Psychiatric Symptomatology and Family Functioning in Children and Adolescents with Spina Bifida

The purpose of this study was to (a) examine the occurrence of psychiatric symptomatology in children and adolescents with spina bifida, (b) investigate the relationship between psychiatric features and aspects of disability, and (c) explore the impact of spina bifida and psychiatric status on family functioning. Fifty-four children and adolescents ages 6 to 18 years (M = 12.94, SD = 3.59) were examined. Parents completed the Child Symptom Inventory (CSI) and the Family Assessment Device (FAD). Using the CSI, a psychiatric diagnostic screen, 43% of the sample obtained one, and 13% obtained two or more screening cutoff scores reflective of psychiatric diagnoses. The two most prevalent diagnostic categories were Attention-Deficit/Hyperactivity Disorder (33%) and Oppositional Defiant Disorder (13%). The sample as a whole exhibited elevated levels of clinical symptoms, with internalizing symptoms more prominent than externalizing symptoms. No differences in diagnostic categories or overall symptomatology were found based on age, gender, ambulation status, or lesion level. Overall symptom counts were positively correlated with scales on the FAD reflecting problematic family functioning (.42–.65). Results suggest that psychiatric symptomatology occurs at a high rate in children and youth with spina bifida. Although ADHD was the modal diagnostic category, the sample as a whole exhibited extensive psychiatric symptoms independent of specific diagnostic categories. Psychiatric symptoms were also associated with increased problematic functioning in families.     

Perceived causal relations: novel methodology for assessing client attributions about causal associations between variables including symptoms and functional impairment

Researchers have argued that the investigation of causal interrelationships between symptoms may help explain the high comorbidity rate between certain psychiatric disorders. Clients' own attributions concerning the causal interrelationships linking the co-occurrence of their symptoms represent data that may inform their clinical case conceptualization, treatment, and psychological theory regarding the etiology of comorbid disorders. The present study developed and evaluated a novel psychological assessment methodology for measuring Perceived Causal Relations (PCR) and examined its psychometric properties as applied to the question of whether posttraumatic stress and anxiety symptoms represent causal risk factors for depressive symptoms in 225 undergraduates. Participants attributed their symptoms of anxiety and posttraumatic reexperiencing as significant causes of their depressive symptoms. Exploratory analyses identified a listing of symptoms reliably attributed as significant causes of other symptoms and functional impairment, as well as a listing of symptoms reliably attributed as significant effects (outcomes) of other symptoms and functional impairment. The PCR method has promise as an idiographic approach to assessing the causes and consequences of comorbid psychiatric symptoms and associated functional impairment. Research is required to assess the relevance and replicate these findings in distinct psychiatric groups experiencing various symptomatic presentations. Future research may also examine PCR ratings associating other individual differences, for example, between measures of history (e.g., life events), life choices, and personality.     

Psychiatric Symptoms and Quality of Life in Patients Affected by Epidermolysis Bullosa

The aim of our study was to provide a psychosocial and psychiatric evaluation of patients with epidermolysis bullosa (EB; a rare genetic disorder characterized by skin fragility), to assess psychological status, ascertain the presence of any psychiatric disorders and understand the impact of EB on quality of life. Twenty-five patients were assessed using a case record form and several standardized instruments. In 82% of patients, EB had a negative impact on quality of life and 80% of patients experienced psychiatric symptoms. Our findings revealed a high prevalence of psychosocial problems and psychiatric symptoms in patients with EB and suggested that a combined bio-psychosocial approach is the most appropriate therapeutic intervention.     

Effects of Control on the Stress Reactions of Commuters1

The effects of morning, rush hour commuting were examined in a quasi-experimental field study involving government-employed commuters (single and carpool drivers). Commuting stress was measured as a response to variations in how difficult it was for commuters to move from home to work. The mediation of these effects by two sources of control in the commuting situation also were assessed. Control was operationalized as control over the internal environment of the car (single versus carpool driver) and choice over routes taken to get to work. Among commuters with a high impedance route, driving to work was associated with significant increases in systolic and diastolic blood pressure and decreases in behavioral performance. The stress of commuting under high impedance conditions was reduced for single drivers relative to carpoolers. Under similar conditions of high impedance, however, having the option to select more than one route to get to work seemed to be more stressful than having only one route. The practical implications of these results are discussed.     

An empirical investigation into carpooling behaviour for sustainability

Carpooling is a sustainable, economical, and environmental friendly solution that can significantly reduce air pollution and traffic congestion in urban areas. In spite of its numerous benefits, commuters are still skeptic about adopting it as a routine choice for transportation. This study attempts to map commuters’ attitude towards carpooling services. The study has focused on a few motivational constructs that can have an influence on commuters’ behavior. The study has looked at the role of cognitive complexity and empowerment perceptions of commuters to check if these constructs significantly intervene in the behavioral outcomes. The methodology used is a scenario-based 2 × 2 survey design where the sample is an individual who has experience with carpooling. The survey has used two levels (high, low) each of cognitive complexity and psychological empowerment to give rise to four scenarios. The final sample consisted of 400 carpoolers selected from an IT park having more than 5000 employees. MANOVA analysis showed that cognitive complexity and psychological empowerment had significant influence on the motivational constructs used in the study. Value beliefs, safety and platform quality perceptions were found to have a direct impact on attitude formation and intention to engage in carpooling behavior. The findings offer many implications for managers in the sense that that they can focus on creating suitable communication that creates favorable perceptions towards carpooling to bring about better adoption intentions.     

Aggressive Behaviors and Suicide Ideation in Inpatient Adolescents: The Moderating Roles of Internalizing Symptoms and Stress

The present study examined a conceptual model in which the association between aggressive behaviors and suicide ideation is moderated by internalizing symptoms and ongoing stress. Participants were 304 psychiatric inpatient adolescents (65.8% girls) ranging in age from 12 to 17 years (Mean age = 14.69). The association between aggressive behaviors and suicide ideation was significantly moderated by internalizing symptoms and ongoing stress; the association was positive in adolescents low in internalizing symptoms or high in ongoing stress, but negative in adolescents high in internalizing symptoms or low in ongoing stress. The three‐way interaction between aggressive behaviors, internalizing symptoms, and ongoing stress was not statistically significant. The current findings indicate that in adolescents who display high levels of aggressive behaviors, the presence of high ongoing stress provides a more useful indicator of levels of suicide ideation than the presence of high internalizing symptoms. Implications for case identification and prevention are discussed.     

Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence

The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.     

Assessment of Long-Term Psychosocial Sequelae Among POW Survivors of the Korean Conflict

Psychological and psychiatric assessments were performed among 20 prisoner-of-war (POW) Korean-Conflict survivors. Results revealed extraordinary biological and psychological abuse with weight losses exceeding 35% of preservice weights and long-term cognitive, emotional, and behavioral sequelae. The full range of posttraumatic stress disorder symptoms was seen in 90% to 100% of the cases with high prevalence of co-morbidity, specifically mood (75%), other anxiety disorders. Documented by clinical investigators at (45%), and alcohol abuse (20%) POW release and now more than 30 years later, symptoms of apprehensiveness, confusion, detachment, and depression reflect the persistence of psychiatric morbidity over time.     

Assessment of long-term psychosocial sequelae among POW survivors of the Korean Conflict

Psychological and psychiatric assessments were performed among 20 prisoner-of-war (POW) Korean-Conflict survivors. Results revealed extraordinary biological and psychological abuse with weight losses exceeding 35% of preservice weights and long-term cognitive, emotional, and behavioral sequelae. The full range of posttraumatic stress disorder symptoms was seen in 90% to 100% of the cases with high prevalence of co-morbidity, specifically mood (75%), other anxiety (45%), and alcohol abuse (20%) disorders. Documented by clinical investigators at POW release and now more than 30 years later, symptoms of apprehensiveness, confusion, detachment, and depression reflect the persistence of psychiatric morbidity over time.     

Mental health problems among internally displaced persons in Darfur

War victims are regarded as one of the highest risk groups for mental disturbances. This study investigated the effects of the Darfur conflict on mental health of 430 internally displaced persons (IDPs) from three camps located around Fasher and Nyala towns. A stratified random sampling technique was used to select participants. Male participants represented 50.6% of the sample while female participants represented 49.4%. The Posttraumatic Stress Disorder Checklist and the General Health Questionnaire (GHQ-28) were used in addition to a questionnaire measuring demographic variables and living conditions. It was hypothesized that high prevalence of posttraumatic stress disorder (PTSD) symptoms and of nonpsychotic psychiatric symptoms will be evident. Results showed a high dissatisfaction rate (72%) with living conditions among IDPs. There was also high prevalence of PTSD (54%) and general distress (70%) among IDPs. Female participants showed more somatic symptoms than their male counterparts. Married participants were more distressed, anxious, and showed more social dysfunction, while single ones reported more avoidance symptoms. Significant differences related to date of displacement were found in PTSD and hyperarousal. The group of IDPs displaced in 2003 scored higher on these scales than those displaced in 2004 and 2005. There was also significant difference related to date of displacement in distress, somatic symptoms, depression, anxiety, and social dysfunction. IDPs displaced in 2003 scored higher on these scales. Results are discussed in light of the study hypotheses and previous findings. It is concluded that three factors might affect the dissatisfaction of IDPs with living conditions inside camps. These are: lack of employment, unsuitability of food items, and lack of security around camps. It was recommended that psychological support services should be among the prime relief services provided by aid agencies.     

The Value of Measuring Impact Alongside Symptoms in Children and Adolescents: A Longitudinal Assessment in a Community Sample

The impact that psychiatric symptoms have on the lives of young people is central to clinical practice and classification. However, there is relatively little research on impact and its association with symptoms. This paper examines how well impact can be measured and how it relates to psychiatric outcomes. On four separate occasions over 3 years, symptoms and impact were assessed in a UK epidemiological sample (n?=?4,479; 51.5 % boys) using the Strengths and Difficulties Questionnaire (SDQ) as reported by parents, youths and teachers. Disorders were ascertained using the Development and Well-Being Assessment. An impact scale made of items about distress and impairment demonstrated considerable internal consistency, cross-informant correlations, and longitudinal stability by all reporting sources. Impact at baseline was a strong predictor of psychiatric disorder 3 years later after accounting for psychiatric disorders and symptoms measured at baseline: odds ratio OR?=?2.10, 95 % Confidence Interval (CI) [1.50, 2.94] according to parent-rated impact and OR?=?1.71, CI [1.08, 2.72] according to teacher-rated impact. Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline. Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders. More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.     

Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

Would you rather teleport or spend some time commuting? Investigating individuals’ teleportation preferences

The “teleportation test” is a unique question—used in some travel behavior research since the 2000s—to examine individuals’ perceptions towards travel time and affinities for travel. It gives people a hypothetical choice between teleporting or spending some time traveling. All studies (using different methods, including focus groups, interviews, and questionnaires) have consistently reported high teleportation preferences (about 70%). Yet, few correlates of teleportation preferences (especially sociodemographic and perceptual characteristics) have been investigated. Using data from an online questionnaire of 648 commuters in Portland, Oregon, this study investigated factors affecting individuals’ teleportation preferences. While generally representative of the area’s commuters, the sample did have higher shares of high-income workers and people using active modes or transit. Overall, 62% of respondents preferred to teleport than to spend some time commuting. Results from binary logit models identified actual commute duration, typical mode of travel, and “ideal” travel time (but no demographic attributes) as major predictors of preferences to teleport. As expected, people with longer commute durations had a greater desire to teleport, whereas bicyclists and pedestrians more often preferred to commute. People with longer ideal travel times had a greater affinity to commute and were less keen to teleport. Analysis of follow-up questions exploring reasons for respondents’ answers suggested that most “teleporters” were motivated by saving time to do other things, while most “commuters” found parts of their commutes to be enjoyable or productive. Findings from this study are consistent with related studies in implying that a teleportation preference does not necessarily represent zero ideal travel time or viewing travel time as wasted. Finally, this study discusses several travel behavior policy implications of the teleportation test, along with limitations and areas for future research.     

Level of service delivery of public transport and mode choice in Accra,Ghana

Worsening traffic congestion and air quality has been associated with the proliferation of informal operation of private microbus and minibus in African cities. It is recognised that large buses hold the promise of relieving the growing congestion of African cities if they are managed efficiently and sustainably.It is in line with this that this study seeks to explore the reasons behind commuters’ non-preference of Metro Mass Transit (MMT) for intra-city commuting in Accra, Ghana. A revealed preference survey was administered to 134 commuters to find out the reasons behind their non-preference and their perception of the level of service (LOS) delivery of the Metro Mass Transit.The Study revealed that though Metro Mass Transit was 20% cheaper in terms of price, commuters perceived its service delivery as poor. Over-crowding of buses, non-adherence to time schedule, long in-vehicle time, perception of not getting access to seats, non-availability of bus at respondents’ origins and destinations, accessibility of alternative modes and long waiting times for buses accounted for the major reasons for non-preference.Metro Mass Transit Limited’s improvement in its service attributes especially in-vehicle time, waiting time, comfort, reliability and accessibility is a means of increasing its modal share. Adherence to these is the surest way to achieving the objective of promoting mass transit in Accra by shifting people from the use of unsustainable modes such as mini-buses and taxis to the use of efficient high capacity systems as Metro Mass Transit.     

The utility of the structured interview of reported symptoms in a sample of individuals with intellectual disabilities

The challenges of accurate forensic assessment are aggravated when evaluatees have intellectual disabilities. Few studies have addressed the efficacy of forensic assessment in samples diagnosed with an intellectual disability, and those that have typically focus on measures of cognitive effort rather than on feigned psychiatric symptoms. This study focuses on the applicability of the original and revised versions of the Structured Interview of Reported Symptoms (SIRS) in a sample of participants with genuine intellectual disabilities. The SIRS was administered to 43 individuals diagnosed with intellectual disabilities, all of whom were asked to respond honestly. A considerable proportion of these respondents were misclassified as feigning psychiatric symptoms. These misclassifications were most frequent when the respondents had comorbid psychiatric diagnoses. The updated scoring algorithm of the SIRS-2 generated a rate of misclassifications that was substantially lower but that still exceeded published normative data. The implications for forensic assessment are discussed.     

Flextime Commuters and Their Driver Stress, Feelings of Time Urgency, and Commute Satisfaction

The purpose of this study was to investigate the effect of a flextime-working environment on driver stress, feelings of time urgency, and commute satisfaction for commuters in a large-city environment. It was hypothesized that, regardless of gender, commuters with flextime would have less driver stress, fewer feelings of time urgency, and more commute satisfaction. The study was conducted using one hundred and twenty-five full-time employed commuters from Atlanta, Georgia, the city with the largest average commute distance in the world. Results showed that the commuters with flextime reported less driver stress and fewer feelings of time urgency than those without flextime. Significant differences were not found for commute satisfaction. Gender did not appear to be a significant factor in determining driver stress, time urgency, or commute satisfaction.     

Goal projection in public places

Three studies investigated the phenomenon of goal projection in everyday life considering three moderators: goal commitment, the perceived similarity of the target person, and goal attainment. Moviegoers' (Study 1) highly committed to see a particular movie projected this goal onto other movie patrons. Commuters (Study 2) highly committed to catch a certain train projected this goal onto other commuters, given that these commuters were perceived as similar. Shoppers (Study 3) projected buying a particular item when both their goal commitment and the perceived similarity of another shopper were high, and the goal was not yet attained. The results imply that goal projection is part of our everyday life and is fostered by high‐goal commitment, perceiving others as similar, and ongoing goal striving.     

Sleep and psychopathology

This article examines the relationship between sleep disturbance and psychopathology. Epidemiological, cross-sectional, and longitudinal data suggest a high rate of comorbidity between sleep disturbance and psychopathology, particularly between insomnia, anxiety, and depression. Between 50% and 80% of psychiatric patients complain of sleep disturbances during the acute phase of their illness. Conversely, among treatment-seeking individuals with a primary complaint of insomnia and randomly selected community samples, approximately one third display a concurrent psychopathology, one third exhibit psychological symptoms that do not necessarily exceed the threshold for a psychiatric disorder, and another third present insomnia as a functionally autonomous disorder. There is a positive relationship between severity of sleep disturbances and concurrent psychopathology, but unequivocal evidence of a cause-and-effect relationship is still lacking. However, longitudinal data suggest that anxiety and stressful life events often precede acute sleep difficulties, whereas persistent insomnia may be a risk factor for subsequent development of depression. Implications for the prevention and treatment of coexisting sleep disturbance and psychopathology are discussed.     

Toward the content validity of premenstrual dysphoric disorder: do anger and irritability more than depressed mood represent treatment-seekers' experiences?

The content validity of Premenstrual Dysphoric Disorder in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) has been questioned in the literature. We tested whether mood-related symptoms reported by 26 women seeking treatment for premenstrual disorders were among the proposed criteria. These women were asked to list their premenstrual symptoms and rate the severities of listed symptoms daily for two menstrual cycles before treatment. They completed semistructured interviews to differentiate symptoms of Premenstrual Dysphoric Disorder from those of other psychiatric disorders in women who had other disorders. All participants reported functional interference due to the symptoms. 19 symptoms of or similar to those of Premenstrual Dysphoric Disorder were among the 22 most frequent premenstrual symptoms experienced. Premenstrual depressed mood was less frequent than premenstrual irritability or anger when other psychiatric disorders such as major depression were taken into account. Results suggest that the DSM-IV-TR criteria have generally good content validity but may need revision to represent treatment-seekers experiences more accurately.     

Symptom modelling can be influenced by psychiatric categories: choices for research domain criteria (RDoC)

Psychiatric researchers typically assume that the modelling of psychiatric symptoms is not influenced by psychiatric categories; symptoms are modelled and then grouped into a psychiatric category. I highlight this primarily through analysing research domain criteria (RDoC). RDoC’s importance makes it worth scrutinizing, and this assessment also serves as a case study with relevance for other areas of psychiatry. RDoC takes inadequacies of existing psychiatric categories as holding back causal investigation. Consequently, RDoC aims to circumnavigate existing psychiatric categories by directly investigating the causal basis of symptoms. The unique methodological approach of RDoC exploits the supposed lack of influence of psychiatric categories on symptom modelling, taking psychiatric symptoms as the same regardless of which psychiatric category is employed or if no psychiatric category is employed. But this supposition is not always true. I will show how psychiatric categories can influence symptom modelling, whereby identical behaviours can be considered as different symptoms based on an individual’s psychiatric diagnosis. If the modelling of symptoms is influenced by psychiatric categories, then psychiatric categories will still play a role, a situation which RDoC researchers explicitly aim to avoid. I discuss four ways RDoC could address this issue. This issue also has important implications for factor analysis, cluster analysis, modifying psychiatric categories, and symptom based approaches.