Behavioural symptoms, cognitive deficits, and findings from electrophysiological, neuroimaging and genetic studies all suggest atypical performance monitoring in ADHD. Performance monitoring involves error detection and post-error behavioural adjustment and is crucial to behavioural self-regulation and reinforcement learning, both of which are dysfunctional in ADHD. Therefore, post-error slowing was examined in children with ADHD and controls using a modified flanker task both with, and without, error detection provided. There was a significant main effect of group on post-error slowing across conditions and when error-detection was provided, significant post-error slowing deficits were found in children with ADHD. These findings suggest that the performance monitoring deficit in ADHD is specific to post-error behavioural adjustment and supports the inclusion of this deficit in the neurocognitive profile of ADHD. Findings are discussed in terms of current neurocognitive reinforcement learning models of ADHD.

The present study explored the influence of survivor weight and participant gender, rape myth acceptance and anti-fat attitudes on perceptions of sexual assault. Using an online survey tool, participants (N = 413) read a vignette describing a hypothetical sexual assault scenario and completed several self-report questionnaires. Generalized linear model analyses revealed that participants were more likely to hold the survivor responsible, excuse the perpetrator’s actions, and respond more negatively toward the survivor and more positively toward the perpetrator when the survivor was depicted as thin versus overweight. Interactions were found between rape myth acceptance and survivor weight, gender and survivor weight, and gender and anti-fat attitudes, for certain dependent variables. In addition, men and those with higher levels of rape myth acceptance and anti-fat attitudes were found to make more negative evaluations of the survivor and more positive evaluations of the perpetrator. Recommendations for future research and interventions are discussed.

Purpose: To examine the social competence of childhood brain tumour survivors in the context of a group social skills intervention program developed to address documented social deficits among this population and to expand outcomes obtained from a feasibility study, by: conceptualizing social competence as three separate but interrelated constructs including social adjustment, social performance, and social skills; incorporating a control group; eliciting teacher responses; and examining sense of self. Methods: Participants were 23 survivors (10 males; 13 females) aged 7 to 15 years and comprised an intervention (n=15) and control group (n=8). The intervention consisted of 8 2-hour weekly sessions focused on social skills including friendship making. At the level of social adjustment, intervention participants, controls, parents, and teachers (n=6) completed standardized measures of social adjustment including: social skills (SSRS, Gresham & Elliott, 1990); social functioning (Varni, 1999); and social problems (Achenbach, 2001). At the level of social performance, behavioural observations were conducted on intervention participants. At the level of social skills, intervention participants responded to the Social Problem-Solving Measure (SPSM; Vannatta, 1993). Survivors also completed standardized sense of self measures. Results: Outcomes related to social adjustment showed a significant increase from Time 1 to Time 2 for parent reported SSRS within and between groups. Significant improvements were also found for parent reported social problems between groups. Child reported social problems decreased within groups and a borderline effect was found between groups. Teachers reported improved SSRS scores form Time 1 to Time 2. For social performance, significant increases in frequency were found for maintaining facial attention and social conversations with peers over the course of the intervention. At the level of social skills, a borderline significant increase was found for quantity of strategies offered from Time 1 to Time 2. No significant findings were found for sense of self data. Conclusions: Improvements after intervention were noted at each level of social competence, but primarily at the level of social adjustment. Control group and teacher outcomes strengthen findings. This is the first study to explore varying levels of social competence and provides important insight into the source of survivors’ social deficits.

Siblings of children with cancer encounter stressors and challenges that can lead to severe distress and a host of psychological difficulties. Factors including age, gender, and disease characteristics of the child with cancer are reported to influence sibling adjustment. The majority of research, however, is dated, inconsistent, and marred by methodological problems. Guided by the disability-stress-coping model, the study examined the: (a) frequency of sibling and parent reported symptoms of anxiety and depression, internalizing and externalizing behavior problems, and somatic problems, (b) influence of sibling, family, and disease factors on sibling adjustment, (c) moderating effects of age on the relationship between sibling factors and sibling adjustment, and (d) mediating effect of primary cognitive appraisal on the relationship between self-esteem and sibling adjustment. One hundred and eight siblings (7-17 years; 51 males; 57 females) participated. Siblings completed the State-Trait Anxiety Inventory for Children and the Children’s Depression Inventory to provide measures of sibling reported symptoms of anxiety and depression. Parents completed the Child Behavior Checklist to provide measures of parent reported internalizing behavior problems, externalizing behavior problems, and somatic problems. The communication and intrapersonal thoughts and feelings subscales of the Sibling Perception Questionnaire, completed by siblings, were used to assess perceived social support and primary cognitive appraisal. Self-esteem was assessed with the global self-worth subscale of the Self Perception Profile for Children/Adolescents, completed by siblings. Hierarchical regression analyses were conducted to assess the direct and indirect effects of sibling, family, and disease factors on psychological outcomes. Siblings and parents reported higher incidents of clinically significant symptoms of anxiety, internalizing behavior problems, and somatic problems than expected in a normative population. Sibling age and gender, diagnosis of the child with cancer, social support, self-esteem, and primary cognitive appraisal were significantly associated with sibling and parent reported psychological adjustment measures. Age moderated the relationship between gender, social support, and primary cognitive appraisal and several adjustment outcomes. Lastly, primary cognitive appraisal partially mediated the relationship between self-esteem and sibling reported anxiety and depression symptoms. These findings highlight the need for sibling psychosocial interventions and provide direction for the development and implementation of such groups.

The study explores the experience of individuals who have lost a number of close people in their life, through death, over the course of their adult lifetime. Twelve individual interviews (11 women, 1 man) are presented in narrative form and explored for their content and meaning. The experience of multiple loss was revealed to be unique and varied for each participant and each loss was experienced independently from the others, concomitant on the relationship to the deceased, the nature and timing of the death and the relevance to the participant’s identity. Similar themes occurred across and within cases that are attributable to having lost a number of close others. Common effects were seen in participants’ experiential knowledge of grief and its vicissitudes, death and its processes, and life and its meaningfulness. Participants believed that their losses have had a profound effect on them, changing their lives immutably. Changes were perceived in terms of impact on the way they view the world, themselves and their relationships. Individuals perceived both positive and negative effects. Analogous with current research and theories in the field many of the participants reported experiencing personal growth as a result of their losses. The present study extends past research findings by attributing these effects to the accumulation of losses. A model for understanding the process of meaning-making in multiple loss was devised. Respondents were apt to process one death at a time, incorporate its meanings and effects on them, compare the effects to each other by contrasting the distinct experiences, and create a framework for meaning that was mutable. There were typical features of these meanings that were characteristic to the tone of the narrative. Stories of multiple loss tended to have an unresolved, a transformational or a growth related tone. An enhanced model of meaning- making in loss is described that augments current models of meaning-making in coping with loss. The implications of these findings for theory and practice are discussed.

Commonly employed executive function measures may be of limited use due to their modest ecological validity. A novel task was developed - the Multitasking in the City Test (MCT) - in an attempt to improve ecological validity. The MCT involves task demands that resemble the demands of everyday activities. In study one, healthy participants were recruited in order to explore ‘normal’ performance on the MCT and its relationship with other cognitive measures. The MCT showed poor associations with executive tests and significant correlations with non-executive tests. This suggested the MCT may evaluate executive functioning in a different way from other executive measures such that it does not simply measure component executive processes but the integration of these components into meaningful behaviour. Patients with stroke and traumatic brain injury were recruited for study two to further explore the ecological validity and MCT performance characteristics. Only the MCT and a semantic fluency task demonstrated good ecological validity via significant relationships with a behavioural rating scale. Patients and normals made qualitatively similar types of errors although patients made these errors more frequently. Patients demonstrated better planning ability but completed fewer tasks than normals on the MCT. This discrepancy was attributed to impaired initiation. In study three, the MCT and verbal fluency tasks were administered to brain-injured individuals both pre- and post-executive function rehabilitation to evaluate their utility as treatment outcome measures and to assess ecological validity via a different behavioural rating scale from the one used in study two. Strategies trained during treatment generalized to MCT but not verbal fluency performance. Both MCT and semantic fluency performance were found to have good ecological validity. Overall, the findings from this research project suggest the MCT and semantic fluency tasks have good ecological validity. They further suggest that several common executive function measures lack adequate ecological validity and may not be predictive of real world behaviour. Moreover, these results support the concept of an executive function ‘system’ that can be fractionated into a variety of executive processes and that impairments in one process (e.g., initiation) can exist alongside intact functioning in other processes (e.g., planning).

Although research supports cognitive behaviour therapy (CBT) as the treatment of choice for childhood obsessive compulsive disorder (OCD) and recommends family involvement (e.g., AACAP, 1998; Barrett, Healey-Farrell, & March, 2004a), little is known about the role of the family in the development, maintenance, and treatment of childhood OCD. Furthermore, although significant improvements are found in treatment response, many children remain symptomatic (de Haan, 2006). Objective: The aims of the study were to examine (1) the perceptions of the family environment among family members and if child perceptions change with treatment and (2) treatment response and child and family characteristics that may predict treatment response. Gender differences were also examined. Method: This study involved 82 children (ages 8 to 17 years) receiving CBT for OCD and a concurrent parent program. Children and parents were assessed at initial, pre-, and post-treatment with questionnaires, a symptom severity interview, a family environment questionnaire, and child self-report measures of anxiety and depression. Pre-treatment data were used for the prediction of treatment response. Results: Child and parent perceptions of the family environment differ in terms of family expressiveness, with children perceiving their family as being ‘distressed.’ Although girls and boys had similar perceptions of their family environment, girls’ perceptions were more in agreement with their parents than boys. Children’s ratings of family cohesiveness were ‘normal’ at pre-treatment, and increased significantly at post-treatment; however, this was not meaningful when gender was considered. We found a similar treatment response to past research. Different characteristics were found to predict treatment response for boys and girls, with more predictors being identified for girls. Conclusions: Results emphasize the importance that families may have in the treatment of OCD and in our attempt to find predictors, as well as the need to examine boys and girls separately. This research is critical to refine and tailor treatment techniques to match child and family characteristics.

This project dissertation, entitled 'Grief Management: Programming for Care in the Local Church', addresses the issue of grief that is caused by the death of a significant other. This work also includes information on the dynamics of grief; grief management resources from psychological, sociological, and theological perspectives. In addition, it gives an overview of the African American church as a resource for grief support. The dissertation provides a model for programming for grief management and grief support for the Ben Hill United Methodist Church in Atlanta, Georgia.

Despite high rates of alcohol and marijuana use and dating violence among individuals between the ages of 15 and 24, limited research has examined a link between substance use and dating violence within adolescent samples. Moreover, although both problem drinking and dating violence perpetration have been linked to a history of childhood maltreatment (CM), few studies have examined the potential mechanisms of a relationship between these variables. The current study tested the predictive role of CM in adolescent alcohol and cannabis use and dating violence perpetration in a sample of youth with CM histories; in particular, we were interested in predicting the temporal co-occurrence of these behaviours. It was hypothesized that trauma symptomatology would play a mediating role in this relationship. Results demonstrated that only witnessing emotional domestic violence predicted the co-occurrence of substance use and dating violence; in general, trauma symptomatology was not found to be a significant mediator.

The overarching goal of this dissertation was to examine the self-perceptions of adolescents with ADHD with regard to their core ADHD symptoms and associated problem behaviors. Self-perceptions were examined in relation to awareness of problem behaviors (i.e., presence of a “positive illusory bias” or PIB), attributions, and stigma. Study 1 examined the PIB in relation to the ignorance of incompetence hypothesis in 74 13-to-18 year old adolescents [40 ADHD; 34 Typically-Developing Comparison (TD)]. Compared to TD adolescents, adolescents with ADHD underestimated their ADHD symptoms and associated oppositional, academic, and social problems relative to parent raters, indicating that they have a PIB. Nevertheless, they were cognizant of their patterns of academic achievement and social problems. The only area in which adolescents with ADHD demonstrated limited awareness of their difficulties was for oppositional behaviors. Within the ADHD sample, adolescents with external locus of causality attributions had a higher PIB for oppositional behaviors than adolescents with ADHD with internal locus of causality attributions. Using a cross-sectional design, Study 2 examined the PIB, attributions, and stigma perceptions in 66 14-to-18 year old adolescents (31 ADHD, 35 TD) and 107 9-to-12 year old children (65 ADHD, 42 TD); cognitive immaturity as a mechanism for the PIB and developmental differences in attribution patterns and stigmatization were the focus. Although both children and adolescents with ADHD demonstrated a PIB for their ADHD symptoms, the magnitude of the PIB was reduced in adolescence (particularly for hyperactivity-impulsivity). Both adolescents with and without ADHD showed a reduction in the PIB for inattentive symptoms relative to children. Participants with ADHD viewed their problem behaviors as more pervasive, uncontrollable, and stigmatizing than participants without ADHD, and adolescents viewed their behaviors as more pervasive, uncontrollable, and stigmatizing than children. The findings offered theoretical support to the cognitive immaturity mechanism for the PIB and to Harters(2012) model of normative development of self-representations. Associations were found between the PIB and attributions. Minimal support was obtained for the ignorance of incompetence hypothesis in most domains. Future research directions and clinical implications are discussed.