Group-based parent training programme for children with neurological conditions: a feasibility study.

OBJECTIVE AND DESIGN: This study aimed to determine the feasibility and effectiveness of a parent training programme for parents of children with neurological conditions and behaviours that challenge. SETTING: Child and adolescent mental health service within a specialist children's hospital. PARTICIPANTS: Parents of 31 children with neurological conditions and behaviours that challenge. INTERVENTIONS: Parents attended a 6-week evidence-based behavioural parenting programme delivered in a group format, either face-to-face or remote. MAIN OUTCOME MEASURES: Feasibility was determined by attendance rates. Effectiveness was analysed primarily using parent-reported measures of child behaviour (Strengths and Difficulties Questionnaire, Paediatric Quality of Life and Goal-Based Outcomes). Secondary measures of parental well-being were also reported (Brief Parental Self-Efficacy Scale, Depression Anxiety Stress Scale Short Form and Parental Sense of Competence). Paired t-tests or Wilcoxon rank-sum tests were conducted to analyse differences preintervention and postintervention. RESULTS: The attendance rates for the face-to-face and remote groups were 80% and 79%, respectively. Medium to large effect sizes were reported for most measures of child behaviour and parental well-being. There were statistically significant improvements found postintervention in children's behaviour (p=0.014), quality of life (p<0.001), goal-based outcomes (p<0.001), parental self-efficacy (p<0.001) and parental anxiety (p=0.030). Anecdotal feedback showed that parents indicated the group format was acceptable. CONCLUSIONS: The group parenting intervention for parents of children with heterogeneous neurological conditions and behaviours that challenge appears feasible and effective in improving child behaviour and parental well-being.

It is a problem and it is not a problem: Dilemmatic talk of the psychological effects of female genital cutting.

This qualitative study aimed to explore the psychological effects of female genital cutting in the United Kingdom within a systemic psychological framework. Semi-structured interviews were carried out with 13 women who had experienced female genital cutting. Four key themes emerged from thematic analysis of the data: (1) wholeness contested, (2) sexuality milestones and female genital cutting awareness, (3) salvaging family relationships and (4) for our own good. Findings highlight the importance of recognising the relational nature of how women perceive the psychological effects of female genital cutting and how these reactions are negotiated in their social sphere.

Mentalising and social problem solving in adults with Asperger's syndrome.

INTRODUCTION: It is well established that autistic spectrum disorder is linked to difficulties with mentalising, but the ways in which this affects everyday behaviour is less well understood. This study explored the nature and extent of difficulties in everyday social functioning in adults with Asperger's syndrome (AS), since increased understanding can enhance the development of more effective intervention strategies. METHODS: Individuals with AS (n=21) were compared with healthy control participants (n=21) on three tests of social cognition: the Mentalistic Interpretation task, which assesses interpretation of sarcasm and actions; the Social Problem Fluency task, which assesses ability to generate problem solutions; and the Social Problem Resolution task, which assesses judgement in selecting problem solutions. RESULTS: Comprehension of both sarcastic remarks and actions was impaired in those with AS on the mentalistic interpretation task. Participants with AS showed difficulties in identifying the awkward elements of everyday social scenarios, and they were also impaired in generating problem solutions but not in judging alternative solutions on the social problem fluency and resolution tasks. CONCLUSIONS: These tasks potentially provide a means of profiling strengths and weaknesses in social processing, which in turn has implications for informing clinical evaluation and training.

Effortful and automatic cognitive inhibition in adults with Tourette's syndrome.

OBJECTIVE: Inhibition has been widely investigated in Tourette's syndrome (TS), but some inhibitory processes have received more attention than others. This study examined the relatively underresearched construct of cognitive inhibition in adults with TS and no comorbidities (TS-alone), using tasks thought to tap automatic (without conscious intent) and effortful (with deliberate intent) inhibitory processes. METHOD: Adult participants with TS-alone (n = 20) and healthy controls (n = 21) were compared on a retrieval-induced forgetting task thought to tap automatic cognitive inhibition and a directed forgetting task thought to tap effortful cognitive inhibition. Both tasks involved effortful memory as well as the key inhibitory effects. RESULTS: Both the TS-alone and control groups showed typical inhibitory effects on both tasks, but the TS-alone group showed generally poorer effortful memory on both tasks. CONCLUSIONS: The findings appear to indicate intact cognitive inhibition in adults with TS-alone, with some evidence of impairment in effortful processing. This highlights the importance of using tasks related to different inhibitory processes to explore cognitive performance in TS-alone, and suggests that any inhibitory impairment associated with TS-alone is mild and relatively circumscribed.