Gloria K. Lee

RCT of a Manualized Social Treatment for High-Functioning Autism Spectrum Disorders.

This RCT examined the efficacy of a manualized social intervention for children with HFASDs. Participants were randomly assigned to treatment or wait-list conditions. Treatment included instruction and therapeutic activities targeting social skills, face-emotion recognition, interest expansion, and interpretation of non-literal language. A response-cost program was applied to reduce problem behaviors and foster skills acquisition. Significant treatment effects were found for five of seven primary outcome measures (parent ratings and direct child measures). Secondary measures based on staff ratings (treatment group only) corroborated gains reported by parents. High levels of parent, child and staff satisfaction were reported, along with high levels of treatment fidelity. Standardized effect size estimates were primarily in the medium and large ranges and favored the treatment group.

Anxiety and Depression in Children with HFASDs: Symptom Levels and Source Differences

The purpose of this study was to: (1) examine symptom levels of anxiety and depression in children with high-functioning autism spectrum disorders (HFASDs) compared with matched control children using child self-reports and parent ratings; and (2) examine source differences within the two condition groups. An overall multivariate effect indicated significantly elevated depression and anxiety symptoms for children with HFASDs based on parent reports; however no significant between-group differences based on child self-reports. Within-condition source comparisons (parent vs. child) revealed a significant multivariate effect indicating a significant difference in symptoms of depression and anxiety for the HFASD group but none for the control. Correlations between parent and child reports for the HFASD group suggested some positive association between child-reports and parent-reports for depressive symptoms only; however, the difference in average scores reflected a substantial discrepancy in the magnitude of symptoms by rater. Implications for clinical assessment and future research are provided.

Health-Related Quality of Life of Parents of Children With High-Functioning Autism Spectrum Disorders

The physical and mental health-related quality of life (QOL) of 89 parents of children with high-functioning autism spectrum disorders (HFASDs) was compared to the health-related QOL of 46 parents of children without disabilities. Parents completed a packet of surveys measuring demographics, parenting stress, coping, resources, and QOL. Results of t tests showed significant differences between the two groups for all variables. Hierarchical regression analyses indicated that for parents of children with HFASDs, demographics and psychosocial variables accounted for a significant amount of variance for physical health-related QOL, with income, number of children, and stress being significant variables. Demographics and psychosocial variables also accounted for a significant amount of variance for parents’ mental health-related QOL, with income and stress being significant variables.

Structural Equation Modeling in Rehabilitation Counseling Research

Structural equation modeling (SEM) has become increasingly popular in counseling, psychology, and rehabilitation research. The purpose of this article is to provide an overview of the basic concepts and applications of SEM in rehabilitation counseling research using the AMOS statistical software program.

Training Needs of Certified Rehabilitation Counselors for Contemporary Practice.

In order to meet the demands of todays rehabilitation counseling practice environments effectively, rehabilitation counselors must be well prepared in traditional, as well as emerging, knowledge areas. The purpose of this study was to determine the training needs of certified rehabilitation counselors practicing in a variety of settings by identifying knowledge areas perceived by counselors as important for which they also reported limited preparation levels. Results of the analysis revealed 23 knowledge areas in which a critical training need was identified across all settings. Training needs for each of the three primary practice settings (public, proprietary, and nonprofit) are also provided. Implications for practice, preservice preparation, and professional development are discussed.

The Effects of Psychosocial Factors on Quality of Life among Individuals with Chronic Pain.

This study investigated the psychosocial factors affecting the quality of life (QOL) of 171 individuals with chronic pain. Participants completed a battery of self-rated inventories measuring three sets of predictor variables—demographic (age, gender, income, marital status), pain-specific (chronicity, severity, duration, frequency, pain impairment), and psychosocial (interference, social support, depression, coping)—and one criterion variable with five models (physical, psychological, social, environmental, total). Hierarchical multiple regression indicates that income predicts the psychological and environmental domains of QOL. Across all five models, 56% to 76% of the variance was accounted for with the three sets of variables. Demographics remained minimally predictive of all models. Pain impairment was predictive of all five models. Depression was predictive of all but physical QOL, and coping was predictive of all but physical and environmental QOL. The pain impairment variable and the two psychosocial variables (depression and coping) remained imperative in predicting QOL of individuals with chronic pain.

Factors affecting depression among people with chronic musculoskeletal pain: A structural equation model

Objective: To adapt and test P. M. Lewinsohn, H. M. Hoberman, L. Teri, and M. Hautzinger’s (1985) integrative model of depression for individuals with chronic musculoskeletal pain. Design: Structural equation modeling. Participants: Individuals with chronic pain (N 171), recruited from 6 outpatient rehabilitation facilities in Canada. Outcome Measures: Two measures of the latent variable, depression (the Center for Epidemiologic Studies—Depression Scale and the Zung Self-Rating Depression Scale), along with multiple measures of each of 5 latent predictors (pain, interferences, stress, coping, and social and family support) and 2 measured predictors (preinjury psychopathology and catastrophizing). Results: The normed fit index, comparative fit index, and parsimony ratio indicated an adequate fit for the model, suggesting that stress, perceived severity of pain, activity interferences, and catastrophizing contributed to increased depression (vulnerabilities), whereas pain coping skills and social and family support contributed to decreased depression (immunities). Conclusions: Empirical support was found for the proposed model of depression for people with chronic musculoskeletal pain, and the model appears to provide useful information for clinical rehabilitation interventions.

Catastrophizing as a cognitive vulnerability factor related to depression in workers' compensation patients with chronic musculoskeletal pain.

The purpose of this study was to examine the role of catastrophizing as a mediator and moderator between life stress and depression in a sample of workers’ compensation patients with chronic musculoskeletal pain. Pain intensity, life stress (especially work and financial stress), and catastrophizing contributed significantly to depression. Catastrophizing was found to be partially mediating the relationship between life stress and depression and a moderator between social stress and depression. The results supported the role of catastrophizing as a cognitive vulnerability-stress factor related to depression in chronic pain patients. Screening for life stress and intervening early to prevent catastrophizing from occurring in the workers’ compensation rehabilitation process may reduce psychosocial distress and enhance the overall effectiveness of rehabilitation programming for workers’ compensation patients with chronic pain.

Comparison of Adaptive Behavior Measures for Children with HFASDs

Adaptive behavior rating scales are frequently used to gather information on the adaptive functioning of children with high-functioning autism spectrum disorders (HFASDs), yet little is known about the extent to which these measures yield comparable results. This study was conducted to (a) document the parent-rated VABS-II, BASC-2, and ABAS-II adaptive behavior profiles of 6- to 11-year-olds with HFASDs (including relative strengths and weaknesses); (b) examine the extent to which these measures yielded similar scores on comparable scales; and (c) assess potential discrepancies between cognitive ability and adaptive behavior across the measures. All three adaptive measures revealed significant deficits overall for the sample, with the VABS-II and ABAS-II indicating relative weaknesses in social skills and strengths in academic-related skills. Cross-measure comparisons indicated significant differences in the absolute magnitude of scores. In general, the VABS-II yielded significantly higher scores than the BASC-2 and ABAS-II. However, the VABS-II and ABAS-II yielded scores that did not significantly differ for adaptive social skills which is a critical area to assess for children with HFASDs. Results also indicated significant discrepancies between the childrens average IQ score and their scores on the adaptive domains and composites of the three adaptive measures.

Effects of parent management training programs on disruptive behavior for children with a developmental disability: a meta-analysis.

This meta-analysis determined the effects of parent management training (PMT) on disruptive behaviors in children with a developmental disability. Parent management training programs, based on behavioral theories of psychology, are commonly used in addressing disruptive behavior in children. Eleven studies met inclusion criteria with a total of 540 participants, with 275 in experimental groups and 265 in control groups. The effect of PMT on the disruptive behavior in children with a developmental disability was significant (g=0.39). The moderator effects of type of PMT, delivery type and setting, and administrator level of education were also significant. The moderator effects of child age, and session number and duration were not significant in this meta-analysis.