Base rates of probable malingering and symptom exaggeration are reported from a survey of the American Board of Clinical Neuropsychology membership. Estimates were based on 33,531 annual cases involved in personal injury, (n = 6,371). disability (n = 3,688), criminal (n = 1,341), or medical (n = 22,131) matters. Base rates did not differ among geographic regions or practice settings, but were related to the proportion of plaintiff versus defense referrals. Reported rates would be 2-4% higher if variance due to referral source was controlled. Twenty-nine percent of personal injury, 30% of disability, 19% of criminal, and 8% of medical cases involved probable malingering and symptom exaggeration. Thirty-nine percent of mild head injury, 35% of fibromyalgia/chronic fatigue, 31% of chronic pain, 27% of neurotoxic, and 22% of electrical injury claims resulted in diagnostic impressions of probable malingering. Diagnosis was supported by multiple sources of evidence, including severity (65% of cases) or pattern (64% of cases) of cognitive impairment that was inconsistent with the condition, scores below empirical cutoffs on forced choice tests (57% of cases), discrepancies among records, self-report, and observed behavior (56%), implausible self-reported symptoms in interview (46%), implausible changes in test scores across repeated examinations (45%), and validity scales on objective personality tests (38% of cases).
Approximately 38% of patients who sustain head trauma characterized by a brief disturbance of consciousness and clinically unremarkable neuroradiologic findings meet International Classification of Diseases 10th edition (ICD-10) diagnostic criteria for postconcussion syndrome (PCS). Physicians treat a majority of cases with nonsteroidal analgesics or antidepressants, and refer about 40% for psychological consultation. Psychological treatment typically involves education, reassurance, and reattribution of symptoms to benign causes. A review of controlled treatment outcome studies conducted over the past 2 decades in Scandinavia, Great Britain, Canada, and the United States suggests that early single session treatment can prevent the syndrome as effectively as traditional outpatient therapy. Several standardized, empirically supported treatment manuals are available.
Self-efficacy forecasts student persistence and achievement in challenging subjects. Thus, it is important to understand factors that contribute to students' self-efficacy, a key factor in their success in math and science. The current cross-sectional study examined the contribution of students' gender and math and science anxiety as well as schools' use of Social and Emotional Learning (SEL) practices to students' math and science self-efficacy. Fifth graders (n = 1,561) completed questionnaires regarding their feelings about math and science. Approximately half of the students attended schools implementing the Responsive Classroom® (RC) approach, an SEL intervention, as part of a randomized controlled trial. Results suggested no difference in math and science self-efficacy between boys and girls. Students who self-reported higher math and science anxiety also reported less self-efficacy toward these subjects. However, the negative association between students' anxiety and self-efficacy was attenuated in schools using more RC practices compared with those using fewer RC practices. RC practices were associated with higher science self-efficacy. Results highlight anxiety as contributing to poor self-efficacy in math and science and suggest that RC practices create classroom conditions in which students' anxiety is less strongly associated with negative beliefs about their ability to be successful in math and science.
We used mixed methods to examine the association between setting-level factors and observed implementation of a social and emotional learning intervention (Responsive Classroom® approach; RC). In study 1 (N = 33 3rd grade teachers after the first year of RC implementation), we identified relevant setting-level factors and uncovered the mechanisms through which they related to implementation. In study 2 (N = 50 4th grade teachers after the second year of RC implementation), we validated our most salient Study 1 finding across multiple informants. Findings suggested that teachers perceived setting-level factors, particularly principal buy-in to the intervention and individualized coaching, as influential to their degree of implementation. Further, we found that intervention coaches' perspectives of principal buy-in were more related to implementation than principals' or teachers' perspectives. Findings extend the application of setting theory to the field of implementation science and suggest that interventionists may want to consider particular accounts of school setting factors before determining the likelihood of schools achieving high levels of implementation.
In Qualitative Research Methods, Hennink, Hutter, and Bailey (2011) offer readers an overview of every phase of qualitative research from formulating research questions, to participant recruitment, to writing and presenting results. In each of these phases, the authors push readers to continuously move between induction and deduction and embrace the cyclical nature of the qualitative research process.
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