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Article
Publication date: 12 November 2019

Henny Kupferstein

The purpose of this paper is to explore why autistic people and their caregivers choose interventions other than applied behavior analysis (ABA), and how their decision…

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Abstract

Purpose

The purpose of this paper is to explore why autistic people and their caregivers choose interventions other than applied behavior analysis (ABA), and how their decision impacts them over their lifespan. The focus group was divided into those who pursued augmentative and alternative communication (AAC)-based supports, received ABA, selected other interventions or received no intervention at all. The reported posttraumatic stress symptoms (PTSS) of ABA recipients were compared to non-ABA recipients in order to evaluate the long-term impacts of all intervention types. Using a mixed-method thematic analysis, optional comments submitted alongside a quantitative online survey were reviewed for emergent themes. These comments augmented the survey Likert scores with a qualitative impression of the diverse intervention-related attitudes among participants. Investigating the lived experiences of autism intervention recipients illuminated the scope of the long-term impacts of each intervention that was chosen. Overall, autistics who received no intervention fared best, based on the lowest reported PTSS. These findings may inform the potential redesign of autism interventions based on the firsthand reported experiences and opinions of autistics.

Design/methodology/approach

The aim of this study was to conduct research that is both question-driven and data-driven to aid in the analysis of existing data (Van Helden, 2013). In the research question-driven approach, the independent variables were the intervention type and duration of exposure relative to lifespan; the dependent variables were the PTSS severity score and binary indicator of meeting PTSS criteria. The analyses that were conducted included linear regression analyses of severity score on intervention type and duration, and χ2 tests for independence of the probabilities of PTSS criterion satisfaction and intervention type. This experiment was designed to test the data-driven hypothesis that the prevalence and severity of PTSS are dependent on the type of autism intervention and duration of exposure. After reviewing the primary data set, the data-driven inquiry determined that the sample for secondary analysis should be categorized by communication-based vs non-communication-based intervention type in order to best complement the limitations and strengths of the published findings from the primary analysis.

Findings

Autistics who received no intervention had a 59 percent lower likelihood of meeting the PTSS criteria when compared to their ABA peers, and they remained 99.6 percent stable in their reported symptoms throughout their lifespan (R2=0.004). ABA recipients were 1.74 times more likely to meet the PTSS criteria when compared to their AAC peers. Within the 23 percent who selected an intervention other than ABA, consisting of psychotherapy, mental health, son-rise and other varying interventions, 63 percent were asymptomatic. This suggests that the combined benefits of communication-based interventions over behaviorism-influenced ABA practices may contribute to enhanced quality of life. Although not generalizable beyond the scope of this study, it is indicated from the data that autistics who received no intervention at all fared best over their lifetimes.

Research limitations/implications

The obvious advantage of a secondary analysis is to uncover key findings that may have been overlooked in the preliminary study. Omitted variables in the preliminary data leave the researcher naive to crucially significant findings, which may be mitigated by subsequent testing in follow-up studies (Cheng and Phillips, 2014, p. 374). Frequency tables and cross-tabulations of all variables included in the primary analysis were reproduced. The secondary analysis of existing data was conducted from the design variables used in the original study and applied in the secondary analyses to generate less biased estimates (Lohr, 2010; Graubard and Korn, 1996). Inclusion criteria for each intervention group, PTSS scores and exposure duration, were inherited from the primary analysis, to allow for strategic judgment about the coding of the core variables pertaining to AAC and PTSS. The data sample from 460 respondents was reduced to a non-ABA group of n=330. An external statistician scored each respondent, and interrater reliability was assessed using Cohen’s κ coefficient (κ=1).

Practical implications

Including the autistic voice in the long-term planning of childhood interventions is essential to those attempting to meet the needs of the individuals, their families and communities. Both parents and autistic participant quotes were obtained directly from the optional comments to reveal why parents quit or persisted with an autism intervention.

Social implications

Practitioners and intervention service providers must consider this feedback from those who are directly impacted by the intervention style, frequency or intensity. The need for such work is confirmed in the recent literature as well, such as community-based participatory research (Raymaker, 2016). Autistics should be recognized as experts in their own experience (Milton, 2014). Community–academic partnerships are necessary to investigate the needs of the autistic population (Meza et al., 2016).

Originality/value

Most autistic people do not consider autism to be a mental illness nor a behavior disorder. It is imperative to recognize that when injurious behavior persists, and disturbance in mood, cognition, sleep pattern and focus are exacerbated, the symptoms are unrelated to autism and closely align to the diagnostic criteria for posttraumatic stress disorder (PTSD). When PTSD is underdiagnosed and untreated, the autistic individual may experience hyperarousal and become triggered by otherwise agreeable stimuli. Since autism interventions are typically structured around high contact, prolonged hours and 1:1 engagement, the nature of the intervention must be re-evaluated as a potentially traumatic event for an autistic person in the hyperarousal state. Any interventions which trigger more than it helps should be avoided and discontinued when PTSS emerge.

Details

Advances in Autism, vol. 6 no. 1
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 27 April 2018

Marin C. Beagley, Zoë D. Peterson, David R. Strasshofer and Tara E. Galovski

Women comprise a significant and growing proportion of the law enforcement population. Despite this, their potentially unique reactions to job-related posttraumatic stress…

Abstract

Purpose

Women comprise a significant and growing proportion of the law enforcement population. Despite this, their potentially unique reactions to job-related posttraumatic stress symptoms (PTSS) and depression have been underrepresented in the relevant literature, particularly within the context of exposure to community violence. Also understudied is the role of empathy in the development of post-trauma reactions, which has been a risk factor for the development of posttraumatic distress in previous studies. With the recent endorsement of empathy training by the President’s Task Force on 21st Century Policing, it is important to examine ways in which empathy may contribute to differences in PTSS and depression for male and female officers. The paper aims to discuss this issue.

Design/methodology/approach

Male and female police officers (n=189) exposed to violence during the 2014 Ferguson protests completed a battery of measures designed to assess demographic information, prior trauma history, and mental health outcomes.

Findings

Moderation analyses showed that empathy moderated the relationships between exposure and PTSS and exposure and depression in female officers, such that exposure was associated with higher posttraumatic stress and depressive symptoms only for female officers with high levels of empathy. These relationships were not found for men.

Originality/value

This study is the first to examine sex differences and the role of empathy in the mental health effects of law enforcement secondary to violence during community protests against policing.

Details

Policing: An International Journal, vol. 41 no. 5
Type: Research Article
ISSN: 1363-951X

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Article
Publication date: 2 January 2018

Henny Kupferstein

The purpose of this paper is to examine the prevalence of posttraumatic stress symptoms (PTSS) in adults and children who were exposed to applied behavior analysis (ABA…

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2944

Abstract

Purpose

The purpose of this paper is to examine the prevalence of posttraumatic stress symptoms (PTSS) in adults and children who were exposed to applied behavior analysis (ABA) autism early childhood intervention. Using an online questionnaire to survey autistic adults and caregivers of autistic children, the author collected data from 460 respondents on demographics, intervention types, and current pathological behaviors with symptom severity scales. This study noted PTSS in nearly half of ABA-exposed participants, while non-exposed controls had a 72 percent chance of being asymptomatic. ABA satisfaction ratings for caregivers averaged neutral or mild satisfaction. In contrast, adult satisfaction with ABA was lower on average and also tended to take on either extremely low or extremely high ratings. Exposure to ABA predicted a higher rate and more severe PTSS in participants, but the duration of exposure did not affect satisfaction with the intervention in caregivers.

Design/methodology/approach

Participants were recruited for an online survey through social media networks, adult gatherings, social skills groups, and autism support groups nationwide. Adult inclusion criteria consisted of autism – diagnosed or self-diagnosed – and an age of 18 or older. A total of 460 respondents, consisting of autistic adults and caregivers of autistic children, completed an online survey. The caregiver entries (n=217) concerned 79 percent male children, 21 percent female children (male to female 3.80:1), and one MtF transgender child, ages 1-38, with an average age at diagnosis of 4.69 years. The adult entries (n=243) concerned 30 percent males, 55 percent females (male to female 0.55:1), and 14 percent other gender, ages 18-73, with an average age at diagnosis of 25.38 years.

Findings

Nearly half (46 percent) of the ABA-exposed respondents met the diagnostic threshold for PTSD, and extreme levels of severity were recorded in 47 percent of the affected subgroup. Respondents of all ages who were exposed to ABA were 86 percent more likely to meet the PTSD criteria than respondents who were not exposed to ABA. Adults and children both had increased chances (41 and 130 percent, respectively) of meeting the PTSD criteria if they were exposed to ABA. Both adults and children without ABA exposure had a 72 percent chance of reporting no PTSS (see Figure 1). At the time of the study, 41 percent of the caregivers reported using ABA-based interventions.

Originality/value

The majority of adult respondents were female, raising questions about the population of online autistic survey respondents. Further, the high numbers of reported gender other than male or female in the adult respondents, as well as at least on MtF child from the caregiver respondents indicates that future studies should consider these intersections. These accompanied significant discrepancies in reporting bias between caregivers and ABA-exposed individuals, which highlight the need for the inclusion of the adult autistic voice in future intervention design. Based on the findings, the author predicts that nearly half of ABA-exposed autistic children will be expected to meet the PTSD criteria four weeks after commencing the intervention; if ABA intervention persists, there will tend to be an increase in parent satisfaction despite no decrease in PTSS severity.

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Article
Publication date: 12 December 2016

Cassandra Perryman, Genevieve Dingle and David Clark

The purpose of this paper is to investigate the changes in posttraumatic stress disorder (PTSD) symptomatology during treatment in a drug and alcohol therapeutic community.

Abstract

Purpose

The purpose of this paper is to investigate the changes in posttraumatic stress disorder (PTSD) symptomatology during treatment in a drug and alcohol therapeutic community.

Design/methodology/approach

A repeated measures design was employed that looked at PTSD, depression, anxiety, and stress at a pre- and post-timepoint. A second sample was then evaluated at time of program completion to seven months post-treatment.

Findings

PTSD symptomatology significantly decreased in individuals who had undertaken treatment, and continued to decline post-treatment. This finding was irrespective of any PTSD-specific treatment.

Research limitations/implications

PTSD specific treatment is not necessary to lower the symptomatology. Furthermore, this provides evidence that PTSD and substance use disorders are so highly intertwined that the comorbidity can almost be considered a single, diagnosis.

Originality/value

This is a partial replication of previous research which had not previously been replicated. This research also adds to the limited research which looks at PTSD from the perspective of drug and alcohol rehabilitation.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 37 no. 4
Type: Research Article
ISSN: 0964-1866

Keywords

Content available
Article
Publication date: 4 October 2018

Justin Barrett Leaf, Robert K. Ross, Joseph H. Cihon and Mary Jane Weiss

Kupferstein (2018) surveyed 460 respondents and found that 46 percent of respondents met the diagnostic threshold for posttraumatic stress disorder after exposure to…

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13160

Abstract

Purpose

Kupferstein (2018) surveyed 460 respondents and found that 46 percent of respondents met the diagnostic threshold for posttraumatic stress disorder after exposure to applied-behavior-analysis-based intervention. The purpose of this paper is to provide an evaluation a critical analysis of Kupferstein (2018) including the experimental methods and discussion of the results.

Design/methodology/approach

The authors evaluated the Kupferstein’s methodological rigor with respect to the use of hypothesis testing, use of indirect measures, selection of respondents, ambiguity in definitions, measurement system, and framing of the experimental question when conducting the correlational analysis in addition to Kupferstein’s analysis and discussion of the results.

Findings

Based upon the analysis, Kupferstein’s results should be viewed with extreme caution due to several methodological and conceptual flaws including, but not limited to, leading questions used within a non-validated survey, failure to confirm diagnosis, and incomplete description of interventions.

Originality/value

It is the authors’ hope that this analysis provides caregivers, clinicians, and service providers with a scientific lens which will useful in viewing the limitations and methodological flaws of Kupferstein.

Details

Advances in Autism, vol. 4 no. 3
Type: Research Article
ISSN: 2056-3868

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Article
Publication date: 13 July 2015

Allan O'Connor, Kai Du and Göran Roos

Developed economies with high-cost environments face industrial transitions from scale-based manufacturing (MAN) to knowledge, technology and intangible asset-based…

Abstract

Purpose

Developed economies with high-cost environments face industrial transitions from scale-based manufacturing (MAN) to knowledge, technology and intangible asset-based sectors. The purpose of this paper is to examine the changes in employment and value-adding profiles of transitioning industry sectors in Australia and discuss the implications for policy that influences the intellectual capital (IC) profile of industrial sectors in transition.

Design/methodology/approach

The approach borrowed concepts from the firm-level strategic management literature and applied them to a macro level of industry analysis. In this paper the authors examine the transitions in the Australian economy which, due to a rising cost base, is experiencing a decline in its value chain-oriented MAN sector. The authors contrast four industry sectors with the MAN sector and examine the different value creation models.

Findings

The findings clearly show how the contribution to employment and value added (termed Economic Value Contribution ) of the different sectors vary. The authors extend these findings to a discussion on policy and the dimensions of IC that may have a role to play in facilitating transitions within an economy. The main conclusion is that a more rapid transition and higher value may be created if innovation and entrepreneurship are facilitated by targeted policies in transitioning sector.

Research limitations/implications

This work is based on a single country analysis of selected industry sectors. Further work needs to be done across many more countries to contrast the findings across nations/regions that differ in industrial complexity and to refine the analytical framework to improve construct validity and increase analytical power.

Practical implications

This work has implications for policy-makers facing the challenges of a transitioning economy, whether national or regional. Governments that are hands-on with respect to interventions to salvage and/or extend the life of sectors are at risk of missing opportunities to build the capacities and capabilities of emerging sectors while those governments that are hands-off, deferring to market mechanisms, risk transitions that are too little and/or too late to maintain a national or regional competitiveness.

Originality/value

To the authors knowledge, this is the first attempt to integrate the specific firm-level strategic management perspectives, used in this paper, with the macro-policy level to examine industry sectors with the twin metrics of economic productivity and employment in transitioning economies.

Details

Journal of Intellectual Capital, vol. 16 no. 3
Type: Research Article
ISSN: 1469-1930

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Article
Publication date: 11 June 2021

Christopher Gan, Dao Le Trang Anh and Quang Thi Thieu Nguyen

This study investigates the psychological impact of the COVID-19 lockdown on Vietnamese people and examines the factors affecting their psychological well-being during and…

Abstract

Purpose

This study investigates the psychological impact of the COVID-19 lockdown on Vietnamese people and examines the factors affecting their psychological well-being during and after the lockdown period.

Design/methodology/approach

Based on the survey answers of 701 Vietnamese respondents, this study explores the psychological impact associated with COVID-19 lockdown in Vietnam. Using a newly developed “mvord” package in R that controls the heterogeneity in error structure of the sample units (Hirk et al., 2020), the study runs multivariate ordinal logistic regression models to examine the determinants of the emotional outcomes.

Findings

The study discloses negative psychological states among the Vietnamese community during and after the lockdown, including boredom, anxiety, sadness, stress, anger, precautionary measures and post-traumatic stress symptoms. Demographic characteristics (male gender, young age, poor-health condition, high educational level, small family size, officers or professionals, using public transport, quarantine experience before the lockdown, non-extended lockdown period and living in rural areas) and various difficulties during lockdown (insufficient information about COVID-19, income loss, having daily-life difficulties and unhappy experiences during lockdown) are related to higher degrees of different psychological symptoms during and after lockdown in Vietnam.

Originality/value

This study identifies the importance of mitigating the detrimental effects of the COVID-19 lockdown on Vietnamese well-being and prepares the Vietnamese government better to handle the public mental issues during future lockdowns.

Details

International Journal of Social Economics, vol. 48 no. 9
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 18 May 2015

Elizabeth Donnelly, Colby Valentine and Karen Oehme

The toll of the stresses of policing on officers’ physical and mental health and on their individual work and family functioning has been well documented in the…

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2508

Abstract

Purpose

The toll of the stresses of policing on officers’ physical and mental health and on their individual work and family functioning has been well documented in the literature. Given the well-established consequences of work-related stress on law enforcement, it becomes important to understand how officers are utilizing institutional support systems. Specifically, the purpose of this paper is to elucidate the relationship between officers and Employee Assistant Programs (EAPs).

Design/methodology/approach

Data were collected from surveys attached to an online officer training targeting domestic violence in law enforcement families in a large southern state.

Findings

A total of n=934 participants were retained for analyses. Few respondents (16.2 percent) reported accessing their EAPs. Totally, 56.4 percent reported knowing enough about their EAP and how to access it; 33 percent of participants would not use their EAPs for domestic violence concerns. No significant differences among officers who did and did not access their EAPs for workplace stress, posttraumatic stress, alcohol use, or domestic violence were identified. Significant differences in alcohol use, posttraumatic stress, and operational stress were identified in those who reported not knowing enough about how to access their EAP.

Practical implications

Concrete suggestions are offered to help increase officers’ knowledge and understanding of the importance of mental health and EAPs. Agencies should consider a more comprehensive approach to mental health to ensure that officers get the help they need.

Originality/value

Very little is known about the relationship that law enforcement officers have with EAP services. This study sheds light on some important differences in work-related stress, stress reactions, and knowledge and familiarity with EAP services.

Details

Policing: An International Journal of Police Strategies & Management, vol. 38 no. 2
Type: Research Article
ISSN: 1363-951X

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Article
Publication date: 22 June 2012

Shannon L. Wagner and Melanie O’Neill

The purpose of this paper is to add to the overall body of literature regarding mental health implications related to fire service membership; in particular, to look…

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797

Abstract

Purpose

The purpose of this paper is to add to the overall body of literature regarding mental health implications related to fire service membership; in particular, to look specifically at the implications of volunteer membership and to compare results with previous research looking at paid‐professional members.

Design/methodology/approach

Responses to the Impact of Event Scale‐Revised (IES‐R), the Neuroticism‐Extroversion‐Openness Personality Inventory (NEO‐PI) and the Symptom checklist (SCL)‐90R were collected from a sample of volunteer firefighters (n=64), as well as from a similar comparison sample (n=103).

Findings

Volunteer fire service members reported significantly higher rates of posttraumatic stress symptomatology when compared to a similar group of comparison participants. In contrast, no differences were found in other types of mental health symptomatology between the volunteer fire fighters and comparison group. Additionally, there appeared to be few differences in the patterns regarding prediction of mental health symptomatology from individual personality characteristics for the two groups. Generally, the authors’ results suggested that, regardless of group, neuroticism was a predictor of mental health symptomatology in many domains.

Originality/value

To the authors’ knowledge, this is the only available study to have as its primary intent to describe the mental health implications of volunteer fire service membership, as opposed to a similar comparison sample. In addition, the authors’ data provide some meaningful comparison with previously published results found in a paid‐professional sample; such comparison, to this point, has been unavailable.

Details

Disaster Prevention and Management: An International Journal, vol. 21 no. 3
Type: Research Article
ISSN: 0965-3562

Keywords

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