Eliciting affect via immersive virtual reality: a tool for adolescent risk reduction.

OBJECTIVE: A virtual reality environment (VRE) was designed to expose participants to substance use and sexual risk-taking cues to examine the utility of VR in eliciting adolescent physiological arousal. METHODS: 42 adolescents (55% male) with a mean age of 14.54 years (SD = 1.13) participated. Physiological arousal was examined through heart rate (HR), respiratory sinus arrhythmia (RSA), and self-reported somatic arousal. A within-subject design (neutral VRE, VR party, and neutral VRE) was utilized to examine changes in arousal. RESULTS: The VR party demonstrated an increase in physiological arousal relative to a neutral VRE. Examination of individual segments of the party (e.g., orientation, substance use, and sexual risk) demonstrated that HR was significantly elevated across all segments, whereas only the orientation and sexual risk segments demonstrated significant impact on RSA. CONCLUSIONS: This study provides preliminary evidence that VREs can be used to generate physiological arousal in response to substance use and sexual risk cues.

Time-window sequential analysis: an introduction for pediatric psychologists.

OBJECTIVE: Pediatric psychologists are often interested in interactions among individuals (e.g., doctors and patients, parents and children). Most research examining the nature of these interactions has used correlational analyses. Sequential analysis provides greater detail on contingencies during interactions and the way that interactions play out over time. The purpose of this article is to offer a non-technical introduction to sequential analyses for pediatric psychologists. METHODS: A more recent derivation of the basic method, called time-window sequential analysis, is introduced and distinguished from other forms of sequential analysis. RESULTS: A step-by-step pediatric psychology example of time-window sequential analysis is provided and the integration of sequential analysis with traditional statistical methods is discussed. An example of physician-child interaction during anesthesia induction is used to illustrate the technique. CONCLUSION: Sequential analysis is a technique that is useful to pediatric psychologists who are interested in contingencies among data collected over time.

Predictors and moderators of treatment outcome in the Pediatric Obsessive Compulsive Treatment Study (POTS I).

OBJECTIVE: To identify predictors and moderators of outcome in the first Pediatric OCD Treatment Study (POTS I) among youth (N = 112) randomly assigned to sertraline, cognitive behavioral therapy (CBT), both sertraline and CBT (COMB), or a pill placebo. METHOD: Potential baseline predictors and moderators were identified by literature review. The outcome measure was an adjusted week 12 predicted score for the Children's Yale Brown Obsessive Compulsive Scale (CY-BOCS). Main and interactive effects of treatment condition and each candidate predictor or moderator variable were examined using a general linear model on the adjusted predicted week 12 CY-BOCS scores. RESULTS: Youth with lower obsessive-compulsive disorder (OCD) severity, less OCD-related functional impairment, greater insight, fewer comorbid externalizing symptoms, and lower levels of family accommodation showed greater improvement across treatment conditions than their counterparts after acute POTS treatment. Those with a family history of OCD had more than a sixfold decrease in effect size in CBT monotherapy relative to their counterparts in CBT without a family history of OCD. CONCLUSIONS: Greater attention is needed to build optimized intervention strategies for more complex youth with OCD. Youth with a family history of OCD are not likely to benefit from CBT unless offered in combination with an SSRI. CLINICAL TRIALS REGISTRATION INFORMATION: Treatment of Obsessive Compulsive Disorder (OCD) in Children, http://www.clinicaltrials.gov, NCT00000384.