The current study was conducted to obtain preliminary data on the Nova Multilingual Neuropsychological Battery (NMNB) from a sample of 95 undergraduate and graduate university students (46 monolingual English and 49 bilingual English-Spanish speakers). The measure consisted of 39 subtests and an effort measure in English and Spanish, developed to account for language and cultural factors hypothesized to influence neuropsychological test results. The subtests included measures of mental status, reading comprehension, short-term and long-term verbal and visual spatial memory, short-term and long-term verbal and visual spatial recognition memory, motor coordination, processing speed, serial learning, anomia, and executive functioning. An acculturation measure was also administered. It was hypothesized that there would be a significant difference in performance between the Bilingual Spanish group compared to the Monolingual English and Bilingual English groups, with anticipated better performance in the Monolingual English and Bilingual English groups compared to the Bilingual Spanish group. It was also hypothesized that there would be a significant positive correlation between level of acculturation and test performance. Results of ANCOVAs, controlling for the effects of age and education, compared the performance of 20 bilingual participants on the Spanish version of the test between the 46 English monolinguals and 29 bilingual participants administered the English version of the test. Results of the ANCOVA's did not generally support the hypothesis at the p < .01 level that bilingual speakers administered the Spanish version of this measure would perform significantly lower compared to bilingual speakers or monolingual English speakers administered the English version. The subtest Verbal Command was significant for poorer performance in the Bilingual Spanish group compared to the Bilingual English group. The subtest Categorical Fluency was significant for poorer performance in the Bilingual Spanish group compared to the Monolingual English group and the Bilingual English group. The results of Pearson Product-Moment correlations (p < .01) did not support the hypothesis of a positive correlation between acculturation and test performance for the bilingual groups. Only three of the 39 subtests were correlated with acculturation in the he Bilingual English group. These results were inconsistent with prior research on neuropsychological test performance for Spanish-speaking populations. Previous research on several Spanish neuropsychological measures administered to Spanish-speaking participants, such as the Mini Mental State Exam, Digit Span, and the Spanish Naming Test, typically resulted in significantly poorer performance for bilingual or monolingual Spanish speakers compared to English speaking participants administered the same tests in English. Additionally, preliminary research with acculturation and neuropsychological assessment had suggested that higher levels of acculturation would result in better neuropsychological test performance. However, these results should be interpreted with caution as there were limitations to this study which included a small sample size, a sample of higher education level participants, and exposure to the English language and the U.S. educational system. Future studies should focus on development of normative data for the older adult population, individuals who have sustained a traumatic brain injury and monolingual Spanish speakers so that information can be made available for this underserved population.

Much of the research on childhood sexual abuse (CSA) has utilized demographic factors (e.g., the gender, age, and race/ethnicity of the child victim) and specific characteristics of the abusive experience (e.g., the severity of abuse, the relationship between the perpetrator and the child victim, the child's age at the onset of abuse, etc.) as predictors of children's adjustment. Unfortunately, the ability of such factors to predict children's adjustment consistently across studies has been limited. Alternatively, while it has been recognized that survivors of CSA often hail from dysfunctional family environments and that the disclosure of CSA frequently results in emotional distress for caregivers, less research has focused on how these factors may serve to influence sexually abused children's adjustment. This study included 163 sexually abused youth and their non-offending caregivers who completed measures of psychological adjustment and the family environment. Demographic information and abuse-related characteristics were also collected. Children's age, gender, and race/ethnicity were not significantly predictive of emotional adjustment. Structural equation modeling was used to examine the direct and indirect effects of total abuse severity, caregiver distress, and children's perceptions of their family environments as predictors of emotional adjustment. Results indicated that both children's perceptions of their family environments and total abuse severity were significantly predictive of children's emotional adjustment, whereas caregiver distress did not have significant direct or indirect effect on adjustment. Finally, the implications of these findings for future research and the development of effective interventions for sexually abused children and their families was discussed

Failure to engage and retain low-income, ethnic minority and immigrant families in treatment is a problem that plagues many intervention initiatives. Often, those most in need of services also experience significant barriers to treatment (e.g., logistical barriers, stress), resulting in low attendance rates. This study employed an ecological framework to examine the relationship between parents' report of stress, social support, and their engagement in a culturally sensitive, school-based intervention. Stress related to low income, minority and/or immigrant status is presented as a specific barrier that impacts treatment engagement. Additionally, social support is conceptualized as having a "buffering effect" on the potential negative impact of stress on engagement. Archival data was examined for families who participated in Connections intervention, a family focused intervention intended to strengthen family relationships, coping skills, and social support and to prevent child mental health problems. Thirty-five mothers of 3rd to 5th grade children were included in this study. Of this sample, 43% identified as Haitian, 31% as Hispanic, 14% as African American, 6 as "other," 3% as English-Speaking Caribbean, and 3% as European-American. Results indicated that maternal stress was negatively related to attendance, and satisfaction with social support was positively related to attendance. In addition, a stress by need for support interaction emerged, suggesting that attendance is most negatively impacted for mothers reporting high levels of stress and high levels of need for support. Among mothers with high stress, those indicating low need for support were able to attend almost twice as many sessions as those with high need for support. Attendance rates were also related to maternal acculturation: mothers identified as "enculturated" had the highest attendance rates (74%), followed by "assimilated" mothers(67%), "bicultural" mothers (50%), and marginalized mothers (20%). Treatment engagement is frequently conceptualized as an individual-level factor (e.g., motivation, readiness for change), but results suggest engagement also is shaped by contextual factors such as stress and social support. Future directions in research and clinical implications are discussed.

Estimates suggest that 6% of adults aged 65 years and older reported binge drinking in the past month and 2.2% reported heavy drinking. This dissertation investigates the associations between stress, coping, and alcohol consumption specifically in older adults. The literature on the direct relationship between stress and drinking in older adults has yielded inconsistent results (i.e., some produced positive associations, others yielded negative or nonsignificant relations). Previous findings for the relationship between various types of coping and drinking in older adults have yielded more consistent results, with avoidant coping, alcohol outcome expectancy, and/or drinking to cope generally contributing to alcohol use either independently or in combination. The strengths and limitations of currently used alcohol screening instruments with older adults (e.g., Michigan Alcoholism Screening Test-Geriatric Version, CAGE Questionnaire, and Alcohol Use Disorders Identification Test) are also reviewed. Based on the literature, it was hypothesized that (a) lowering the definition of binge drinking to make it more age-sensitive to older adults would identify more individuals drinking at at-risk levels, (b) perceived stress, coping, and alcohol consumption would correlate with each other, and (c) coping would mediate the association between perceived stress and alcohol consumption. The study's sample consisted of 60 independent-living older adults (65 years of age and older), most of whom were White, female, and well educated. The results of this study only partially supported the hypotheses. Specifically, there was no clinically meaningful difference when the definition of binge drinking was lowered to a more age-specific classification on the Alcohol Use Disorders Identification Test - Consumption measure. Perceived stress and both task- and avoidant-focused coping were correlated, but perceived stress and alcohol consumption were not significantly correlated, nor were either task- or avoidant-focused coping and alcohol consumption correlated. Finally, neither task- nor avoidant-focused coping mediated the relationship between perceived stress and alcohol consumption. Limitations of the present study are discussed.

Anxiety and depressive disorders are among the most common mental health problems diagnosed in children and adolescents, and numerous theories explaining why children experience these debilitating disorders have been proposed. Established diagnostic criteria that differentiate anxious and depressive symptomatology characterize both groups of disorders as having an adverse effect on the child's academic and social functioning. While research has sought to examine the cognitive effects these disorders have on adults, there is relatively limited research on the cognitive effects in children and adolescents. The available research literature examining effects of anxiety and depression on intelligence test performance is also inconclusive, and there are no studies that characterize the effects of these disorders on the Wechsler Intelligence Scale for Children - Fourth edition. The purpose of the study was to clarify the effects of childhood anxiety and depression on intelligence test scores using the current fourth edition of the Wechsler Intelligence Scale for Children. Participants were selected from an archival database from a neuropsychology clinic and separated into two groups according to clinical diagnosis. No significant differences were found between the children and adolescents diagnosed with clinical disorders and the standardization sample or in idiographic analyses with regard to the WISC-IV Full Scale IQ or the Working Memory Index. The Processing Speed Index was found to be significantly lower than the Verbal Comprehension Index in children diagnosed with major depressive disorder. This finding was not observed in the anxiety disorders group. Examination of component subtest score patterns showed that Coding and Symbol Search were reduced in the depression group. This finding is consistent with previous studies, which suggest that reduced performance on the Processing Speed Index may be attributed to psychomotor retardation in major depressive disorder.

This study examined the relationship between five neurocognitive domains, including memory, visual-spatial skills, executive functioning, language, and attention, and three instrumental activities of daily living (IADLs), (financial management, medication management, and driving), as well as three basic activities of daily living (ADLs), including dressing, feeding, and grooming. Subjects were community dwelling older adults diagnosed with Alzheimer's Disease (AD) ranging in severity from mild to severe. Correlation and regression models were used to analyze the relationship between neurocognitive domains and self-care activities. All of the neurocognitive domains were significantly but mildly correlated with declines in IADLs, and all of the neurocognitive domains, except memory, were significantly but mildly correlated with ADL decline. None of the regression models, except driving, produced significant results. The hypotheses were based on the belief that overlap occurs between declines in cognitive domains and self-care skills. The results of this study support the assertion that global cognitive decline occurs followed by declines in IADLs and later declines in ADLs. Thus, instead of specific neurocognitive domains predicting decline in individual self-care skills, this research indicates that the degree of severity of cognitive decline is predictive of impairments in IADLs or ADLs with milder global impairment predicting IADLs and more pronounced decline predicting declines in ADLs. Degree of severity may have been more predictive because while individuals vary in cognitive symptom presentation, the course of AD always progresses from mild to more severe. The role of over-learning also potentially impacted the results of the study. Individuals learn and daily practice ADLs at a young age causing them to require less higher level cognitive skills (over-learned). Since over-learned IADLs require less higher level cognition, they were preserved longer in AD course, thus declining after global cognitive impairment. Clinicians need to thoroughly assess the degree to which an individual has over-learned a task in order to make the most accurate recommendations. If an individual has milder global decline, IADLs are likely to be impaired, and if an individual has moderate global decline with memory reaching a floor, ADLs are likely to be impaired.

Approximately 36% of adults in the United States population are obese. Obese patients have an increased risk of mortality and morbidity, particularly related to hypertension, dyslipidemia, Type 2 diabetes, asthma, sleep apnea, and impaired psychosocial functioning. The popularity of bariatric surgery has seen significant increases in recent years as a cost-effective way to manage weight. Determining candidates' psychological suitability for bariatric surgery is complicated by the fact that research on psychosocial predictors of success and/or poor outcomes is lacking and results are inconsistent. Psychologists often develop their own guidelines to assist in deciding whether a candidate should be cleared for surgery; thus evaluation procedures and cited contraindications to surgery vary greatly among programs. This study investigated predictors of psychological evaluation recommendation status in a sample of 100 bariatric surgery candidates. The variables that were examined included demographics, Axis I and Axis II psychopathology, and data from the Millon Behavioral Medicine Diagnostic (MBMD) (i.e., coping styles, stress moderators such as social isolation, and treatment prognostics such as interventional fragility, utilization excess, and problematic compliance). Number of Axis I diagnoses, social isolation, and educational level emerged as the strongest predictors of recommendation status. Multivariate logistic regression results suggest that for every additional Axis I diagnosis, the odds of being in the delayed group are approximately 5 times higher after controlling for the other factors in the model. Participants who reported greater social isolation on the MBMD have the odds of being delayed 6% times higher than those with higher social support. For those participants whose highest level of education is grade school, the odds of being delayed were 55 times higher than those participants who completed college or beyond. Additional research into predictors of success following bariatric surgery using large-scale, prospective, longitudinal studies is needed to better inform psychological evaluations. Efforts should also be made to review one's own bariatric psychological evaluation procedure to uncover which factors are most influential in the decision-making process.

Assessments designed to estimate the probability of sexual offense recidivism have gained popularity due to research that suggests these instruments are psychometrically sound for this purpose. The Static-2002 (Hanson & Thornton, 2003), an actuarial instrument of sexual recidivism, has been validated in specific populations, but in the absence of multicultural populations. It is necessary to establish the validity of the Static-2002 for a multicultural population, especially considering the increasing impetus to mandate measures of sexual recidivism. This study was designed to assess the predictive validity of the Static-2002 as an actuarial instrument that estimates the probability of sexual, violent, and general recidivism within a multicultural population. Recent criminal histories and de-identified archival records of 103 adult sex offenders were used to complete demographic questionnaires and to calculate retroactive predictive accuracy scores for the Static-2002. Records were obtained from a private practice office in South Florida, which provides outpatient treatment to conditionally released offenders. Hypothesis testing utilized a receiver operating characteristic area under the curve (ROC AUC) analysis to examine the discriminating power of the Static-2002 and to identify optimal cutoff values for each risk category. These cutoff values were then compared to the established Static-2002 risk categories to evaluate the cutoff scores' congruency. For this sample population, resulting ROC AUC values indicated the predictive accuracy of the Static-2002 to be moderate for any (including general; .67) offense recidivism, and high for violent recidivism (.74). However, the Static-2002 was ineffective for predicting sexual recidivism among this sample population since the predictive accuracy of the ROC area for sexual reoffenses was not statistically significant above chance (p = .07). The four Static-2002 risk categories derived for this study are: low, moderate-low, moderate-high, and high. When compared with the established Static-2002 risk categories, this study's risk categories were found to be mostly concurrent with the established categories. Similar to previous research, this study found that when the sample population differs racially/ethnically from the normed population (60% of this study's participants were Hispanic), the Static-2002 was ineffective for accurately predicting sexual reoffending. However, the Static-2002 effectively predicted violent and general recidivism with this sample population.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prominent neurobehavioral disorders of childhood that is heavily researched and often revised. Deficits in attention/concentration, impulsivity, inhibition, information processing speed, working memory and executive functioning manifest differently according to subtype diagnosis for both children and adults. As a result, previous attempts to construct a unifying theory of ADHD with neural correlates and quantifiable performance discrepancies have resulted in a proliferation of literature reviews citing both significant and insignificant research findings. The purpose of the current study was to construct a homogenous sample of children diagnosed with ADHD and examine purported subtype differences in working memory and information processing speed using the Wechsler Intelligence Scales for Children - Forth Edition (WISC-IV). Sixty participants were selected from archival data from two clinical sites and separated into three groups according to the current DSM-IV-TR ADHD subtype criteria: ADHD Predominately Inattentive type (ADHD-IN), ADHD Predominately Hyperactive/Impulsive type (ADHD-HY), and ADHD Combined type (ADHD-C). Significant differences within groups were revealed on the Coding subtest and Processing Speed Index (PSI) relative to performance on the Perceptual Reasoning Index (PRI). No significant between groups or interaction effects were revealed. While the goal of the current study was aimed at discovering evidence of greater deficits in processing speed by the ADHD-IN group compared to the other two groups, processing speed was reduced for the entire sample providing more evidence of a possible neurological deficit/basis inherent to ADHD. The results of the current study provided minimal evidence of differences on WISC-IV measures of working memory within the current sample. The current study was successful in correcting previous methodological flaws inherent in the relevant literature by constructing a truly homogenous sample of ADHD and provided strong evidence for the necessity of an accurate diagnosis of ADHD subtypes.

One of the most debated constituents of intimate partner violence pertains to attachment theory. Although, attachment theory can provide a theoretical framework for understanding the linkage between childhood family experiences and subsequent experiences with partner violence, there are controversial perspectives as to whether attachment style is stable from childhood to adulthood (Bowlby, 1973, 1980, 1982) or if attachment style can be formulated directly from adult abusive relationships (Caspi & Elder, 1988; Ricks, 1985). Therefore, the purpose of this research was to explore how attachment style presents in the Battered Woman Syndrome, determine if the battered woman's attachment style is consistent throughout childhood to adulthood or if it is manifested due to intimate partner violence exposure as well as to determine how attachment style is manifested in interpersonal functioning and perceived power and control. The theory of learned helplessness (Seligman, 1975) was used as a conceptual model for understanding why battered women remain in abusive relationships. There were 137 female sample participants who reported a history of domestic violence. Measures administered included the Battered Woman Syndrome Questionnaire (BWSQ, Walker, 1978) that assessed childhood history, interpersonal functioning and power and control and the Revised Adult Attachment Scale (Collins and Read, 1996) that assessed the participant's attachment style. Statistical techniques employed included latent class analysis, one-way analysis of variance (ANOVA) and logistic regression. Results indicated that aversive childhood environment (as measured primarily by childhood battering variables) and involvement in adulthood abusive relationships were significantly related to childhood environment and involvement in adulthood abusive relationships. Across all five adulthood battering episodes there were significant overall effects of attachment style on sexual abuse scores. Results also confirmed the hypotheses that insecurely attached participants were more likely to report more interpersonal functioning difficulties and lower perceived power and control when compared to secure participants. Implications for future research are also presented.