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The present study tested cognitive-behavioral therapy (CBT) for insomnia in older adults with osteoarthritis, coronary artery disease, or pulmonary disease. Ninety-two participants (mean age = 69 years) were randomly assigned to classroom CBT or stress management and wellness (SMW) training, which served as a placebo condition. Compared with SMW, CBT participants had larger improvements on 8 out of 10 self-report measures of sleep. The type of chronic disease had no impact on these outcomes. The hypothesis that CBT would improve daytime functioning more than SMW was only supported by a global rating measure. These results add to findings that challenge the dichotomy between primary and secondary insomnia and suggest that psychological factors are likely involved in insomnias that are presumed to be secondary to medical conditions.

The present research builds upon the extant literature as it assesses psychophysiological factors in relation to empathy, conflict resolution, and romantic relationship satisfaction. In this study, we examined physiological reactivity of individuals in the context of emotionally laden interactions with their romantic partners. Participants (N = 31) completed self-report measures and attended in-person data collection sessions with their romantic partners. Participants were guided through discussions of problems and strengths of their relationships in vivo with their partners while we measured participants' skin conductance level (SCL) and interbeat interval (IBI) of the heart. We hypothesized that participants' level of empathy towards their partners would be reflected by physiological arousal (as measured by SCL and IBI) and relationship satisfaction, such that higher levels of empathy would be linked to changes in physiological arousal and higher relationship satisfaction. Further, we hypothesized that differences would be found in physiological arousal (as measured by SCL and IBI) based on the type of conflict resolution strategy used by participants. Finally, we hypothesized that differences would be found in empathy towards partner and relationship satisfaction based on the type of conflict resolution strategies used by participants. Results partially supported hypotheses and were discussed in light of existing knowledge based on empirical and theoretical sources.

Down syndrome is the most common genetic cause of mental retardation and one of the most frequently occurring neurodevelopmental genetic disorders in children. Children with Down syndrome typically experience a constellation of symptomology that includes developmental motor and language delay, specific deficits in verbal memory, and broad cognitive deficits. Children with Down syndrome are also at increased risk of medical problems, which can exacerbate their cognitive deficits. Although the diagnosis of Down syndrome is facilitated by cytogenetic testing and the unique physical phenotype, the development of proper interventions for this group of children is less obvious. Despite their functional deficits, children with Down syndrome possess relative strengths, which can be the focus of interventions. This article reviews the etiology and developmental course of Down syndrome, appraises examples of empirically validated interventions, and discusses neurocognitive processing issues that should be considered during a psychoeducational evaluation for intervention.

School readiness and functioning in children diagnosed with Reactive Attachment Disorder (RAD) are important issues due to the dramatic impact RAD has on multiple areas of development. The negative impact of impaired or disrupted early relationships, characterized by extreme neglect, abuse, parental mental illness, domestic violence, and repeated changes in caregivers is examined. A key component of social and emotional development is self-regulation, which is a critical variable in school readiness and is often impaired in children with RAD. Highlighted topics include the academic and school areas which may exacerbate attachment disturbances as well as ways in which teachers and other school professionals can encourage the development of more productive relationships. Interventions are provided which lead to greater success in school for these children. © 2006 Wiley Periodicals, Inc. Case Example1 Nancy is a 6-year-old girl entering the first grade in a new school. This is Nancy's fourth new school since age 5. Nancy has been in five foster homes since being removed from her biological mother's care at approximately 2 years of age. Prior to being removed from her mother's care by the Department of Social Services, Nancy was exposed to sexual activity between her mother and others, was emotionally and physically abused, and was profoundly neglected. As an infant, Nancy was often left in her crib screaming, unfed, dirty, and unattended. Nancy was found in a closet, eating garbage, covered in urine and feces. Nancy's mother's parental rights were terminated when Nancy was 4. She has been removed from previous foster homes due to uncontrollable rages and destructive behavior. Nancy becomes angry quickly and strikes without warning. She responds to nurturance with contempt and fear, and tries to control everything in her environment. She reportedly does not feel badly about her actions. Her foster parents report Nancy can be charming and sweet, depending upon the situation, yet her behavior and emotions can change instantaneously. Her fourth foster mother described Nancy as follows:You can't really know Nancy . . . . She is . . . so superficial; at times she is wary around strangers, yet at other times she will simply go up to someone she doesn't know and hug them. She is very careful to observe her surroundings and seems to take notice of small details. Sometimes after I have been away from her for a few hours . . . she sees me and has no reaction. She doesn't seem to look at adults as people who can help her.Nancy has been in her fifth foster home for about 2 months and is having a very hard time adjusting to this placement. She has hurt the other foster children in the home. Nancy's first day at school did not go well. She refused to share and bullied several children into giving up play activities. She hit her teacher once when the teacher tried to set limits. When her teacher attempted to console Nancy after she started crying, Nancy shuddered and recoiled back from the touch. She ended up in a fetal position in...

Child maltreatment has the potential to alter a child's neurodevelopmental trajectory and substantially increase the risk of later psychiatric disorders, as well as to deleteriously impact neurocognitive functioning throughout the lifespan. Child maltreatment has been linked to multiple domains of neurocognitive impairment, including language, visual-spatial functioning, intelligence, executive functioning, and motor skills. Research is increasingly indicating that alterations in neurobiological functioning occur as a result of childhood maltreatment, which in turn may produce an epigenetic and transgenerational effect. School psychologists should be aware of these factors when working with maltreated children to better understand their current functioning and assessment results, and to educate family members, school personnel, and the community about the adverse effects of childhood maltreatment, as well as to work toward prevention. C 2014 Wiley Periodicals, Inc.In essence, clinical neuropsychology is the application of the brain-behavior relationship to answer diagnostic questions, design strength-based interventions, and determine functional deficits, outcomes, and prognoses. For pediatric neuropsychology, this process involves the integration of neurological, psychiatric, genetic, psychosocial, physiological, academic, and environmental variables, all in the context of developmental trajectories. At first glance, the inclusion of an article with this approach may seem surprising in a discussion of child abuse and neglect, henceforth referred to as child maltreatment, as it relates to the practice of school psychology. This may stem from a typical approach of primarily considering familial, societal, and environmental variables in studying child maltreatment; however, child maltreatment can have a profound impact on the child's developing central nervous system. Given the fact that most observable behavior involves the central nervous system, it stands to reason that considering neuropsychological variables for children who have been maltreated is an essential aspect of interacting clinically with this population. School psychologists are essential members of the treatment team for maltreated children and, as such, the primary focus of this article is to discuss the role of the brain-behavior relationship and associated longitudinal considerations for school psychologists working with children who have been maltreated. NEURODEVELOPMENTAL FACTORS IN CHILD MALTREATMENTThe central nervous system undergoes massive changes very early in a child's life, including substantial development during the perinatal period. Maltreatment during this time can have a profound impact on neurodevelopmental processes. Given that neurological development proceeds throughout childhood, disruption at different times in this process can interfere with the acquisition of different developmental milestones. Indeed, when more basic functions are impacted by maltreatment, the brain is less able to develop in a manner that facilitates hea...

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) typically exhibits a pattern of behavioral deficits, impairment in academic achievement, and cognitive processing, and presents with sensory-motor deficits. This study examined the relationships between sensory-motor tasks, cognitive processing, and academic achievement for a group of 67 children with ADHD. Strong canonical correlations emerged between sensory-motor functioning and academic achievement (.93) and sensory-motor functioning and cognitive processing (.98). An analysis of the redundancy coefficient showed that sensory-motor skills accounted for 65% of the variance in the achievement variables and 31% of the variance in the cognitive processing variables. The strong relationship between sensory-motor skills and higher order cognitive processes indicates that early assessment of sensory-motor skills may be useful in the identification of subsequent deficits in academic performance. Neuropsychologists should carefully consider the contribution of sensory-motor functioning to the more widely studied and assessed constructs of academic, behavioral, and emotional problems in children with ADHD.

Moyamoya disease is a rare progressive cerebrovascular disorder that can be congenital or acquired and involves progressive stenosis and occlusion of cerebral arteries. The brain through compensatory angeogenesis then attempts to compensate for ischemia by producing a local network of tiny blood vessels, which appear cloud-like on angiograms. Consistent with multifocal or diffuse areas of ischemia, people with moyamoya often have multiple areas of cognitive impairment. A thorough literature review of the neuropsychological profile in individuals diagnosed with moyamoya disease is provided. Medical and neuropsychological/neurobehavioral data of a middle-aged woman with moyamoya disease is also described. The patient (MA) suffered an embolic shower with insult to both cerebral hemispheres. Neuropsychological results suggested a multifocal decline, with both cortical and subcortical involvement. Data were consistent with impairments in attention, concentration, executive skills, processing speed, and memory encoding and retrieval, with relatively spared aspects of memory and language skills. This case study supports the literature and provides an additional example of the neuropsychological profile and deficit pattern of an individual with moyamoya following an embolic stroke shower.