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Timmer SG, Urquiza AJ, Boys DK, Forte LA, Quick-Abdullah D, Chan S, Gould W. Filling potholes on the implementation highway: Evaluating the implementation of Parent-Child Interaction Therapy in Los Angeles County. Child Abuse Negl 2016; 53:40-50. [PMID: 26704299 DOI: 10.1016/j.chiabu.2015.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 10/30/2015] [Accepted: 11/18/2015] [Indexed: 05/15/2023]
Abstract
In October 2012, first 5 LA funded a unique collaboration between Los Angeles County Department of Mental Health (DMH) and UC Davis PCIT Training Center (UCD PCIT) to train county-contracted agencies to provide Parent-Child Interaction Therapy (PCIT). This $20 million dollar, 5-year grant represented the largest implementation effort of an empirically based treatment to date. The purpose of this paper was to describe the first 2 years of the implementation process of this project, beginning with project start up and pre-implementation phases, and to present agency training and client performance outcomes from our first year of training. Results presented in this evaluation suggest that it is possible to train LA County providers in PCIT, and that PCIT is an effective intervention for DMH-contracted providers in LA County. This evaluation also discusses challenges to successful implementation. Barriers to progress included unanticipated delays building county infrastructure, trainee attrition, and insufficient client referrals. We discuss the results of the current implementation with respect to theory, research, and others' training models, with the aim of evaluating and prioritizing different implementation drivers, noting the ongoing competition between knowing what to do and the need for action.
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Affiliation(s)
- Susan G Timmer
- CAARE Diagnostic & Treatment Center, University of California, Davis Children's Hospital, Sacramento, CA, USA
| | - Anthony J Urquiza
- CAARE Diagnostic & Treatment Center, University of California, Davis Children's Hospital, Sacramento, CA, USA
| | - Deanna K Boys
- CAARE Diagnostic & Treatment Center, University of California, Davis Children's Hospital, Sacramento, CA, USA
| | - Lindsay A Forte
- CAARE Diagnostic & Treatment Center, University of California, Davis Children's Hospital, Sacramento, CA, USA
| | | | - Sam Chan
- Los Angeles County Department of Mental Health, Los Angeles, CA, USA
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2
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Fisher WW, Greer BD, Querim AC, DeRosa N. Decreasing excessive functional communication responses while treating destructive behavior using response restriction. Res Dev Disabil 2014; 35:2614-2623. [PMID: 25036315 DOI: 10.1016/j.ridd.2014.06.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 06/25/2014] [Indexed: 06/03/2023]
Abstract
Functional communication training (FCT) is an established treatment for destructive behavior that missucceeds in about 37% of cases when the reinforcement schedule for the functional communication response (FCR) is thinned using multiples schedules (mult FCT; Hagopian, Boelter, & Jarmolowicz, 2011). In this investigation, we evaluated the use of response restriction FCT (RR FCT) in a cohort of patients with poorly differentiated responding of the FCR during mult FCT. Results showed that (a) RR FCT maintained high rates of correct FCRs during the reinforcement component of RR FCT without increasing destructive behavior; (b) children displayed highly discriminated FCRs when an FCR card and a control card were simultaneously available during the reinforcement component of RR FCT; and (c) near-zero rates of destructive behavior were observed during the last five sessions of the terminal reinforcement schedule. Results are discussed relative to differences between mult FCT and RR FCT and successive and simultaneous discriminations.
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Affiliation(s)
- Wayne W Fisher
- University of Nebraska Medical Center's Munroe-Meyer Institute, 985450 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Brian D Greer
- University of Nebraska Medical Center's Munroe-Meyer Institute, 985450 Nebraska Medical Center, Omaha, NE 68198, USA.
| | - Angie C Querim
- University of Nebraska Medical Center's Munroe-Meyer Institute, 985450 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Nicole DeRosa
- University of Nebraska Medical Center's Munroe-Meyer Institute, 985450 Nebraska Medical Center, Omaha, NE 68198, USA
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3
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Kim MS, Blair KSC, Lim KW. Using tablet assisted Social Stories™ to improve classroom behavior for adolescents with intellectual disabilities. Res Dev Disabil 2014; 35:2241-2251. [PMID: 24927518 DOI: 10.1016/j.ridd.2014.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 05/07/2014] [Accepted: 05/16/2014] [Indexed: 06/03/2023]
Abstract
The present study examined the use of tablet assisted Social Stories™ intervention for three high school students with severe intellectual disabilities whose problem behavior interfered with their learning and caused classroom disruptions. A multiple probe design across participants was employed to test the impact of the tablet assisted SS on the participants' target behaviors. During intervention, the participants read the Social Stories that were created on Prezi and accessed via Quick Response (QR) codes using a Galaxy Tap smart tablet before participating in an academic period. Data indicated that the SS intervention decreased disruptive behavior and increased academic engagement in all three participants. All three demonstrated generalization of behaviors to a nontargeted academic period and maintenance of improved behaviors at the 2-week follow-up.
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4
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Ahmann E. Encouraging positive behavior in 'challenging' children: the Nurtured Heart Approach. Pediatr Nurs 2014; 40:38-42. [PMID: 24757920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Conventional parenting approaches often fall short of the mark for children who exhibit difficult behavior, sometimes inadvertently leading to increased oppositionality and poor self-esteem. As a result, parents of children with intense personalities and challenging behaviors need strategies that work very differently. The Nurtured Heart Approach is a philosophy/technique developed to help parents rewrite the often negative parenting scripts used with these children by limiting the amount of attention given to negative or undesirable behaviors while noticing and acknowledging even small positive behaviors, naming them, "energizing" attention given to them, and valuing their occurrence. Although there has been very limited empirical study of the Nurtured Heart Approach to date, it has been used, with anecdotal reports of success, in a variety of settings, including Head Start programs, schools, foster care agencies, a treatment center, and a pre-adolescent diversion program (Glasser, 2000).
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5
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Abstract
Stepping Stones Triple P (SSTP) is a parenting program designed for families of a child with a disability. The current study involved a randomized controlled trial of Group Stepping Stones Triple P (GSSTP) for a mixed-disability group. Participants were 52 families of children diagnosed with an Autism Spectrum Disorder, Down syndrome, Cerebral Palsy, or an intellectual disability. The results demonstrated significant improvements in parent-reported child behavior, parenting styles, parental satisfaction, and conflict about parenting. Results among participants were similar despite children's differing impairments. The intervention effect was maintained at 6-month follow-up. The results indicate that GSSTP is a promising intervention for a mixed-disability group. Limitations of the study, along with areas for future research, are also discussed.
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Affiliation(s)
- Gemma Roux
- School of Psychology, The University of Queensland, St. Lucia, QLD, Australia
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6
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McCracken J, Hicks R. Personality traits of a disruptive physician. Physician Exec 2012; 38:66-68. [PMID: 23888665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- John McCracken
- University of Texas at Dallas School of Management, USA.
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7
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Huitink C, Embregts PJCM, Veerman JW, Verhoeven L. Staff behavior toward children and adolescents in a residential facility: a self-report questionnaire. Res Dev Disabil 2011; 32:2790-2796. [PMID: 21700418 DOI: 10.1016/j.ridd.2011.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 05/15/2011] [Indexed: 05/31/2023]
Abstract
The purpose of the present study was to examine psychometric properties of the Staff Behavior toward Clients questionnaire (SBC), a self-report measure for care staff working with children and adolescents with mild to borderline intellectual disabilities in residential care. Ninetynine care staff completed the SBC and the Strengths and Difficulties Questionnaire (SDQ) for 99 of their clients. Factor analysis revealed four factors (i.e. behavior regulation, client-directed care, teaching and empowerment). Results indicated excellent internal consistency of all factors and ability of the SBC to detect differences in client populations with respect to behavior problems. These data suggest that the SBC could provide a reliable and valid measure of staff behavior toward clients in residential facilities.
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Affiliation(s)
- C Huitink
- Tilburg University, Clinical Psychology, Tilburg, The Netherlands.
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LaRue RH, Sloman KN, Weiss MJ, Delmolino L, Hansford A, Szalony J, Madigan R, Lambright NM. Correspondence between traditional models of functional analysis and a functional analysis of manding behavior. Res Dev Disabil 2011; 32:2449-2457. [PMID: 21821393 DOI: 10.1016/j.ridd.2011.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 07/12/2011] [Accepted: 07/14/2011] [Indexed: 05/31/2023]
Abstract
Functional analysis procedures have been effectively used to determine the maintaining variables for challenging behavior and subsequently develop effective interventions. However, fear of evoking dangerous topographies of maladaptive behavior and concerns for reinforcing infrequent maladaptive behavior present challenges for people working in applied settings. The present investigation sought to evaluate the utility of an adjunctive functional analysis model that involved the reinforcement of mands rather than problem behavior and compared the results to traditional functional analyses. The results from the manding analysis yielded results similar to the traditional FA in 3 of 4 cases. These findings suggest that manding analyses may represent a useful assessment tool for difficult to assess problem behavior or for individuals in settings where consultative support is limited.
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Affiliation(s)
- Robert H LaRue
- Rutgers, The State University of New Jersey, United States.
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Samyn V, Roeyers H, Bijttebier P. Effortful control in typically developing boys and in boys with ADHD or autism spectrum disorder. Res Dev Disabil 2011; 32:483-490. [PMID: 21255973 DOI: 10.1016/j.ridd.2010.12.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 12/27/2010] [Indexed: 05/30/2023]
Abstract
Despite increased interest in the role of effortful control (EC) in developmental disorders, few studies have focused on EC in autism spectrum disorders (ASD) and no study so far has directly compared children with ASD and children with ADHD. A first aim of this study was to investigate whether typically developing (TD) boys, boys with ADHD and boys with ASD can be differentiated based on EC levels. A second aim was to evaluate the relationship between EC and symptoms of ADHD and ASD. We assessed EC in 27 TD boys, 27 boys with ADHD and 27 boys with ASD (age 10-15) using different EC questionnaires. Clinical groups scored lower than the TD group on all EC total scales, but could only be differentiated from each other by means of self-reported persistence, impulsivity and activation control. Our data suggest that although EC is useful in differentiating TD boys from clinical groups, it is less efficient in distinguishing ADHD from ASD. Also, results suggest that EC plays a role in the manifestation of symptoms of both ADHD and ASD and that high levels of EC enable children to function more adequate in daily situations.
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Affiliation(s)
- Vicky Samyn
- Ghent University, Department of Experimental Clinical and Health Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium.
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10
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Fava L, Strauss K. Multi-sensory rooms: comparing effects of the Snoezelen and the Stimulus Preference environment on the behavior of adults with profound mental retardation. Res Dev Disabil 2010; 31:160-171. [PMID: 19815373 DOI: 10.1016/j.ridd.2009.08.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 08/24/2009] [Indexed: 05/28/2023]
Abstract
The present study examined whether Snoezelen and Stimulus Preference environments have differential effects on disruptive and pro-social behaviors in adults with profound mental retardation and autism. In N=27 adults these target behaviors were recorded for a total of 20 sessions using both multi-sensory rooms. Three comparison groups were created by diagnosis and motor respective linguistic abilities. Each client was exposed to only one multi-sensory room. Results showed that Snoezelen intervention decreased disruptive behaviors only in individuals with autism, while Stimulus Preference increased pro-social behaviors only in participants with profound mental retardation with co-occurring poor motor and linguistic abilities. Furthermore, several trend analyses of the improved behaviors were conducted throughout all sessions toward short and mid term effects of the multi-sensory room applications. These findings support both the prudence of using the Snoezelen room in individuals with developmental disabilities and the importance of using a Stimulus Preference assessment in multi-sensory environments in clients with profound mental retardation.
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Affiliation(s)
- Leonardo Fava
- Department of Psychology, University of Rome La Sapienza, Rome, Italy.
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11
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Glantz MD, Anthony JC, Berglund PA, Degenhardt L, Dierker L, Kalaydjian A, Merikangas KR, Ruscio AM, Swendsen J, Kessler RC. Mental disorders as risk factors for later substance dependence: estimates of optimal prevention and treatment benefits. Psychol Med 2009; 39:1365-1377. [PMID: 19046473 PMCID: PMC2705467 DOI: 10.1017/s0033291708004510] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although mental disorders have been shown to predict subsequent substance disorders, it is not known whether substance disorders could be cost-effectively prevented by large-scale interventions aimed at prior mental disorders. Although experimental intervention is the only way to resolve this uncertainty, a logically prior question is whether the associations of mental disorders with subsequent substance disorders are strong enough to justify mounting such an intervention. We investigated this question in this study using simulations to estimate the number of substance disorders that might be prevented under several hypothetical intervention scenarios focused on mental disorders. METHOD Data came from the National Comorbidity Survey Replication (NCS-R), a nationally representative US household survey that retrospectively assessed lifetime history and age of onset of DSM-IV mental and substance disorders. Survival analysis using retrospective age-of-onset reports was used to estimate associations of mental disorders with subsequent substance dependence. Simulations based on the models estimated effect sizes in several hypothetical intervention scenarios. RESULTS Although successful intervention aimed at mental disorders might prevent some proportion of substance dependence, the number of cases of mental disorder that would have to be treated to prevent a single case of substance dependence is estimated to be so high that this would not be a cost-effective way to prevent substance dependence (in the range 76-177 for anxiety-mood disorders and 40-47 for externalizing disorders). CONCLUSIONS Treatment of prior mental disorders would not be a cost-effective way to prevent substance dependence. However, prevention of substance dependence might be considered an important secondary outcome of interventions for early-onset mental disorders.
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Affiliation(s)
- M D Glantz
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Bethesda, MD 20892, USA.
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12
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Murray DW, Arnold LE, Swanson J, Wells K, Burns K, Jensen P, Hechtman L, Paykina N, Legato L, Strauss T. A clinical review of outcomes of the multimodal treatment study of children with attention-deficit/hyperactivity disorder (MTA). Curr Psychiatry Rep 2008; 10:424-31. [PMID: 18803917 PMCID: PMC5524214 DOI: 10.1007/s11920-008-0068-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Over the past decade, the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder has provided a bewildering wealth of data (more than 70 peer-reviewed articles) addressing treatment-related questions for children with attention-deficit/hyperactivity disorder. However, the take-home messages for clinicians may not always be clear. Therefore, this article reviews key findings, including relative benefits of medication and behavioral treatments, long-term effects at 2 and 3 years, treatment mediators and moderators, preliminary delinquency and substance use outcomes, and growth suppression related to stimulant use. Appropriate interpretations of the findings and their limitations are discussed, and recommendations for clinical practice are derived.
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Affiliation(s)
- Desiree W Murray
- Duke University Medical Center, 718 Rutherford Street, Durham, NC 27705, USA.
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13
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Knecht T. [Lunar phases as triggers for delinquent behavior?]. Arch Kriminol 2008; 222:105-109. [PMID: 19044137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
For many centuries, mankind has been concerned about the potential impact that the moon may have on human behavior, especially delinquency. The author presents a case report, in which the delinquency of the offender seems to show a certain synchronisation with the lunar phases. Finally, the issue is discussed on the basis of today's scientific literature on this topic.
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Affiliation(s)
- Thomas Knecht
- Aus der Psychiatrischen Klinik Münsterlingen, Bereich Sucht und Forensik
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14
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Affiliation(s)
- Ralph J Wood
- Department of Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA 70402, USA.
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15
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Buckley S, Hillery J, Guerin S, McEvoy J, Dodd P. The prevalence of features of attention deficit hyperactivity disorder in a special school in Ireland. J Intellect Disabil Res 2008; 52:156-162. [PMID: 18197954 DOI: 10.1111/j.1365-2788.2007.01017.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND The prevalence of features of attention deficit hyperactivity disorder (ADHD) in children with intellectual disabilities (ID) in Irish schools is unknown. The aim of this study was to examine the prevalence of features of ADHD in a special school, in order to ascertain the number of children who may need further assessment for ADHD. The study also explores the reliability of the Conners Teachers Rating Scale in this population. METHOD All teachers in a special school for children with ID were asked to complete the Conners Teachers Rating Scale and the Attention-Distractibility, Inhibition-Excitation Classroom Assessment Rating Scale, for those children whose parents had consented for them to take part in this study. Consent was obtained for 84 children a response rate of 71%, between the ages of 5 and 18 (mean = 10.5 years; SD = 3.7). RESULTS The Conners Teachers Rating Scale was found to be internally reliable and had a normal distribution with our results. Overall, 55.9% of participants (47/84) had markedly elevated scores (T > 69) for at least one of the target subscales, which were the 'Hyperactivity', 'Inattention' and the 'ADHD Index' subscales of the Conners Teachers Rating Scales. In addition, the findings would suggest that the Conners Teachers Rating Scale can be a useful screening tool in the population of school children with ID. CONCLUSIONS The study suggests that ADHD may be under diagnosed in children with ID. This has practical implications for the mental health needs of these children. It is recommended that further studies are carried out to determine the prevalence of ADHD in this population.
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Affiliation(s)
- S Buckley
- Child Guidance Clinic, St James Hospital, Dublin 8, Ireland.
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16
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Murrie DC, Boccaccini MT, McCoy W, Cornell DG. Diagnostic labeling in juvenile court: how do descriptions of psychopathy and conduct disorder influence judges? J Clin Child Adolesc Psychol 2007; 36:228-41. [PMID: 17484695 DOI: 10.1080/15374410701279602] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the influence of diagnostic criteria and diagnostic labels for psychopathy or conduct disorder on judicial decisions. A national sample of judges (N = 326) rendered hypothetical dispositions based on 1 of 12 mock psychological evaluations. The evaluations varied the presence of 2 sets of diagnostic criteria (antisocial behavioral history and psychopathic personality traits) and 3 diagnostic labels (conduct disorder, psychopathy, no diagnosis) to distinguish diagnostic criterion effects from diagnostic labeling effects. Results revealed substantial effects (Cohen's d = .33- 1.27 on 6 of 9 variables) for a history of antisocial behavior. Psychopathic personality features also appeared influential, albeit on fewer variables. There were no negative effects associated with conduct disorder or psychopathy labels. Results suggest that the criteria underlying labels, more than labels themselves, exert influence in juvenile justice contexts.
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Affiliation(s)
- Daniel C Murrie
- Psychology Department, Sam Houston State University, Huntsville, TX 77341, USA.
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Abstract
OBJECTIVE Children with ADHD experience peer problems that may place them at risk for adverse outcomes. Using a short-term longitudinal design, this study links specific behaviors to peer functioning in groups of previously unfamiliar children with ADHD. METHOD The participants were 268 children with ADHD who took part in an intensive summer treatment program. The program used a comprehensive behavioral point system that yielded observational data for 12 behavioral categories. These behavioral categories were used to predict peer acceptance, rejection, and liking assessed at three times during the program. RESULTS Following activity rules, helping, whining, and attention emerged as best predictors of initial peer status. Subsequent helping behaviors and activity rule following predicted changes in peer status, but their contributions were small. CONCLUSION The results indicate that increasing helping and rule- following behaviors may improve peer functioning of children with ADHD in similar settings.
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Affiliation(s)
- Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, AL, USA
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Piccardi L, Nico D, Bureca I, Matano A, Guariglia C. Efficacy of visuo-spatial training in right-brain damaged patients with spatial hemineglect and attention disorders. Cortex 2007; 42:973-82. [PMID: 17172177 DOI: 10.1016/s0010-9452(08)70203-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several rehabilitative approaches have been used to reduce neglect disorders. Some studies tried to demonstrate that hemineglect can be ameliorated by using tasks promoting attentional activation towards the neglected hemispace (Robertson et al., 1995, 2001). As a consequence, a functional link between level of attention and disorders of space exploration has been proposed. For this reason we tried to explore the possible role of attentional deficits on the efficacy of a standard neglect treatment based on visuo spatial rehabilitation. In this study we then examined the performances of a selected group of seven right brain damaged patients, suffering from both severe hemineglect and attentional deficits (of both phasic and tonic components of attention), to several tasks before and after a visuo-spatial training (VST) whose efficacy has been already demonstrated (Pizzamiglio et al., 1992). Results showed that VST induces a significant remission of hemineglect symptoms independently from disorders of attention. Moreover, after visuo-spatial rehabilitation, no improvement of attentional deficits is detectable.
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Affiliation(s)
- Laura Piccardi
- Neuropsychology Research Centre and Diagnosis and Neuropsychological Therapy Unit, IRCCS Santa Lucia Fondation, Rome, Italy.
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Abstract
This study was conducted to evaluate aggression and noncompliance among child psychiatric inpatients in relation to demographic, clinical, and hospitalization characteristics, including the use of restraints and seclusion. Eighty six children (10.8+/-2.4 years old, 67% male) consecutively admitted to an inpatient psychiatric unit were rated weekly using the Modified Overt Aggression Scale (MOAS) and the Disruptive Behavior Rating Scale (DBRS) between November 1, 2002 and June 30, 2003. Moderate to high correlations were observed between the four types of aggression (verbal, and physical against self, others, or objects) and noncompliant behavior. In hierarchical regression analyses, only mental retardation emerged as a significant predictor of aggression and noncompliance. Aggression and noncompliance were associated with different characteristics of inpatient treatment. Aggressive behavior was significantly associated with the use of restraints and seclusion, and noncompliant behavior with length of hospitalization and number of psychiatric medications at time of discharge. Modifying milieu interventions for youths with mental retardation, and adapting behavioral interventions empirically proven to target noncompliance may be effective loci for reducing aggression in child psychiatric inpatient units.
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Affiliation(s)
- Denis G Sukhodolsky
- Child Study Center, Yale University School of Medicine, New Haven, CT 06520-7900, USA.
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van Bokhoven I, Matthys W, van Goozen SHM, van Engeland H. Adolescent outcome of disruptive behaviour disorder in children who had been treated in in-patient and day-treatment settings. Eur Child Adolesc Psychiatry 2006; 15:79-87. [PMID: 16463012 DOI: 10.1007/s00787-006-0490-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2005] [Indexed: 10/25/2022]
Abstract
Although several studies have been conducted on the longitudinal course of childhood disruptive behaviours in community samples and in general psychiatric samples, little is known about adolescent adjustment in psychiatrically treated disruptive behaviour disorder (DBD) children. We examined a sample of adolescents (n = 47) who had been treated as children in an in-patient and/or day-treatment setting because of their severely disruptive behaviour. At follow-up, we found that half of the adolescents had a DBD diagnosis, and on average higher numbers of participants ever used soft drugs, had ever been in court, were not attending school when this was mandatory, and were smoking on a daily basis, as compared to comparison groups. There was, however, a large variance among the adolescents of our sample. When outcome was defined in terms of DBD diagnosis, living status, delinquency, school attendance, and smoking behaviour, 38 % had a positive outcome and 34 % had a poor outcome. For clinical purposes, it is important to recognise that there are large individual differences in outcome.
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Affiliation(s)
- I van Bokhoven
- Dept. of Child and Adolescent Psychiatry, B01-324, University Medical Centre Utrecht, 85500, 3508 GA, Utrecht, The Netherlands.
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21
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Affiliation(s)
- Bruce F Chorpita
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI 96822, USA.
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22
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Bowers L, Douzenis A, Galeazzi GM, Forghieri M, Tsopelas C, Simpson A, Allan T. Disruptive and dangerous behaviour by patients on acute psychiatric wards in three European centres. Soc Psychiatry Psychiatr Epidemiol 2005; 40:822-8. [PMID: 16172813 DOI: 10.1007/s00127-005-0967-1] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND The disturbed behaviour of acute in-patients can have serious consequences, and methods of management are contentious and vary between countries. Little is known about this variation and its relationship to the characteristics of in-patient populations. AIM The aim of this study was to compare rates and patterns of disturbed behaviours and containment methods in acute psychiatric wards in three centres in the United Kingdom, Italy and Greece. METHOD A retrospective survey of medical and nursing records (n=838) at seven hospitals for the first 2 weeks of patients' admissions was done using a structured data collection tool. RESULTS Nearly all types of disruptive behaviour varied by centre, with rates being generally higher in the UK and lowest in Italy. Specific relationships between different behaviours were replicated across all three centres. Ethnic minority patients were more likely to be subject to containment measures in all centres, even when their behaviours did not differ from the majority. Rates of containment method use were only partially related to the frequency of disturbed behaviour. CONCLUSIONS More research is required to discover the efficacy of varying containment methods, with a view to minimising their use. Gross international and inter-hospital variation demands large samples rather than single site studies. Clinicians need to reflect upon containment rates that may be, in some places, excessive and incorrectly targeted.
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Affiliation(s)
- Len Bowers
- St Bartholomew School of Nursing and Midwifery, City University, Philpot Street, London, E1 2EA, UK.
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Dicesare A, McAdam DB, Toner A, Varrell J. The effects of methylphenidate on a functional analysis of disruptive behavior: a replication and extension. J Appl Behav Anal 2005; 38:125-8. [PMID: 15898483 PMCID: PMC1224405 DOI: 10.1901/jaba.2005.155-03] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the present investigation, a functional analysis of the disruptive behavior of a 18-year-old man who had been diagnosed with attention deficit hyperactivity disorder and moderate mental retardation was conducted, both when he was taking methylphenidate and when he was not taking the medication. The results of this functional analysis demonstrated that the participant's disruptive behaviors were reinforced by access to attention only when he was not taking methylphenidate.
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Affiliation(s)
| | - David B McAdam
- University of Rochester
- Correspondence should be sent to David B. McAdam, Golisano Children's Hospital at Strong, Strong Center on Developmental Disabilities, Autism Spectrum Disorders Program, 601 Elmwood Avenue, Box 671, Rochester, New York, 14642, (e-mail: )
| | - Amy Toner
- Lindens Neurobehavioral Program Bancroft Neurohealth
| | - James Varrell
- Lindens Neurobehavioral Program Bancroft Neurohealth
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Abstract
We conducted and compared both brief and extended functional analyses of disruptive behaviors for 3 individuals with developmental disabilities who attended a vocational training program. Results demonstrated that the brief assessment identified the function of 2 of the 3 participants' disruptive behavior compared to the extended assessment.
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Abstract
Conduct-disordered and substance-abusing adolescents (N = 132) completed the Youth Happiness With Parent Scale (YHPS). The YHPS measures youth happiness with parental behaviors across 11 domains (e.g., communication, chores, and discipline) as well as a single item reflecting overall happiness. Results indicated that youth satisfaction did not vary as a function of parents' or youths' age, ethnic minority status, or gender. Although youth were relatively dissatisfied with their parents across behavioral domains (particularly illegal behaviors, drug use, school conduct, and alcohol use), they were fairly satisfied with their parents overall. Youth happiness with parental behaviors was negatively related to externalizing but not internalizing behavioral problems of the youth. Study implications and future directions are discussed in light of the results.
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Affiliation(s)
- P D Riggs
- Addiction Research and Treatment Services Program, University of Colorado School of Medicine, Denver, USA
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