A prospective longitudinal study of multidomain resilience among youths with and without maltreatment histories.

The majority of children with maltreatment histories do not go on to develop depression in their adolescent and adult years. These individuals are often identified as being "resilient", but this characterization may conceal difficulties that individuals with maltreatment histories might face in their interpersonal relationships, substance use, physical health, and/or socioeconomic outcomes in their later lives. This study examined how adolescents with maltreatment histories who exhibit low levels of depression function in other domains during their adult years. Longitudinal trajectories of depression (across ages 13-32) in individuals with (n = 3,809) and without (n = 8,249) maltreatment histories were modeled in the National Longitudinal Study of Adolescent to Adult Health. The same "Low," "increasing," and "declining" depression trajectories in both individuals with and without maltreatment histories were identified. Youths with maltreatment histories in the "low" depression trajectory reported lower romantic relationship satisfaction, more exposure to intimate partner and sexual violence, more alcohol abuse/dependency, and poorer general physical health compared to individuals without maltreatment histories in the same "low" depression trajectory in adulthood. Findings add further caution against labeling individuals as "resilient" based on a just single domain of functioning (low depression), as childhood maltreatment has harmful effects on a broad spectrum of functional domains.

Immediate and carryover changes of C5-6 joint mobilization on shoulder external rotator muscle strength.

OBJECTIVE: Clinical evidence has shown that extremity dysfunction, such as muscle weakness or inhibition, is associated with spinal disorders. Spinal manual therapy is a common therapeutic approach used to address extremity muscle weakness. The purpose of the study was to assess changes in the maximal muscle strength of the shoulder external rotators immediately and at 10, 20, and 30 minutes after cervical joint mobilization at the C5-6 segment. METHODS: Eighteen participants with existing or a history of neck pain were screened by 2 investigators independently for muscle weakness of shoulder external rotators. Fifteen qualified participants underwent shoulder external rotator strength testing with a handheld dynamometer. Each participant was tested 6 times, twice before, immediately after, and at 10, 20, and 30 minutes after a C5-6 joint mobilization on the involved side. The 2 strength data collected before the mobilization were used to determine intratester reliability. RESULTS: The intratester reliability of the shoulder external rotator strength was excellent (intraclass correlation coefficient(3,2) = 0.985). One-way analysis of variance with repeated measures showed a statistical significance in strength data (P = .002). Post hoc tests revealed a significant increase between prejoint mobilization and immediately postjoint mobilization (P = .003) and between pre joint mobilization and 10-minute post joint mobilization (P < .001). CONCLUSIONS: The results of the study suggest that C5-6 joint mobilization increases muscle strength of the shoulder external rotators immediately and its effect carries over for 10 minutes but not after 20 minutes.

Interrater reliability of a movement impairment-based classification system for lumbar spine syndromes in patients with chronic low back pain.

STUDY DESIGN: A prospective methodological study of interrater reliability. OBJECTIVES: To examine the interrater reliability of a movement impairment-based classification system for patients with chronic low back pain (LBP). BACKGROUND: Movement impairment-based classification for the lumbar spine categorizes LBP based on the findings derived from a patient history and standardized examination. Though many presume this classification to be useful for directing treatment of individuals with LBP, agreement between examiners for assigning a lumbar spine category to a patient has not been studied thoroughly. METHODS AND MEASURES: Two physical therapists independently examined 24 patients (8 men, 16 women) with chronic LBP (pain duration greater than 12 weeks). All patients enrolled in the study had been diagnosed with LBP that was believed to be due to mechanical causes, and the duration of their symptoms ranged from 20 to 1040 weeks. The examiners used a standardized examination to assess patients and classify them into 1 of 5 lumbar spine categories. Percent agreement and kappa coefficients were calculated between the examiners for the lumbar movement impairment-based classifications. RESULTS: Percent agreement between examiners was 75% and the kappa coefficient was 0.61. The most prevalent lumbar spine categories identified by both examiners were lumbar extension rotation syndrome (41.7% of patients by examiner 1, 37.5% of patients by examiner 2) and lumbar rotation syndrome (41.7% of patients by both examiners). CONCLUSIONS: Interrater reliability between 2 physical therapists classifying patients with chronic LBP patients into 1 of 5 lumbar spine movement impairment categories had substantial agreement.

Matching-to-sample assessment of stimulus overselectivity in students with intellectual disabilities.

A delayed matching-to-sample task with multiple sample stimuli was used to evaluate stimulus overselectivity in 70 individuals attending residential special-education schools. A Mental Age Equivalent score (MAE) was obtained for each student using the Peabody Picture Vocabulary Test. Twenty-one participants failed to complete matching-to-sample pretests (mean MAE = 3.70 years). Results on the multiple-sample test for the remaining 49 participants indicated no overselectivity for 14 students (mean MAE = 7.44 years) and were consistent with overselectivity for 35 students (mean MAE = 5.28 years). Performances of students with overselectivity were more variable than those with no overselectivity. The MAE scores were related to both matching-to-sample performance and stimulus overselectivity.

Overselective stimulus control in residential school students with intellectual disabilities.

Overselective stimulus control was assessed in 29 students at residential schools for individuals with developmental disabilities. Overselectivity testing included three different delayed identity matching-to-sample tasks. Sample stimuli for the Form/Color Test were nine possible combinations of three colors and three forms. On each trial, the S+ stimulus was identical to the sample, one S- was the same color as the sample but a different form, and the other S- was the same form but a different color. Sample stimuli for the Two-Sample Test were two alphanumeric characters. The S+ stimulus was identical to one of the sample stimuli, and two S- stimuli were characters different from both samples. Sample stimuli for the Faces Test were six digital images of adult faces. On each trial, the S+ stimulus was identical to the sample, one S- stimulus was a non-matching face to which one sample feature had been added (e.g., an identical hat or scarf), and the other S- stimulus was an unaltered non-matching face. All participants were also tested with the Peabody Picture Vocabulary Test III (PPVT) and the Autism Diagnostic Observation Schedule (ADOS). Results indicated overselective stimulus control on at least one test for 18 of the 29 participants. Overselectivity (a) was distributed across a range of PPVT mental age equivalent scores from <1.75 to 8.83; (b) was more likely in individuals with higher ADOS scores; (c) was most likely on the Two-Sample Test; and (d) was found in five individuals on more than one of the tests. Thus, overselective stimulus control may occur across a range of characteristics typical for students who attend residential special-education programs.

Comparison of changes in supraspinatus muscle thickness in persons with subacromial impingement syndrome and asymptomatic adults.

PURPOSE: To compare changes in supraspinatus muscle thickness in persons with subacromial impingement syndrome (SAIS) and asymptomatic adults and to determine the reliability of the ultrasound imaging (USI) protocol. SUBJECTS: Twenty-two persons with SAIS and 22 age- and gender-matched asymptomatic controls. METHODS: Ultrasound images of supraspinatus muscle thickness at rest and at 0°, 30°, 60°, and 90° of arm elevation were captured and measured. To determine same-day intratester reliability, one examiner imaged the same subject twice and two examiners took turns capturing images in order to determine same-day intertester reliability. SUBJECTS were asked to return for between-day intratester reliability. RESULTS: Statistical analyses revealed a larger mean supraspinatus thickness in the SAIS group at the 0° condition than in the asymptomatic group (p < 0.05). Same-day intratester and intertester reliability was good with ICC(2,3) = 0.73-0.96 for asymptomatic controls and ICC(2,3) = 0.61-0.94 for persons with SAIS. Overall, between-day intratester reliability was fair to good for most conditions [ICC(2,3) = 0.31-0.90]. CONCLUSIONS: The thicker supraspinatus muscles at 0° in the SAIS group may indicate a protective spasm. The USI protocol used in the study demonstrated good same-day intratester and intertester reliability for both groups.