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ABSTRACT Approximately 3.5% of adolescents in the United States have chronic daily headache (CDH). Chronic daily headaches in adolescents are often refractory to the adult pharmacological interventions. And as a result, adolescents typically experience increased levels of stress, which exacerbates their headaches. Chronic daily headaches negatively impact both the adolescent

ABSTRACT Approximately 3.5% of adolescents in the United States have chronic daily headache (CDH). Chronic daily headaches in adolescents are often refractory to the adult pharmacological interventions. And as a result, adolescents typically experience increased levels of stress, which exacerbates their headaches. Chronic daily headaches negatively impact both the adolescent and their family. Adolescents with CDHs frequently exemplify comorbid psychiatric symptoms such as anxiety, depression, and increased risk for suicide. Risk factors for CDH in adolescents have been well studied; however, few studies have focused on psychologically based interventions to enhance effective coping, positive mental health, and pain relief in this group of teens. Given the paucity of psychologically focused interventions in this group, further research is necessary to test and develop the effectiveness of cognitive behavioral skills building (CBSB) interventions. This pilot study focused on the use of a CBSB intervention that emphasized problem solving, cue recognition, effective communication, behavior modeling, cognitive reappraisal, stress management, effective coping, and positive thinking. A randomized controlled trial pilot study was conducted. The intervention group received a seven-week intervention focused on CBSB techniques and headache education, while the comparison headache education group received a seven-week program focused on basic headache hygiene measures (e.g., adequate sleep, adequate hydration, dietary triggers, environmental triggers). The total sample included 32 adolescents inclusive of the ages 13 and 17 years. Paired t-tests resulted in significant preliminary positive effects for COPE-HEP on anxiety, depression, beliefs, headache disability, headache frequency, and headache duration. Comparison group education resulted in significant preliminary positive effects on anxiety, depression, headache disability, headache frequency, headache pain level, headache duration, and medication frequency. There were no significant changes over time in means of parent perception of pain interference for both groups. Independent t-tests revealed that COPE-HEP teens had significantly less anxiety and headache duration at post-intervention. The acceptability of the COPE-HEP intervention with adolescents with CDHs in a specialty care setting is supported by this study, while the feasibility of conducting this study in a specialty care setting is partially supported. These findings support a need to refine the intervention and test both its short and long-term effects in a full-scale randomized controlled trial with adolescents who have CDHs.
ContributorsHickman, Carolyn (Author) / Melnyk, Bernadette M (Thesis advisor) / Jacobson, Diana (Thesis advisor) / Gance-Cleveland, Bonnie (Committee member) / Szalacha, Laura (Committee member) / Arizona State University (Publisher)
Created2012
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We integrate multiple domains of psychological science to identify, better understand, and manage the effects of subtle but powerful biases in forensic mental health assessment. This topic is ripe for discussion, as research evidence that challenges our objectivity and credibility garners increased attention both within and outside of psychology. We

We integrate multiple domains of psychological science to identify, better understand, and manage the effects of subtle but powerful biases in forensic mental health assessment. This topic is ripe for discussion, as research evidence that challenges our objectivity and credibility garners increased attention both within and outside of psychology. We begin by defining bias and provide rich examples from the judgment and decision making literature as they might apply to forensic assessment tasks. The cognitive biases we review can help us explain common problems in interpretation and judgment that confront forensic examiners. This leads us to ask (and attempt to answer) how we might use what we know about bias in forensic clinicians’ judgment to reduce its negative effects.

ContributorsNeal, Tess M.S. (Author) / Grisso, Thomas (Author)
Created2014-05
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We conducted an international survey in which forensic examiners who were members of professional associations described their two most recent forensic evaluations (N=434 experts, 868 cases), focusing on the use of structured assessment tools to aid expert judgment. This study describes:

1. The relative frequency of various forensic referrals.
2. What tools

We conducted an international survey in which forensic examiners who were members of professional associations described their two most recent forensic evaluations (N=434 experts, 868 cases), focusing on the use of structured assessment tools to aid expert judgment. This study describes:

1. The relative frequency of various forensic referrals.
2. What tools are used globally.
3. Frequency and type of structured tools used.
4. Practitioners’ rationales for using/not using tools.

We provide general descriptive information for various referrals. We found most evaluations used tools (74.2%) and used several (on average 4). We noted the extreme variety in tools used (286 different tools). We discuss the implications of these findings and provide suggestions for improving the reliability and validity of forensic expert judgment methods. We conclude with a call for an assessment approach that seeks structured decision methods to advance greater efficiency in the use and integration of case-relevant information.

ContributorsNeal, Tess M.S. (Author) / Grisso, Thomas (Author)
Created2014-09-25
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This chapter integrates from cognitive neuroscience, cognitive psychology, and social psychology the basic science of bias in human judgment as relevant to judgments and decisions by forensic mental health professionals. Forensic mental health professionals help courts make decisions in cases when some question of psychology pertains to the legal issue,

This chapter integrates from cognitive neuroscience, cognitive psychology, and social psychology the basic science of bias in human judgment as relevant to judgments and decisions by forensic mental health professionals. Forensic mental health professionals help courts make decisions in cases when some question of psychology pertains to the legal issue, such as in insanity cases, child custody hearings, and psychological injuries in civil suits. The legal system itself and many people involved, such as jurors, assume mental health experts are “objective” and untainted by bias. However, basic psychological science from several branches of the discipline suggest the law’s assumption about experts’ protection from bias is wrong. Indeed, several empirical studies now show clear evidence of (unintentional) bias in forensic mental health experts’ judgments and decisions. In this chapter, we explain the science of how and why human judgments are susceptible to various kinds of bias. We describe dual-process theories from cognitive neuroscience, cognitive psychology, and social psychology that can help explain these biases. We review the empirical evidence to date specifically about cognitive and social psychological biases in forensic mental health judgments, weaving in related literature about biases in other types of expert judgment, with hypotheses about how forensic experts are likely affected by these biases. We close with a discussion of directions for future research and practice.

ContributorsNeal, Tess M.S. (Author) / Hight, Morgan (Author) / Howatt, Brian C. (Author) / Hamza, Cassandra (Author)
Created2017-04-30