The impact of childhood sexual abuse in anorexia nervosa

OBJECTIVE: The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). METHOD: The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. RESULTS: Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p<.02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. CONCLUSIONS: Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype.     

A psychoeducational model of counseling

This paper reviews the salient features of the Mega Interactive Model of Instruction (MIMI) MIMI has been proposed as the basis for a conceptual framework with which to study and interpret instructional/counseling interactions. The relevance of this model for instructional and counseling research are discussed.     

Factors affecting treatment acceptability for psychostimulant medication versus psychoeducational intervention

Future teachers' judgments of acceptability for two common treatments for children with the Attention Deficit Hyperactivity Disorder (ADHD) label were examined. One hundred forty‐four pre‐service teachers were grouped according to their high school location at graduation (urban vs. rural) and were randomly assigned to read one of four vignettes. The content of the vignettes was held constant but label (ADHD vs no label) and treatments (special education placement vs. Ritalin) were varied. Results indicated a significant main effect on treatment acceptability for High School Location, a Label × Treatment interaction on the attention problems variable, a main effect for Label on the social problems variable, and a High School Location × Treatment interaction on the social problems variable. A number of implications can be made. Observer characteristics such as urban or rural high school experiences may influence judgments about a labeled child more than the characteristics of the child being observed. In this study, the ADHD label evoked greater expectations of attentional difficulties even when the pattern of functioning was similar to nonlabeled children. On the other hand, children with the ADHD label were judged as having better social functioning, which suggests that the ADHD label allows observers to attribute behavioral difficulties or the social problems displayed by these children to some factor that is outside the control of the child, or for which the child does not have personal responsibility. © 2001 John Wiley & Sons, Inc.     

Parental evaluations of psychoeducational reports: A case study

The purpose of this case study report was to determine what parents want and the degree to which they value psychoeducational reports prepared by school psychologists. The sample (N = 44) consisted of parents whose children were seen as out-patients of the Learning Disorder Clinic within the Department of Pediatrics at the UCLA Center for the Health Sciences. All subjects completed a questionnaire designed to determine the parents' expectation and satisfaction concerning their child's psychological evaluation. Results showed positive impressions regarding evaluations, their usefulness, and their content.     

A method for the systematic observation of examiner behavior during psychoeducational assessments

A specific empirical method for the systematic observation of examiner behavior during psychoeducational assessments, the SOS-A, is described. Development of the instrument is discussed and data on intra- and interobserver agreement are presented. The instrument is regarded as an initially adequate method for systematically collecting data on examiner behavior.     

Parental interpretation of psychoeducational reports

The intent of the present investigation was to determine the readability of psychoeducational reports and the effectiveness of manipulating selected report variables to facilitate parental interpretation. A sample of 50 reports was analyzed to determine the reading level at which reports were written. One report written at the median reading level was identified as a traditional report and was modified by lowering the reading level, replacing professional terminology, and removing information identified as unrelated to placement decisions. One objective test was developed to measure parents' abilities to interpret both the traditional and modified reports. One hundred fourteen parents were randomly assigned to read either the traditional or modified version of the report. Following treatment, subjects responded to the test instrument. The data indicate that traditional reports are written above the reading level of most parents. In addition, the data support the position that modification of selected report variables facilitates parental interpretation. Suggestions are made to report writers as to how specific modifications can enhance parental access to report contents.     

Perceptual influence of psychoeducational reports

In the present study, teachers read fictitious psychoeducational reports that interpretively were consistent, inconsistent, or absent with respect to a child's diagnostic label. On a perceptual expectation questionnaire, teachers indicated both their perceptions of the child and their confidence in these perceptions, after reading a cumulative folder and again after reading a psychoeducational report. Although the reports differed by just one or two interpretive statements, results revealed that teacher perceptions of child characteristics changed in an adaptive direction for the school performance clusters of general adjustment, academic skill, and learning approach, while report interpretation negatively influenced ratings for intellectual capacity. Further, the type of diagnostic label provided in the cumulative folder was an important variable in determining the perceptual effect of the report's interpretation, since different patterns of teacher perception and their confidence in these perceptions were observed for LD, BD, or EMH labels.     

Use of clustering techniques in deriving psychoeducational profiles

This study explores whether a synthesis of clinical and statistical data taken from the psychoeducational reports completed on a group of 42, 9- to 11-year-old boys referred to a Child Psychiatric Outpatient Department for school-learning problems, would yield discrete clinical categories or clusters of children. An amalgamated hierarchical clustering technique which formed clusters by subjects based on a measure of euclidean distance was used. Forty-two reports were evaluated by licensed educational psychologists in five input areas: Developmental History, School History, Cognitive Functioning, Sensorimotor/Perceptual Functioning, and Academic Achievement. One of three educational placement recommendations was identified for each subject: No Educational Placement Intervention Necessary, Special Tutoring or Remediation, and Special Class Placement. Using clinical characteristic ratings given by the evaluators on each variable, a similarity-dissimilarity matrix was formed which classified subjects into four discrete clusters based on their clinical profiles. A χ² test determined that there was a significant association (p < .01) between cluster membership and educational placement recommendations.     

Social validation of psychoeducational assessment reports

The present study obtained written feedback concerning psychoeducational reports about youngsters referred to a pediatric hospital for known or suspected learning difficulties. A total of 269 questionnaires, with reference to 80 reports, were sent to parents and professionals. The results indicated that the reports were rated favorably in terms of understandability, explanatory value, and usefulness. There was a trend for parents and physicians to rate the report as less understandable than did school professionals. Parents rated the recommendations as more useful and reported implementing more of the recommendations than did teachers. These results are discussed with reference to service delivery.     

Factors influencing the decision to administer psychoeducational tests

Ninety-nine NASP members participated in a study designed to investigate bias in the early stages of the referral process (i.e., in the decision to administer psychological tests). Each school psychologist received one of eight case studies, which described a child referred for academic learning problems. The case studies included typical referral information and varied student race (Black, White), socioeconomic status (higher, lower), and group achievement test scores (average, below average). The decision to administer individual psychoeducational tests was not influenced by the student's race or socioeconomic status. School psychologists were influenced by the group achievement test data. Students who showed lower achievement test results were more likely to be recommended for testing than were those who showed average performance levels. Thus, these school psychologists were not biased by knowledge of a child's race or socioeconomic status, but were influenced by instructionally relevant data (i.e., achievement test scores). In addition, when objective test data indicated average achievement levels, the psychologists did not generally recommend subsequent individual psychoeducational testing. The findings suggested that, under certain conditions, testing may not automatically follow receipt of a referral.     

Preventing boys' problems in schools through psychoeducational programming: A call to action

Controversy currently exists on whether boys are in crises and, if so, what to do about it. Research is reviewed that indicates that boys have problems that affect their emotional and interpersonal functioning. Psychoeducational and preventive programs for boys are recommended as a call to action in schools. Thematic areas for boys' programming are enumerated including life skills and issues with masculinity ideology and gender role conflict. An example of a program that promotes positive and affirmative masculinity is given. Some of the barriers and strategies to implement programs for boys are discussed. © 2009 Wiley Periodicals, Inc.     

A psychoeducational program dealing with child abuse for elementary school children

This paper reports the outcome of an attempt to teach children in grades 5 and 6 about child abuse and neglect. The Child Abuse Component of the Human Relations Program described and evaluated here is a unique effort to provide children with an opportunity to discuss and learn about this aspect of family violence. An impact assessment was conducted by documenting possible changes in student knowledge and attitudes regarding child abuse as a result of exposure to the Child Abuse Component of the Human Relations Program. The test group of children consisted of 315 boys and girls in grades 5 and 6. A comparison group of 298 children was closely matched with the test group on the basis of age and sex. These groups were formed by randomly selecting 12 teachers from all teachers agreeing to use the Component and 10 teachers choosing not to employ the Component. The students in the classrooms of these teachers received the same curriculum for their grade level with the exception of the field-test group additionally receiving the Component. Selected child abuse knowledge, attitude, and personality (security) measures were given all subjects in a post-test with comparison group research design. Teacher knowledge and attitude were also assessed. The results of the data analysis, teacher, and special observer reports suggest that the Component was effective in meeting its objectives and was not disturbing to test subjects. Apparently, the test children profited by experiencing the Component mainly because of the opportunity it provided for class discussion. Moreover, the knowledge levels and interest of the children in both groups was seriously underestimated.     

Useful terms in psychoeducational reports: A survey of students,teachers, and psychologists

The usefulness of terminology in psychoeducational reports is examined. Students, teachers, and psychology interns rated the usefulness of 25 terms frequently found in reports. Psychology interns also rated each term on the frequency with which they used it in their own reports. Significant differences were found in the usefulness ratings of the terms, depending on major, category, and whether or not the rater had taken a special education course. Special education majors were found to be more comfortable with technical terms than were students who had prepared to be regular classroom teachers or students in other majors. Findings suggest that it is necessary to use clear, unambiguous terms in reports, and to explain more technical terms in context.     

Predictors of ability-achievement discrepancies in children referred for psychoeducational evaluation

The present study evaluated a school district's psychoeducational screening program to determine the best predictors of two difference score variables: (a) WISC-R FSIQ – PIAT reading recognition score and (b) WISC-R FSIQ – PIAT math score. The study also investigated the merit of using scores from a group-administered achievement test (CAT) as predictors. Subjects were 61 first through fifth graders initially referred for testing from 1982–1984. Multiple regression analyses indicated: (a) for reading, the SIQ score and the PPVT-R – CAT reading difference score were significant predictors, together accounting for 27% of the variance, and (b) for math, the PPVT-R score accounted for 28% of the variance, with additional variables producing nonsignificant increments. Results suggest that CAT scores may prove useful predictors when combined with screening IQ tests to form difference scores.