<p> This study was designed to investigate the impact of Adlerian parent trainings on parenting style and perceived competence, in order to determine if Positive Discipline parent training courses promote the <i> authoritative parenting style.</i> It was hypothesized that an Adlerian parent training would both promote the authoritative style and reduce authoritarian style and permissive style. It was also hypothesized that after attending a parent training, parents would note an increase in their sense of competence as parents. The central constructs were assessed through an online survey that included a measure of parenting style (Parenting Styles and Dimensions Questionnaire; PSDQ) and a measure of parenting competence (Parent Sense of Competence; PSOC). The sample consisted of 101 parents who attended one of 26 distinct Positive Discipline parent training group classes offered in cities across the United States. For the study, parents were assessed for parenting style and competence before the start of the course, after they completed the course, and at a 3-month follow-up period. Results indicated that parents experienced significant increases in both authoritativeness and sense of competence from pre-test to post-test. There was an even stronger significance associated with the increase in authoritativeness from pre-test to the three-month follow-up. Results also confirmed the hypothesis that attendance at the parent training would lead to reduced levels of authoritarian and permissive parenting styles. The study provides emperical support for the theoretical link between the Adlerian parenting model and the authoritative parenting model.</p>

<p> The purpose of this study was to better understand the parenting experience Latino parents of children with autism before and after participating in an 8-week family recreational pilot intervention program which was facilitated by behavior therapists and framed using Nintendo's Wii gaming console. Archival data from this pilot program was utilized to assess the impact of the intervention. The sample consisted of eleven parents with a child between the ages of five and nine who had been diagnosed with an autism spectrum disorder and at least one neurotypical sibling. Families were all enrolled from a greater sample of a university based developmental clinic and its associated family support group. Parental perception of family impairment, parental sense competence, and maladaptive behaviors were measured at pre and post intervention using the Family Life Impairment Scale, The Parental Sense of Competence Scale, and the Vineland-II Adaptive Behavior Scales Spanish/English Caregiver report Version II. Following participation in the program, parents reported significant increases in parental competency but no statistically significant differences were found in family impairment. No correlations were found between maladaptive behaviors and measures of family functioning. A comparison between families where one parent participated and those where two participated found that when two parents participated, families experienced higher levels of impairment. </p>

Families are classified as being ‘High' versus ‘Low' in Expressed Emotion (EE), depending on their attitude towards a mentally ill family member. Research shows that High EE predicts relapse in schizophrenia patients in the short-term. However, limited work examines EE in relation to schizophrenia outcomes beyond 24 months. This study aimed to determine the extent to which past EE status predicts patient outcomes over fifteen years. Data from the hospital charts of 27 schizophrenia outpatients were collected, for every 6 months of that period, and analysed. During the first 5 years, EE status did not influence the initial levels or the rate of change of relapse, positive and negative symptoms and months of useful employment. Although patients in the Low EE group tended to function slightly better in both clinical and social-occupational outcomes over the fifteen years, both EE groups presented relatively similar and stable trajectories. / Les familles sont classifiées comme ayant un «haut» ou un «bas» niveau d'Émotions Exprimées (EE), selon leur attitude envers un proche souffrant d'une maladie mentale. Bien que les EE prédisent la rechute des patients schizophrènes à court terme, peu d'études ont examiné les EE en relation avec la schizophrénie au-delà de 24 mois. Cette étude vise à déterminer comment le statut antérieur d'EE prédit les résultats chez les patients sur une période de 15 ans. Les dossiers médicaux de 27 patients externes schizophrènes ont été analysés. Pendant les 5 premières années, le niveau d'EE n'a pas influencé les niveaux initiaux ou les taux de changement de rechute, des symptômes positifs ou négatifs, ni des mois d'occupation utile. Bien que le groupe bas en EE avait tendance à fonctionner légèrement mieux cliniquement et socialement au cours des 15 ans, les deux groupes d'EE présentaient des trajectoires semblables et relativement stables.

The literature has indicated that frequently examined patient variables at intake have shown mixed results in the prediction of dropout from outpatient substance abuse treatment. In this research sociodemographic characteristics, substance use and psychological problem severity at intake were examined as predictors of early dropout in 411 patients enrolled in a 6-month outpatient substance abuse treatment program. Early dropout was defined as participation of less than 6 weeks, the first phase of treatment. Another focus of the research was to determine how patients who dropped out of treatment early fared in terms of substance use at 6 months compared to those retained longer. It was found that being younger, unmarried or not cohabitating, and having a greater severity of employment problems at intake were associated with early treatment dropout. Substance abuse and psychological problem severity at intake were not associated with dropout from the first phase of treatment. Patients who left treatment early had some reduction in alcohol consumption at 6-month follow-up, but overall, those retained in treatment longer had better alcohol and drug use outcomes at 6 months. Both the outcomes on retention and substance use were examined in order to explore possible solutions to dropout from the perspective of health services. Despite the improvements in substance abuse for patients retained longer than 6 weeks, it was determined that only 40% of patients were retained for 6 months, thereby indicating that the majority of patients had not received the planned 6-month intervention. In response to these facts, a brief intervention consisting of 5 individual therapy sessions based on coping skills and motivational enhancement strategies was designed and manualized with participation of the clinical staff. Following this, a randomized clinical trial was conducted with 72 patients, and substance use at 6-month follow-up was compared between the brief intervention and the conventional treatment groups. At 6 months, both the brief intervention and conventional treatment groups had reductions in alcohol use compared to intake, but no conclusions could be made about drug use. The implications of the findings for substance abuse treatment service delivery are discussed.

The Canadian population suffering from dementia has been estimated at 8% and the cost associated with it is remarkably high. Simple, validated cognitive screening tools, such as the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) are used in clinics to evaluate cognitive impairment with a total score. Just as test scores can identify patients with global cognitive impairment, we hypothesized that individual test item scores can identify cognitive impairment in different domains. In the present study, individual MoCA items were tested for their validity and clinical utility for prediction of domain-specific cognitive impairment. A total sample size of 185 patients who were tested on both the MoCA and neuropsychological tests were extracted from data collected at two geriatric outpatient clinics. Domains assessed by the neuropsychological tests were identified using a Principal Component Analysis. Validity of the individual MoCA items was demonstrated by comparing scores obtained from MoCA items and neuropsychological tests using bivariate correlations followed by multiple stepwise regressions. Significant, but weak-to-moderate correlations were seen between the MoCA items and neuropsychological tests. The strongest association (r = .46, p < .01) was seen between MoCA 5-word recall and performance in the memory domain. Some of MoCA items were significantly correlated to multiple cognitive domains. Predictive utility of the MoCA items for domain-specific cognitive impairment in clinical setting was tested using accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Items with a satisfactory level of accuracy (>70%) were: Date for memory, Repeat Sentence 2 for processing speed, Serial 7s Subtraction for visuospatial, and Repeat Sentences and Clock tasks for language. Most of the MoCA items were sensitive, but not specific. Additionally, all the items showed high NPVs, but poor PPVs. These findings suggest that the MoCA items that patients failed were not as informative as items that they passed. / La population canadienne souffrant de démence est estimée à 8% et les coûts qui y sont associés sont remarquablement élevés. Des outils de dépistage cognitif simples et validés, comme le Montreal Cognitive Assessment (MoCA) et le Mini-Mental State Examination (MMSE), sont utilisés en clinique pour évaluer les déficits cognitifs avec un score global. Tout comme ces scores globaux peuvent identifier des patients souffrant de troubles cognitifs plus généraux, nous émettons l'hypothèse que les scores pour les items individuels peuvent permettre d'identifier des déficits dans des sphères cognitives spécifiques. Dans le cadre de la présente étude, la validité et l'utilité prédictive clinique des items individuels du MoCA pour des déficits cognitifs spécifiques ont été testées. Un échantillon total de 185 patients ayant été évalués avec le MoCA et d'autres tests neuropsychologiques a été extrait d'une base de données collectées dans deux cliniques ambulatoires de gériatrie. Les sphères cognitives évaluées par les tests neuropsychologiques ont été identifiées en utilisant une analyse en composantes principales. La validité des items individuels du MoCA a été démontrée en comparant les scores obtenus aux items du MoCA et les tests neuropsychologiques avec des corrélations à deux variables suivies d'une analyse de régression multiple à étape. Des corrélations significatives, mais faibles à modérées, ont été observées entre les items du MoCA et les tests neuropsychologiques. La corrélation la plus forte (r = .46, p < .01) a été obtenue entre le rappel de 5 mots du MoCA et les capacités mnésiques. Quelques items du MoCA étaient corrélés de façon significative à plusieurs sphères cognitives. L'utilité prédictive des items individuels du MoCA pour des déficits cognitifs spécifiques en milieu clinique a été évaluée en utilisant la précision, la sensibilité, la spécificité, la valeur prédictive positive (VPP) et la valeur prédictive négative (VPN). Les items avec un degré de précision satisfaisant (>70%) étaient: Date pour la mémoire, Répétition de la phrase 2 pour la vitesse de traitement, Soustraction sérielle de 7 pour les capacités visuospatiales, et les tâches de Répétition des phrases et de l'Horloge pour le langage. La plupart des items du MoCA étaient sensibles, mais pas spécifiques. De plus, tous les items ont démontré une VPN élevée, mais une VPP faible. Ces résultats suggèrent que les items du MoCA que les patients ont échoués n'étaient pas aussi informatifs que les items qu'ils ont réussis.

Bulimia Nervosa (BN) is believed to have a multidimensional causality including developmental factors and neurobiological vulnerabilities. This study examined diverse clinical features (e.g., binge and vomit frequency, eating attitudes, impulsivity, dissociative symptoms, and affective instability) and two putative causal agents (e.g., childhood sexual/physical abuse and serotonin abnormalities) in bulimics with and without a comorbid Borderline Personality Disorder (BPD). Twenty-seven BN sufferers and 25 normal-eater controls underwent a multidimensional assessment of eating symptoms, psychiatric symptoms, personality disturbances, experiences of childhood abuse and serotonin (5-HT) dysfunction. The latter was measured using paroxetine binding in blood platelets. In contrast to control subjects, borderline and nonborderline bulimics both displayed comparable abnormalities on paroxetine binding Bmax measure and eating symptomatology, whereas the borderline bulimics alone displayed particular elevations on measures of childhood trauma, impulsivity, dissociation, and to some extent affective instability. We interpret our results as suggesting that problems of 5-HT neurotransmission may be associated generally with BN, whereas developmental abuse may be relevant to characterological disturbances seen in only a subset of BN sufferers.

Research shows distinct premorbid subtypes in schizophrenia. While family history of schizophrenia and obstetric complications are associated with poor premorbid adjustment, risk factors associated with good premorbid adjustment, characterizing most patients, remain unidentified. Both childhood trauma and premorbid substance use appear to increase vulnerability to schizophrenia. The goals of this study were to determine the association among family history, obstetric complications, childhood trauma, and premorbid substance use; and secondly, to assess whether trauma and premorbid substance use are associated with good premorbid schizophrenia. Trauma and substance use were assessed in 26 schizophrenia patients whose mothers were asked about family history of schizophrenia and obstetric complications. Results suggest that childhood trauma may co-occur with a family history of schizophrenia; high premorbid cannabis consumption was significantly associated with an absence of family history. Childhood trauma and premorbid substance use, however, did not consistently predict a good premorbid adjustment profile.

<p> It is important to determine factors that may exacerbate the negative effects of experiences of racism on anxiety, as well as factors that might buffer racism's negative impact on anxiety in Black American samples. To examine these factors, we conducted two related studies. In study 1, 119 Black American individuals completed the Schedule of Racist Events, the five factor mindfulness questionnaire, the anxiety control questionnaire (assessing perceptions of control), the self-hatred subscale of the cross racial identity scale, and the depression anxiety and stress Scale. As hypothesized, frequency of racist experiences over the past week was significantly positively associated with anxious arousal symptoms and frequency of experiences of racism over the past year was significantly positively associated with anxious arousal and general anxiety symptoms. Additionally, stress appraisal of racist experiences was significantly positively associated with anxious arousal and general anxiety symptoms. Unexpectedly, frequency of racist experiences over the past week were not significantly associated with general anxiety symptoms. As hypothesized, internalized racism mediated the relationship between past week experiences of racism and anxious arousal symptoms. Additionally, internalized racism mediated the relationship between frequency of past year experiences of racism and anxious arousal and general anxiety symptoms. Finally, internalized racism mediated the relationship between stress appraisal of racist experiences and anxious arousal and general anxiety anxiety symptoms. Contrary to hypotheses, perceptions of control (ACQ-R) did not mediate the relationship between racist experiences and anxious symptomology in this sample. Finally, as hypothesized, trait mindfulness moderated the relationship between past week frequency of racist experiences and anxious arousal only, in the present sample. </p><p> In a second experimental study, we explored the potential causal relationships between variables. Thirty Black American participants from Study 1 who endorsed that they had experienced racism in the past year, in addition to other inclusion criteria, participated in this study. Participants were randomly assigned to a mindfulness condition (<i>N</i>= 16) or control condition (<i> N</i>= 14) and were presented with a racially evocative stimulus before and after the experimental manipulation. We examined the effects of the brief mindfulness manipulation on self-report measures of distress and state anxiety. ANCOVA analyses (controlling for distress and anxiety prior to the manipulation) revealed that condition assignment had no significant effect on overall subjective units of distress, <i>F</i> (1, 29) = .13, <i>p</i> = .73, &eta;_p² = .005, or overall state anxiety symptoms, <i> F</i> (1, 27) = .23, <i>p</i> = .64, &eta;_p² = .009. </p><p> These results provide preliminary evidence suggesting that experiences of racism are associated with anxiety symptoms in Black American populations and that internalized racism may be a mechanism through which experiences of racism and anxiety are connected. Additionally, these results suggest that mindfulness may buffer the negative effects of racism on anxiety in Black American populations, however, further research is needed to investigate the causal relationships between racism, mindfulness, and anxiety in Black populations. </p>

Objective: Despite the established effectiveness of medication in improving symptoms of attention-deficit hyperactivity disorder (ADHD) (Spencer et al 2000), rates of adherence to pharmacotherapy are low, ranging from 34% to 91% (Gau et al., 2006). Since higher adherence rates are associated with more symptomatic improvement (Corkum, Rimer, &amp; Schachar, 1999), increasing adherence may result in better treatment outcomes. This study examined the relationship between adherence of children with ADHD to pharmacotherapy and their parents' knowledge, and attitudes regarding ADHD medication. It also investigated the impact of an intervention aimed at increasing parental knowledge regarding medication on children's adherence. Methods: Parents of 24 children diagnosed with ADHD and recommended for pharmacological treatment were randomly assigned to watch either a video containing specific information about ADHD medication (specific intervention group, n=12) or a video containing general information about ADHD (non-specific intervention group, n=12). Their knowledge and attitudes regarding medication were assessed using the Attitudes, Satisfaction, Knowledge and Medication Experiences scale prior to the video session, after the video session, and after their child had been on medication for three months. During the 3-month evaluation period children's medication adherence was monitored using weekly medication logs. Results: Attitudes towards medication became more positive following the specific intervention (pre-intervention: 23.64 ± 2.50; post-intervention: 27.18 ± 3.71; p &lt; .0005), and remained more positive at the end of the 3-month evaluation period (27.33 ± 3.08). There was no change in attitudes following the non-specific intervention (pre-intervention: 23.20±4.02; post-intervention: 23.20 ± 3.97; p = 1.00). Neither intervention had an appreciable effect on knowledge. At the 12-week follow-up, the adherence levels for both groups were substantially higher (intervention group 98.21% ± 4.00, non-intervention group 96.33% ± 6.91) than those previously reported (34% to 91%), but there was no difference in adherence between the groups (p = 0.524). Knowledge and attitudes at all three assessment points were unrelated to adherence (ps &gt; 0.05).Conclusion: The specific intervention was successful at increasing positive attitudes of parents towards medication. However, the effectiveness of the specific intervention relative to the non-specific intervention at improving adherence was not significantly different. This may be in part due to the relatively small sample size. In addition, the adherence rates in this study were markedly higher than those reported previously, which may be due to non-specific factors inherent to both intervention groups, such as, weekly contact with research staff, service provided at tertiary medical facilities and the utilization of video interventions. / Objectif: L'efficacité de l'usage de médicaments pour traiter les symptômes de Trouble de déficit d'attention avec ou sans Hyperactivité (TDAH) est bien établie. (Spencer et al 2000) Malgré cela, les taux d'adhésion aux médicaments est bas, variant entre 34% et 91%. (Gau et al., 2006). Étant donné qu'une adhésion assidue a étée associée à l'amélioration des symptômes (Corkum, Rimer, &amp; Schachar, 1999), augmenter cette adhésion pourrait mener à de meilleurs résultats de traitement. La présente étude a examiné, chez les enfants vivant avec le TDAH, la relation entre leur adhérence à la pharmacothérapie et les conaissances ainsi que les attitudes de leurs parents sur la médicamentation du TDAH. Cette étude a aussi exploré l'efficacité d'une intervention en particulier, qui pour objectif d'augmenter le niveau de connaisances des parents sur ces médicaments. En particulier, l'impact de cette 'intervention sur l'adhérance a été étuidié. Méthodes: Les parents de 24 enfants diagnostiqués de TDAH pour qui un traitement pharmacologique avait été recommandé, ont reçu un assignment alléatoire soit au visionnement d'un film contenant de l'information spécifique sur la médication du TDAH (groupe d'intervention spécifique n=12); soit au visonnement d'un film contenant de l'information générale sur le TDAH (groupe d'intervention non-spécifique n=12). Les connaissances et attitudes des parents furent évaluées avec l'usage du Attitudes, satisfaction, connaissances, expériences avec les médicaments pour le traitement du TDAH avant le visonnement du film, après le visonnement du film et après que l'enfant ait été médicamenté pour une période de trois mois. Lors de ces trois mois d'évaluation, l'adhésion aux medicaments à été suivie par la biais d'un journal de bord de médicamentation hebdomadaire. Résultats: L'attitude face à la médicamentation s'est accru suivant l'intervention spécifique (pré-intervention: 23.64 ± 2.50; post-intervention: 27.18 ± 3.71; p &lt; .0005), et cet acroissement s'est avéré maintenu à la fin du trois mois de prise de medicaments (27.33 ± 3.08). Aucun changement d'attitude ne fut enregistré suite à l'intervention non-spécifique (pre-intervention: 23.20±4.02; post-intervention: 23.20 ± 3.97; p = 1.00). Aucune des intervention n'a eu d'impact considerable sure le niveau de conaissance des parents. Au suivit, 12 semaines plus tard, le niveau d'adhérance pour les deux groups était considérablement plus élevé (groupe avec internvetion 98.21% ± 4.00, groupe sans intervention 96.33% ± 6.91) que les résultats rapportés plus tôt (34% to 91%), mais il n'y avait pas de difference d'adhérance entre les deux groupes lors de ce suivit (p = 0.524). Attitudes et connaissances sur le sujet, à touts les points d'évaluation, n'étaient pas relies à l'adhérance. (ps &gt; 0.05).Conclusion: L'intervention spécifique s'est avérée efficace à augmenter l'attitude positive des parents envers les medicaments pour traiter le TDAH. par contre, l'efficacité de l'intervention spécifique à l'augmentation de l'adhérance en comparaison d'avec l'intervnetion non-spécifique, n'est pas significativement différente. Cela pourrait être du à un échantillon relativement petit. De plus, le niveau d'adhérance était particulièrement plus élevé que l'adhérence généralement rapportée, ce qui pourrait être expliqué par des facteurs non-spécifiques et inhérents au deux groups de l'étude, tel que le contact hebdomadaire avec les membres de l'equipe de recherché, l'accès aux services d'une institution de santé terciaire et finalement, l'utilisation d'une intervention video.

Research in the areas of quality of life and social support suggests a complex relationship with trauma. Most studies have found inverse relationships between both quality of life and social support posttrauma. However, it remains unclear how these findings apply to individuals with a current or past diagnosis of posttraumatic stress disorder (PTSD), or to individuals who do not meet the criteria for PTSD. Furthermore, previous research has been limited to global index outcomes, which overlook specific domains that could reveal more information, obtained from convenience samples. We seek here to address these limitations by analysing data from a large community-based epidemiological catchment area study conducted in the south west of Montreal (N = 2399) broken down according to current PTSD diagnostic status: (i) Current PTSD, (ii) Past PTSD, (iii) No lifetime PTSD in spite of trauma exposure, and (iv) No lifetime trauma exposure. The inverse relationship of decreased quality of life posttrauma, specifically as PTSD severity increases, was replicated within our sample. In contrast to many previous studies, we show that social support was not significantly different between PTSD and No PTSD groups. Subscale scores were examined in depth for both quality of life and social support, with outcomes showing that even after PTSD remits, the gap between PTSD and No PTSD groups widens. This research allows for a much needed broadening of our understanding of quality of life for individuals with current and remitted PTSD. / Les recherches dans les domaines de la qualité de vie et du soutien social suggèrent une relation complexe avec le trauma. La plupart des études ont montré une relation inverse entre la qualité de vie et le soutien social après avoir eu une expérience traumatique. Cependant, il n'est pas encore certain que ces résultats s'appliquent à des personnes présentant un diagnostic actuel ou passé de trouble de stress post-traumatique (TSPT), ou à des personnes qui ne présentent pas de TSPT. Par ailleurs, ces résultats se rapportent à des indices globaux, qui négligent des domaines spécifiques qui pourraient donner davantage d'information, obtenus à partir d'échantillons de commodité. Nous cherchons ici à remédier à ces limites en analysant les données d'une grande base communautaire issue d'une étude épidémiologique du sud-ouest de Montréal (N =2399) répartis selon leur état de TSPT courant: (i) le TSPT courant, (ii) le TSPT passé, (iii) aucun diagnostic de TSPT en dépit des événements traumatiques, et (iv) aucune exposition à un événement traumatique à vie. La relation inverse de la diminution de la qualité de vie, spécifiquement quand les symptômes de TSPT augmentent, a été reproduite dans notre échantillon. Contrairement à de nombreuses études antérieures, nous montrons que le soutien social n'a pas été significativement différent en comparant les groupes avec TSPT et les groupes sans TSPT. Les résultats des sous-échelles ont été également examinés pour la qualité de vie et le soutien social, avec des résultats montrant que même lorsque le TSPT est passé, le fossé entre le groupe avec TSPT et le groupe sans TSPT s'élargit. Cette recherche permet d'améliorer grandement notre compréhension de la qualité de vie des personnes souffrant de TSPT courant et remis.