Multivariate predictors of success with cochlear implants.
Explore the source record for details and available documents.
Cochlear Implants↗
Biomedical subjects
J F Knutson
Publications and source records attributed to J F Knutson.
Multivariate predictors of audiological success with multichannel cochlear implants.
To predict the audiological outcomes of 2 multichannel cochlear implants, a preoperative battery of historical, audiological, electrophysiologic, and psychologic variables from 48 postlingually deafened adults was tested in a prospective randomized clinical trial. Multivariate analyses were used to select and combine these preoperative variables in a predictive index that was significantly related to audiological outcome at 9 months. The preoperative variables included in the predictive index were duration of profound deafness, speech reading ability, residual hearing, cognitive ability, measures of compliance and engagement with treatment, and use of nonverbal communication strategies. The preoperative predictive index had correlations of .81 with the Iowa Sentences Test, and .78 with the NU-6 word understanding scores, both obtained in a sound-only test. Probability and percentile curves generated from these data offer considerable optimism in forecasting the range of likely audiological outcomes that would be realized by postlingually deafened adult candidates for multichannel cochlear implants.
Adult↗
The effects of psychotherapy on behavior problems of sexually abused deaf children.
This study assessed the effectiveness of a broad based psychotherapeutic intervention with a sample of 72 children sexually abused at a residential school for the deaf. An untreated comparison group emerged when about half of their parents refused the offer for psychotherapy provided by the school. Treated and untreated children were randomly assigned to two assessment groups: those who participated in a pretreatment assessment and those who did not. Houseparents at the residential school used the Child Behavior Checklist (CBC) to rate the pretreatment assessment children before treatment and all 72 children one year after the implementation of psychotherapy. Children receiving therapy had significantly fewer behavior problems than children not receiving therapy. There was a differential response to therapy on the basis of sex. Boys receiving therapy had significantly lower scores on the following CBC scales than the no treatment group: Total, Internal, External, Somatic, Uncommunicative, Immature, Hostile, Delinquent, Aggressive, and Hyperactive. There were no differences on the Schizoid and Obsessive scales. Girls receiving therapy had significantly lower scores than the no treatment group on the following CBC scales: Total, External, Depressed, Aggressive, and Cruel. There were no differences on the Internal, Anxious, Schizoid, Immature, Somatic, and Delinquent scales.
Adolescent↗
Blood pressure, heart rate, and regional resistance in behavioral defense.
Rats were instrumented with arterial catheters and directional pulsed Doppler flow probes for measurement of arterial blood pressure, heart rate, and blood flow in the renal, mesenteric, and hindquarter vascular beds. When tested as intruders in a resident-intruder aggression test, subjects responded to resident attack with species-characteristic defensive behavior and the "defense reaction" pattern of increased heart rate, renal resistance, and mesenteric resistance, and decreased hindquarter resistance. Blood pressure was variable, but sustained increases in blood pressure were rarely observed. The maintenance of blood pressure during species-specific defensive behavior can be contrasted with the sustained pressor responses observed in the centrally elicited defense reaction. The combination of pulsed Doppler technology and the resident-intruder paradigm appears to be a promising method for investigating the mechanisms of cardiovascular adjustment to behavioral defense.
Aggression↗
The self-report of personal punitive childhood experiences and those of siblings.
Earlier studies of punitive childhood experiences using the Assessing Environments III questionnaire found that subjects were twice as likely to report having a sibling who was abused as they were likely to label themselves abused. The present study investigated the extent to which descriptions of personal experiences and descriptions of experiences of a sibling were similar, and how those experiences were perceived. Results indicated that, although similar experiences of subjects and siblings were reported, labeling of these experiences as abusive remained discrepant. The perception of being deserving of punishment or the sibling being deserving of punishment was correlated negatively with the classifications of personal and sibling abuse, respectively. This pattern suggests that severely punitive events are evaluated as abusive as a function of whether they were perceived to be deserved.
Adolescent↗
Patterns of physical and sexual abuse of communicatively handicapped children.
Evidence suggests that handicapped children are at increased risk for abuse and neglect. Communicatively impaired youngsters are particularly vulnerable because of their limited ability to report the maltreatment. Of 482 abused handicapped children evaluated at Boys Town National Research Hospital, 212 had hearing impairment, 87 speech language disorders, 39 learning disorders, 43 behavioral-emotional disturbances, 74 mental retardation, 5 visual impairment, 3 cleft lip or palate, and 19 other disorders. The perpetrator was either a relative or a "trusted other" in 97.2% of sexual abuse cases. Handicapped males were much more likely to be victims of sexual abuse than nonhandicapped males in the general population. Children being educated in residential schools were more likely to be sexually abused than mainstreamed youngsters. These children may be at risk for abuse from a wide variety of potential perpetrators, including teachers, dormitory counselors, van drivers, clergy, classroom aides, older students, peer siblings, scout leaders, abused peers, baby-sitters, and custodians.
Adolescent↗
Psychological predictors of audiological outcomes of multichannel cochlear implants: preliminary findings.
The purpose of this research was to determine whether psychological variables were associated with the variability that characterizes the audiological performance of recipients of multichannel cochlear implants. Twenty-nine consecutive recipients of multichannel implants participated in a preoperative psychological assessment and audiological follow-up assessments after 18 months of implant use. Experimental cognitive measures that assess an ability to rapidly detect and respond to features imbedded in sequentially arrayed information accounted for up to 30% of the variance in implant outcome, suggesting the importance of cognitive abilities in implant outcome. Standardized measures of intellectual ability, however, were not predictive of outcome. The Health Opinion Survey, a measure of participatory engagement, was also a significant predictor of audiological outcome. Overall, the results implicated the importance of several specific psychological factors in the audiological outcome of cochlear implants in postlingually deafened adult recipients.
Adult↗
Psychological change following 18 months of cochlear implant use.
Consecutive recipients of multichannel cochlear implants participated in preimplant as well as 9-month and 18-month psychological evaluations. Before receiving a cochlear implant, psychological tests indicated that the implant recipients were more depressed, suspicious, socially isolated, lonely, and socially anxious than was the general population. After 18 months of implant use, there was a significant reduction in depression, loneliness, social anxiety, social isolation, and suspiciousness. These changes in psychological state did not correlate with improved performance on audiological measures. The data suggest that although cochlear implants can have a positive effect on the emotional and behavioral status of persons with acquired postlingual profound deafness, the psychological outcome of implants is not simply a function of the audiological benefit assessed with standardized speech-based audiological tests.
Cochlear Implants↗
The relationship between communication problems and psychological difficulties in persons with profound acquired hearing loss.
Communication strategies, accommodations to deafness, and perceptions of the communication environment by profoundly deaf subjects were correlated with indices of psychosocial adjustment to determine whether accommodations to deafness could play a role in the presence of psychological difficulties among deaf persons. Persons with postlingually acquired profound deafness were administered the Communication Profile for the Hearing Impaired (CPHI) and several standardized tests of psychological functioning and adjustment. Inadequate communication strategies and poor accommodations to deafness reported on the CPHI were associated with depression, social introversion, loneliness, and social anxiety. Limited communication performance at home and with friends was related to both social introversion and the experience of loneliness; perceived attitudes and behaviors of others correlated with depression as well as loneliness. In general, the pattern of correlations obtained suggests that specific communication strategies and accommodations to deafness, rather than deafness per se, may contribute to the presence of some psychological difficulties in individuals.
Adult↗
Effects of behavior and social condition on cardiovascular response to footshock stress.
Rats were instrumented with arterial catheters and directional-pulsed Doppler flow probes for assessment of blood pressure, heart rate, and blood flow in the renal, mesenteric, and hindquarter vascular beds. Subjects were tested in an intermittent shock procedure under paired and isolated social conditions and the cardiovascular indices associated with first shock, prone immobile behavior, upright behavior, and boxing behavior were recorded. Both shock procedures resulted in increased heart rate, mesenteric resistance, and renal resistance, as well as decreased hindquarter resistance. Blood pressure response was variable. Social and behavioral conditions generally accounted for little variance in cardiovascular indices during the treatments. Blood pressure assessed 2.5 min after the last shock was significantly higher in the isolated shock condition. In the context of divergent results from previous research in the area, the current results are most consistent with the view that a similar form of cardiovascular adjustment is present under paired and isolated shock, but that under some conditions the presence of a conspecific or the opportunity to fight may attenuate cardiovascular response to shock.
Aggression↗
Presenting problems of sexually abused girls receiving psychiatric services.
Twenty-three behaviors among those suggested in the literature to be associated with sexual abuse were studied in 195 girls, ages 2-18 years, who were consecutive admissions to three Midwestern mental health agencies. Results indicated that sexually inappropriate behaviors, sleep disturbance, depressed mood, and delinquent behavior occurred more frequently in young abuse victims than in clinic comparisons. Sexually inappropriate behaviors and running away appeared more often in older sexually abused girls, than they appeared in older clinic comparisons. These comparisons of the presenting problems of sexually abused and nonabused girls suggested there are few behavioral "markers" of sexual abuse in clinical samples and that sexual abuse may not be a unique contributing factor in the ontogeny of childhood psychopathology.
Adolescent↗
The self-report of punitive childhood experiences of young adults and adolescents.
A questionnaire designed to assess childhood disciplinary experiences was administered to a large sample of university students. The responses of these subjects indicated many of these predominantly middle-class young adults had experienced disciplinary activities that could be considered abusive. The results provide prevalence data on child abuse histories in a nonclinical sample and were seen as supporting the idea that physical abuse of children is widespread and not restricted to groups identified on the basis of clinical service or social deviance. Regardless of the criterion for physical abuse applied to the data, most respondents who met a criterion for having been abused failed to label themselves as having been abused. Additionally, correlations between severe physical punishment and abuse-related domains were shown to obtain in these nonclinical samples in a manner consistent with descriptions of abusive families in the clinical literature. A second study conducted with truly abused and nonabused adolescents established the validity of the questionnaire approach used in this research, and the two studies indicated the feasibility of conducting research on physical child abuse in natural collectivities of nonclinical subjects.
Adolescent↗
Evaluation of five different cochlear implant designs: audiologic assessment and predictors of performance.
The audiologic performance of 54 postlingually deafened adults wearing cochlear implants was uniformly evaluated. The participants had 9 months' or more experience with one of five different cochlear prostheses (Los Angeles Single Channel (N = 11), Vienna Single Channel (N = 4), Melbourne Multichannel (N = 18), Utah Multichannel (N = 19), San Francisco Multichannel (N = 2). The multichannel designs enabled participants to recognize more environmental sounds, provided more speech reading enhancement, and enabled most users to understand limited speech in the sound-only condition, compared to the single-channel implant group.
Adult↗
Animal analogues of human aggression: studies of social experience and escalation.
Explore the source record for details and available documents.
Aggression↗
Influence of blinding and home-cage lighting on aggressive behaviors of laboratory rats.
Explore the source record for details and available documents.
Aggression↗
Influence of PCPA, shock level, and home-cage conditions on shock-induced aggression.
In a series of experiments, the effect of parachlorophenylalanine (PCPA) on shock-induced fighting was assessed rats raised and maintained under either a 12-hr alternating light-dark cycle (LD) or constant light conditions (LL). PCPA increased shock-induced aggression only in LL groups when testing was accomplished using a 2 mA shock; PCPA resulted in increased aggression in groups from the LD condition only when testing was done at 1 mA. A procedure that used castrated and intact cagemates to manipulate home-cage social experience provided evidence for a role for social experience in determining differences between LL and LD reared rats in shock-induced aggression. However, these data also suggested that home-cage social experience was not a factor in the lighting condition influence on the effect of PCPA on shock-induced aggression. Finally, a separate experiment demonstrated that diurnal rhythms in shock-induced aggression were disrupted by handling and vehicle injection in the control procedures, so the possible role of serotonin in diurnal rhythms of aggression behavior could not be assessed.
Aggression↗
Influence of colony lighting conditions on home-cage spontaneous aggression.
In a series of experiments the effects of colony lighting conditions on home-cage aggression were examined, and the relation among measures of home-cage aggressive behavior and shock-induced aggression were determined. In each experiment rats were maintained under either a light/dark (LD) cycle or a continous light (LL) schedule. Experiments 1A and 1B indicated that for cages of LD rats the highest rates of home-cage aggression occurred during the dark segment of the light cycle whereas the lowest rates of aggression characterized the light segment. In contrast, the rate of home-cage aggression was low and constant across time periods for cages of LL rats. Reflecting these differences between lighting conditions, regression analyses in Experiment 1B identified a periodic trend following the fundamental sine curve in the home-cage aggression data from cages of LD rats but not in the data from cages of LL rats. In Experiment 2 the relation between individual differences in home-cage aggression and shock-induced aggression and shock-induced aggression was found to be time dependent for pairs of LD rats. Correlations based on scores of home-cage aggression and shock-induced aggression obtained during the dark segment were positive and statistically significant. Correlations of these two aggressive behaviors based on scores obtained during the light segment were not statistically significant. For pairs of LL rats, no time-dependent pattern in the relation of home-cage aggression to shock-induced aggression was observed.
Aggression↗
Influence of home-cage lighting conditions on shock-induced fighting.
A series of experiments was conducted to assess the influence of home-cage lighting conditions on shock-induced aggression in rats. The first two experiments tested rats six times within 24 hr and demonstrated that subjects maintained on a light/dark (LD) cycle fought more than rats maintained on a 24-hr light schedule (LL). In addition, a periodic trend could be identified in the data of the LD groups but not in the data of the LL groups. The second two experiments assessed the effects of castration on this lighting effect. Castration of adults did not influence the lighting effects, but castration of weanling rats eliminated the group difference between LL and LD groups. However, the LD rats castrated at weaning did show the periodic trend characteristic of all of the LD groups tested within 24 hr. Two additional experiments assessed the effects of time of testing in between-subjects designs. Time of testing was a significant variable in the LD groups but unimportant in the LL groups. A final experiment demonstrated that the difference between the LD and LL groups does not emerge in a daily testing procedure.
Age Factors↗