Grief intervention and sudden infant death syndrome

A program utilizing nurses to deliver grief intervention to parents losing a baby to Sudden Infant Death Syndrome (SIDS) is described. Because parents of SIDS victims experience profound feelings of guilt and especially servere crisis reactions, programs relieving guilt and providing additional support to them are felt to have significant preventive potential. Data are presented tentatively supporting the conclusion that the SIDS grief intervention program had a beneficial impact on the participants. Implications for crisis theory and preventive programming in general are also discussed.     

Neonatal functioning and the sudden infant death syndrome

A male infant, diagnosed as a Sudden Infant Death Syndrome (SIDS) at 5 months, 3 weeks, had been extensively tested as a part of a larger sample in a longitudinal study. The longitudinal sample was comprised of 137 clinically normal neonates, born to intact upper middle-class families, living in a large metropolitan area. A neonatal assessment consisted of 5 hours of polygraphic recordings of heart and respiratory rate during sleep and waking cycles, and 1 hour of behavioral testing. At 3 months of age the infant was observed for 12 hours in the home. Retrospective analyses of these data suggested that: (a) neonatal respiratory behavior during sleep did not distinguish this infant from a sample of control infants; (b) the infant lacked strength in movements requiring the involvement of shoulder and neck muscles (head lift from a prone position); and (c) informal observations by skilled and experienced observers distinguished this infant from the sample of controls.     

suspicion of sudden infant death syndrome & injuries to infants: the effects of type of death certifier,training, and economics

This paper examines the level of suspicion by death certifiers when ruling infant deaths as accidents. Data were gathered on economic factors, amount of training in death investigation received, and personal characteristics for 1995 from 776 medical examiners or coroners. Findings indicate that personal and social factors such as age, education, and population have negligible or no effects on the level of suspicion held by death certifiers in manner of death rulings for infants. The findings from this study do suggest there is potential for inaccurate rulings of infant death due to lack of training, education, and economic resources depending on the events surrounding an infant's death and whether the death certifier is a coroner or medical examiner.     

The relation between horizontality and rod-and-frame and vestibular navigational performance

Sex differences on Piaget's water-level (horizontality) test are well established but poorly understood. In this article, correlates of female horizontality performance are systematically explored. Across the five experiments reported, it was found that female subjects who failed the water-level test (poor-horizontality female subjects) were selectively impaired on tasks that required processing information from the otolith organs. In Experiment 1, poor-horizontality female subjects were found to be impaired relative to good-horizontality subjects on the rod-and-frame test. In Experiment 2, a relation was found between female horizontality performance and the ability to process vestibular information in a passive transport task. Experiment 3 ruled out poor spatial updating as a mediating factor in this relation. The results of Experiments 4 and 5 indicated that poor-horizontality female subjects perform randomly on vestibular navigation because they cannot judge linear displacement under conditions of passive transport. The linear transport task is similar to the rod-and-frame task in that both require the central processing of otolith signals. It is proposed that one way to solve the water-level test is to imagine, on the basis of prior perceptual experiences, what the water level looks like inside tilted containers. Because of complex visual-otolith interactions, poor-horizontality female subjects may experience these events differently than good-horizontality subjects.     

Geophysical variables and behavior: LXXXV. Sudden infant death, bands of geomagnetic activity, and pc1 (0.2 to 5 HZ) geomagnetic micropulsations.

Pc1s (continuous pulsations) within the geomagnetic field, whose durations are about 30 minutes but which can reoccur several times nightly, are observed during periods when global geomagnetic activity is very low (less than 10 nT). The hypothesis that these 0.2 to 5 Hz synchronized micropulsations or hydromagnetic emissions might stimulate physical chemical cascades within the brain that precipitate the sudden death in infants was tested by correlational analysis for a two-year period (1960-1961) for Ontario. Results were consistent with the hypothesis that the monthly incidences of these unexpected deaths, pcl micropulsations and geomagnetic activity less than 10 nT displayed a shared source of variance. Implications are discussed.     

The interaction of home environment features and their relation to infant competence

This investigation examined the relation between features of the home environment (HOME Scale) and domains of development (Griffiths Scales) in 6-month-olds. The sample consisted of 155 families with diverse demographic characteristics who were part of a larger study. Data were analyzed using hierarchical multiple regression. More favorable eye-hand development was associated with more availability of appropriate play materials. The interaction of appropriate play materials and maternal involvement was related to both social and hearing-speech development. For the infants who had high exposure to appropriate play materials, social and hearing-speech development was more optimal if their mothers were highly involved with them. The analyses were conducted separately for low (n = 87) and middlelhigh (n = 55) socioeconomic status groups from the sample. Partial replication of the interaction effect was present for the middle/high group, but not for the low group. Findings support the importance of examining interaction as well as additive effects of the impact of early environment for relatively large samples in which there is a diversity of experiences.     

Perinatal indicators of sudden infant death syndrome: A study of 34 Rhode Island Cases

Pre- and perinatal characteristics of 34 victims of Sudden Infant Death Syndrome (SIDS) were compared with those controls matched for sex, race, birthdate, and hospital. Data were collected retrospectively from hospital records. Factors which reliably differentiated the SIDS group from controls included low birth-weight, short second stage of labor, fewer years of maternal schooling, and maternal anemia during pregnancy. The constellation of findings was interpreted as reflecting the interaction of physiological predispositions and environmental “setting conditions”, culminating in sudden and unexpected death. The efficacy of a previously established SIDS risk scale was assessed for these cases. Some issues concerning prediction of outcome from perinatal variables are discussed.     

The relation of hypertension to cognitive function

Hypertension is an established risk factor for stroke. However, prior to such a major clinical event, hypertension exerts a more subtle impact on the brain that is revealed by diminished cognitive function. Studies comparing the performance of people with high and normal blood pressure levels have shown that high blood pressure or hypertension is related to poorer performance on tests of attention, learning and memory, executive functions, visuospatial skills, psychomotor abilities, and perceptual skills. Hypertension is also predictive of cognitive decline. Variables that may alter (i.e., moderate) the relation of hypertension to cognitive function include age, education, several biological characteristics of hypertension, and the presence of concurrent diseases. Although hypertensives are not clinically impaired, their diminished levels of cognitive performance could affect their perceived quality of life. Various brain mechanisms may explain the relation of hypertension to lower levels of cognitive function. Further understanding of the relation between hypertension and cognition is critical to the preservation of cognitive function across the life span.     

Tourette syndrome: relation to children's and parents' self-concepts

We investigated the self-concepts of Tourette Syndrome patients and their mothers. The subjects were 30 children with Tourette Syndrome and their mothers, and 30 children matched on age, sex, and socioeconomic status and their mothers. The results indicated that, while the children did not differ on self-concept, the mothers of the Tourette Syndrome patients had lower self-concepts than the mothers of the controls, suggesting that family members should be considered in the treatment of the Tourette Syndrome children. In addition, severity of illness was positively correlated with the children's reports of behavior disturbance and dysphoric mood, although not with over-all self-concept. These results indicate that in more severe cases of Tourette Syndrome, children may experience emotional problems requiring therapeutic intervention.     

The role of infant soothability in the relation between infant negativity and maternal sensitivity

Maternal perceptions of infant soothability moderated the relation between negative infant temperament and maternal sensitivity. Infant negative temperament and maternal sensitivity were significantly positively related when maternal perception of infant soothability was high and significantly negatively related when maternal perception of infant soothability was low.     

Effect of alcohol on visual constancy values and possible relation to driving performance

The effects of the constancy phenomena in vision seem to be to provide information about the environment which is not solely dependent upon the characteristics of shape or size of the retinal image but which is modified by the brain to appear closer to the idealized characteristics of the real object. There is a regression away from the retinal image towards the actual object's characteristics. A plate viewed from an angle tends to look more like a disc than would be predicted from the geometry of perspective. This ability of the brain to impose conditions on perception is a high-level process which may be adversely affected by the depressive action of alcohol on the nervous system. In this case, objects such as road signs, etc. would tend to look smaller and so more distant than when sober if regression is inhibited. Drivers' reactions may be delayed if hazards are seen smaller and further away, thereby increasing the possibility of accident. This research indicates a reduction in phenomenal regression after ingestion of alcohol. There are implications for accident-rates in driving or in industry.     

Reflections on death and mourning in relation to Dickens' novel Our Mutual Friend

Both Bion and Jung indicate in their theories of oscillating cycles of coniunctio/mortificatio and Ps<-->D that the toleration of psychic states of disintegration is both dangerous and essential to new development and that change is resisted and feared. Our fear of growth and development is described by Jung in the mortificatio phase of the coniunctio cycles where movement can be forward towards coniunctio or backwards into disiunctio and by Bion in his delineation of a grid, with its negative grid, where the normal direction of growth may be permanently reversed. Both highlight the inevitability of elements destructive to thought being present in the psyche and the need to know these forces. This paper relates their ideas to the difficult processes of mourning explored by Dickens in his novel Our Mutual Friend.     

Anxiety and vulnerability in parents following the death of an infant

Empirical data on the subjectively reported anxiety reactions of 117 parents who lost an infant at birth or daring the first year of life are presented. From a retrospective survey conducted 1 to 4 years after the death it was evident that parents experienced a great deal of anxiety following the death of their child. Parents who experienced a sudden death in the home reported the strongest anxiety, but other parents who lost their child in hospital at birth or thereafter also experienced strong anxiety. The anxiety for surviving children and later-born children was extensive. In all areas mothers experienced more anxiety than fathers. More intense and longer grief in one's partner, the perceived lack of support from others, being older, and being a female were significantly correlated with anxiety. The results are interpreted as a confirmation that parents who lose their children experience a fundamental change in their beliefs about their family's future security. Better training of health personnel is required to secure an adequate follow up of families that lose a child.     

Assessment of infant oral sensorimotor and swallowing function

The development of feeding and swallowing is the result of a complex interface between the developing nervous system, various physiological systems, and the environment. The purpose of this article is to review the neurobiology, development, and assessment of feeding and swallowing during early infancy. In recent years, there have been exciting advances in our understanding of the physiology and neurological control of feeding and swallowing. These advances may prove useful in furthering our understanding of the pathophysiology of dysphagia in infancy. Progress in developing standardized, reliable, and valid measures of oral sensorimotor and swallowing function in infancy has been slow. However, there have been significant advances in the instrumental analysis of feeding and swallowing disorders in infancy, including manometric analyses of sucking and swallowing, measures of respiration during feeding, videofluoroscopic swallow evaluations, ultrasonography, and flexible endoscopic examination of swallowing. Further efforts are needed to develop clinical evaluative measures of dysphagia in infancy.     

Stillbirth, neonatal death and Sudden Infant Death (SIDS): parental reactions

The differences between parental grief reactions following different types of infant losses were investigated. A total of 117 parents (55 couples) from three groups of parents (stillbirth, neonatal death and Sudden Infant Death), 53% women and 47% men, answered a survey on different grief reactions one to four years following the death. Included in the survey were psychometric measures relating to anxiety, depression, impact of event, bodily discomfort, and general wellbeing. The results demonstrated that the three groups differed in their experience of various grief reactions. Sudden Infant Death Syndrome (SIDS) parents reported significantly more anxiety and intrusive thoughts than the other two groups in the early post-loss period, as well as significantly more anger, restlessness, and sleep disturbances than the neonatal group. The SIDS parents also scored significantly higher on some of the measures (experience of recovery, IES intrusion) relating to how they felt at the time of study. While the death being sudden did not show any correlation with the parents experience of recovery or the psychometric measures, the length of time the child had lived showed a strong relationship to these measures. It is emphasized that counselling to parents must be based on increased knowledge about parental reactions, tailored to the individual family's needs.     

Avoidance responding as a function of stimulus duration and relation to free shock

Response-independent pairings of a tone and a brief shock were superimposed on uncued avoidance responding in four groups of rhesus monkeys. For one group, tone presentations were immediately followed by an unavoidable electric shock; for the remaining groups, gaps of 5, 20, and 80 sec intervened between tone termination and shock delivery. These temporal values subsume paradigms usually treated as discrete procedures; the conditioned emotional response procedure (0-sec gap between tone and shock), trace procedure (5-sec gap) and safety-signal training (80-sec gap). Within each group, tone durations of 10, 20, 40, and 80 sec were examined. A response pattern marked by maximum response rate in the initial 5 sec of the tone followed by deceleration before shock was observed when shock immediately followed the tone, but not when gaps were interposed between the tone and shock. Response rates in the first 5 sec of the tone were a function of both tone duration and duration of the gap. When the gap was 0 to 5 sec, initial response rates were highest in longer duration tones; this relationship between tone duration and initial tone response rate was not observed for longer gaps.     

Neuropsychological performance in patients with fibromyalgia syndrome: relation to pain and anxiety

Previous studies have revealed the presence of cognitive impairment in patients with fibromyalgia syndrome (FMS). However, they have not determined the possible influence of the diverse clinical variables in these disturbances. The first aim of the current study is to compare the cognitive function of 81 patients with FMS and 35 healthy controls by means of a neuropsychological battery. The second aim is to determine the influence of anxiety and pain in the cognitive impairment of patients with FMS. The results of our study show that patients with FMS display a significantly lower cognitive performance and a significantly higher anxiety level than the healthy controls in all the parameters assessed. The neuropsychological performance in patients with FMS is associated with pain, and this relation was independent of the anxiety level. The relationship between cognitive performance and anxiety level was also significant. Therefore, we conclude that cognitive performance is primarily affected by pain. The level of anxiety explains part of the variability in neuropsychological tests that is not explained by pain.     

Parents' adjustment to late abortion,stillbirth or infant death: the role of causal attributions

The aim of the present study was to explore the attributional processes and the effect of various causal attributions on post-traumatic symptomatology among 110 parents who had lost an infant. The attributional processes were examined with longitudinal data collected over 12 months. One to four weeks post-loss, approximately half of the parents reported that they were never or rarely concerned with attributing responsibility for their baby's death. The importance of attributing responsibility was associated with several post-traumatic symptoms, as was searching for meaning in the death. Attributions to oneself, others, or God were positively and significantly associated with numerous post-traumatic symptoms. The results are discussed with reference to other studies dealing with the effect of attributions on subsequent adjustment among victims of trauma.