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Biomedical subjects

M R Dadds

Publications and source records attributed to M R Dadds.

At least 37 records · Page 2Linked to original sources
PubMed1996

Family process and child anxiety and aggression: an observational analysis.

Barrett, Rapee, Dadds, and Ryan (1996) described a phenomenon whereby family discussions magnified the style of children's problem solving in a way characteristic of their particular clinical diagnosis. That is, anxious children became more avoidant, aggressive children more aggressive, and nonclinic children more prosocial, after discussing ambiguous hypothetical situations with their parents. This study examined specific sequences of communications exchanged between parents and children hypothesized to underlie this family exacerbation of child cognitive style. Family discussions were videotaped and categorized for groups of anxious, aggressive, and nonclinic children and their parents. Results revealed differences between groups of parents in frequency of agreeing with and listening to their child and the frequency of pointing out positive consequences. Conditional probability analyses showed that parents of anxious children were more likely to reciprocate avoidance, while parents of nonclinic children were more likely to agree with and listen to prosocial plans from their child. Differences in parent behaviors observed during the family discussions were reliably associated with the child's response to the ambiguous situation proposed after the family discussion. Results support a model of developmental anxiety and aggression that emphasizes the interaction of family processes and social-cognitive development in the child.

Adolescent↗
PubMed1996

Adaptive demands along the HIV disease continuum.

Our knowledge of the problems or adaptive demands associated with HIV infection has largely been derived from clinical history taking and qualitative research of persons with AIDS. This study uses a behaviour-analytic approach to systematically describe and quantify the specific adaptive demands encountered by persons with HIV across the disease continuum. Ninety six HIV-infected gay men and 33 seronegative comparison group participants were interviewed in depth. Participants were divided into three groups representing the disease continuum: seronegative, HIV asymptomatic and HIV symptomatic groups. Responses to a Problem Checklist were statistically and content analysed. Distressing emotions, relationship difficulties and HIV-related symptoms were the three most frequently endorsed problems and were also the three most frequently reported problems of most concern. Overall there was a trend for instrumental difficulties to increase with disease progression, whereas emotional and existential problems did not vary as a function of HIV stage. The behaviour-analytic approach to the specification of problems related to HIV infection has implications for both clinical and research endeavours. The specification of problems provided a means for accurately identifying common problems to target and could, therefore, provide the basis for developing suitably matched interventions for use with HIV-infected persons.

Adaptation, Psychological↗
PubMed1996

Family treatment of childhood anxiety: a controlled trial.

A family-based treatment for childhood anxiety was evaluated. Children (n = 79) aged 7 to 14 who fulfilled diagnostic criteria for separation anxiety, overanxious disorder, or social phobia were randomly allocated to 3 treatment conditions: cognitive-behavioral therapy (CBT), CBT plus family management (CBT + FAM), and waiting list. The effectiveness of the interventions was evaluated at posttreatment and at 6 and 12 months follow-up. The results indicated that across treatment conditions, 69.8% of the children no longer fulfilled diagnostic criteria for an anxiety disorder, compared with 26% of the waiting-list children. At the 12-month follow-up, 70.3% of the children in the CBT group and 95.6% of the children in the CBT + FAM group did not meet criteria. Comparisons of children receiving CBT with those receiving CBT + FAM on self-report measures and clinician ratings indicated added benefits from CBT + FAM treatment. Age and gender interacted with treatment condition, with younger children and female participants responding better to the CBT + FAM condition.

Adolescent↗
PubMed1996

Moderating effects of family structure on the relationship between physical and mental health in urban children with chronic illness.

Examined whether certain family structures modify the relationship between psychological adjustment and severity of physical illness, as measured by an index of functional status, among children with chronic illness. 352 families were divided into four types: two biological parents (n = 149), mother plus another adult relative (n = 47), mother plus unrelated spouse or partner (n = 23), and mother alone (n = 133). Correlations between children's functional status and adjustment were higher in the mother plus unrelated partner and mother alone families, and lower when mother lived with either the biological father or another adult relative. Children in the mother plus unrelated partner group also tended to have poorer overall adjustment than other children. Results are discussed in terms of family structure, childhood illness and adjustment, and the possible mechanisms that interrelate these variables.

Activities of Daily Living↗
PubMed1995

Carers' burden and adjustment to HIV.

Empirical evidence from well designed studies into the effects on carers of caring for a person with HIV is lacking. This study investigated the correlates of carers' burden and adjustment to their caring for a person with HIV. Thirty-four carers and their HIV-infected patients were interviewed and completed self-administered scales. Measures included two psychosocial adjustment indices, a Problem Checklist (burden) and two patient health status indices. The most common elements of carer's burden were distressing emotions, relationship difficulties, somatic symptoms, and grief. Demographic variables, patient's HIV stage, nature of caregiving relationship and duration of caregiving were unrelated to carers' burden or adjustment. However, living arrangement was found to be significantly associated with carers' burden, with those carers co-residing experiencing more burden than those living apart from the patient. Carers' coping strategies were only weakly related to carer's adjustment and burden. The patients' emotional and existential concerns were strongly positively related to carers' burden and all domains of adjustment, while patients' instrumental concerns and measures of patients' health status were positively related to carers' burden. As predicted, patients had significantly poorer levels of adjustment than carers. The findings supported the use of a reciprocal determinism approach for understanding the relationship between the patient and carer and adjustment outcomes.

Adaptation, Psychological↗
PubMed1995

The role of maternal psychological adjustment in the measurement of children's functional status.

Studied the ways that mothers interpret illness behavior in their children to assess whether maternal psychological adjustment predicts maternal perceptions of children's behavioral limitations and attribution of these behaviors to chronic illness. Functional status ratings and attributions to illness by 365 mothers of 5- to 8-year-old children with chronic illnesses were associated with children's overall adjustment but not with mothers' own psychological distress. Illness attributions also were related to the child's medical visits and hospitalizations. Thus, mother's illness attributions are related to her perceptions of the child's health and more general behavioral adjustment, but not to her own mental health. Results support the validity of the FS II(R) as a measure of functioning related to children's health status that is not influenced by maternal psychological adjustment.

Activities of Daily Living↗
PubMed1994

The sleep patterns of normal children.

OBJECTIVES: To determine the range of sleep behaviour of normal children to age 38 months and to ascertain the level of parents' problems associated with their child's sleep behaviour. DESIGN AND SETTING: A cross-sectional survey by questionnaire of parents presenting with their children for routine well-child checks at child health centres, mobile clinics, flying doctor clinics and home visits throughout Queensland. Of 3383 questionnaires distributed 3269 (96.5%) were returned. MAIN OUTCOME MEASURES: 1. Sleep frequency and duration, settling procedures, time taken to settle at night, age when child first slept through the night and number of night-time wakenings requiring parental intervention. 2. Parents' problems with their child's sleep behaviour. RESULTS: There is a wide range of normal childhood sleep behaviour. Circadian rhythm is not well established until four months of age. Daytime sleep becomes less regular with increasing age. Frequent night-time wakening is common from four to 12 months. Night-time settling requires more parental input from 18 months. A large proportion of parents (28.6%) have a problem with their child's sleep behaviour. CONCLUSIONS: Parents require information from health care providers about the wide range of normal childhood sleep patterns. This information can help prevent misdiagnosis, inappropriate medication use, child abuse and parental depression when children's sleep patterns are a problem.

Child Behavior↗
PubMed1994

Relationships between adjustment to HIV and both social support and coping.

This study examined the relationships between HIV stage, social support, coping strategies, and adjustment to HIV. Ninety-six HIV-infected gay men and 33 seronegative comparison group participants participated in the study. In general, coping strategies and social support did not differ according to HIV stage. As predicted, adjustment was related to social support and coping strategies. Coping strategies were linked to psychosocial adjustment, whereas social support was more strongly associated with health-related variables. There was little evidence of buffering effects of either coping strategies or social support. Four coping strategies were related to low levels of psychological distress. Contrary to expectation, the relationships between coping strategies and adjustment did not vary as a function of HIV stage. However, the relationship between adjustment and some elements of social support varied as a function of HIV stage.

Adaptation, Psychological↗
PubMed1994

Reliability of the DSM-III-R childhood anxiety disorders using structured interview: interrater and parent-child agreement.

OBJECTIVE: The aim of the study was to examine the interrater and parent-child agreement for the major child anxiety disorders. METHOD: One hundred sixty-one children and their parents underwent a semistructured interview (Anxiety Disorders Interview Schedule for Children). To increase external validity, clinicians did not receive specific, extensive training in diagnosing anxiety disorders apart from their standard qualifications. The design of the study allowed for calculation of agreement between raters based on information obtained from the parents alone, from the child alone, or through combined information from both the parents and child, and for calculation of agreement between information obtained from the parents and information obtained from the child. RESULTS: Levels of interrater agreement either as principal or additional diagnoses were moderate to strong for all of the major childhood anxiety disorders (kappa values .59 to .82). In contrast, parent-child agreement was poor for most diagnostic categories (kappa values .11 to .44). CONCLUSIONS: The data indicate that, despite the fact that parents and their children do not demonstrate strong agreement, the DSM-III-R childhood anxiety disorders can be reliably diagnosed by pairs of general clinicians using structured interviews.

Adolescent↗
PubMed1993

Nausea induced by mental images of chemotherapy.

BACKGROUND: Although anecdotal reports indicate that patients with cancer undergoing chemotherapy can become nauseated outside the chemotherapy clinic when they think or talk about treatment, this phenomenon has not been investigated systematically. METHODS: A series of experimental analyses with individual patients was conducted to explore the possibility that mental images of chemotherapy can elicit nausea in patients who, during the course of their treatment, experienced nausea in anticipation of chemotherapy infusions. Occurrence and intensity of nausea were examined in each patient in response to three imagery scenes: pastoral, a nonchemotherapy medical procedure, and chemotherapy. RESULTS: Eight of 10 patients with clinically documented histories of anticipatory nausea to clinic stimuli experienced nausea when they imagined chemotherapy. They did not become nauseated when they imagined non-chemotherapy medical procedures. For the four patients without prior anticipatory nausea, imaginal reexposure to chemotherapy did not elicit nausea. CONCLUSIONS: Results provide evidence that mental images of chemotherapy elicit nausea in patients with histories of anticipatory nausea and suggest that cognitive factors may play a more important role in the occurrence of chemotherapy side effects than previously recognized.

Adult↗
PubMed1993

Personal and family distress in homeless adolescents.

Previous research has indicated that homeless children exhibit high rates of behavioral and emotional problems and come from families characterised by conflict and rejection. Further, some evidence exists to show that family variables may relate to adolescent distress differently for homeless males and females. In this study, 117 homeless adolescents were compared to a sample of non-homeless youths on the self reported incidence of personal and family problems. The homeless children reported the highest incidence of all behavioral and emotional problems, parental marital discord, overprotection, and the lowest levels of parental care and acceptance. Sex effects were not evident in reported levels of personal or family problems. However, substantially more variance in the adolescents level of behavioral and emotional disturbance was predictable from family measures for females than males. Overall, the results point to the importance of incorporating family distress models in the understanding and remediation of adolescent homelessness.

Adolescent↗
PubMed1992

Social support and treatment outcome in behavioral family therapy for child conduct problems.

This study assessed the role of social support in the outcome of child management training (CMT) for single parents of conduct problem children and assessed the impact of adjunctive ally support training (AST) on treatment outcome. Single parents (N = 22) with a child diagnosed as oppositional or conduct-disordered received CMT or CMT plus AST. Each group received the same 6-week parent training program and the AST group received an extra social support intervention. Measures of parent behavior, child deviance, social support (SS), and parental depression were obtained at pre- and posttreatment and at 6-month follow-up. Both groups improved, and changes maintained at follow-up. AST produced no extra gains. Responders from either group were more likely than nonresponders to report high levels of SS from friends. Results emphasize the importance of SS and the difficulty of incorporating changes in SS into treatment programs.

Adult↗
PubMed1992

Attributions of symptomatology: an exploration of family factors associated with expressed emotion.

This study explored family factors associated with Expressed Emotion (EE) in families with a member diagnosed with schizophrenia. Drawing on an attributional model of expressed emotion it was predicted that high EE relatives would have less knowledge of the illness and would attribute negative symptoms to the personality, rather than the illness, of the sufferer. Thirty-one caregivers of schizophrenic patients were interviewed. Results indicated that EE status was related to knowledge, coping and causal attributions of negative symptoms. Low EEs, as compared with High EEs, tended to have more knowledge of the illness and to cope better with the patient, and were less likely to attribute the cause of negative symptoms to the sufferer's personality. Support was therefore obtained for the utility of an attributional model in attempting to understand the determinants of levels of EE.

Activities of Daily Living↗
PubMed1992

Childhood depression and conduct disorder: I. Behavioral, affective, and cognitive aspects of family problem-solving interactions.

We assessed the family interactions of depressed, conduct-disordered, mixed depressed-conduct-disordered, and nonclinic children, ages 7-14 years, during a standardized family problem-solving discussion in the clinic. The child's and the mother's problem-solving proficiency, aversive behavior, and associated affective behavior (depressed and angry-hostile) were observed. The child and mother also rated each other's affect during the interaction for the dimensions sad, angry, critical, and happy on Likert-type scales. The child's and mother's cognitive constructions about the interaction were assessed using video-mediated recall. Although all clinic groups had lower levels of effective problem solving than did nonclinic children, their deficiencies were somewhat different. Mixed and depressed children displayed high levels of depressed affect and low levels of angry affect, whereas conduct-disordered children displayed both angry and depressed affect. In addition, conduct-disordered children had lower levels of positive problem solving and higher levels of aversive content than did non-conduct-disordered children. Depressed and conduct-disordered children had higher levels of self-referent negative cognitions than did mixed and comparison children, and depressed children also had higher other-referent negative cognitions than did all other groups. The study provides support for theories and treatment that stress the importance of family problem-solving and conflict resolution skills in child psychopathology.

Affect↗
PubMed1992

Childhood depression and conduct disorder: II. An analysis of family interaction patterns in the home.

Few researchers have assessed family interaction patterns associated with childhood depression, especially using observations in natural settings. We directly sampled the interaction patterns of families with depressed, conduct-disordered, mixed depressed-conduct-disordered, and comparison children ages 7-14 years in their homes during the evening meal. Observational measures were taken of positive and aversive behaviors and affect expression for both parents, the referred children, and their siblings. Results replicated previous research showing that conduct-disordered children express high levels of aversive behavior and anger and are part of a family system marked by conflict and aggression. The depressed children were exposed to maternal aversiveness but did not show any evidence of elevated levels of anger or aversiveness in their own behavior. Surprisingly, this was also true for the mixed-disorder children. High levels of depression in both groups of depressed children were associated with low levels of conflict and anger in family members. Overall, siblings showed very similar patterns of behavior, and were exposed to similar patterns of parental behavior, as the referred children. Results are discussed in terms of family models that emphasize the function of aggression and depression in the maintenance of child psychopathology.

Affect↗
PubMed1991

The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinic children.

Although there is agreement that marital problems are associated either directly or indirectly with particular child behavior problems, there is disagreement about the types of marital conflict associated with these problems and the differential effects on boys and girls in clinic and nonclinic samples. We examined the relationships among mothers' ratings of marital adjustment, parenting disagreements, and three child problem factors (aggression, anxiety, and immaturity) after the child's age and family socioeconomic status were controlled. These relationships were compared with samples of boys and girls (3 to 8 years of age) from clinic and nonclinic populations, revealing that parenting disagreement predicted aggression in all groups and that both marital adjustment and parenting disagreement predicted anxiety in boys. Neither marital variable predicted immaturity. Possible reasons for the results (including methodological limitations of the present data) are discussed.

Aggression↗
PubMed1991

Body weight attributions and eating self-efficacy in adolescence.

In an attempt to find an optimum age during adolescence to target weight control programs successfully, 189 adolescents were surveyed using measures of eating self-efficacy and body-weight attributions. The sensitivity of the attribution measures was assessed in a pilot study using 100 adolescents. The major experiment indicated higher levels of eating control at 12 and 13 years of age, decreasing with age. However, the locus of control measure indicated an increase in internal attributions with age. It is argued that this paradox between degree of control subjects reported over their eating and the degree subjects believed their body weight to be controlled internally may have important clinical implications and should be investigated further.

Adolescent↗