Addressing the impact of trauma before diagnosing mental illness in child welfare

Congress set requirements for child welfare agencies to respond to emotional trauma associated with child maltreatment and removal. In meeting these requirements, agencies should develop policies that address child trauma. To assist in policy development, this study analyzes more than 14,000 clinical assessments from child welfare in Illinois. Based on the analysis, the study recommends child welfare agencies adopt policies requiring that (1) mental health screenings and assessments of all youth in child welfare include measures of traumatic events and trauma-related symptoms; (2) evidence-based, trauma-focused treatment begin when a youth in child welfare demonstrates a trauma-related symptom; and (3) a clinician not diagnose a youth in child welfare with a mental illness without first addressing the impact of trauma. The study also raises the issue of treatment reimbursement based on diagnosis.     

Linking child welfare and mental health using trauma-informed screening and assessment practices

An abundance of research suggests that children in the child welfare system (CWS) have experienced numerous traumatic events and are exhibiting traumatic stress symptoms. Therefore, it is critical that the CWS work closely with the mental health system to ensure that these children receive the appropriate trauma screening, trauma-focused assessment, and referral to the appropriate trauma-focused mental health services. This paper will begin by providing a concrete definition of trauma-focused screening and highlighting how that differs from a more comprehensive trauma-focused assessment process and a psychological evaluation. From there, the authors will highlight existing trauma-focused screening and assessment tools that are used widely within CWSs and the challenges related to integrating trauma-focused screening practices into CWSs. The authors will provide recommendations for ways in which child welfare jurisdictions can integrate trauma-focused screening practices into their daily practice.     

Understanding the sex ratio in India: A simulation approach

The highly masculine sex ratio in India has increased substantially in the twentieth century, in contrast to most other countries in the world. Competing arguments alternatively posit under-enumeration, highly masculine sex ratios at birth, or excess female mortality throughout the life course as the factors underlying the level of the overall sex ratio; these arguments have not been resolved. Based on population projections that simulate population dynamics, our findings show that small differences in mortality at young ages, persisting over a long period, as well as a sex ratio at birth of 106 males per 100 females, result in a highly masculine population sex ratio.     

Adopted foster youths' psychosocial functioning: a longitudinal perspective

Researchers have long debated whether adopted youth manifest disproportionate levels of psychological dysfunction compared with non‐adopted youth. Yet, missing from the debate has been a clear understanding of the specific subgroups of adopted youth who may develop behaviour problems and of the risk factors associated with various vulnerable populations. This longitudinal study examined one subpopulation of adopted youth – former foster children – in order to determine their immediate and long‐term functioning, particularly in comparison with their adopted non‐foster care peers. The central goal of this study was to ascertain the prevalence of behavioural problems in adopted foster youth compared with adopted non‐foster youth and to chart the longitudinal course of their behavioural problems. Participants included adopted foster youth (n = 293) and adopted non‐foster youth (n = 312) from a statewide sample of adopted youth, aged 2–18 years. Data were collected from the adoptive parents at approximately 2, 4 and 8 years after adoption. Adoptive parents rated youths’ functioning with the Behaviour Problems Inventory. According to parental report, a striking number of the foster youth displayed behaviour problems, although the non‐foster care group of children also displayed noteworthy levels of problem behaviours. The rates of behaviour problems in both groups far exceed what is observed in the general population of children.     

No Switchbacks: Rethinking Aspiration-Based Dynamics in the Ultimatum Game

Aspiration-based evolutionary dynamics have recently been used to model the evolution of fair play in the ultimatum game showing that incredible threats to reject low offers persist in equilibrium. We focus on two extensions of this analysis: we experimentally test whether assumptions about agent motivations (aspiration levels) and the structure of the game (binary strategy space) reflect actual play, and we examine the problematic assumption embedded in the standard replicator dynamic that unhappy agents who switch strategies may return to a rejected strategy without exploring other options. We find that the resulting “no switchback” dynamic predicts the evolution of play better than the standard dynamic and that aspirations are a significant motivator for our participants. In the process, we also construct and analyze a variant of the ultimatum game in which players can adopt conditional (on their induced aspirations) strategies.     

Multiple assessors of child welfare youths' mental‐health functioning: comparing perceptions of adolescents,caregivers and teachers

For youth involved with the child welfare system, accurate assessment of mental‐health functioning is a critical factor in case planning. To assess correspondence among multiple reporters of child welfare youths' mental‐health difficulties, this study, using data drawn from the National Survey of Child and Adolescent Well‐being dataset, examined the caregiver, teacher and youth (aged 11–16 years) reports on the Child Behavior Checklist (n = 464). Perceptions about symptomatology on a variety of externalizing and internalizing behaviour problem scales were measured with a correlation analysis. Subsequently, logistic regression models were created, which explored how each reporter category matched a fourth reporter category: the child welfare investigation caseworkers' identification of youths' mental‐health needs. Results show that in several models, the odds of matching caseworkers' determination of youths' mental‐health needs significantly increased as youths' perceptions of psychopathology increased. A similar pattern was found for caregivers' perceptions in some of the models, across both internalizing and externalizing domains. Implications for child welfare practice and research with child welfare youth are discussed.     

Sponsor-Imposed Publication Restrictions Disclosed on ClinicalTrials.gov

We investigated whether sponsor-imposed publication restrictions for ClinicalTrials.gov trials were reasonable, based on consistency with Good Publication Practice 2 (GPP2). ClinicalTrials.gov trial record data were electronically imported (October 7, 2012) and screened for eligibility (phase 2–4, interventional, recruitment closed, results available, first received for registration after November 10, 2009, any sponsor type, investigators not sponsor employees). Two authors categorized restrictions information as consistent or not consistent with GPP2, resolving discrepancies by consensus. Of the eligible trials (388/484, n = 81,768 participants), 80.7% (313/388) had restrictions disclosed, and 92.5% (311/388) were industry-sponsored. Significantly more trials had restrictions that were consistent with GPP2 than not (74.1% [232/313], n = 55,280 participants vs. 25.9% [81/313], n = 19,677 participants; P < .001). Reasons for inconsistency were insufficient, unclear, or ambiguous information (48.1%, 39/81), sponsor-required approval for publication (35.8%, 29/81), sponsor-required text changes (8.6%, 7/81), and outright bans (7.4%, 6/81). Follow-up of trials with insufficient information and a contact email (response rate, 46.9% [15/32]) revealed 2 additional bans. A total of 776 participants had consented to trials that had publication bans. Many, but not all, sponsor-imposed publication restrictions disclosed on ClinicalTrials.gov may be considered reasonable. Sponsors should ensure restrictions are appropriately disclosed. Volunteers should be alerted to any restrictions before consenting to participate in a clinical trial.     

Joint modeling of multivariate hearing thresholds measured longitudinally at multiple frequencies

Pure-tone thresholds are used to estimate hearing acuity and, when measured longitudinally, can characterize age-related changes in hearing. Measured at multiple-frequencies, multiple-irregular time points, for right and left ears, these longitudinal studies of age-related hearing loss produce data of inherent complexity due to: 1) multivariate outcomes at different frequencies; 2) longitudinal measurements taken at subject-specific time intervals; and 3) inter-ear correlations due to clustering and nesting. To address limitations in existing methods, we propose a multivariate generalized linear mixed model (mGLMM) and assess its performance. We demonstrate its application using a unique dataset from a cohort study of age-related hearing loss.     

Ensemble preconditioning for Markov chain Monte Carlo simulation

We describe parallel Markov chain Monte Carlo methods that propagate a collective ensemble of paths, with local covariance information calculated from neighbouring replicas. The use of collective dynamics eliminates multiplicative noise and stabilizes the dynamics, thus providing a practical approach to difficult anisotropic sampling problems in high dimensions. Numerical experiments with model problems demonstrate that dramatic potential speedups, compared to various alternative schemes, are attainable.     

The stress of driving: A diary study

A study of daily behaviours and feelings while driving was carried out with a sample of drivers to ascertain driving stress levels and changes in these as a function of time of day and day of the week. The analysis of responses to a specially designed diary/checklist showed that drivers experience more stress in the evening than in the morning, and in mid-week than either at the beginning or end of the week. Daily driving stress varies with age and experience as well as with health condition and sleep quality. It is also related to driving conditions and depends upon people's overall perception of driving as a stressful activity.