The challenge of providing psychological services for young handicapped children.

Examines the challenge faced by psychologists to ensure adequate and appropriate assessment and intervention for young children (birth–6 yrs of age) who have developmental disabilities including emotional, cognitive, sensory, and physical handicaps. Three major problem areas are considered: (1) determining who should provide services, (2) defining what clinical procedures are both appropriate and nondiscriminatory, and (3) obtaining training for assessment and treatment. It is concluded that as health care providers and trainers of practitioners, psychologists must seriously consider the challenge of providing the services to handicapped infants and young children. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-centered social exchange: Differential use of costs versus benefits in prosocial reciprocity.

Maintaining equitable social relations often requires reciprocating “in kind” for others’ prosocial favors. Such in-kind reciprocity requires assessing the value of a prosocial action, an assessment that can lead to egocentric biases in perceived value between favor givers versus favor receivers. In any prosocial exchange, 1 person (the giver) incurs a cost to provide a benefit for another person (the receiver). Six experiments suggest that givers may attend more to the costs they incur in performing a prosocial act than do receivers, who tend to focus relatively more on the benefits they receive. Givers may therefore expect to be reciprocated on the basis of the costs they incur, whereas receivers actually reciprocate primarily on the basis of the benefit they receive. This research identifies 1 challenge to maintaining a sense of equity in social relations and predicts when people are likely to feel fairly versus unfairly valued in their relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health services research clinical trials: issues in the evaluation of economic costs and benefits

The endoplasmic reticulum chaperone glucose-regulated protein 78 (GRP78) is essential for the proper glycosylation, folding and assembly of many membrane bound and secreted proteins. GRP78 mRNA is well known to be induced in cultured cells by lowering medium glucose concentrations from 4.5 to 0 mg/ml. Here we report a study designed to determine the effects of intermediate concentrations of glucose on GRP78 mRNA abundance. Progressive reduction in culture medium glucose from 4.5 to 1.0 mg/ml progressively reduced GRP78 mRNA to approximately 30% of the initial level. Induction of GRP78 mRNA by glucose starvation was observed in medium containing less than 1 mg/ml glucose. Determination of the amount of glucose consumed in these cultures showed that reduction of glucose concentrations led first to repression of GRP78 mRNA abundance, followed by induction of the mRNA only when glucose is nearly exhausted. Caloric restriction in mice both reduces fasting and mean 24 h glucose blood concentrations and GRP78 mRNA abundance in the liver. Thus, it is possible that negative regulation of GRP78 mRNA in the liver is due directly to reduced blood glucose concentrations.     

Local Medicare policies: A pathway for providing mental health services to older adults.

Inconsistent local Medicare service coverage policies constitute one of the most prominent barriers encountered by mental health professionals who provide services to older adults. In this study, the authors analyzed the scope and delineation of local Medicare policies for 19 types of psychiatric and psychological services in 2003 and again in 2006. Results indicated policies now exist for all Medicare services in all the states, and many of the local policies provide definitive statements to guide practice. However, some policies lacked delineation and variability persists from one region to the next. While researchers ascertain how local policies can impact service outcomes, providers should form issue networks and resolve current problems such as the inequities surrounding service documentation requirements and the lack of guidance in providing mental health care to older persons with dementia. Given that the Medicare administrative structure will undergo substantive changes in the next five years, there is an exceptional opportunity for providers to address these problems successfully and pave a pathway for providing specialty mental health services to older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mastery in women's multiple roles and well-being: Adult daughters providing care to impaired parents.

The current study focused on 296 adult daughter caregivers who were simultaneously providing care to an impaired parent, mothers to children living at home, wives, and employees. How mastery (perceived competence and control) in each of these 4 roles was related to well-being was examined. Women experienced higher levels of mastery in the employee role than in any other role. After controlling for household income and dispositional optimism, only employee mastery contributed unique variance to physical health, but mastery in each of the 4 roles contributed unique variance to either depression or life satisfaction. Results also suggest that women's satisfaction with life was related to an accumulation of mastery across roles. The study expands previous research by revealing that mastery in women's additional roles can supplement the benefits of mastery stemming from parent care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The costs and benefits of sexism: Resistance to influence during relationship conflict.

This study tested whether men's and women's hostile sexism (HS) and benevolent sexism (BS) were associated with resistance to influence in couples' conflict interactions. Ninety-one heterosexual couples were recorded while trying to produce desired changes in each other. Participants reviewed their discussions and rated how open they were to their partner's perspective. Objective coders also rated the extent to which each partner exhibited hostile communication. We tested key principles arising from ambivalent sexism theory (Glick & Fiske, 1996). First, BS is necessary because mutual interdependence reduces the power of HS to influence women within intimate relationships. We found that the more men endorsed HS, the less open and more hostile both partners were, and the less successful their discussions were in producing desired change. Second, BS reduces the threat of women's dyadic power by revering and respecting women's interpersonal roles while restricting women's influence outside the relationship domain. We found that men who expressed higher agreement with BS were more open to their partners' influence and behaved with less hostility, and their discussions were more successful. These relationship benefits illustrate why BS is effective at disarming women's resistance to wider inequalities. These benefits, however, were contingent on men adopting BS attitudes. When women strongly endorsed BS but their male partner did not, women were less open, behaved with greater hostility, and perceived their discussions as less successful. These results indicate that, because BS increases the stakes within the relationship domain, women who endorse BS will react more negatively when their expectations are not realized. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The costs and benefits of tonal centers for chord processing.

Harmonic priming studies have shown that a musical context, with its established tonal center, influences target chord processing. This study investigated costs and benefits of priming tonal centers for target processing by adding a baseline condition (sequences without a specific tonal center). Results confirmed harmonic priming, with faster processing for related than for unrelated and less related targets (tonic chord, out-of-key chord, subdominant chord). Comparing targets in baseline contexts with targets in sequences with well-established tonal centers revealed a benefit of processing for related targets but a cost of processing for unrelated and less related targets. Findings are discussed in terms of tonal knowledge activation and suggest that an activated tonal center gives rise to strong expectations for the tonic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Video-assisted thoracoscopic surgery versus thoracotomy for recurrent spontaneous pneumothorax. A comparison of results and costs

OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) represents at present the most suitable treatment of recurrent spontaneous pneumothorax. After three years we consider this interesting to draw up a trial balance of our VATS experience in comparison with the cases treated before 1991 with the classic thoracotomic approach. METHODS: We have considered retrospectively the results obtained in a series of 30 consecutive patients with recurrent spontaneous pneumothorax treated with VATS between November 1991 and August 1994 in comparison with those obtained in a group of 30 patients previously treated with a traditional thoracotomy. The groups have been selected in such a way that surgical indications, sex ratio, age and number of episodes were homogeneous. The parameters we have compared were the postoperative complications, the duration of chest drainage and hospitalization, the operating times and the relapses. Besides these technical parameters we considered the economic data too. RESULTS: On average drains removal occurred one day before in VATS-Group: the time spent in the Hospital was significantly shorter in VATS-Group, being on average 1 week. Short term complications may be considered similar in the two Groups. Prolonged air leaks occurred in 13% and 16% respectively. Emothorax requesting reoperation occurred in 1 case for each Group. One death occurred in thoracotomy-Group in an old patient presenting a severe chronic respiratory insufficience with exacerbation in postoperative time. We have registered 2 relapses after VATS and none after thoracotomy. CONCLUSIONS: The study has demonstrated the therapeutic efficacy of VATS and in the same time that in VATS the total economic cost is lower (22.7%) in comparison with traditional thoracotomy.     

Diagnostic and treatment services for children: Introduction to the section.

Discusses what clinical child psychologists have to offer troubled children and their parents and how the psychologists should be trained. The author considers the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and its impact on child diagnoses and treatments, suggesting that it runs the risk of labeling as disordered behaviors that are not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term comparison of brief versus unlimited psychodynamic treatments with children and their parents.

30 children and their parents were assigned randomly to either time-unlimited or time-limited (12 sessions) psychodynamically oriented treatments or to a minimal-contact control group. All groups showed significant improvements from pretest to posttest. Comparisons between groups at posttest on parental measures of family functioning showed that changes reported by the minimal contact control group were significantly greater than those of the time-unlimited group. When assessments from pretest to 4-yr follow-up were compared, all groups improved significantly on therapist measures of goal attainment, but only the minimal-contact control group reported significant improvements on severity of target problems and measures of family functioning. The results of this study suggest that long-term therapy does not necessarily provide more effective therapy. These findings have important implications for clinical practice, service delivery, and research, particularly in the present climate of financial restraint in health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investing in children: Government and workplace policies for parents.

Changes in the structure and needs of the American family are requiring changes in government and workplace policies. Current policies related to day care, parental leave, work schedules, income support, and child support enforcement are discussed. Consideration is given to psychological research needed to develop effective policies that do not supplant the role of parents, but rather support them and strengthen families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anticipating one's troubles: The costs and benefits of negative expectations.

Although negative expectations may have the benefit of softening the blow when a negative event occurs, they also have the cost of making people feel worse while they are waiting for that event to happen. Three studies suggest that the cost of negative expectations is greater than the benefit. In 2 laboratory experiments and a field study, people felt worse when they were expecting a negative than a positive event; but once the event occurred, their prior expectations had no measurable influence on how they felt. These results suggest that anticipating one's troubles may be a poor strategy for maximizing positive affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily stress, coping, and well-being in parents of children with autism: A multilevel modeling approach.

This study used a repeated daily measurement design to examine the direct and moderating effects of coping on daily psychological distress and well-being in parents of children with Autism Spectrum Disorders (ASD). Twice weekly over a 12-week period, 93 parents provided reports of their daily stress, coping responses, and end-of-day mood. Multilevel modeling analyses identified 5 coping responses (e.g., seeking support, positive reframing) that predicted increased daily positive mood and 4 (e.g., escape, withdrawal) that were associated with decreased positive mood. Similarly, 2 coping responses were associated with decreased daily negative mood and 5 predicted increased negative mood. The moderating effects of gender and the 11 coping responses were also examined. Gender did not moderate the daily coping?mood relationship, however 3 coping responses (emotional regulation, social support, and worrying) were found to moderate the daily stress?mood relationship. Additionally, ASD symptomatology, and time since an ASD diagnosis were not found to predict daily parental mood. This study is perhaps the first to identify coping responses that enhance daily well-being and mitigate daily distress in parents of children with ASD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The benefits and costs of repeated memory tests for young and older adults.

Repeated and prolonged searches of memory can lead to an increase in how much is recalled, but they can also lead to memory errors. These 3 experiments addressed the costs and benefits of repeated and prolonged memory tests for both young and older adults. Participants saw and imagined pictures of objects, some of which were physically or conceptually similar, and then took a series of repeated or prolonged recall tests. Both young and older adults recalled more on later tests than on earlier ones, though the increase was less marked for older adults. In addition, despite recalling less than did young adults, older adults made more similarity-based source misattributions (i.e., claiming an imagined item was seen if it was physically or conceptually similar to a seen item). Similar patterns of fewer benefits and more costs for older adults were seen on both free and forced recall tests and on timed and self-paced tests. Findings are interpreted in terms of age-related differences in binding processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent children of alcoholic parents and the relationship of Alateen to these children.

25 adolescents with an alcoholic parent who are not members of Alateen (Group 1) had significantly higher scores on the negative scales of the Profile of Mood States and a significantly lower score on the positive scale and significantly higher scores (indicating low self-esteem) on the Rosenberg Self-Esteem Scale than a control group of 25 adolescents without an alcoholic parent or 25 adolescents who have an alcoholic parent but are members of Alateen. Group 1 also had problems at school or with law enforcement officials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What kind of information does the health services give to children with asthma and their parents?

Good information to families who have children with bronchial asthma is essential for treatment and in helping the family to cope. The aim of this study was to find out what kind of information the parents meant they had received, their knowledge about asthma, and what sanitary measures had been taken at home. A questionnaire was sent to all children (N = 431) who, during a five year period, were entered into the records of the Department of Paediatrics, Innherred Hospital, Norway, with the diagnosis bronchial obstruction. A selected group of 55 children and their parents were also interviewed. The results showed that the parents were not satisfied with the information they had received about the illness and about effects and side effects of the medication. Furthermore, their knowledge about these matters was not satisfactory, judged both by themselves and by the interviewer. It was more difficult to quit smoking or to stop keeping animals than to do extra cleaning at home. Few parents were informed about their possibilities of receiving financial support and about patient organisations. Only in a few cases did the health service provide the school with information on the child's disease.     

Emergency medical services for children: Beyond lights and sirens.

This article describes the history of emergency medical services for children and identifies important mental health issues. It discusses the roles of psychologists in such services, including intervening with children and their families during times of crisis, helping others who are providing the physical care of children to mitigate rather than exacerbate children's emotional distress, and attending to the emotional needs of health care providers who treat children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptability of alternative treatments for children: Evaluations by inpatient children, parents, and staff.

32 child psychiatric inpatients (7–13 yrs), 32 parents, and 32 staff evaluated the acceptability of alternative treatments for children. Clinical cases of children who displayed severe behavioral problems at home and at school were described along with 4 different treatments. The treatments included positive reinforcement of incompatible behavior, positive practice, medication, and time out from reinforcement. Results show that reinforcement of incompatible behavior was more acceptable than other treatments that followed, in order, positive practice, medication, and time out from reinforcement. Positive practice and medication were no different from each other in acceptability but significantly more acceptable than time out. Although children rated treatments as less acceptable than did parents, the relative standing of different treatments was identical for children, parents, and staff. Results indicate that disturbed children and their parents can readily distinguish the acceptability of alternative treatments. The implications and relevance of acceptability as an important dimension for treatment selection and evaluation are highlighted. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A model for training psychologists to provide services for children and adolescents.

Background and rationale for a comprehensive model of training for psychologists to provide services to children and adolescents are outlined. Eleven integrated aspects of training are described with respect to training topics, justification for the training, and ways to implement the training. The model described address the need for guidance in training specialists in psychologically based mental health services for children, adolescents, and their families. Practitioners can use this model to assess their own backgrounds, knowledge, and skills in working with these populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)