Wrist surgery is a common method for treating carpal tunnel syndrome (CTS) although few studies have examined patient outcomes or predictive correlates of such procedures. The objectives of this study were to characterize Utah workers who received surgery for CTS in terms of relevant presurgical and outcome variables and to identify presurgical correlates of patient outcomes. Participants were 75 Utah workers' compensation patients who underwent surgery for CTS from 1999-2002 and were at least 6 months postsurgery at time of follow-up. A retrospective cohort design was utilized consisting of a review of presurgical medical records and a postsurgical telephone survey. Presurgical variables included: gender, age, history of depression, and litigation status. Correlational analyses revealed that age and lawyer involvement were consistent significant predictors of poorer outcomes. The importance of conceptualizing CTS surgery patient outcomes from a biopsychosocial perspective is discussed.

Autism spectrum disorders (ASD) are associated with many different levels of language and social impairment, differences in levels of cognitive impairment, varying levels of aberrant behavior, and discrepancies in the presence or amount of restrictive and repetitive behavior. The heterogeneity found within the ASD population is coupled with significant heterogeneity in outcome for these individuals. Although interventions based on the principles of applied behavior analysis have been repeatedly cited as evidence-based for individuals with autism, significant discrepancies in outcome are evident within the literature. The heterogeneity in treatment outcome has been hypothesized as related to the heterogeneity of children included within the autism spectrum as well as differences related to treatment variables. The current study evaluated individual child characteristics and differences related to intervention intensity and fidelity as predictors of outcome after one year of exposure to a behaviorally based intervention. The primary goal of this study was to identify individual and treatment level characteristics that were predictive of differences in outcome for children with ASD. Information was gathered from a total of 368 students with autism spectrum disorders in kindergarten through second grade classrooms in the School District of Philadelphia. Correlational analyses and multiple regression analyses indicated that increased levels of expressive language skills at the start of the intervention year were correlated with and predictive of improved outcome. However, no other child level variables were related to differential outcomes. Additionally, higher levels of treatment intensity and treatment fidelity were associated with improved outcome. / School Psychology

Most studies examining predictors of treatment outcomes among problem drinkers have used a traditional statistical approach that examines group outcomes (e.g. analysis of variance, multiple regression analysis). Contrary to traditional methods, a person-centered approach identifies commonalities among clusters of individuals and provides the opportunity to examine the relationship between multiple individual differences and outcomes in a longitudinal manner. Specifically, the person-centered approach makes it possible to cluster individuals into subgroups based on their change patterns, and to examine the relationship between those subgroups and other variables of interest (e.g., drinking problem severity). This approach allows the inclusion of a relatively large number of variables to test complex hypotheses. The present study is a secondary data analysis of early (first three-month) Timeline Followback (TLFB) post-treatment drinking data from 200 problem drinkers who completed a short outpatient intervention. Using a growth mixture modeling (GMM) analysis, the goal was to identify different outcome drinking trajectories and examine the relationship between problem severity levels, treatment modality (i.e. individual versus group format), and goal choice (i.e. low-risk drinking versus abstinence) to those trajectories. Results demonstrated the existence of different outcome subgroups among problem drinkers. In addition, problem severity level was associated with outcomes and class membership. Observed significant differences in the relationships between predictor variables and specific outcome subgroups, and evidence of different drinking fluctuation patterns in the outcomes suggest that using a person-centered approach adds value beyond traditional statistical outcome analyses. The person-centered approach can facilitate the identification of relevant variables for patient-treatment matching hypotheses for problem drinkers.

Doctor of Philosophy (Phd) / Despite general agreement that severely emotionally disturbed children and adolescents are an "at risk" group, and that ongoing evaluation and research into the effectiveness of services provided for them is important, very little outcome evaluation actually takes place. The absence of well-conducted and appropriately interpreted studies is particularly notable for day or residential treatment programs, which cater for the most severely emotionally disturbed youths. This thesis outlines the main areas of conceptual, pragmatic and methodological confusion and neglect which impede progress in research in this area. It argues for plurality of data analytic strategies and research designs. It then critically reviews the reported findings about the effectiveness of day and residential treatment in specialist facilities, and the predictors of good outcomes for this treatment type. This review confirms that there is very little to guide practice. Having argued for the legitimacy of its methods and the necessity to address basic questions, the thesis reports the results of a naturalistic study based on data accumulated during a decade-long evaluative research program taking place at Arndell Child and Adolescent Unit, Sydney. The study addresses the question of what child, family and treatment variables predict outcome for 159 children and adolescents treated at this facility from 1990 to 1999. Statistically significant results with large effect size were obtained. Among the most disturbed subgroup of forty three children, (a) psychodynamic milieu-based treatment was shown to be more effective than the “empirically-validated” cognitive-behavioural treatment which superseded it in 1996, and (b) children from step-families showed better outcome than those from other family structures. Furthermore, it was found for the study sample as a whole that severe school-based problem behaviours were associated with a limited trajectory of improvement in home-based problem behaviour. These results are discussed with regard to implications for treatment, research methodology, policy and further studies.

Doctor of Philosophy (Phd) / Despite general agreement that severely emotionally disturbed children and adolescents are an "at risk" group, and that ongoing evaluation and research into the effectiveness of services provided for them is important, very little outcome evaluation actually takes place. The absence of well-conducted and appropriately interpreted studies is particularly notable for day or residential treatment programs, which cater for the most severely emotionally disturbed youths. This thesis outlines the main areas of conceptual, pragmatic and methodological confusion and neglect which impede progress in research in this area. It argues for plurality of data analytic strategies and research designs. It then critically reviews the reported findings about the effectiveness of day and residential treatment in specialist facilities, and the predictors of good outcomes for this treatment type. This review confirms that there is very little to guide practice. Having argued for the legitimacy of its methods and the necessity to address basic questions, the thesis reports the results of a naturalistic study based on data accumulated during a decade-long evaluative research program taking place at Arndell Child and Adolescent Unit, Sydney. The study addresses the question of what child, family and treatment variables predict outcome for 159 children and adolescents treated at this facility from 1990 to 1999. Statistically significant results with large effect size were obtained. Among the most disturbed subgroup of forty three children, (a) psychodynamic milieu-based treatment was shown to be more effective than the “empirically-validated” cognitive-behavioural treatment which superseded it in 1996, and (b) children from step-families showed better outcome than those from other family structures. Furthermore, it was found for the study sample as a whole that severe school-based problem behaviours were associated with a limited trajectory of improvement in home-based problem behaviour. These results are discussed with regard to implications for treatment, research methodology, policy and further studies.