DSM-5 Autism Spectrum Disorder:in search of essential behaviours for diagnosis

Background: Despite initial concerns about the sensitivity of the proposed diagnostic criteria for DSM-5 Autism Spectrum Disorder (ASD; e.g. Gibbs et al., 2012; McPartland et al., 2012), evidence is growing that the DSM-5 criteria provides an inclusive description with both good sensitivity and specificity (e.g. Frazier et al., 2012; Kent, Carrington et al., 2013). The capacity of the criteria to provide high levels of sensitivity and specificity comparable with DSM-IV-TR however relies on careful measurement to ensure that appropriate items from diagnostic instruments map onto the new DSM-5 descriptions.Objectives: To use an existing DSM-5 diagnostic algorithm (Kent, Carrington et .al., 2013) to identify a set of ‘essential’ behaviors sufficient to make a reliable and accurate diagnosis of DSM-5 Autism Spectrum Disorder (ASD) across age and ability level. Methods: Specific behaviors were identified and tested from the recently published DSM-5 algorithm for the Diagnostic Interview for Social and Communication Disorders (DISCO). Analyses were run on existing DISCO datasets, with a total participant sample size of 335. Three studies provided step-by-step development towards identification of a minimum set of items. Study 1 identified the most highly discriminating items (p<.0001). Study 2 used a lower selection threshold than in Study 1 (p<.05) to facilitate better representation of the full DSM-5 ASD profile. Study 3 included additional items previously reported as significantly more frequent in individuals with higher ability. The discriminant validity of all three item sets was tested using Receiver Operating Characteristic curves. Finally, sensitivity across age and ability was investigated in a subset of individuals with ASD (n=190).Results: Study 1 identified an item set (14 items) with good discriminant validity, but which predominantly measured social-communication behaviors (11/14). The Study 2 item set (48 items) better represented the DSM-5 ASD and had good discriminant validity, but the item set lacked sensitivity for individuals with higher ability. The final Study 3 adjusted item set (54 items) improved sensitivity for individuals with higher ability and performance and was comparable to the published DISCO DSM-5 algorithm.Conclusions: This work represents a first attempt to derive a reduced set of behaviors for DSM-5 directly from an existing standardized ASD developmental history interview. Further work involving existing ASD diagnostic tools with community-based and well characterized research samples will be required to replicate these findings and exploit their potential to contribute to a more efficient and focused ASD diagnostic process.

DSM-5 Autism Spectrum Disorder:in search of essential behaviours for diagnosis

The objective of this study was to identify a set of 'essential' behaviours sufficient for diagnosis of DSM-5 Autism Spectrum Disorder (ASD). Highly discriminating, 'essential' behaviours were identified from the published DSM-5 algorithm developed for the Diagnostic Interview for Social and Communication Disorders (DISCO). Study 1 identified a reduced item set (48 items) with good predictive validity (as measured using receiver operating characteristic curves) that represented all symptom sub-domains described in the DSM-5 ASD criteria but lacked sensitivity for individuals with higher ability. An adjusted essential item set (54 items; Study 2) had good sensitivity when applied to individuals with higher ability and performance was comparable to the published full DISCO DSM-5 algorithm. Investigation at the item level revealed that the most highly discriminating items predominantly measured social-communication behaviours. This work represents a first attempt to derive a reduced set of behaviours for DSM-5 directly from an existing standardised ASD developmental history interview and has implications for the use of DSM-5 criteria for clinical and research practice. © 2014 The Authors.

An examination of the UK community pharmacist's role in facilitating patient self-management of cardiovascular disease through lifestyle behaviours

The progression of cardiovascular disease (CVD) is largely modifiable through lifestyle behaviours. UK pharmacists are contractually obliged to facilitate patient self-management of chronic conditions such as CVD. Pharmacists are easily accessible health professionals who are well placed to identify “at risk” patients through medication regimes. Research has identified varying attitudes towards and levels of involvement in pharmacist-led health promotion activity. Given the diverse and exploratory nature of the work, a pragmatic, mixed methods approach was used to explore community pharmacists’ role in facilitating patient self-management of CVD. The thesis presents four studies: a qualitative study with pharmacists; a cross sectional questionnaire of community pharmacists; a systematic review and a qualitative study with patients with CVD. The qualitative study with pharmacists gave an insight into pharmacists’ experiences of giving patients with CVD lifestyle advice and the factors underpinning commonly cited barriers to providing public health services. This informed the development of the cross-sectional questionnaire which identified the predictors of pharmacists’ intentions to give two different types of advice to facilitate patient self-management. The systematic review identified a small number of interventions to prepare pharmacists to facilitate patient lifestyle behaviour change and evaluated the theories and behaviour change techniques used in successful interventions; however due to poor study quality and poor reporting of the interventions limited conclusions about the efficacy of the interventions could reliably be drawn. Finally, the qualitative study gave an insight into the experiences of patients with CVD using community pharmacy services and their expectations of the service they receive from community pharmacists. Recommendations about changes to pharmacy policy and practice in order to support pharmacists’ provision of CVD self-management advice are made.

Rethinking change:downsizing businesses, changing behaviours and still managing to come out on top

As an indicator of global change and shifting balances of power, every September in Dalian, China, the World Economic Forum meets. The subject in 2011 – Mastering Quality Growth. On the agenda is pursuing new frontiers of growth linked to embracing disruptive innovation. With growth coming from emerging markets, and European and North American economies treading water, many firms in the West are facing the reality of having to not just downsize but actually close manufacturing operations and re-open them elsewhere, where costs are lower, to remain competitive. There are thousands of books on “change management”. Yet very few of these devote much time to downsizing preferring to talk about re-engineering or restructuring. What lessons are available from the past to achieve a positive outcome from what will inevitably be something of a human, as well as an economic, tragedy. The authors reached three fundamental conclusions from their experience and research in facility closure management within Vauxhall, UK: put your people first, make sure you keep running the business and manage your legacy. They devlop the ideas into a new business model linked to the emotions of change.

Social and individual influences on eating in preadolescents:the role of friends’ eating behaviours and individual anxiety and depression

Background: Friends are important role models for the formation of social norms and behaviour comparisons, particularly in children. This study examined the similarities between pre-adolescent children’s own eating behaviours with the eating behaviours of those in their friendship group. It also evaluated whether symptoms of anxiety and depression were related to eating behaviours in this age group. Methods: Three hundred and forty three children (mean age 8.75 years) completed questionnaires designed to measure dietary restraint, emotional eating and external eating, as well as general and social anxiety, and symptoms of depression. Children also provided details about their friendship groups. Results: Pre-adolescents’ dietary restraint was positively predicted by the dietary restraint of members of their friendship groups, and their individual levels of anxiety and depression. The levels of general anxiety exhibited by pre-adolescents predicted emotional and external eating behaviours. Younger children were significantly more likely to report higher levels of emotional and external eating than older children, and boys were more likely to report more external eating behaviours than girls. Conclusions: These results suggest that greater dieting behaviours in pre-adolescents are related to their friends’ reports of greater dieting behaviours. In contrast, greater levels of eating governed by emotions, and eating in response to external hunger cues, are related to greater symptoms of anxiety in pre-adolescent children. Such findings underline the importance of friends’ social influences on dieting behaviours in this age group and highlight the value of targeting healthy eating and eating disorder prevention interventions at pre-adolescents.

Within-role, extra-role and anti-role behaviours in retail banking

Purpose: This paper aims to explore front line employee performance in retail banking and presents distinct components of employee performance, including extra-role and sabotage behaviours. Design/methodology/approach: Data was collected from Irish bank employees. Usable responses were received from 404 respondents and subjected to exploratory factor analysis. Structural Equation Modeling (SEM) was used to undertake a confirmatory factor analysis of the emergent five-factor model. Findings: Results indicate front line employee performance is multi-faceted and comprised of civility, assurance and reliability, customer orientation, as well as extra-role behaviour and anti-role behaviour, or sabotage. Research limitations/implications: This exploratory study focuses on the Irish banking sector. To explore the generalisabilty of results, replication studies among other samples of branch banking employees in other countries are in order. Moreover, our survey is limited to the views of branch employees. We advocate research among bank managers and customers to triangulate potentially divergent views about performance. Practical implications: Findings have implications for recruitment, training and rewards. To ensure new hires are service minded, managers must consider their potential for extra-role or sabotage behaviour. Employees who demonstrate extra-role behaviours must be rewarded to encourage the adoption of such behaviours. Managers must also seek to minimise job stress in order to curtail anti-role behaviours. Originality/value: This paper offers insights into employees' views about their own performance at the front line. It extends the conceptualisation of service quality, by considering extra-role behaviour and sabotage as components of employee performance. © Emerald Group Publishing Limited.

Internal communication and prosocial service behaviors of front-line employees:investigating mediating mechanisms

This paper contributes to the prosocial service behavior (PSB) literature by developing and testing a conceptual framework to investigate the mediating mechanisms underlying the relationships between internal communication and PSBs. Data collected from front-line employees (FLEs) in a UK based service organization was used to test our conceptual framework. Our findings demonstrate that FLE perceptions of internal communication practices influence their role stress and organizational commitment, which, in turn, influence their PSBs. The results highlight the significance of studying role stress and organizational commitment as mediators in the relationship between internal communication and PSBs. The limitations of the study are then sketched, and suggestions for future research are also provided.

Eating behaviours of preadolescent children over time:stability, continuity and the moderating role of perceived parental feeding practices

The links between childhood eating behaviours and parental feeding practices are well-established in younger children, but there is a lack of research examining these variables in a preadolescent age group, particularly from the child's perspective, and longitudinally. This study firstly aimed to examine the continuity and stability of preadolescent perceptions of their parents' controlling feeding practices (pressure to eat and restriction) over a 12 month period. The second aim was to explore if perceptions of parental feeding practices moderated the relationship between preadolescents' eating behaviours longitudinally. Two hundred and twenty nine preadolescents (mean age at recruitment 8.73 years) completed questionnaires assessing their eating behaviours and their perceptions of parental feeding practices at two time points, 12 months apart (T1 and T2). Preadolescents' perceptions of their parental feeding practices remained stable. Perceptions of restriction and pressure to eat were continuous. Perceptions of parental pressure to eat and restriction significantly moderated the relationships between eating behaviours at T1 and T2. The findings from this study suggest that in a preadolescent population, perceptions of parental pressure to eat and restriction of food may exacerbate the development of problematic eating behaviours.

Internal market orientation and market/oriented behaviours

Purpose – The purpose of this empirical paper is to investigate internal marketing from a behavioural perspective. The impact of internal marketing behaviours, operationalised as an internal market orientation (IMO), on employees' marketing and other in/role behaviours (IRB) were examined. Design/methodology/approach – Survey data measuring IMO, market orientation and a range of constructs relevant to the nomological network in which they are embedded were collected from the UK retail managers. These were tested to establish their psychometric properties and the conceptual model was analysed using structural equations modelling, employing a partial least squares methodology. Findings – IMO has positive consequences for employees' market/oriented and other IRB. These, in turn, influence marketing success. Research limitations/implications – The paper provides empirical support for the long/held assumption that internal and external marketing are related and that organisations should balance their external focus with some attention to employees. Future research could measure the attitudes and behaviours of managers, employees and customers directly and explore the relationships between them. Practical implications – Firm must ensure that they do not put the needs of their employees second to those of managers and shareholders; managers must develop their listening skills and organisations must become more responsive to the needs of their employees. Originality/value – The paper contributes to the scarce body of empirical support for the role of internal marketing in services organisations. For researchers, this paper legitimises the study of internal marketing as a route to external market success; for managers, the study provides quantifiable evidence that focusing on employees' wants and needs impacts their behaviours towards the market. © 2010, Emerald Group Publishing Limited