.01). Results of our study support the use of HRV as a measure of stress in HIV-positive adults. Additionally, the results of our study demonstrate significant relationships between stigma, social support and stress in HIV-positive adults.
The present study evaluated the utility of heart rhythm coherence (HRC) feedback to reduce the reported pain intensity of patients enrolled in a multimodal pain management program. Participants were recruited and assigned to a usual treatment group (UT) or a heart rhythm coherence feedback group (UT+HRC). It was hypothesized that UT+HRC participants who achieved heart rhythm coherence would report a reduction of pain intensity, as measured by the McGill Pain Inventory. For those whose pain intensity decreased, it was also expected that their self reported levels of depression as measured by the Beck Depression Inventory-Second Edition and state anger as measured by the State Trait Anger Inventory would decrease. It is also hypothesized that with a reduction in pain levels, anger, and depression, blood pressure would also decrease among those who had high blood pressure prior to the intervention. Multivariate analyses of variance (MANOVA) were used to investigate the relationship between treatment condition, coherence status and pain levels. A series of independent t-tests were utilized to investigate the change in pain, depression, and state anger from baseline to posttest, followed by Pearson product moment correlation coefficients on difference scores to understand the relationship between the outcome variables for Hypothesis 2. Standard multiple regression analyses were computed using difference scores to determine if the outcome measures were significant predictors of systolic blood pressure and diastolic blood pressure. Results indicated a failure to reject the null with regard to hypothesis one. No relationship between treatment assignment, coherence status or pain levels were found. Hypothesis 2 was partially supported. Although there was a positive significant relationship between depression and anger when utilizing difference scores, these affective measures were not related to difference scores on either pain measure. In regard to Hypothesis 3, there was also a failure to reject the null. None of ...
Acute lymphocytic leukemia (ALL) is one of the most common types of pediatric cancers. Improvements in treatment within the last 20 years have resulted in reduced mortality and a greater focus upon quality of life. Several researchers have documented neuropsychological impairments in children following treatment for ALL; however, there have not been any comparative studies documenting differences in neuropsychological functioning based upon treatment modality despite the documented effects of radiation therapy and combined radiation/chemotherapy upon the developing brain. In addition, past studies have focused on unitary measures, ignoring the hierarchical relationship between basic cognitive functions and more abstract skills. This study examined the neuropsychological functioning of 81 children who were treated for ALL at a metropolitan children's hospital. All children were tested a minimum of two years after the final treatment session and were administered the NEPSY. Results do not support any interactions or main effects with the exception of the age of the child at diagnosis. Children diagnosed prior to the age of 5 showed greater impairments on tasks measuring attention, memory, and visuospatial reasoning in comparison to peers diagnosed after age 6.
The purpose of this study was to examine the ability of the Cognitive Assessment System (CAS) and the NEPSY, A Developmental Neuropsychological Assessment, to differentiate between the subtypes of Attention Deficit/ Hyperactivity Disorder (AD/HD). The CAS and NEPSY are neuropsychological instruments which provide norms for AD/HD children in general. This study examined the performance of the two subtypes of AD/HD on the CAS and NEPSY. In addition, this study examined the performance of the two AD/HD groups on the Screening Test for Auditory Processing Disorders (SCAN). Since AD/HD children tend to have difficulty with language, the SCAN was used to determine if any of the AD/HD subjects had auditory processing difficulties that might impact their performance on the CAS and/or NEPSY subtests. The sample consisted of 118 children between the ages of 8 and 12 years of age. Using the DSM-IV criteria, the children were diagnosed as having three types of AD/HD: A Predominantly Hyperactive-Impulsive Type (AD/HD-HI), a Predominantly Inattentive Type (AD/HD-I) and a Combined Type The subtypes were also identified by the Attention Deficit Disorders Evaluation Scale-Home Version (ADDES-H). Only two subtypes, AD/HD-I and AD/HD-C, were identified by the ADDES-H. There were not enough AD/HD-HI subjects to include in the study. Therefore, this study focused on the AD/HD-I and AD/HD-C subtypes. A binomial logistic regression analysis was conducted on the AD/HD-I and AD/HD-C subtypes with selected subtests of the NEPSY and the four PASS Scales of the CAS. Results indicated a significant difference between the AD/HD-I and AD/HD-C groups on the Tower subtest of the NEPSY and the Planning Scale of the CAS. The Tower and the Planning Scale are both purported measures of executive functioning; however, results of the Planning Scale were in an unexpected direction. No significant difference was found between the two AD/HD groups on the ...
Physical activity has been demonstrated in the literature as an effective way to reduce the risk for development of chronic disease. The Transtheoretical Model (TTM) of behavior change has been developed as a means to predict and facilitate movement into healthier lifestyle behaviors. The model is centered on "stages of change", which describe a continuum of readiness to engage in a health behavior change. Stages contain temporal, qualitative, and quantitative characteristics. This was a six-month study that evaluated the effectiveness of stage-matched (theorized to be pertaining only to the maintenance stage of change) vs. generic (theorized to be pertaining to anyone, regardless of stage) newsletters in assisting subjects to attain the Maintenance stage of change. It also sought to identify further qualitative characteristics that can differentiate between the Action and Maintenance stages of change. Results indicated that monthly stage-matched newsletters were no more effective in helping subjects reaching Maintenance than were the generic newsletters. Exerciser self-schema was related to stages of change, but those relationships differed from baseline to six-month follow-up, indicating development of exerciser self-schema during the study period. Implications of this are discussed. Other concepts discussed included "structure" of change process, in that three new scores were developed and correlated with self-efficacy as well as intercorrelated. Motivation was also evaluated and compared across levels of success at adhering to exercise during a three-month period. Limitations of the study and implications are discussed.
Two hundred twenty individuals participated in the present study from a university population. The study examined the relationship among attachment styles to caregivers, relationship with God, depressive symptomology, and depressive experiences. Attachment theorists have suggested a connection between childhood attachment to caregivers and current attachment to God through the idea that individuals have "working models" that form how they interpret present relationships. For the most part, the results of the current study supported the idea of correspondence between attachment to caregiver and attachment to God. Individual attachment styles to caregivers matched their attachment style to God. However, when caregiver religiousness was included as a moderating variable, results supported the theory of combined compensation-correspondence for those with insecure attachments to caregivers. Individuals with insecure attachment to caregivers were more likely to compensate for their insecure attachment bonds through participation in religious activity, whereas their internal, private relationship with God corresponded with their previous insecure attachment bonds. Individuals with insecure attachment to caregivers were more likely to endorse symptoms of depression and report introjective, but not anaclitic, depressive experiences. With respect to attachment to God, introjective depressive experiences were positively related to both anxious and avoidant attachments, whereas, anaclitic depressive experiences were positively related only to anxious attachment to God. Anxious attachment to God was found to partially mediate the relationship between insecure attachment to caregivers and depression symptoms. Finally, attachment effects were similar across gender, ethnicity, and age, with some notable exceptions.
Medication non-compliance has become one of the most prevalent reasons for hospitalization and doctor's visits by the elderly. As the elderly population is more likely to have decreased cognitive abilities, it is suggested that neuropsychological factors, especially executive function, are more influential in medication non-compliance than once thought. This study looked at executive function performance on a traditional battery of neuropsychological tests, self-report of perceived ability to perform executive function tasks, and the newly developed Pillbox Test, a performance based IADL measure. The Pillbox Test is designed to replicate a type of medication-management specific IADL as a means to asses executive function. Standard executive function measures only tap a portion of executive function, but it is believed that the Pillbox Test incorporates all four theoretical domains of executive function. The multiple measures of executive function performance were compared in three prevalent subgroups of the elderly population (mixed neurological group, cardiac medical-control group, and healthy community-control group). Results found significant differences, where the community-control and cardiac groups outperformed the mixed neurological group on the large majority of executive function tasks. Smaller differences were also noted between the community-control and cardiac groups and between the cardiac and mixed neurological groups. Together, these findings provide support for the diagnostic prevalence of mild cognitive impairment in the older adult cardiac population. Results also indicated the level of executive dysfunction on standardized neuropsychological measures was highly correlated with performance on both the Pillbox Test and the IADL based Direct Assessment of Functional Status measure. Finally, the Pillbox Test has moderate to strong ecological validity with 75% sensitivity and 87.5% specificity for five or more errors on this test.
The Rey-Osterrieth Complex Figure Task (ROCFT) has been a standard in neuropsychological assessment for six decades. Many researchers have contributed administration procedures, additional scoring systems and normative data to improve its utility. Despite the abundance of research, the original 36-point scoring system still reigns among clinicians despite documented problems with ceiling and floor effects and poor discrimination between levels of impairment. This study is an attempt to provide a new method based upon item response theory that will allow clinicians to better describe the impairment levels of their patients. Through estimation of item characteristic curves, underlying traits can be estimated while taking into account varying levels of difficulty and discrimination within the set of individual items. The ultimate goal of the current research is identification of a subset of ROCFT items that can be examined in addition to total scores to provide an extra level of information for clinicians, particularly when they are faced with a need to discriminate severely and mildly impaired patients.
Type 2 diabetes (T2DM) has an estimated incidence of nearly 11 million US adults aged 65 years and older. Evidence suggests that the quality of the marital relationship is an important factor for diabetes related health outcomes affecting self-management and adherence (Kiecolt-Glaser & Newton, 2001). However, an individual in need may compensate for primary support that is unavailable or not optimal by looking for other sources of support, which may be important for health outcomes (Rini, et al., 2008). The present study examined compensation for poor spousal support through other social relationships. A total of 12,640 participants reported they had diabetes and were married (Male = 6,317 and Female = 6,323), and of this group 1,084 men and 583 women had died over the course of the study period. Women reported lower spousal support, but significantly more aggregated social support across relationships than men. Few persons reported low spousal support and low support compensation, rendering the cell sizes highly unequal and the associated data uninterpretable. Ancillary analyses were conducted with the idea that some variance in total compensation support may moderate mortality risk finding that higher aggregated social support across non-spousal relationships was associated with lower risk of death accounting for ~3% of the variance in the final model. The current findings demonstrate how an individual can compensate for a poor primary support relationship through a broader support network. These findings should guide future research to focus on how individuals build, maintain, and seek support from social relationships.
This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These results provide exceptionally strong support for the hypothesis that group classification can be obtained through the use of an objective screening instrument. The pathologically dependent patients tend to focus on disease, frequently are unemployed, have histories of childhood illnesses, have limited emotional controls, are depressed, ambivalent, and distrustful. Additionally, they experience difficulty establishing goals or accepting personal responsibility. Those patients identified as nonpathologically dependent exemplify the more positive aspects of these traits. The pathologically dependent patients appear to be caught in a dilemma between wellness and satisfaction of dependency needs. While all patients need an organized approach to treatment, the ...
The differences among certain physiological changes occurring in response to mirthful laughter, directed relaxation, and verbal speech were investigated. These changes included amount of muscle tension, as measured with surface electromyography, in the forehead and in the upper body as recorded from the forearms bilaterally, peripheral surface skin temperature, heart rate, and respiration rate. The study sought to determine whether the net effect of laughter, as measured on these five variables after a three-minute refractory period, is a more relaxed state than existed before the laughter. Determination of the similarity between the changes following laughter and the changes following directed relaxation was made in comparison with the changes following verbal speech. Factors of prior anxiety, pre- and post-self-esteem levels, humor level, and laughter intensity were examined. Historical and theoretical perspectives were reviewed, as well as the known information on physiological responses to laughter.
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