Anxious children who received treatment grow -up: An 8-to-13 year follow-up study

This dissertation examined the long-term efficacy (8-to-13 years, M = 9.54, SD = 1.689) of exposure-based cognitive-behavioral therapy (CBT) for phobic and anxiety disorders in youths. Long-term efficacy was examined in terms of diagnostic recovery, symptom reductions, and clinically significant change. This dissertation also examined predictors of long-term efficacy (e.g., age, gender, and other clinical characteristics) as well as the relative long-term efficacy of CBT for Hispanic/Latino and European American youth. ^ Participants consisted of 67 youth (age range 15–26 years; M = 19.43, SD = 3.02 years at time of follow-up assessment), (47.8% females, 37.3% Hispanic/Latino) who had participated in one of two clinical trials (Silverman et al., 1999a, b). After providing informed consent to participate in the long term follow-up, youths completed a diagnostic interview and a battery of questionnaires. Results indicated that treatment gains were maintained about 9.5 years after treatment was completed. Maintenance of treatment gains was evident in terms of diagnostic recovery, symptom reductions, and clinically significant change. Long-term treatment gains extended to both ethnic groups and the two ethnic groups were functionally equivalent along most indices examined. Analyses of predictors of long-term outcome showed that parent self-reported pre-treatment depression, youth-reported pre-treatment depression, and youths retrospective reports of negative life events were significantly associated with less favorable long-term gains in terms of total symptoms of anxiety at long-term follow-up. In terms of long-term sequelae, youths with less successful post-treatment outcomes reported seeking-out additional treatment as well as using/abused substances and substance dependence significantly more than youths with successful post-treatment outcomes. Results are discussed in terms of the contribution of the present study to knowledge base about the long-term efficacy of exposure-based CBT procedures for phobic and anxiety disorders in youth. Findings also are discussed in terms of the need to modify CBT procedures to target youths with less successful post-treatment outcomes. Limitations and future directions are presented. ^

Design and evaluation of a consulting system for database design

Database design is a difficult problem for non-expert designers. It is desirable to assist such designers during the problem solving process by means of a knowledge based (KB) system. A number of prototype KB systems have been proposed, however there are many shortcomings. Few have incorporated sufficient expertise in modeling relationships, particularly higher order relationships. There has been no empirical study that experimentally tested the effectiveness of any of these KB tools. Problem solving behavior of non-experts, whom the systems were intended to assist, has not been one of the bases for system design. In this project a consulting system for conceptual database design that addresses the above short comings was developed and empirically validated.^ The system incorporates (a) findings on why non-experts commit errors and (b) heuristics for modeling relationships. Two approaches to knowledge base implementation--system restrictiveness and decisional guidance--were used and compared in this project. The Restrictive approach is proscriptive and limits the designer's choices at various design phases by forcing him/her to follow a specific design path. The Guidance system approach which is less restrictive, provides context specific, informative and suggestive guidance throughout the design process. The main objectives of the study are to evaluate (1) whether the knowledge-based system is more effective than a system without the knowledge-base and (2) which knowledge implementation--restrictive or guidance--strategy is more effective. To evaluate the effectiveness of the knowledge base itself, the two systems were compared with a system that does not incorporate the expertise (Control).^ The experimental procedure involved the student subjects solving a task without using the system (pre-treatment task) and another task using one of the three systems (experimental task). The experimental task scores of those subjects who performed satisfactorily in the pre-treatment task were analyzed. Results are (1) The knowledge based approach to database design support lead to more accurate solutions than the control system; (2) No significant difference between the two KB approaches; (3) Guidance approach led to best performance; and (4) The subjects perceived the Restrictive system easier to use than the Guidance system. ^

Supplemental instruction, study habits, and the community college student

The purpose of this study was to demonstrate if the academic assistance program Supplemental Instruction (SI) facilitates the acquisition of effective study behaviors through strategies that transcend simple double-exposure to the course material. Its advocates claim it increases academic achievement using learner-centered knowledge and acquisition of effective study behaviors. SI sessions are specifically related to particular courses that students are taking. Sessions are facilitated by the SI leader who has taken the subject matter course in the past. Students review the content of the previous subject matter class using collaborative learning strategies coordinated by a SI leader. In addition, the SI leader models appropriate study behaviors in his or her interactions with the students. ^ An instructor at a large Florida community college who taught five classes of an Anatomy & Physiology I course (traditionally supported by SI) was identified. Two of the classes were randomly selected to participate in SI activities, and two classes were random chosen to participate in alternate, computer-based activities that dealt with the course content, but did not include work in developing students' study behaviors. These treatments were carried out over the course of an entire semester. Participation was mandatory. ^ Data were collected on two variables. Academic achievement in anatomy and physiology content was measured both pre- and post-treatment using an instructor developed examination. Student study behaviors were measured using pre- and post-treatment administration of the Study Behavior Inventory, a valid and reliable instrument that provides scores on three categories of study behaviors: (a) Academic self-efficacy, (b) Preparation for routine academic tasks, and (c) Preparation for long range academic tasks. Measures obtained at the end of the semester of treatment revealed no significant differences between the SI and alternative treatment groups in post-treatment achievement test score and the post-treatment scores on the three study behaviors categories when adjusted for pre-treatment scores. ^ These results suggest that the development of appropriate study behaviors requires more time than SI, as it is now implemented, can provide. In addition, results indicate that improved academic achievement may be attained through any number of means that include repeated exposure to course material. ^

Effects of service-learning on student attitudes toward academic engagement and civic responsibility

This empirical study explored the impact of service-learning participation on high school students' attitudes toward academic engagement and civic responsibility. This study focused whether a group of high school students who participated in a service-learning project had more positive attitudes toward academic engagement and civic responsibility than their high school peers who did not participate in a service learning project. ^ Data were collected from 67 volunteer students as participants in grades 9–12. A service-learning treatment group of 34 high school students was examined relative to a comparison group of 33 high school students with similar demographic and academic characteristics. The investigator used questionnaires, an oral history/service-learning project, and interviews with the teacher-coordinators of the project to collect the data. The two surveys, one investigating high school students' attitudes about academic engagement, the other investigating high school students' attitudes toward civic responsibility, were administered in a pre-treatment/post-treatment design. There were 90 days between the pre-treatment and post-treatment administrations. A factor analysis of the civic responsibility instrument and multivariate analysis of gain scores were used to compare the means of the total aggregate scores of the treatment and comparison groups. Factor analysis was performed on the academic engagement instrument but it was determined that only the total scores could be used in subsequent analyses. Results were used to determine the efficacy of service-learning as interpreted in student attitudes toward academic engagement and student attitudes toward civic responsibility. ^ The study found no significant difference between the academic engagement and the civic responsibility attitudes of a high school service-learning project group and a high school comparison group with comparable school and similar demographic characteristics. One of the implications for educational practice and policy from the study results is a need to design and implement more powerful studies, studies implemented at many sites rather than just at two sites that were the basis of this study, and studies that investigate the research questions over longer time periods. Although it was not a focus of the study, the investigator concluded that service learning projects such as this might be more effective if they were better aligned with Dewey's principles. ^

Comparison of medical and forensic profiling potential of volatile biomarkers from different biological specimens from individuals and across populations

There is limited scientific knowledge on the composition of human odor from different biological specimens and the effect that physiological and psychological health conditions could have on them. There is currently no direct comparison of the volatile organic compounds (VOCs) emanating from different biological specimens collected from healthy individuals as well as individuals with certain diagnosed medical conditions. Therefore the question of matching VOCs present in human odor across various biological samples and across health statuses remains unanswered. The main purpose of this study was to use analytical instrumental methods to compare the VOCs from different biological specimens from the same individual and to compare the populations evaluated in this project. The goals of this study were to utilize headspace solid-phase microextraction gas chromatography mass spectrometry (HS-SPME-GC/MS) to evaluate its potential for profiling VOCs from specimens collected using standard forensic and medical methods over three different populations: healthy group with no diagnosed medical or psychological condition, one group with diagnosed type 2 diabetes, and one group with diagnosed major depressive disorder. The pre-treatment methods of collection materials developed for the study allowed for the removal of targeted VOCs from the sampling kits prior to sampling, extraction and analysis. Optimized SPME-GC/MS conditions has been demonstrated to be capable of sampling, identifying and differentiating the VOCs present in the five biological specimens collected from different subjects and yielded excellent detection limits for the VOCs from buccal swab, breath, blood, and urine with average limits of detection of 8.3 ng. Visual, Spearman rank correlation, and PCA comparisons of the most abundant and frequent VOCs from each specimen demonstrated that each specimen has characteristic VOCs that allow them to be differentiated for both healthy and diseased individuals. Preliminary comparisons of VOC profiles of healthy individuals, patients with type 2 diabetes, and patients with major depressive disorder revealed compounds that could be used as potential biomarkers to differentiate between healthy and diseased individuals. Finally, a human biological specimen compound database has been created compiling the volatile compounds present in the emanations of human hand odor, oral fluids, breath, blood, and urine.

Design and evaluation of a consulting system for database design

Database design is a difficult problem for non-expert designers. It is desirable to assist such designers during the problem solving process by means of a knowledge based (KB) system. Although a number of prototype KB systems have been proposed, there are many shortcomings. Firstly, few have incorporated sufficient expertise in modeling relationships, particularly higher order relationships. Secondly, there does not seem to be any published empirical study that experimentally tested the effectiveness of any of these KB tools. Thirdly, problem solving behavior of non-experts, whom the systems were intended to assist, has not been one of the bases for system design. In this project, a consulting system, called CODA, for conceptual database design that addresses the above short comings was developed and empirically validated. More specifically, the CODA system incorporates (a) findings on why non-experts commit errors and (b) heuristics for modeling relationships. Two approaches to knowledge base implementation were used and compared in this project, namely system restrictiveness and decisional guidance (Silver 1990). The Restrictive system uses a proscriptive approach and limits the designer's choices at various design phases by forcing him/her to follow a specific design path. The Guidance system approach, which is less restrictive, involves providing context specific, informative and suggestive guidance throughout the design process. Both the approaches would prevent erroneous design decisions. The main objectives of the study are to evaluate (1) whether the knowledge-based system is more effective than the system without a knowledge-base and (2) which approach to knowledge implementation - whether Restrictive or Guidance - is more effective. To evaluate the effectiveness of the knowledge base itself, the systems were compared with a system that does not incorporate the expertise (Control). An experimental procedure using student subjects was used to test the effectiveness of the systems. The subjects solved a task without using the system (pre-treatment task) and another task using one of the three systems, viz. Control, Guidance or Restrictive (experimental task). Analysis of experimental task scores of those subjects who performed satisfactorily in the pre-treatment task revealed that the knowledge based approach to database design support lead to more accurate solutions than the control system. Among the two KB approaches, Guidance approach was found to lead to better performance when compared to the Control system. It was found that the subjects perceived the Restrictive system easier to use than the Guidance system.