Development and Calibration of the TBI-QOL Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction With Social Roles and Activities Item Banks and Short Forms.

OBJECTIVE: To develop traumatic brain injury (TBI)-optimized versions of the Quality of Life in Neurological Disorders (Neuro-QoL) Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks, evaluate the psychometric properties of the item banks developed for adults with TBI, develop short form and computer adaptive test (CAT) versions, and report information to facilitate research and clinical applications. DESIGN: We used a mixed methods design to develop and evaluate Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities items. Focus groups defined the constructs, cognitive interviews guided item revisions, and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics. SETTING: Five TBI Model Systems centers in the United States. PARTICIPANTS: Community-dwelling adults with TBI (N=556). INTERVENTIONS: None. OUTCOME MEASURES: Traumatic Brain Injury-Quality of Life (TBI-QOL) Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities item banks. RESULTS: Forty-five Ability to Participate in Social Roles and Activities and 41 Satisfaction with Social Roles and Activities items demonstrated good psychometric properties. Although some of the items are new, most were drawn from analogous banks in the Neuro-QoL measurement system. Consequently, the 2 TBI-QOL item banks were linked to the Neuro-QoL metric, and scores are comparable with the general population. All CAT and short forms correlated highly (>0.90) with the full item banks and demonstrate comparable construct coverage and measurement error. CONCLUSION: The TBI-QOL Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities item banks are TBI-optimized versions of the Neuro-QoL Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks and demonstrate excellent measurement properties in individuals with TBI. These measures, particularly in CAT or short form format, are suitable for efficient and precise measurement of social outcomes in clinical and research applications.

Dementia-related restlessness: relationship to characteristics of persons with dementia and family caregivers.

OBJECTIVE: Dementia-related restlessness is commonly endorsed by caregivers but not well understood. This study examines differences in characteristics (demographics, cognitive status, physical function, pain, and mood) of persons with dementia whose caregivers endorse restlessness versus those who do not. We also examine the relationship of restlessness to caregiver well-being including burden, upset with behaviors, mastery, and depressive symptomatology. METHODS: We combined baseline data from three caregiver intervention studies of community-dwelling persons with dementia who exhibited neuropsychiatric symptoms (n = 569) as measured by the Agitated Behaviors in Dementia Scale. We conducted bivariate correlations and independent t-tests by using the Agitated Behaviors in Dementia Scale restlessness item. RESULTS: Nearly 65% (n = 367) of dementia caregivers reported restlessness. There were no significant differences between those with and without (n = 202) reported restlessness concerning functional status (physical or cognitive). However, persons with restlessness had significantly higher pain scores (p < 0.01), were more likely to be on behavioral medications (p < 0.001), and had more neuropsychiatric symptoms as compared with persons without restlessness (M = 11.11, nonrestless; M = 6.61, restless) (p < 0.001). Caregivers of persons with dementia-related restlessness reported greater burden (p < 0.001), behavioral upset (p < 0.001), depression (p < 0.001), and lower mastery providing care (p < 0.01) compared with caregivers of persons without dementia-related restlessness. CONCLUSIONS: Restlessness is a common neuropsychiatric symptom that appears to be associated with poorer functioning in persons with dementia and greater distress in their caregivers. Further research is needed to understand the unique contributions of restlessness to care burden and quality of life of persons with dementia, as well as ways to address this distressing symptom. Copyright © 2017 John Wiley & Sons, Ltd.

Virtual Environment for Social Information Processing: Assessment of Children with and without Autism Spectrum Disorders.

Social information processing (SIP) skills are critical for developing and maintaining peer relationships. Building on existing assessment techniques, Virtual Environment for SIP (VESIPTM ), a simulation-based assessment that immerses children in social decision-making scenarios, was developed. This study presents preliminary evidence of VESIP's usefulness for measuring SIP skills in children with and without autism spectrum disorders (ASD). Twenty-one children with ASD and 29 control children participated. It was hypothesized that (a) children (8-12 years old), with and without ASD, would understand and interact effectively with VESIP; (b) VESIP scores would be reliable in both populations; and (c) children with ASD would score lower on SIP domains than typically developing peers. Results supported these hypotheses. Finally, response bias was also evaluated, showing that children with ASD have different problem-solving strategies than their peers. VESIP has great potential as a scalable assessment of SIP strengths and challenges in children with and without ASD. Autism Res 2018, 11: 305-317. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorders (ASDs) often struggle interpreting and responding to social situations. The present study suggests that an animated, simulation-based assessment approach is an effective way to measure how children with or without ASDs problem-solve challenging social situations. VESIP is an easy-to-use assessment tool that can help practitioners understand a child's particular strengths and weaknesses.

Atypical dimensions of caregiver-adolescent interaction in an economically disadvantaged sample.

The Goal-Corrected Partnership Adolescent Coding System (GPACS) has shown promise in assessing a secure as well as three atypical patterns of parent-adolescent interaction during a conflict discussion. The current study of 186 economically disadvantaged families examines the degree to which four GPACS patterns: secure/collaborative, hostile/punitive, role confused, and disoriented, prospectively predict adolescents' social competence and maladaptive behavior (internalizing, externalizing, and risk behaviors) at age 15 years after controlling for these social behaviors at age 13 years and contemporaneous GPACS scores. Adolescents from secure/collaborative dyads at age 13 were more likely to have a secure state of mind in the Adult Attachment Interview at age 15 and showed higher levels of teachers' ratings of empathy and lower levels of teachers' ratings of externalizing behaviors at age 15 years. Adolescents in disoriented dyads showed higher levels of teacher-rated internalizing problems, while male adolescents in role confused dyads reported higher levels of involvement in risk behaviors, including unprotected sexual activity and substance use problems.

Social Dysfunction and Diet Outcomes in People with Psychosis.

This analysis aimed to examine the association of social dysfunction with food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption in people with psychosis from the Hunter New England (HNE) catchment site of the Survey of High Impact Psychosis (SHIP). Social dysfunction and dietary information were collected using standardised tools. Independent binary logistic regressions were used to examine the association between social dysfunction and food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption. Although social dysfunction did not have a statistically significant association with most diet variables, participants with obvious to severe social dysfunction were 0.872 (95% CI (0.778, 0.976)) less likely to eat breakfast than those with no social dysfunction p < 0.05. Participants with social dysfunction were therefore, 13% less likely to have breakfast. This paper highlights high rates of social dysfunction, significant food insecurity, and intakes of fruits and vegetables below recommendations in people with psychosis. In light of this, a greater focus needs to be given to dietary behaviours and social dysfunction in lifestyle interventions delivered to people with psychosis. Well-designed observational research is also needed to further examine the relationship between social dysfunction and dietary behaviour in people with psychosis.

[ADHD and illegal conduct: a survey in Juvenile Justice Services in Puglia]. / ADHD e comportamenti antigiuridici: un'indagine presso i Centri di Giustizia Minorile della Regione Puglia.

OBJECTIVE: The aim of our study was to identify possible risk factors related to carrying out of illegal conducts by minors on their first offense, and any individual variables, family, economic and socio-cultural related to phenomenon also investigated. MATERIALS AND METHODS: The longitudinal study involved the acquisition of a series of biographical information, family, school, behavioral and clinical characteristics of children on their first crime recruited over a year in Puglia Region. For its purpose the study involved the use two standardized clinical scales (Youth Self-Report and Conners Adolescent Self Report Scale). For over a year we proceeded to follow-up. RESULTS: The survey revealed some variables family, social and school related to antisocial behavior of children in their first contact with the judicial authorities. CONCLUSIONS: The results confirm the need for primary and secondary prevention of children at risk through mutidisciplinary, early, selective interventions.

[Assessment of Social-Communicative Behaviour Problems and Expression of Emotions in Three- to Six-Year Old Children in Nursery School and Kindergarten]. / Beurteilung von sozial-kommunikativem Problemverhalten und Emotionsausdruck Drei- bis Sechsjähriger in einer Kindertageseinrichtung.

Developmental support and promotion of children with behavioural disorders received little attention in nursery school and kindergarten in the last years. Parents expect that their children exhibiting psychosocial deficits or problems in social-communicative competence will also get support by the said educational institutions. This requires a preliminary, but reliable and economic monitoring, estimation and evaluation of selected behaviour patterns. Therefore, we developed and validated a scale to rate social-communicative behaviour problems and expression of emotions. Factor analysis suggested two factors which corresponded to the intended measurement object and the defined taxonomy of behavioural problems (scale 1: mainly internalized behaviour; scale 2: externalized behaviour). Both internal consistency and split-half reliability proved to be good. High convergent criterion validity was found for scale 1 and still substantial, although lower, for scale 2. The rating is simple and can be performed within ten and scored within five minutes. The result is a reliable indicator for a step-by-step approach to recommend an expanded specific psycho-diagnostics, so that therapeutic interventions as well as prevention programmes for vulnerable children and appropriate social training programmes can start timely.

Clinical assessment of social cognitive function in neurological disorders.

Social cognition broadly refers to the processing of social information in the brain that underlies abilities such as the detection of others' emotions and responding appropriately to these emotions. Social cognitive skills are critical for successful communication and, consequently, mental health and wellbeing. Disturbances of social cognition are early and salient features of many neuropsychiatric, neurodevelopmental and neurodegenerative disorders, and often occur after acute brain injury. Its assessment in the clinic is, therefore, of paramount importance. Indeed, the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduced social cognition as one of six core components of neurocognitive function, alongside memory and executive control. Failures of social cognition most often present as poor theory of mind, reduced affective empathy, impaired social perception or abnormal social behaviour. Standard neuropsychological assessments lack the precision and sensitivity needed to adequately inform treatment of these failures. In this Review, we present appropriate methods of assessment for each of the four domains, using an example disorder to illustrate the value of these approaches. We discuss the clinical applications of testing for social cognitive function, and finally suggest a five-step algorithm for the evaluation and treatment of impairments, providing quantitative evidence to guide the selection of social cognitive measures in clinical practice.

[An inclusive misunderstanding--why noncategorization in special education for people with emotional and social behavior disorders complicates the cooperation with child and adolescent psychiatry]. / Ein inklusives Missverständnis--Warum die Dekategorisierung in der Verhaltensgestörtenpädagogik die Kooperation mit der Kinder- und Jugendpsychiatrie erschwert.

The welcomed coeducation of children and adolescents with and without disabilities is going into dangerous territory since it has become burdened with a number of illusionary expectations. The constraints applied by real-life and meaningful circumstances should be taken into account, especially for children with emotional and social behavior disorders. Practicable prevention and intervention measurements cannot be generated without profound knowledge about disorders among this heterogeneous group of people. Abandoning all previously relevant terminology («noncategorization¼), demanded by some radical inclusion advocates, leads to a situation that is helplessly confronted with its duties but lacks the basic skills and the necessary support stemming from an interdisciplinary dialogue. The contact with child and adolescent psychiatry is threatened to the disadvantage of the profession.

Keep your sunny side: a street-level look at homelessness.

This opinion piece considers my personal experiences of poverty, homelessness, loss, and physical disability in relation to recent discussions of social defeat and resistance among permanent supported housing tenants with physical and mental illnesses. By drawing attention to the onslaught of deprivation and humiliation that generally comes with the territory of poverty and homelessness in the United States, I hope to influence the ways in which clinicians, social service providers, and scholars think about specific instances of social defeat and resistance. My basic point is that any specific experience of resistance or defeat cannot be adequately understood in isolation. Rather, such experiences must be understood in relation to individual life histories of defeat and resistance, and to the symbolic and material sources of success and failure available to citizens who occupy a particular section of social space in a given society.

'Journeys' in the life-writing of adult-child dementia caregivers.

This article explores how Alzheimer's disease caregivers struggle under the impact of a parent's memory loss on their own personality. In particular, it analyses how caregivers perceive and, thus, present their experiences of the ever intensifying caregiving activity in terms of a 'journey'. In doing so, this work takes into account both the patient's continuing bodily as well as cognitive decline and its intricately linked influence on the caregiver's physical and emotional stability. Equally, this study investigates how caregivers portray memory loss, and how their portrayal fits into our conceptualisation of illness narratives and the culture of autobiographical writing.

The effects of cumulative risk and protection on problem behaviors for youth in an urban school-based system of care.

The present study examined the cumulative effects of risk and protective factors on internalizing and externalizing problems for a sample of youth who were diagnosed with a severe emotional disturbance and enrolled in an urban school-based system of care. The sample included 139 Latino and African American children (ages 5-19; 65 % male) and their families. After controlling for demographic variables, the results of hierarchical multiple regression analyses revealed that cumulative risk and protection were significantly related to internalizing problem behaviors, and cumulative protection was negatively related to externalizing problem behaviors. The findings support the importance of including or increasing strength building approaches, in addition to risk reduction, in order to maximize prevention and intervention efforts for system-of-care populations.

[Assessment of behavior in non-psychiatric settings: use of a simple and reliable method]. / Evaluation du comportement en milieu somatique: utilisation d'une méthode simple et fiable.

Behavioral and psychological symptoms of dementia are the most common complication in hospitalized older people with dementia. This article describes the development of a French version of a simple and reliable scale that is easy to use in somatic settings to foster clear and objective communication around this symptomatology.

Merging developmental and criminal career perspectives: implications for risk assessment and risk prediction of violent/sexual recidivism in adult sexual aggressors of women.

Currently, a majority of actuarial risk-assessment tools for sexual recidivism contain static risk factors that measure various aspects of the offender's prior criminal history in adulthood. The goal of the current study was to assess the utility of extending static risk factors, by using developmental and criminal career parameters of offending, in the actuarial assessment of risk of violent/sexual recidivism. The current study was based on a sample of 204 convicted sexual aggressors of women incarcerated in the province of Quebec, Canada between April 1994 and June 2000. Semistructured interviews were used to gather information on the offender's antisocial history prior to adulthood, and police records were used to collect data on the criminal career of these offenders in adulthood. For an average follow-up period of approximately 4 years, the violent/sexual recidivism rate for the sample was 23.7%. The results provided support for the inclusion of both developmental and criminal career indicators for the prediction of violent/sexual recidivism. More specifically, recidivists were characterized by an early onset antisocial trajectory and a pattern of escalation of antisocial behavior between childhood and adolescence. The findings suggest that risk assessors should look beyond broad adult criminal history data to include aspects of antisocial development to improve predictive accuracy.

Variables modulating depression in dementia caregivers: a longitudinal study.

BACKGROUND: Dementia caregiving has been linked to negative consequences for mental health in caregivers. Although depression seems to be an enduring psychological consequence associated with caregiving, little is known about the longitudinal effects that modulating variables related to coping strategies have on caregiver's changes in depression over time. This study is aimed at investigating whether, in a one-year longitudinal study with 130 dementia caregivers, caregivers' depression scores co-vary with modulating variables such as self-efficacy for controlling upsetting thoughts, frequency of leisure activities, and cognitive reappraisal, after controlling for gender and caregivers' stressors (frequency of disruptive behaviors). METHODS: Linear mixed models analysis was used to analyze the associations between time-varying values for caregivers' stressors and modulating variables in predicting caregivers' depression. RESULTS: It was found that increases in caregivers' self-efficacy, frequency of leisure activities, and cognitive reappraisal significantly predicted decreases in caregivers' depression over time, even after controlling for gender and frequency of disruptive behaviors. In addition, increases in stressors were significantly related to increases in depression over time. CONCLUSIONS: The inclusion of modulating variables significantly contributed to the explanation of the variance in caregivers' depression, adding explanatory power to the variables usually included in the stress and coping model (gender and stressors).

Evidence-based practice for youth in supervised out-of-home care: a framework for development, definition, and evaluation.

Adolescents comprise more than half of the children in child welfare supervised out-of-home care. This article considers the evidence-base for an array of services to adolescents in out-of-home care and evaluates the existing research base for each program. This review advances a framework for considering the critical need to develop, define, and evaluate the essential elements of out-of-home care services for older foster youth. Policy, program, and evaluation recommendations are forwarded.

Recommended measures for the assessment of behavioral disturbances associated with dementia.

OBJECTIVE: The study reviewed all the published instruments used for the assessment, diagnosis, screening, and outcomes monitoring/evaluation of behavioral disturbances associated with dementia (BDAD) to recommend a set of psychometrically valid measures for clinicians and researchers to use, across a range of different practice settings. METHODS: The study involved a broad scoping search, followed by a series of in-depth literature reviews on 29 instruments using scientific literature databases (MEDLINE, PsycINFO, CINAHL, and the Cochrane Library) and various national, international government, and government agency websites and professional organization websites. External consultations from measurement, clinical and research experts in dementia care, consumer representatives, and policy/decision makers, were sought in selecting the best instruments and in making the final recommendations. FINDINGS: Key attributes and psychometric properties of a short list of five instruments were measured against prespecified criteria. The Neuropsychiatry Inventory (NPI) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) were rated as the best measures for assessment of behavioral disturbances, followed by the Consortium to Establish a Registry for Alzheimer's Disease-Behavior Rating Scale for Dementia (CERAD-BRSD), the Dementia Behavior Disturbance Scale, and the Neurobehavioral Rating Scale. CONCLUSION: The use of valid and standardized outcome measures for the assessment of BDAD is critical for epidemiological studies, prevention, early intervention and treatment of dementia conditions, and funding for relevant healthcare services. The review recommends the NPI and BEHAVE-AD as the most appropriate measures for both clinical and research, whereas the CERAD-BRSD is suited better for research. The review was designed for the Australian context; however, the findings are applicable in other developed countries.

Does money matter? The effects of cash transfers on child development in rural Ecuador.

A large body of research indicates that child development is sensitive to early-life environments, so that poor children are at higher risk for poor cognitive and behavioral outcomes. These developmental outcomes are important determinants of success in adulthood. Yet, remarkably little is known about whether poverty-alleviation programs improve children's developmental outcomes. We examine how a government-run cash transfer program for poor mothers in rural Ecuador influenced the development of young children. Random assignment at the parish level is used to identify program effects. Our data include a set of measures of cognitive ability that are not typically included in experimental or quasi-experimental studies of the impact of cash transfers on child well-being, as well as a set of physical health measures that may be related to developmental outcomes. The cash transfer program had positive, although modest, effects on the physical, cognitive, and socioemotional development of the poorest children in our sample.

War's long shadow: masculinity, medicine, and the gendered politics of trauma, 1914-1939.

War is an inherently traumatizing experience, and during the First World War more than 15,000 Canadian soldiers were diagnosed with some form of war-related psychological wounds. Many more went unrecognized. Yet the very act of seeking an escape from the battlefield or applying for a postwar pension for psychological traumas transgressed masculine norms that required men to be aggressive, self-reliant, and un-emotional. Using newly available archival records, contemporary medical periodicals, doctors' notes, and patient interview transcripts, this paper examines two crises that arose from this conflict between idealized masculinity and the emotional reality of war trauma. The first came on the battlefield in 1916 when, in some cases, almost half the soldiers evacuated from the front were said to be suffering from emotional breakdowns. The second came later, during the Great Depression, when a significant number of veterans began to seek compensation for their psychological injuries. In both crises, doctors working in the service of the state constructed trauma as evidence of deviance, in order to parry a larger challenge to masculine ideals. In creating this link between war trauma and deviance, they reinforced a residual conception of welfare that used tests of morals and means to determine who was deserving or undeserving of state assistance. At a time when the Canadian welfare state was being transformed in response to the needs of veterans and their families, doctors' denial that "real men" could legitimately exhibit psychosomatic symptoms in combat meant that thousands of legitimately traumatized veterans were left uncompensated by the state and were constructed as inferior, feminized men.