Christian DeLucia

Trajectories of Psychosocial Adjustment in Adolescents with Spina Bifida: A 6-Year, Four-Wave Longitudinal Follow-up.

OBJECTIVE As a follow-up to an earlier cross-sectional study (Holmbeck et al., 2003), the current multimethod, multi-informant investigation examined individual growth in psychosocial adjustment across the adolescent transition in 2 samples: young adolescents with spina bifida (SB) and typically developing adolescents (N = 68 in both groups at Time 1). METHOD Growth curve modeling procedures were used to describe the developmental course of psychosocial adjustment across 4 waves of data collection from ages 8 to 15. Child gender was included in the models as a moderator of associations between illness status and adjustment trajectories. RESULTS AND CONCLUSIONS Findings revealed that preadolescent differences between groups were maintained for several adjustment variables, indicating that adolescents with SB have enduring academic and attention problems and difficulties with social development (e.g., fewer friends and less influence during family interactions). For other outcomes, trajectories of adjustment levels for adolescents with SB converged on levels observed in comparison adolescents, indicating some areas of resilience. Girls with SB were at risk for increasing levels of social difficulties and negative perceptions of their physical appearance. Clinical implications are discussed.

Trajectories of family processes across the adolescent transition in youth with spina bifida.

The current study investigated change in family processes, including conflict, cohesion, and stress, across the adolescent transition, comparing the developmental trajectories of youth with and without spina bifida. Individual growth curve modeling procedures were utilized to describe the developmental course of family processes across 4 waves of data collection, from ages 9 to 15 years, and to test whether illness status (spina bifida vs. matched comparison group [N = 68 for both groups at Time 1]) would significantly predict individual variability in family processes. Potential moderators (child gender, socioeconomic status [SES], and child verbal ability) of the association between illness status and family functioning were also examined. Differences were found between the trajectories of family processes for families of youth with and without spina bifida. For families of youth with spina bifida, changes in family conflict and cohesion may be less dramatic than or inconsistent with what is expected during typical adolescence. Families of youth with spina bifida from low SES homes appear to demonstrate resilience in terms of family stress.

Recovery in Narcotics Anonymous from the perspectives of long-term members: A qualitative study

Narcotics Anonymous (NA) is a community-based, 12-step organization that holds nearly 62,000 meetings weekly in 129 countries. Relatively little is known about NA members’ recovery experiences. This study presents results of focus groups conducted with long-term NA members to identify key ingredients of recovery, recovery-related processes, and quality-of-life outcomes beyond abstinence. Participants identified personal and program characteristics that were critical to recovery (e.g., responsibility), illuminated several recovery-related processes (e.g., using the 12 steps to obtain a deeper self-understanding), and described personal and interpersonal quality-of-life enhancements (e.g., improved relationships). In addition, fellowship was described as a pervasive and essential element of recovery.

Evidence-based fitness promotion in an afterschool setting: Implementation fidelity and its policy implications

Little is known about how the adoption of evidence-based physical activity (PA) curricula by out-of-school time (OST) programs affects childrens physical fitness, and there are no clear guidelines of what constitutes reasonable gains given the types of PA instruction currently offered in these programs. Using a three-wave, quasi-experimental, naturalistic observation design, this study evaluated the implementation of an evidence-based PA instruction curriculum (Sports, Play, and Active Recreation for Kids [SPARK]) and examined whether the potential health benefits of evidence-based PA instruction can be replicated in this context when compared to OST programs that do not use evidence-based PA curricula. Quality of PA instruction and SPARK implementation fidelity were also assessed. Results indicated that children in the non-evidence-based/standard PA instruction programs engaged in higher levels of moderate-to-vigorous PA (MVPA) and showed greater improvements in fitness levels over time. The findings from this chapter suggest that while it is generally accepted that evidence-based approaches yield higher levels of PA when implemented by researchers under controlled conditions, findings are inconsistent when evidence-based PA instruction is implemented in the field, under presumably less controlled conditions. It appears that when it comes to PA instruction in afterschool, either less structured activities or well-implemented evidence-based practices could be the key to promoting higher PA levels and greater health and fitness for school-aged children.

Clinical trainees' knowledge and beliefs about 12-step organizations: Implications for training and future practice

Generalist mental health practitioners are likely to encounter patients with substance use disorders, indicating community-based, 12-Step mutual-help organizations (MHOs) can be a valuable referral source for these clinicians. Little is known, however, about how generalist practitioners and trainees understand these organizations. Results of a survey among 316 clinical trainees showed that knowledge levels were below a competency benchmark. While views were positive overall, empirically-inconsistent beliefs were also common. Beliefs and attitudes accounted for approximately one half of the variance in professional intentions (e.g., appropriate referral). The study highlighted knowledge gaps, though trainees appeared open to learning more about 12-Step MHOs. Thus systematic development and evaluation of clinical training in the area may be warranted.