How, when and why abilities go social: researching children's empathy and prosocial behaviors in context.

Introduction: The current paper undertakes interdisciplinary research on empathy in children by combining insights and methodological tools from the fields of psychology, education and anthropology. The researchers aim to map how children's individual empathic abilities studied on a cognitive level do or do not coincide with their empathic expressions as part of group dynamics in daily life at the classroom level. Method: We combined qualitative and quantitative methods within three different classrooms at three different schools. In total, 77 children aged between 9 to 12 years participated. Results: The results indicate how such an interdisciplinary approach can provide unique insights. Through the integration of data from our different research tools we could reveal the interplay between different levels. More specifically this meant showing the possible influence of rule-based prosocial behaviors versus empathy based prosocial behaviors, the interplay between community empathic abilities and individual empathic abilities, and the role of peer culture and school culture. Discussion: These insights can be seen as encouragement toward a research approach that extends beyond the single disciplinary field in social science research.

Social network responses to victims of potentially traumatic events: A systematic review using qualitative evidence synthesis.

BACKGROUND: A substantial number of qualitative studies examined how adult victims of potentially traumatic events (PTEs) experienced support provided by family members, friends, colleagues, and other significant others in the informal network. Importantly, the large majority of qualitative studies focused on the perceived support of victims of specific events such as sexual offences, partner violence, homicide, accidents and disasters. Although it is likely that across specific PTEs there are similarities as well as differences in experienced support from the informal network, to date no systematic review synthesized the results of qualitative studies on support from the informal network following various types of PTEs. The aim of the present systematic review is to fill this gap in the scientific knowledge, which is also highly relevant for victim services, policymakers, and the informal network. METHODS: A literature search of qualitative studies was conducted using the electronic databases of PubMed, Web of Science, CINAHL, Psych INFO, Scopus, Criminal Justice Abstracts and Picarta. The quality of the identified studies was assessed with the Consolidated Criteria for Reporting Qualitative research (COREQ) checklist, followed by analysis of the results of the identified studies using Qualitative Evidence Synthesis. FINDINGS: Seventy-five papers were included in the synthesis, involving 2799 victims of PTEs such as accidents, disasters, homicide, intimate partner violence (IPV), and sexual offences. Saturation was only achieved for IPV. Overall, four major categories of perceived social support were identified, namely, support perceived as supportive, supportive but insufficient, unsupportive, and absent from informal support providers, which included friends, family, neighbors, (if applicable) offender's family, religious group members, work/school colleagues, fellow victims, the local community, and the social network in general. Across the PTE groups, there were similarities in experiencing positive forms of support (particularly empathy and sharing experiences) as well as negative forms of support (abandonment, avoidance, lack of empathy, and not experiencing support despite victim's request for help). There were also differences across PTE groups, in particular, victims of sexual and intimate partner violence mentioned a number of other supportive (mobilizing support, no unsupportive responses) and non-supportive (e.g., justification or normalization of violence and minimizing responses) responses. CONCLUSIONS: The review showed that different actors within the social informal network can play an important role in providing support after victims experience violence, homicide, accidents, and disasters. However, the review revealed that the large majority of qualitative studies were aimed at victims of IPV, and only for this type of PTE was saturation achieved. This indicates that, although this synthesis identified several similarities and differences, it is still too early to draw more definitive conclusions on similarities and differences in experienced social support after various PTEs and that future qualitative studies focusing on other PTEs are much needed.

Students' beliefs about the nature of intelligence (mindset).

Important adolescents' career-related decisions might be influenced by their beliefs about malleability of intelligence and learning (mindset). We combined quantitative and qualitative data to provide in-depth insights in the beliefs that 13-14-year-olds hold about learning and intelligence, the factors influencing these beliefs, and the consequences of these beliefs in relation to classroom behaviour and study choices. To establish students' mindsets quantitatively, we categorised theory of intelligence questionnaire (TOI; Dweck, 1999) averaged scores into three levels: entity, intermediate or incremental mindsets, to provide insight into the distribution of the different mindset types in our sample (N = 492). The results of this quantitative study show that more than half of the students believed intelligence is "fixed" (entity mindset), these data showed no effect of gender. To gain more in-depth insight in the views of these students, focus groups about mindset and its influences and consequences were held in a subsample (n = 176). The qualitative data provide more nuanced insights, for example they reveal subtle gender differences regarding effort beliefs and motivation. Integrated discussion of the quantitative and qualitative results demonstrates that this multi-method approach reflects the complexity of the concept mindset better than only the widely used TOI questionnaire.

Quantitizing findings from qualitative studies for integration in mixed methods reviewing.

In mixed methods reviewing, data from quantitative and qualitative studies are combined at the review level. One possible way to combine findings of quantitative and qualitative studies is to quantitize qualitative findings prior to their incorporation in a quantitative review. There are only a few examples of the quantification of qualitative findings within this context. This study adds to current research on mixed methods review methodology by reporting the pilot implementation of a new four-step quantitizing approach. We report how we extract and quantitize the strength of relationships found in qualitative studies by assigning correlations to vague quantifiers in text fragments. This article describes (a) how the analysis is prepared; (b) how vague quantifiers in text fragments are organized and transformed to numerical values; (c) how qualitative studies as a whole are assigned effect sizes; and (d) how the overall mean effects size and variance can be calculated. The pilot implementation shows how findings from 26 primary qualitative studies are transformed into mean effect sizes and corresponding variances.

How do adolescents with cerebral palsy participate? Learning from their personal experiences.

BACKGROUND: Participation in society can be difficult for adolescents with cerebral palsy (CP). Information is often based on quantitative studies, and little is known about their personal participation experiences. OBJECTIVE: The aim of this study was to examine the participation experiences of adolescents (aged 12-17 years) with CP. METHODS: A qualitative participatory research method was used. Twenty-three semi-structured open interviews were conducted with 13 male and 10 female adolescents (mean age 15 years) with CP. An interview checklist was developed jointly with adolescents with CP. This checklist ensured that the adolescents reflected on various participation areas, that is school, sports, health care and work. The analysis was based on principles of grounded theory. FINDINGS: From the adolescents' experiences, 4 key categories were identified. One concerned participation, as such, expressed as "My participation experiences," including experiences, thoughts and feelings while participating in daily life. Three other categories concerned factors that influence participation experiences, expressed as "My disability," "Me as a person" and "My environment." These 4 categories together formed a model showing the interactions and dynamics of participation according to adolescents with CP. CONCLUSION: Adolescents with CP expressed their participation experiences, including various important influencing factors. This study conceptualized these experiences into a dynamic model. This experience-based participation model may provide new, personalized perspectives for practice, for instance in rehabilitation, but also for schools and sports (or sports clubs) attended by adolescents. Focusing on personal and environmental factors might be the key to successful participation.

Teacher Mindsets Concerning the Malleability of Intelligence and the Appraisal of Achievement in the Context of Feedback.

The pedagogical beliefs (e.g., beliefs or "mindsets" concerning the malleability of intelligence) that teachers hold may have a far-reaching impact on their teaching behavior. In general, two basic mindsets can be distinguished with regard to the malleability of intelligence: fixed (entity) and growth (incremental). In this article, we present two studies investigating the associations between teachers' mindset and (1) their appraisal of students' achievements and (2) the feedback they provide. Study 1 focuses on the associations between mindset and appraisal. The findings reveal an association between growth mindset and the appraisal of increasing student achievements. Study 2 investigates the impact of teachers' mindset on the amount and type of oral feedback they provide to their students. Contrarily to expectations, the findings reveal a significant negative correlation between mindset and the amount of feedback.

Using the realist perspective to link theory from qualitative evidence synthesis to quantitative studies: Broadening the matrix approach.

BACKGROUND: This study describes an approach for the use of a specific type of qualitative evidence synthesis in the matrix approach, a mixed studies reviewing method. The matrix approach compares quantitative and qualitative data on the review level by juxtaposing concrete recommendations from the qualitative evidence synthesis against interventions in primary quantitative studies. However, types of qualitative evidence syntheses that are associated with theory building generate theoretical models instead of recommendations. Therefore, the output from these types of qualitative evidence syntheses cannot directly be used for the matrix approach but requires transformation. This approach allows for the transformation of these types of output. METHOD: The approach enables the inference of moderation effects instead of direct effects from the theoretical model developed in a qualitative evidence synthesis. Recommendations for practice are formulated on the basis of interactional relations inferred from the qualitative evidence synthesis. In doing so, we apply the realist perspective to model variables from the qualitative evidence synthesis according to the context-mechanism-outcome configuration. FINDINGS: A worked example shows that it is possible to identify recommendations from a theory-building qualitative evidence synthesis using the realist perspective. We created subsets of the interventions from primary quantitative studies based on whether they matched the recommendations or not and compared the weighted mean effect sizes of the subsets. The comparison shows a slight difference in effect sizes between the groups of studies. The study concludes that the approach enhances the applicability of the matrix approach.

Researching children's individual empathic abilities in the context of their daily lives: the importance of mixed methods.

In social neuroscience, empathy is often approached as an individual ability, whereas researchers in anthropology focus on empathy as a dialectic process between agents. In this perspective paper, we argue that to further elucidate the mechanisms underlying the development of empathy, social neuroscience research should draw on insights and methods from anthropology. First, we discuss neuropsychological studies that investigate empathy in inter-relational contexts. Second, we highlight differences between the social neuroscience and anthropological conceptualizations of empathy. Third, we introduce a new study design based on a mixed method approach, and present initial results from one classroom that was part of a larger study and included 28 children (m = 13, f = 15). Participants (aged 9-11) were administered behavioral tasks and a social network questionnaire; in addition an observational study was also conducted over a period of 3 months. Initial results showed how children's expressions of their empathic abilities were influenced by situational cues in classroom processes. This effect was further explained by children's positions within classroom networks. Our results emphasize the value of interdisciplinary research in the study of empathy.

What can measures of text comprehension tell us about creative text production?

Evidence is accumulating that the level of text comprehension is dependent on the situatedness and sensory richness of a child's mental representation formed during reading. This study investigated whether these factors involved in text comprehension also serve a functional role in writing a narrative. Direct influences of situatedness and sensory richness as well as indirect influences via the number of sensory and situational words on the creativity (i.e., originality/novelty) of a written narrative were examined in 165 primary school children through path analyses. Results showed that sensory richness and situatedness explained 35 % of the variance in creativity scores. Sensory richness influenced the originality/novelty of children's narrative writing directly, whereas situatedness had an indirect influence, through the number of sensory words, but both pathways influenced the outcomes to a comparable extent. Findings suggest that creative writing requires similar representational processes as reading comprehension, which may contribute to the development of instructional methods to help children in creative writing assignments.

Recording and accounting for stakeholder involvement in systematic reviews.

OBJECTIVES: The use of stakeholders in systematic reviews is increasingly valued, but their influence on the systematicity of the review is often unclear. The aim of this study was to describe some of the processes of involvement of stakeholders and to demonstrate a Tool for Recording and Accounting for Stakeholder Involvement (TRASI). METHODS: We demonstrate the TRASI in two worked examples. In one project, the reviewers collaborated with the end-user and an expert during the literature search. In the other project, experts were consulted to generate keywords before searching the literature. RESULTS: In the first project, disagreements about keywords to identify studies for the research topic were solved by informal discussion. In the second project, difficulties arose in reaching agreement between experts and reviewers about the core construct and the meaningful keywords associated with it. DISCUSSION: The TRASI aids researchers to systematically and transparently account for the decisions taken. The TRASI supports information specialists and librarians to shape the search strategy to match the objectives of the review. CONCLUSIONS: We propose the TRASI as a first step in resolving the challenges of detecting and reconstructing stakeholder influences. Potential new applications of the TRASI are discussed.

Why do ethnic Chinese in the Netherlands underutilize mental health care services? Evidence from a qualitative study.

Chinese immigrants in the Netherlands are less likely than other ethnic groups to utilize mainstream mental health care services. This study investigated the experiences of Chinese with mental health problems, to inform measures to make services more responsive to the needs of this group. Qualitative methods of analysis were applied to interview data in order to explore ways of finding help, barriers to accessing mainstream mental health care, experiences in care, factors jeopardizing the quality of care, and views on mental health services among Chinese migrants in the Netherlands. Rather than recruiting individuals with mental health problems, an indirect method was used in which ethnic Chinese participants were invited to tell us about one or more Chinese individuals in their social environment whom they regarded as having (had) mental health problems (Symbol: see text). Although most Chinese regarded mainstream Dutch care as the appropriate resource for dealing with mental health problems, many barriers to access and threats to care quality were reported. In contrast to the widely accepted view that cultural differences in health beliefs underlie the low utilization of mental health services by Chinese in the West, the main obstacles identified in this study concerned practical issues such as communication problems and lack of knowledge of the health system. Respondents also described concerns about entitlement to care and discrimination (actual or anticipated). Measures suggested by respondents for improving care included increased use of interpreters and cultural mediators, encouraging migrants to increase their language proficiency, and better dissemination of information about the health system. The article concludes with a discussion of the policy implications of these findings.

Pathophysiological domains underlying the metabolic syndrome: an alternative factor analytic strategy.

PURPOSE: Factor analysis (FA) has become part and parcel in metabolic syndrome (MBS) research. Both exploration- and confirmation-driven factor analyzes are rampant. However, factor analytic results on MBS differ widely. A situation that is at least in part attributable to misapplication of FA. Here, our purpose was (i) to review factor analytic efforts in the study of MBS with emphasis on misusage of the FA model and (ii) to propose an alternative factor analytic strategy. METHODS: The proposed factor analytic strategy consists of four steps and confronts weaknesses in application of the FA model. At its heart lies the explicit separation of dimensionality and pattern selection and the direct evaluation of competing inequality-constrained loading patterns. A high-profile MBS data set with anthropometric measurements on overweight children and adolescents is reanalyzed using this strategy. RESULTS: The reanalysis implied a more parsimonious constellation of pathophysiological domains underlying phenotypic expressions of MBS than the original analysis (and many other analyses). The results emphasize correlated factors of impaired glucose metabolism and impaired lipid metabolism. CONCLUSIONS: Pathophysiological domains underlying phenotypic expressions of MBS included in the analysis are driven by multiple interrelated metabolic impairments. These findings indirectly point to the possible existence of a multifactorial etiology.

Rape-related symptoms in adolescents: short- and long-term outcome after cognitive behavior group therapy.

BACKGROUND: Efficacy studies on treatment in adolescent victims of single rape are lacking, even though sexual victimization is most likely to occur during adolescence and despite the fact that adolescents are at risk to develop subsequent posttraumatic stress disorder. AIM: The aim of this prospective observational study was to evaluate the short- and long-term outcomes of a nine-session cognitive behavior group therapy (STEPS), including a parallel six-session parents' group on rape-related symptomatology in female adolescents (13-18 years). STEPS includes psychoeducation, exposure in sensu as well as in vivo, cognitive restructuring, and relapse prevention. METHODS: Fifty-five female adolescents with mental health problems due to single rape, but without prior sexual trauma, received STEPS while their parents participated in a support group. Subjects were assessed on posttraumatic stress (PTS) and comorbid symptoms using self-report questionnaires prior to and directly after treatment, and at 6 and 12 months follow-up. RESULTS: Repeated measures analysis showed a significant and large decrease in symptoms of PTS, anxiety, depression, anger, dissociation, sexual concerns, and behavior problems directly after treatment, which maintained at 12 months follow-up. Time since trauma did not influence the results. Dropout during STEPS was 1.8%. CONCLUSIONS: The results potentially suggest that the positive treatment outcomes at short- and long-term may be caused by STEPS. The encouraging findings need confirmation in future controlled studies on the effectiveness of STEPS because it may be possible that the treatment works especially well for more chronic symptoms, while the less chronic part of the sample showed considerable improvement on its own.

Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis.

BACKGROUND: It is unclear how many children and adolescents develop post-traumatic stress disorder (PTSD) after trauma. AIMS: To determine the incidence of PTSD in trauma-exposed children and adolescents as assessed with well-established diagnostic interviews and to examine potential moderators of the estimate. METHOD: A systematic literature search identified 72 peer-reviewed articles on 43 independent samples (n = 3563). Samples consisting only of participants seeking or receiving mental health treatment were excluded. Main analyses involved pooled incidence estimates and meta-analyses of variance. RESULTS: The overall rate of PTSD was 15.9% (95% CI 11.5-21.5), which varied according to the type of trauma and gender. Least at risk were boys exposed to non-interpersonal trauma (8.4%, 95% CI 4.7-14.5), whereas girls exposed to interpersonal trauma showed the highest rate (32.9%, 95% CI 19.8-49.3). No significant difference was found for the choice of assessment interview or the informant of the assessment. CONCLUSIONS: Research conducted with the best available assessment instruments shows that a significant minority of children and adolescents develop PTSD after trauma exposure, with those exposed to interpersonal trauma and girls at particular risk. The estimates provide a benchmark for DSM-5 and ICD-11.

Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder.

BACKGROUND: In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective of the current study was to assess HPA-axis functioning in female adolescents with rape-related PTSD, but no prior sexual trauma, in comparison to non-victimized controls. METHOD: Salivary cortisol and dehydroepiandrosterone sulfate (DHEAS) were measured in 52 female adolescent rape victims with PTSD and 37 healthy adolescents at 0, 15, 30, 45 and 60 min after awakening, both under basal conditions and after 0.5 mg dexamethasone administration. RESULTS: Compared to age-matched controls, adolescent rape victims with PTSD showed significantly reduced cortisol and DHEAS levels. No group differences for the effect of dexamethasone suppression were found. Both the event of rape and PTSD diagnosis, and not factors such as sleep duration, smoking, education or oral contraceptives, accounted for the neuroendocrine differences between rape victims and controls. CONCLUSIONS: The results show evidence for a dysregulated HPA-axis in female adolescent victims of single sexual trauma with PTSD. The finding of hypocortisolism is consistent with endocrine dysfunctioning in chronic sexual abuse victims and may have clinical implications with regard to treatment possibilities.

Building child trauma theory from longitudinal studies: a meta-analysis.

Many children are exposed to traumatic events, with potentially serious psychological and developmental consequences. Therefore, understanding development of long-term posttraumatic stress in children is essential. We aimed to contribute to child trauma theory by focusing on theory use and theory validation in longitudinal studies. Forty studies measuring short-term predictors and long-term posttraumatic stress symptoms were identified and coded for theoretical grounding, sample characteristics, and correlational effect sizes. Explicit theoretical frameworks were present in a minority of the studies. Important predictors of long-term posttraumatic stress were symptoms of acute and short-term posttraumatic stress, depression, anxiety, and parental posttraumatic stress. Female gender, injury severity, duration of hospitalization, and elevated heart rate shortly after hospitalization yielded small effect sizes. Age, minority status, and socioeconomic status were not significantly related to long-term posttraumatic stress reactions. Since many other variables were not studied frequently enough to compute effect sizes, existing theoretical frameworks could only be partially confirmed or falsified. Child trauma theory-building can be facilitated by development of encouraging journal policies, the use of comparable methods, and more intense collaboration.

Making a difference: towards a method for weighing the evidence in a qualitative synthesis.

OBJECTIVES: In a qualitative synthesis, primary qualitative studies are integrated to develop a theory or evidence-based interventions. Until now, the strength of the evidence in the primary studies has not been taken into account in the outcome of the qualitative synthesis. In this paper, a method is developed and evaluated to assign weights to the findings of the qualitative studies using both the frequency and the quality of the reported results. METHOD: Seventeen qualitative studies were retrieved in an illustrative example project on children and trauma. Findings were extracted from the primary studies with the use of coding which resulted in 14 themes. The quality of the studies was appraised using both expert judgement and a quality checklist. These outcomes are used to calculate the weights. RESULTS: When the outcomes of the checklist appraisal are compared with those of the expert judgement, the effect on the strength of the evidence is virtually always in the same direction. We found that as the frequency with which a concept is studied is low, the strength of the evidence oftentimes decreases even further when using the quality of the results in the weighing process. CONCLUSIONS: In the end, the outcomes of a critical appraisal affect the weight that is placed on particular studies. The use of a checklist is recommended because of its more distinguishing ability. The method that was developed for assigning weights to the evidence is discussed in light of both the quality appraisal in qualitative research and the objectives of qualitative synthesis.