Kimberly R. Zlomke

Psychometric properties of internet administered versions of Penn State Worry Questionnaire (PSWQ) and Depression, Anxiety, and Stress Scale (DASS)

A limited amount of research has been conducted on the psychometric properties of commonly used measures of anxious or depressive symptomatology for use on the internet, although such measures are seeing increasing use in internet administration for both clinical and research uses. A plethora of advantages exist for the use of internet administration of questionnaires, both in terms of assessment and the potential use in treatment monitoring as well as for research. The aim of this study was to examine the psychometric properties of two common clinical measures, the Penn State Worry Questionnaire and the. Depression, Anxiety, and Stress Scale, in an internet administered format (N=1138). Results suggest that these two measures may be used with confidence in an online format in terms of reliability and validity.

A Taxometric Investigation of the Latent Structure of Worry: Dimensionality and Associations With Depression, Anxiety, and Stress

Worry has been described as a core feature of several disorders, particularly generalized anxiety disorder (GAD). The present study examined the latent structure of worry by applying 3 taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from 2 large samples. Worry in the first sample (Study 1) of community participants (n=1,355) was operationalized by worry engagement, absence of worry, and the worry feature of trait anxiety. Worry in the second sample (Study 2) of undergraduate participants (n=1,171) was operationalized by the tendency to experience worry, intolerance of uncertainty, beliefs about worry, and symptoms of GAD. Results across both samples provided converging evidence that worry is best conceptualized as a dimensional construct, present to a greater or lesser extent in all individuals. Findings from Study 2 also indicated that the latent dimension of worry generally has an equal association with symptoms of depression, anxiety, and stress across the entire continuum. These findings are discussed in relation to the conceptualization and assessment of worry in GAD and related disorders.

Exploring the development and dismantling of equivalence classes involving terrorist stimuli

The present paper describes 2 studies that present a conceptual interpretation and experimental findings involving the developing and dismantling of equivalence cl’asses consisting of terrorist stimuli. In the first study, 8 United States citizen participants were trained to match nonterrorist stimuli to American and terrorist images. Afterwards, participants were tested for derived relations between American and terrorist stimuli. Results revealed all participants had a high probability of making predictable responses across culturally framed stimuli during a pretest (i.e., match American to American and terrorist to terrorist), yet after training, made fewer culturally controlled responses during the posttest. The second study examined the acquisition rate and resulting equivalence test performance of 7 United States citizen participants who received training with 3 sets of visual stimuli that consisted of (a) terrorist, (b) mixed terrorist/American, and (c) neutral (flowers) images. Most participants acquired the relations involving the terrorist stimuli in fewer trials and scored with higher accuracy during testing when compared to their performance on the other two sets (mixed terrorist/American, flowers). Implications for various theories of stimulus equivalence are discussed.

Linking cognitive avoidance and GAD symptoms: The mediating role of fear of emotion.

Although cognitive avoidance has been linked to generalized anxiety disorder (GAD), the mechanism that may account for this association has not been fully elucidated. The current study uses structural equation models to evaluate the relationship between cognitive avoidance and symptoms of GAD in a large unselected sample (n = 1220), and to examine whether subjective fear of emotion partially mediate this relationship. Results support partial mediation, and follow-up analyses suggest that the pattern of relations among fear of emotion, cognitive avoidance, and GAD symptoms is invariant for men and women. However, subsequent analysis revealed equivalence of meditational models where cognitive avoidance leads to GAD symptoms and vice versa. The implications of these findings for better understanding the etiology, maintenance, and treatment of GAD are discussed.

Stress and worry: examining intolerance of uncertainty's moderating effect

Intolerance of uncertainty (IU), or the way an individual perceives, interprets, and reacts to uncertainty in life, has been frequently investigated in relation to anxiety and worry. While a substantial body of research suggests that individual differences in IU foster stress and anxiety, IUs involvement as a potential moderator in the relation between stressful events and worry has only recently been investigated. Therefore, the present study examined the moderating effect of IU on the relation between daily hassles and worry as well as major life events and worry in a sample of 1092 young adults. Results revealed that IU showed a significant moderation effect in the relation between daily stress and worry. More specifically, when the two factors were examined individually only inhibitory IU served as a moderator between daily stress and worry. While major life events significantly predicted worry, no moderation effect was found for this relation. These findings highlight the need to better understand the mechanisms through which IU impacts worry and contributes to anxiety.

Obesity Stigma and Bias

Overweight and obesity are escalating in epidemic proportions in the United States. Individuals with overweight and obesity are often reluctant to seek medical help, not only for weight reduction but also for any health issue because of perceived provider discrimination. Providers who are biased against individuals with obesity can hinder our nations effort to effectively fight the obesity epidemic. By addressing weight bias in the provider setting, individuals affected by obesity may be more likely to engage in a meaningful and productive discussion of weight. Providers need to be the go-to source for obesity-focused information on new and emerging treatments.

Cardiovascular Health of Filipinos in the United States A Review of the Literature

Purpose: Filipino Americans (FAs) are at high risk for cardiovascular disease. The purpose of this literature review is to enhance understanding of cardiovascular health among FAs. Design: Databases searched: MEDLINE (via PubMed), Google Scholar, Journals@OVID, and EBSCO databases including CINAHL Complete. Health Source: Nursing/Academic Edition, Academic Search Complete, and Biological Abstracts 1969-Present. Key terms used: FAs and cardiovascular disease. Criteria for inclusion: peer-reviewed empirical articles published in English. Findings/Results: A total of 51 studies were identified and 27 were selected for the review based on relevance to nursing care for FAs. Three main themes emerged from the literature reviewed: risk factors and disease prevalence, health promotion, and health beliefs/practices. Discussion/Conclusions: The literature review identified that FAs were at high risk for cardiovascular disease, hypertension, type 2 diabetes, and metabolic syndrome at lower BMI levels. Implications for Practice: Health care providers should implement prevention strategies and interventions for the FA population to ensure the best outcomes.

Open-Trial Pilot of Parent-Child Interaction Therapy for Children With Autism Spectrum Disorder

ABSTRACT In this pilot study, the effectiveness and feasibility of Parent-Child Interaction Therapy (PCIT) for decreasing disruptive behavior was evaluated in 17 young children with Autism Spectrum Disorder (ASD). PCIT is a behaviorally based play therapy which targets the parent-child relationship through live coaching of play interactions and the implementation of consistent discipline techniques. Following an average of 19 sessions, disruptive behavior as measured by multiple indices significantly decreased. Congruently, parents increased positive parental following skills and decreased negative parental leading skills across the course of treatment. In addition, parents reported increased levels of child functional communication and prosocial behavior. High levels of parent acceptability of the intervention were also noted. Effect sizes were medium to large across measured dependent variables, including parent report and behavioral observations. Implications for the clinical use of PCIT within an ASD population and future research with controlled outcome studies are discussed.

Marital conflict and fifth-graders' risk for injury

BACKGROUND Injuries are the leading cause of morbidity and mortality for American children. Marital conflict has been associated with a range of negative health outcomes, but little is known about how marital conflict may influence risk of injury among children. We hypothesized marital conflict would be related to increased youth injury risk after controlling for relevant demographic and parenting covariates. METHODS A community sample of 3218 fifth-graders recruited from three US locales was utilized. Ordinal logistic regression models were used to predict the frequency of unintentional injuries from marital conflict while adjusting for demographics, parenting factors (nurturance, communication, involvement with youth), and family cohesion. RESULTS Higher levels of marital conflict were associated with higher rates of injury that required professional medical attention (OR=1.20, 95% CI 1.06, 1.35 per standard deviation). The same association held after inclusion of all covariates in a multivariate ordinal logistic regression model. CONCLUSIONS Parental marital conflict is associated with higher rates of injuries requiring professional medical attention in preadolescent children.

Positive Peer Reporting in the Classroom: a Review of Intervention Procedures

Positive peer reporting (PPR) is a classroom-based intervention to improve social interactions between students using rewards and positive social attention. Along with a variant of the procedure referred to as “Tootling,” PPR has demonstrated overwhelmingly positive results since its development. However, a unified, standard protocol for successful implementation of PPR interventions has not yet been established. A review of 24 studies, including 48 separately described cases of PPR in classroom settings, provided information concerning adaptations for students in special education, alternative school, and mainstream classrooms. Student participants ranged from preschool (age 4) to eighth grade (age 16). This paper summarizes the common procedural components found across cases described in the studies. A comparison of PPR-based interventions reported in the literature by various research teams also revealed differences in the procedures for targeting individuals or groups, providing training and support, allocating rewards, proceeding with daily peer report sessions, and terminating the intervention. Variations in specific procedural elements that may relate to PPR’s effectiveness are discussed. The authors also provide suggestions to guide and support the advancement of standardized methods of PPR for future research and clinical application.