Empirically supported treatments in pediatric psychology: regimen adherence.
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OBJECTIVE: To review empirical studies of psychological interventions for nonadherence to medical regimens for three chronic illnesses: asthma, juvenile rheumatoid arthritis (JRA), and type 1 diabetes. METHODS: The Chambless criteria for "promising," "probably efficacious," or "well-established" were applied to 8 intervention studies on asthma, 4 on JRA, and 11 on type 1 diabetes. RESULTS: For asthma, organizational strategies appear probably efficacious in promoting adherence, whereas educational and behavioral strategies appear promising. For JRA, behavioral strategies appear probably efficacious in improving adherence. For type 1 diabetes, multicomponent packages and operant learning procedures appear probably efficacious, whereas cognitive-behavioral strategies appear promising. No interventions were identified as "well-established." CONCLUSIONS: Future studies will need to develop adequate definitions of adherence, accurate methods of assessing adherence, and appropriate designs to evaluate multicomponent treatment programs to advance interventions to the "well-established" category. (+info)
The relation between the psychological functioning of children with Down syndrome and their urine peptide levels and levels of serum antibodies to food proteins.
(26/544)
AIMS: To investigate the relation between psychological functioning of subjects with Down syndrome, and their levels of urine peptide and serum antibodies to food proteins. METHODS: 55 children with Down syndrome in a cross-sectional study. Psychological functioning was measured by the Stanford-Binet Intelligence Scale: Fourth Edition, McCarthy Scales of Children's Abilities and Fagan's computer based test of novelty preference. RESULTS: The participants, and their siblings, were found to have significantly increased total urine peptide levels. There were no significant correlations between peptide levels and psychological functioning. Significantly increased levels of IgG activity to gliadin and gluten, and IgA activity to gliadin, gluten and casein were found. There were significant negative correlations (Spearman r = -0.13 to -0.51) between psychological functioning, and IgG and IgA activity to gliadin and gluten. CONCLUSIONS: A significant relation between antibodies to gluten and psychological functioning was documented. The mechanism and potential causal link are still unknown. (+info)
An attempt to reconstruct children's donor concept: a comparison between children's and lesbian parents' attitudes towards donor anonymity.
(27/544)
BACKGROUND: This study investigated the donor concept of children who were born by means of donor insemination (DI), and their lesbian parents. METHODS: A total of 41 children aged between 7 and 17 years, and 45 parents, took part in the follow-up study. In-depth topic interviews were used to reconstruct how DI children and their mothers perceived the donor. Data were collected about the birth story, about children's conversations with their mothers concerning donor characteristics and about children's and parents' attitudes towards the status of the donor. RESULTS: 54% of these children preferred donor anonymity at this point in their life, whereas 46% wanted to know more about the donor. The majority of the latter group would have liked to know the donor's identity, with boys outnumbering girls. The remaining children of this group were content with non-identifying information. Children wanted to know more about the donors whereas the majority of the mothers preferred the donor to remain anonymous. CONCLUSIONS: Our results suggest that among DI children in general and among members of the same family, unit opinions differ on the status of the donor. A flexible system offering different types of donors seems to be necessary in order to meet the needs of each family. (+info)
Steps toward a clinically relevant science of interventions in pediatric settings: introduction to the special issue.
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OBJECTIVE: To describe methods and strategies to advance the science of interventions in pediatric psychology. METHODS: We consider the advantages of various strategies to develop and extend the applications of intervention research in pediatric practice settings. RESULTS: Strategies are needed to enhance application of empirically supported interventions to pediatric settings, including testing the generalizability of empirically supported interventions in clinical samples, developing interventions based on clinical experience and tested in controlled clinical trials, designing program evaluations in the context of practice settings, and conducting case studies and series. Critical next steps in intervention research include documenting the clinical significance of interventions, conducting multisite research concerning interventions, including interventions conducted in clinical settings, and implementing integrated clinical intervention and research. Training in empirically supported treatments and intervention research and developing policy related to intervention research would also promote a clinically relevant scientific agenda concerning intervention research with pediatric populations. CONCLUSIONS: Pediatric psychologists have the opportunity to develop a clinically relevant science of interventions in pediatric settings by using multiple methods and strategies. (+info)
Evaluating outpatient pediatric psychology services in a primary care setting.
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OBJECTIVE: To provide descriptive and outcome information of an outpatient pediatric psychology clinic based in a medical center in a major metropolitan area. METHODS: We coded the characteristics and outcomes of 100 patients prospectively on a number of dimensions. Surveys and interviews were used to gather follow-up information. RESULTS: The majority of patients were Caucasian boys (n = 56 out of 100) between 2 and 12 years of age. The most common reasons for initiating contact with the clinic were assessment of school problems, behavior problems, anger, attention problems, depression, and temper tantrums. Eighty-one percent of the patients saw a therapist for brief treatment, between one and five sessions, and behavioral treatments were administered for the majority. The children's behavior for which the parents sought treatment improved significantly from pre- to posttreatment, as rated by parents and therapists. CONCLUSIONS: Overall, parents were satisfied with the services received and indicated that the recommendations given during therapy were helpful and easy to implement. This study provides general evidence for the effectiveness of pediatric psychology services. (+info)
Collecting and managing multisource and multimethod data in studies of pediatric populations.
(30/544)
OBJECTIVE: To provide recommendations for the collection and management of multisource and multimethod data in studies of children and adolescents with pediatric conditions. METHODS: We discuss limitations of single-source and single-method data collection strategies. We review strategies for collecting and managing multisource and multimethod data, including coverage of the literature on level of agreement across sources, strengths and weaknesses of various source and method aggregation strategies, and methods of examining discrepancies between sources. RESULTS: Multisource and multimethod data collection strategies enable researchers to rule out alternative explanations for their findings and pose research questions that would probably not be testable with single-source, single-method data sets. CONCLUSIONS: We emphasize the utility of multisource and multimethod data and provide recommendations for future work. (+info)
Reporting of demographics, methodology, and ethical procedures in journals in pediatric and child psychology.
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OBJECTIVE: To identify potential problems in methodology reporting that may limit research interpretations and generalization. METHODS: We examined the rates at which articles in four major journals publishing research in pediatric, clinical child, and child psychology report 18 important demographic, methodological, and ethical information variables, such as participants' gender, socioeconomic status, ethnicity, inclusion/exclusion criteria, and consent and assent procedures. RESULTS: Overall, participants' ages, genders, and ethnicity were reported at moderate to high rates, whereas socioeconomic status was reported less often. Reports of research methodology frequently did not include information on how and where participants were recruited, the participation/consent rates, or attrition rates. Consent and assent procedures were not frequently described. CONCLUSIONS: There is wide variability in articles reporting key demographic, methodological, and ethical procedure information. Necessary information about characteristics of participation samples, important for drawing conclusions, is lacking in the flagship journals serving the child psychology field. (+info)
Contrasts and correlations in theory assessment.
(32/544)
OBJECTIVE: To describe a systematic quantitative approach to assessing the predictions made by competing theories using contrasts and correlational indices of effect sizes. METHODS: We illustrate the use of the contrast F and t to compare and combine predictions when the raw data are continuous scores, and z contrasts when working with frequencies in 2 x k tables of counts. RESULTS: The traditional effect size correlation indicates the magnitude of the effect on individual scores of participants' assignment to particular conditions. The contrast correlation obtained from the contrast F or t is, in some cases, the easiest way of estimating the effect size correlation in designs using more than two groups. The alerting correlation is another way of appraising the predictive power of a contrast and can be used to compute the contrast F from published results when all we have are condition means and the omnibus F from an overall analysis of variance. Omnibus Fs, those with more than 1 df in the numerator, are rarely useful in data analytic work since they address unfocused questions, yielding only vague answers. CONCLUSIONS: Asking focused questions using contrasts increases the clarity of our questions and the clarity and statistical power of our answers. (+info)