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.     

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.     

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.     

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.     

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.     

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.     

Factor structure of psychoeducational and neuropsychological measures of learning-disabled children

This study investigated the factor structure of psychoeducational and neuropsychological measures used in the assessment of learning-disabled children. The Wechsler Intelligence Scale for Children-Revised, the Halstead-Reitan Neuropsychological Battery, the Peabody Picture Vocabulary Test, and the Wide Range Achievement Test were administered to 934 males and females between the ages of 8 and 16 years. A principal-components analysis with varimax rotation indicated the existence of seven factors: Verbal Reasoning, Academic Achievement, Visual-Perceptual Organization, Developmental, Visual-Motor Speed, Spatial Memory, and Attention and Concentration. Three factors provided new information about the functioning of learning-disabled children that may need to be considered before comprehensive identification and placement decisions can be offered. Results of this study lend support to the notion of utilizing neuropsychological measures as an adjunct to traditional psychoeducational assessment.     

A systems approach to child abuse: management and treatment issues

In the systems approach certain patterns of family interaction are seen as fitting with physical abuse towards children in the family. If these interactions are blocked or changed using specific family therapy interventions, the risk of further abuse will be significantly reduced. Identifying typical patterns of interaction that fit with abuse is a useful first step in planning the management of physically abusing families. A full systemic formulation of the presenting problem will address numerous systems and sub-systems simultaneously, notably the family-professional system, the family within the extended family/friendship system, and the nuclear family. Interventions may have to be directed on a variety of these levels. The Marlborough Family Service has assessed and treated over 100 child-abusing families. A family day unit is used as the setting, and a multifamily group as the principle medium of treatment. Within the day unit real life stress situations are recreated around everyday issues, enabling families to find new and nonviolent solutions to the problems of daily life. In the cases seen, approximately one-third have resulted in a recommendation of permanent alternative family care for the children. In those families reunited, the re-injury rate has been found to be extremely low.     

Motivational readiness and the participation of children with learning and behavior problems in psychoeducational decision making

Efficacy of a brief cognitive-affective intervention to enhance motivational readiness for participating in a psychoeducational decision-making conference was explored. Although outcomes specific to the preconference intervention were not found, findings of relevance to the hypothesized positive relationship between motivational readiness and actual participation in decision making are reported. The positive and negative findings are discussed in terms of implications for enhancing motivational readiness and for understanding the limited impact of skill training to improve participation and decision making.     

Individualizing through treatment matching: A necessary but not sufficient approach

The effects of various alternative treatments (modules), designed to compensate for student differences in precourse memory abilities (processing and retrieval skills) and motivation (anxiety, curiosity), were investigated for lessons differing in content and task requirements. Performance on each module was compared to performance on the original (mainline) instructional module for 63 to 171 students in the Air Force Advanced Instructional System’s inventory management course. Interaction analyses on lesson times-to-criterion and criterion test scores indicated that the compensating treatments were partially effective in improving the performance of low-memory or low-reading ability students, low-curious students, or high-anxious students. Additional benefits that may be expected from an individualization approach that attempts to modify students’ cognitive and affective learning strategies are discussed. This research was supported by Air Force Human Resources Laboratory Contract F33615-73-C-4004. Requests for reprints should be sent to Barbara L. McCombs, Denver Research Institute, Social Systems Research and Evaluation Division, University of Denver, Denver, CO 80208.     

Use of grade-based norms versus age-based norms in psychoeducational assessment for a college population

Considerable discussion has occurred about the most appropriate methods for diagnosing learning disabilities (LD) in postsecondary students. Two of the many areas of controversy that have emerged include the appropriate diagnostic criteria to use and the appropriate referent group. A review of previous court cases demonstrates that the issue of whether to compare an individual to the general population or to a smaller referent population has not been adequately clarified. Furthermore, few empirical studies have examined the impact of choosing different referent groups on the likelihood that one will be diagnosed with LD. Therefore, this correlational study described the levels of agreement between three diagnostic models of LD, using both age- and grade-based norms to represent two referent groups for each of the three models. The sample included 155 postsecondary students referred for testing due to academic difficulties. The findings indicated that in two of the three models tested, comparing individuals to their grade-matched peers (i.e., using grade-based norms) resulted in more LD diagnoses than comparing individuals to their age-matched peers (i.e., age-based norms).     

大学生英语听力学习中存在的问题及对策

听力理解是英语学习中一个非常重要的环节,也是令很多大学生倍感苦恼的方面。让大学生掌握基本的英语听力技巧、扩大词汇量、为学生创造更多的英语听说环境、培养学生良好的听说习惯、了解英美文化不失为解决这些问题的方法及对策。