The Impact of Sexual Abuse and How Children Cope: Different Perspectives from Caretakers and Children

Child sexual abuse is a complicated stressor with a broad range of associated symptoms. It has been suggested that the coping techniques children utilize may act as a mediating variable in the relationship between child sexual abuse and subsequent difficulties. Until recently, child sexual abuse sequelae were assessed in a piecemeal fashion, with individual tests for each symptom domain and reporter. However, recent developments in the area of trauma assessment have provided researchers with complementary caretaker- and self-report measures to assess a broad range of trauma-related symptoms (i.e., the Trauma Symptom Checklist for Young Children [TSCYC] and the Trauma Symptom Checklist for Children [TSCC], respectively). This project utilized the intake assessment data from children who were beginning psychotherapy services subsequent to sexual abuse. The TSCYC is a relatively new measure, therefore, Study 1 evaluated its internal consistency (N=308), the correlation between the caretaker- and self-report measures (N=135), and the convergent validity of the TSCYC with other caretaker-report measures of children¿s symptoms (N=135). The results indicated that the TSCYC has good internal consistency and convergent validity. The inter-correlation of the TSCYC and TSCC is quite low and consistent with other studies attempting to understand multi-informant assessment processes. Children and their caretakers describe very different pictures when asked about the children¿s difficulties. Study 2 (N=98) then evaluated the relationship between children¿s coping style as assessed by the KIDCOPE and trauma-related symptoms as reported by the children themselves and their caretakers. Overall, more external coping behaviors were associated with an increase in caretaker-reported symptoms, but internal coping was associated with more self-reported symptoms among children between the ages of eight and twelve years. The implications of these findings and future directions for research are discussed

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Improving the Usability of Written Exposure Therapy for Therapists in the Department of Veterans Affairs Telemental Health: Formative Study Using Qualitative and User-Centered Design Methods

BackgroundUser modifications are common in evidence-based psychosocial interventions (EBPIs) for mental health disorders. Often, EBPIs fit poorly into clinical workflows, require extensive resources, or pose considerable burden to patients and therapists. Implementation science is increasingly researching ways to improve the usability of EBPIs before implementation. A user-centered design can be used to support implementation methods to prioritize user needs and solutions to improve EBPI usability. ObjectiveTrauma-focused EBPIs are a first-line treatment for patients with posttraumatic stress disorder (PTSD) in the Department of Veterans Affairs. Written exposure therapy (WET) is a brief, trauma-focused EBPI wherein patients handwrite about trauma associated with their PTSD. Initially developed for in-person delivery, WET is increasingly being delivered remotely, and outcomes appear to be equivalent to in-person delivery. However, there are logistical issues in delivering WET via video. In this evaluation, we explored usability issues related to WET telehealth delivery via videoconferencing software and designed a solution for therapist-facing challenges to systematize WET telehealth delivery. MethodsThe Discover, Design and Build, and Test framework guided this formative evaluation and served to inform a larger Virtual Care Quality Enhancement Research Initiative. We used qualitative descriptive methods in the Discover phase to understand the experiences and needs of 2 groups of users providing care within the Department of Veterans Affairs: in-person therapists delivering WET via video because of the COVID-19 pandemic and telehealth therapists who regularly deliver PTSD therapies. We then used user-centered design methods in the Design and Build phase to brainstorm, develop, and iteratively refine potential workflows to address identified usability issues. All procedures were conducted remotely. ResultsIn the Discover phase, both groups had challenges delivering WET and other PTSD therapies via telehealth because of technology issues with videoconferencing software, environmental distractions, and workflow disruptions. Narrative transfer (ie, patients sending handwritten trauma accounts to therapists) was the first target for design solution development as it was deemed most critical to WET delivery. In the Design and Build phase, we identified design constraints and brainstormed solution ideas. This led to the development of 3 solution workflows that were presented to a subgroup of therapist users through cognitive walkthroughs. Meetings with this subgroup allowed workflow refinement to improve narrative transfers. Finally, to facilitate using these workflows, we developed PDF manuals that are being refined in subsequent phases of the implementation project (not mentioned in this paper). ConclusionsThe Discover, Design and Build, and Test framework can be a useful tool for understanding user needs in complex EBPI interventions and designing solutions to user-identified usability issues. Building on this work, an iterative evaluation of the 3 solution workflows and accompanying manuals with therapists and patients is underway as part of a nationwide WET implementation in telehealth settings

Late Positive Potential ERP Responses to Social and Nonsocial Stimuli in Youth with Autism Spectrum Disorder

We examined the late positive potential (LPP) event related potential in response to social and nonsocial stimuli from 9-19 years old youth with (n = 35) and without (n = 34) ASD. Social stimuli were faces with positive expressions and nonsocial stimuli were related to common restricted interests in ASD (e.g., electronics, vehicles, etc.). The ASD group demonstrated relatively smaller LPP amplitude to social stimuli and relatively larger LPP amplitude to nonsocial stimuli. There were no group differences in subjective ratings of images, and there were no significant correlations between LPP amplitude and ASD symptom severity within the ASD group. LPP results suggest blunted motivational responses to social stimuli and heightened motivational responses to nonsocial stimuli in youth with ASD