Conceptualization of the complex outcomes of sexual abuse: a signal detection analysis.

Eighty-five New Zealand based practitioners experienced in treating adults with a history of child sexual abuse participated in an online judgment study of child sexual abuse outcomes using signal detection theory methodology. Participants' level of sensitivity was assessed independent of their degree of response bias when discriminating (a) known child sexual abuse outcomes from behaviors thought to be unrelated to child sexual abuse and (b) direct child sexual abuse effects from subsequent coping strategies. Results demonstrated good sensitivity (accuracy) when identifying child sexual abuse effects from noneffects. When asked to discriminate direct child sexual abuse effects from ways of coping with distress, practitioners' accuracy was reduced, revealing a tendency to identify all effects as coping. Although treatment approaches highlight the pivotal role of identifying coping strategies, practitioners did not perceive maladaptive coping as a distinct clinical feature. Complex abuse cases may benefit from replacing maladaptive coping strategies (e.g., self-harm) with constructive coping (e.g., social support) in order to deliver efficacious practice.

Driving fear and driving skills: comparison between fearful and control samples using standardised on-road assessment.

The present study explores driving skills in a group of 50 media-recruited driving-fearful and 50 control drivers, all of whom were women. Participants completed an on-road practical driving assessment with a professional driving instructor. Diagnostic as well as pre-post self-report and instructor driving assessments were conducted. Fearful drivers made more errors on the driving assessment than controls. However, the pattern of errors was identical for both groups, indicating that fear and anxiety may be associated with the number rather than the type of driving errors made. These differences remained when factors such as driving history, current driving frequency, and diagnosis were controlled using case selection. More research is needed to replicate the findings in more diverse samples. Additional work should also aim to clarify the specific role of driving skills in driving fear, which will facilitate treatment planning for exposure-based treatments and help identify cases where driving skills assessment may be appropriate.

The Driving Cognitions Questionnaire: development and preliminary psychometric properties.

Recent research has suggested that fear of driving is common in the general population. People may have various concerns when driving, and instruments for the assessment of these concerns are lacking. The present paper describes the development and preliminary evaluation of the Driving Cognitions Questionnaire (DCQ). The DCQ is a 20-item scale that measures three areas of driving-related concerns--panic-related, accident-related, and social concerns. In three separate samples from different countries (n=69, 100, and 78), the scale showed good internal consistency and substantial correlations with measures of the severity of driving fear. It discriminated well between people with and without driving phobia. It also showed convergent validity with other measures. The questionnaire shows promise for use in research and clinical practice.

Understanding Guillain-Barré syndrome and central nervous system involvement.

Guillain-Barré syndrome is a rare neurological disease that causes paralysis and may necessitate hospitalization for some patients in its acute stages. It primarily affects the peripheral nervous system, though recent research has shown that for some patients, the central nervous system is involved. The acute phase often requires intensive care services. Recognition is growing that recovery is not as smooth and free of symptoms as previously thought. Following "recovery" some people endure long-term residual symptoms, such as fatigue and pain. Nursing input can be of value by providing support, information, explanations, and empathy to reassure patients and families. A greater understanding of the nature and course of the disease and its ramifications can lead to more effective nursing management and a faster rehabilitation process.

Type 2 tasks in the theory of signal detectability: discrimination between correct and incorrect decisions.

It has been known for over 40 years that there are two fundamentally different kinds of detection tasks in the theory of signal detectability. The Type 1 task is to distinguish between events defined independently of the observer; the Type 2 task is to distinguish between one's own correct and incorrect decisions about those Type 1 events. For the Type 1 task, the behavior of the detector can be summarized by the traditional receiver operating characteristic (ROC) curve. This curve can be compared with a theoretical ROC curve, which can be generated from overlapping probability functions conditional on the Type 1 events on an appropriate decision axis. We show how to derive the probability functions underlying Type 2 decisions from those for the Type 1 task. ROC curves and the usual measures of performance are readily obtained from those Type 2 functions, and some relationships among various Type 1 and Type 2 performance measures are presented. We discuss the relationship between Type 1 and Type 2 confidence ratings and caution against the practice of presenting transformed Type 2 ratings as empirical Type 1 ratings.

Neuropsychological assessment of individuals with expressive disabilities in addition to traumatic brain injuries.

Little empirical research has examined guidelines for neuropsychological assessment of people with severe physical and sensory disabilities. This study focused on people with expressive disabilities--people unable to speak, write, draw, or manipulate test materials. Measures were selected and adapted to be suitable for the assessment of cognitive functioning for such people. Responses were selected from multiple choice answers or were spelled out on an alphabet board. Individuals with expressive disabilities in addition to traumatic brain injuiry (TBI) were compared to individuals with TBI alone and a normative group. The measures were generally found to be reliable and valid assessment instruments. Individuals with expressive disabilities were able to manage the task requirements of the adapted tests. The results provided support for the adaptations trialed.