Comparing preference assessments: Selection- versus duration-based preference assessment procedures

In the current investigation, the results of a selection- and a duration-based preference assessment procedure were compared. A Multiple Stimulus With Replacement (MSW) preference assessment [Windsor, J., Piché, L. M., & Locke, P. A. (1994). Preference testing: A comparison of two presentation methods. Research in Developmental Disabilities, 15, 439–455] and a variation of a Free-Operant (FO) preference assessment procedure [Roane, H. S., Vollmer, T. R., Ringdahl, J. E., & Marcus, B. A. (1998). Evaluation of a brief stimulus preference assessment. Journal of Applied Behavior Analysis, 31, 605–620] were conducted with four participants. A reinforcer assessment was conducted to determine which preference assessment procedure identified the item that produced the highest rates of responding. The items identified as most highly preferred were different across preference assessment procedures for all participants. Results of the reinforcer assessment showed that the MSW identified the item that functioned as the most effective reinforcer for two participants.     

The Role of Context in the Evaluation of Reinforcer Efficacy: Implications for the Preference Assessment Outcomes

Highly preferred stimuli were identified via two preference assessments (based on Fisher et al., 1992), the second of which included stimuli that were ranked low in the initial preference assessment. Following the preference assessments, a subset of stimuli was evaluated as reinforcers in single- and concurrent-operant arrangements. In general, stimuli that were identified as highly preferred in the initial preference assessment functioned as more effective reinforcers. These results are discussed in terms of how the context in which stimuli are evaluated may play a role in the identification of effective positive reinforcers for individuals with autism and related developmental disabilities.     

A Real-Time Emotionality Assessment (RTEA) System Based on Psycho-Physiological Evaluation

Human emotion is assessed by measuring and analyzing various physiological signals in an objective way, or by analyzing adjectives chosen by the subjects in a subjective way. The purpose of this study is to develop an integrated human emotion assessment system, which measures changes in a person's objective and subjective emotionality in real-time and analyzes them in an integrative way. The present system is composed of a real-time subjective emotionality assessment (RTSEA) system and a real-time objective emotionality assessment (RTOEA) system based on physiological signal measurement and analysis. It can be utilized individually, or can be combined as a synthetic emotionality assessment system for comprehensive emotionality assessment.     

Indirect functional assessment of stereotypy in children with autism spectrum disorders

Autism spectrum disorders (ASD) are characterized by the presence of repetitive behavior and stereotyped patterns of interest and activities. It is common for clinicians to assume that repetitive behaviors are maintained by automatic reinforcement but, as with any challenging behavior, the function of stereotypy should not be assumed based on its topography. Previous research on the functional assessment of stereotypy has produced mixed results, and most previous studies on the functional assessment of stereotypy in children with ASD have included small sample sizes, so more research in this area is warranted. In the current study, indirect functional assessments consisting of the questions about behavioral function (QABF) were conducted across 53 children and adolescents with ASD. The QABF produced interpretable results in a high percentage of cases and 90% of the stereotypic behavior appeared to be maintained by automatic reinforcement.     

Utility of the ImPACT test with deaf adolescents

Objective: The goals of the study included empirical examination of the utility of the Immediate and Post-Concussion Assessment and Cognitive Testing (ImPACT) test with adolescents who are deaf or hard-of-hearing and to investigate patterns of performance at baseline that may arise in the assessment of this population. Baseline assessment of student-athletes has been conducted on a widespread scale with focus on performance of typically developing student-athletes and some clinical groups, though to date no studies have examined adolescents who are deaf or hard-of-hearing. Method: Retrospective and de-identified ImPACT baseline test used with deaf and hard-of-hearing high-school student-athletes (N = 143; 66% male, mean age = 16.11) was examined. Results: Review indicated significant differences in some composite scores between the deaf and hard-of-hearing group and hearing normative comparisons. A possible marker of task misunderstanding was identified to occur more frequently within the deaf and hard-of-hearing sample (13% in deaf sample vs. .31% in hearing sample). Conclusions: Results may provide support for the consideration and use of additional measures to ensure comprehension of task demands when considering this tool for use with deaf and hard-of-hearing adolescents.     

The Effects of Coaching on the Verbal and Nonverbal Medical Symptom Validity Tests

Evaluation of resistance to coaching is an important step in the validation of symptom validity tests (SVTs) for clinical use in neuropsychological evaluations. In the present study coaching effects were evaluated for two recently developed SVTs, the Medical Symptom Validity Test (MSVT) and Nonverbal Medical Symptom Validity Test (NVMSVT) as compared with a well-validated existing SVT, the Test of Memory Malingering (TOMM). This study used a simulation design that included 103 healthy younger study volunteers who were randomly assigned into one of four conditions: Symptom Coaching, Test Coaching, Combined Coaching, or Best Effort Control. Specificity for all SVTs was excellent (96–100%). Test Coaching, either alone or combined with Symptom Coaching, was more effective than Symptom Coaching alone in producing raw scores suggestive of “better” effort for all SVTs. However, there were only modest declines in the obtained sensitivity, which remained above 80% for all SVTs. These results provide empirical support for the classification accuracy of the MSVT and NVMSVT, even when challenged with combined coaching interventions. However, further validation using known-groups designs and clinical samples is needed.     

Forensic risk assessment interviews with youth: how do we elicit the most reliable and complete information?

When undertaking a forensic risk assessment with a young person, most evaluators complete an assessment interview to elicit autobiographical history as well as perspectives, thoughts and feelings about the individual’s offending behaviour. While forensic risk assessment tools provide some suggestions on interview questions and techniques, there is no empirical research that explores the most effective strategies for eliciting detailed and reliable information in this context. This article reviews existing recommendations from the related fields of investigative interviewing and suicide risk assessment and integrates this with guidance from the forensic risk assessment literature to identify best practice recommendations for evaluators. It is hoped that this review will provide a starting point to explore how research from other fields may be integrated into risk assessment interviews to improve the quality and accuracy of forensic assessment.     

Contextualized behavioral support in early intervention for children with autism and their families

Parent education programs have become an effective mode of treatment delivery for teaching families effective behavioral strategies to manage challenging behavior in young children with autism. Functional assessment and functional communication training (FCT) are empirically validated procedures that have recently been introduced into parent education programming to help resolve challenging behaviors. The success of these procedures, however, is contingent on family members' ability to integrate them into the specific contexts in which challenging behaviors occur. Consequently, the application of these procedures in home settings necessitates consideration of the family context in the assessment and treatment planning process. A study is presented that investigated the use of information on family context (i.e., caregiving demands, family support, patterns of social interaction) to direct the assessment and intervention planning process. More specifically, information on family context was used to individualize behavioral support plans designed to support family use of functional communication training within important family routines. Through parent-investigator collaboration we individualized the manner in which functional communication training procedures were taught and implemented so they were contextually relevant. Utilizing a multiple baseline design, the challenging behaviors and functional communication of three children with autism were monitored across baseline, intervention (i.e., FCT, and contextulized FCT), and follow-up phases. Multiple routines for each participant were selected and monitored across all phases to evaluate changes in the dependent measures within training and generalization routines. A self-report questionnaire was administered intermittently to parents to determine if consideration of family context improved the goodness of fit of the functional communication training treatment packages across FCT and contextualized FCT intervention phases. Results from the study indicate that consideration of family context in the assessment and intervention planning process does not jeopardize and may contribute to the stability and durability of reductions in challenging behavior achieved with functional assessment and functional communication training procedures.     

Assessing depression symptoms in those with insomnia: an examination of the beck depression inventory second edition (BDI-II)

Background

Due to concerns about overlapping symptomatology between medical conditions and depression, the validity of the beck depression inventory (BDI-II) has been assessed in various medical populations. Although major depressive disorder (MDD) and primary insomnia (PI) share some daytime symptoms, the BDI-II has not been evaluated for use with insomnia patients.

Method

Participants (N = 140) were screened for the presence of insomnia using the Duke structured clinical interview for sleep disorders (DSISD), and evaluated for diagnosis of MDD using the structured clinical interview for DSM-IV-TR (SCID). Participants’ mean BDI-II item responses were compared across two groups [insomnia with or without MDD) using multivariate analysis of variance (MANOVA), and the accuracy rates of suggested clinical cutoffs for the BDI-II were evaluated using a receiver operating characteristic (ROC) curve analysis.

Results

The insomnia with depression group had significantly higher scores on several items; however, the groups did not differ on insomnia, fatigue, concentration problems, irritability, libido, increased appetite, and thoughts relating to suicide, self-criticism and punishment items. The ROC curve analysis revealed moderate accuracy for the BDI-II’s identification of depression in those with insomnia. The suggested BDI cutoff of ?17 had 81% sensitivity and 79% specificity. Use of the mild cutoff for depression (?14) had high sensitivity (91%) but poor specificity (66%).

Conclusion

Several items on the BDI-II might reflect sleep disturbance symptoms rather than depression per se. The recommended BDI-II cutoffs in this population have some support but a lower cutoff could result in an overclassification of depression in insomnia patients, a documented problem in the clinical literature. Understanding which items discriminate insomnia patients without depression may help address this nosological issue.     

Validación del cuestionario simplificado de la escala modificada Rankin (smRSq) telefónico en castellano

IntroductionThe modified Rankin Scale (mRS) is the main functional assessment tool used after stroke. The simplified mRS questionnaire (smRSq) has recently been validated in English, and represents a simpler, reliable scale with an excellent reproducibility via telephone. The present study aims to validate a Spanish-language version of the telephone smRSq.MethodWe conducted a prospective cohort study, assessing 50 patients 3 months after they presented an ischaemic stroke. We assessed the Spanish-language smRSq by telephone and in person, the mRS with a structured interview, the Spanish-language smRSq, and the Stroke Impact Scale-16. Inter-rater reliability, test-retest reliability, construct validity, and criterion validity were assessed.ResultsInter-rater reliability showed strong agreement (k = 0.810); test-retest reliability and criterion validity showed moderate agreement (k = 0.639 and k = 0.759, respectively), and construct validity showed moderate agreement (Spearman correlation coefficient = –0.728).ConclusionsThe Spanish-language telephone smRSq is reliable and simple, and saves time in the functional assessment after a stroke.     

Traversing the Space between Threats and Violence: A Review of Threat Assessment Guidelines

While the majority of violent threats – defined as an expression of intent to do harm or act out violently against someone or something – do not progress to actual violence, a small proportion of threateners do go on to enact violence. Most researchers argue that violence risk assessments are inadequate for assessing threats of violence, which raises the question: how should a threat assessment (TA) be conducted? To begin to understand available frameworks for assessing threats, a systematic review of TA research literature was conducted. Most TA literature pertains to a specific domain (schools, public figure threats, workplaces) and target audience (clinicians, school personnel, law enforcement). TA guidelines are typically based on literature reviews with some based on empirical measures and others having no strong evidential basis. The most common concepts in TA are exploration of the threatener's mental health, the motivation for the threat and the presence of any plans. Rather than advocating for the development of a protocol for conducting TA, this article outlines the common areas of inquiry in assessing threats and highlights the limitations of current TA guidelines.     

Developing a measure to assess attitudes toward epilepsy in the US population

The aim of this study was to develop an instrument to measure the US public's attitudes toward people with epilepsy and to assess the initial reliability and validity of the instrument. A 46-item attitudinal instrument was developed and tested using a proportional, stratified, national, random-digit dial household telephone survey of adults aged > or = 18 (n=758). Exploratory factor analyses revealed four underlying constructs that accounted for 34.4% of the variance in the factor analysis: negative stereotypes (alpha=0.73); risk and safety concerns (alpha=0.85); work and role expectations (alpha=0.76); and personal fear and social avoidance (alpha=0.79). Knowledge was also assessed; participants with less knowledge about epilepsy had more negative attitudes. The results of these analyses provided evidence for reliability and construct validity of the instrument. Additional tests of the reliability, validity, and factor structure of the scales are necessary to refine the instrument.     

Toward generally accepted forensic assessment practices among clinical neuropsychologists: a survey of professional practice and common test use*

Objective: This study investigated professional practice and common test use among clinical neuropsychologists engaging in forensic assessment. Method: Doctorate-level psychologists active in the practice of neuropsychology and on the INS and NAN membership listings (n = 502) were surveyed about their demographics, professional practice, and common test use. Participants who reported engaging in forensic practice (n = 255) were further surveyed about their forensic practice. Results: Forensic participants were more likely to be male and Caucasian, and reported higher ages, more years of professional experience, and a higher prevalence of board certification. While characteristics of their professional and forensic practice varied, forensic participants reported spending most of their professional time conducting neuropsychological assessments with adult clients in a private or group practice setting, focusing on civil referrals and civil legal questions involving older adult issues, developmental issues, head injury, and psychiatric issues. Common test use across neuropsychological assessment domains is presented for board-certified forensic participants (n = 77). An examination of these results reveals that the current pattern of test use is similar to the results of a more general survey of neuropsychological test use. Conclusions: The findings provide insight into the practice of forensic neuropsychological assessment, and further establish the admissibility of neuropsychological evidence in the United States legal system. Results will be useful for clinical neuropsychologists, field leaders, and legal professionals hoping to gain insight into the role of clinical neuropsychology in civil and criminal legal decision-making.     

A Brief Cognitive Assessment Tool for Schizophrenia: Construction of a Tool for Clinicians

Cognitive impairment in schizophrenia is often severe, enduring, and contributes significantly to chronic disability. But clinicians have difficulty in assessing cognition due to a lack of brief instruments. We evaluated whether a brief battery of cognitive tests derived from larger batteries could generate a summary score representing global cognitive function. Using data from 3 previously published trials, we calculated the corrected item-total correlations (CITCs) or the correlation of each test with the battery total score. We computed the proportion of variance that each test shares with the global score excluding that test (R_t²=CITC²) and the variance explained per minute of administration time for each test (R_t²/min). The 3 tests with the highest R_t²/min were selected for the brief battery. The composite score from the trail making test B, category fluency, and digit symbol correlated .86 with the global score of the larger battery in 2 of the studies and correlated between .73 and .82 with the total battery scores excluding these 3 tests. A Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) using the above 3 tests can be administered in 10–11 min. The full batteries of the larger studies have administration times ranging from 90 to 210 min. Given prior research suggesting that a single factor of global cognition best explains the pattern of cognitive deficit in schizophrenia, an instrument like B-CATS can provide clinicians with meaningful data regarding their patients’ cognitive function. It can also serve researchers who want an estimate of global cognitive function without requiring a full neuropsychological battery.