Predictors of posttraumatic stress in children following injury: The influence of appraisals, heart rate, and morphine use

Prospective studies of posttraumatic stress disorder (PTSD) in children that investigate simultaneously both cognitive and biological or psychophysiological predictors are rare. The present research reports on the impact of cognitive factors (trauma-related appraisals) and biological indicators (heart rate, morphine use) in predicting PTSD and depression symptoms following single-incident trauma. Children and adolescents (N = 48) were assessed within 4 weeks of an injury that led to hospital treatment and followed up 6-months later. While morphine did not predict initial PTSD severity, it was associated with lower levels of PTSD at follow-up. Reductions in PTSD symptoms (change scores) between assessments were similarly associated with morphine dosage. Trauma-related appraisals also contributed to PTSD and depression symptom severity. While slightly different patterns of results were obtained depending on whether static or change scores were examined, as a whole the study adds to a growing literature that morphine has the potential to reduce PTSD symptoms severity. Likewise the relationship between unhelpful trauma appraisals and posttrauma psychopathology was replicated.     

Use of peer-mediated intervention in children with attention deficit hyperactivity disorder

The present experiment extended and replicated the use of functional analysis and a peer-mediated intervention to decrease disruptive behavior displayed by children diagnosed with attention deficit hyperactivity disorder in an afterschool program. After determining that the participants displayed off-task behavior maintained by peer attention via a functional analysis, peer-implemented differential reinforcement of other behavior with extinction was effective in reducing participants' off-task behaviors. The use of peers as behavior-change agents is discussed, as are avenues for future research.     

Syndromes or symptoms in the assessment of aphasic patients?

The procedure generally used to diagnose aphasic patients consists of classifying them in one of the classic syndromes on the basis of the analysis of their symptoms. However, this taxonomy has several important problems, the main one being that it does not take into account the variability of aphasic patients, as there are many more disorder profiles than those included in the syndromes. In order to test the homogeneity of a sample of patients diagnosed with the classic taxonomy, 15 aphasic patients (5 Broca, 5 Wernicke and 5 Conduction) and 5 healthy controls were tested with nine comprehension and production tasks. Participants were aged 38 to 81 years old. The results indicate the existence of great variability in patients labeled with the same diagnosis, as revealed by the differences in within-group scores in each task, and a limited adjustment to the expected profile, with some patients showing symptoms allegedly corresponding to other syndromes. Our results call attention to the need to study each patient individually and interpret their disorders regardless of the syndromes.     

Commentary on “Life as a Pregnant Genetic Counselor”

The genetic counseling role is complex. There are frequently challenges raised for the genetic counselor both personally with the client and through factors external to the genetic counselor such as the clinical setting. The pregnant genetic counselor working in a prenantal diagnosis center may be confronted by her own countertransference towards the client or by the client’s tranference. The processes of transference and countrtransference need to be clearly understood, identified and dealt with in a sensitive self aware manner to facilitate the role of communicating empathically and giving genetic information to facilitate informed client decision making. Regular professional supervision and debriefing for the genetic counselor are essential to develop professional boundaries and to develop self awareness.     

A Comparison of Sexual Aggression Risk Factors Between the United States and the Philippines

Sexual violence against women is a global problem, prompting the need to investigate the risk factors among males in non-Western, non-industrialized countries. Using the expanded Confluence Model, this study examined and compared risk factors of sexual aggression between male college students in the Philippines and the United States. Using path analysis and multiple group analysis, results indicated that the expanded Confluence Model was generally invariant between countries. Direct paths from hostile attitudes toward women and impersonal sex to sexual aggression were non-significant, but indirect effects from hostile attitudes toward women, alcohol consumption, and impersonal sex to sexual aggression via the frequency of misperceiving a woman’s sexual intent were observed. Additional risk analysis indicated that the number of elevated risk factors were associated with higher self-reports of sexual aggression.     

Effects of progesterone administration and APPswe+PSEN1Deltae9 mutation for cognitive performance of mid-aged mice

Progesterone (P(4)) and its metabolite, 5alpha-pregnan-3alpha-ol-20-one (3alpha,5alpha-THP) have trophic effects and may improve cognitive function. We investigated the role of progestins in a murine model of Alzheimer's Disease (AD) in which transgenic mice co-overexpress a mutant form of amyloid precursor protein (APPswe) and a deletion in presenilin 1 Delta exon 9 (APPswe+PSEN1Deltae9). We hypothesized that: (1) mice with the APPswe+PSEN1Deltae9 mutation would have performance deficits compared to wildtype mice and (2) long-term administration of P(4) would enhance cognitive performance and increase brain progestin levels over placebo. Mice were ovariectomized at 6 months of age and administered placebo or P(4) via subcutaneously implanted pellets. Mice were tested between 9 and 12 months of age for cognitive performance in the object placement, water maze, object recognition, and T-maze tasks and for motor behavior in an activity monitor and then tissues were collected for steroid measurement. P(4) administration increased progestin levels in cortex, diencephalon, midbrain, and cerebellum of wildtype and mutant mice, but increases in 3alpha,5alpha-THP levels in the hippocampus of APPswe+PSEN1Deltae9 mutant mice were attenuated compared to that observed in wildtype mice. APPswe+PSEN1Deltae9 mice showed poorer performance in hippocampus measures (object placement and water maze tasks). In the object recognition and T-maze task, which are mediated by the cortex and hippocampus, P(4) administration improved performance in both wildtype and APPswe+PSEN1Deltae9 mutant mice compared to placebo administration. Thus, APPswe+PSEN1Delta9 mice have deficits in hippocampal performance and capacity to form 3alpha,5alpha-THP in the hippocampus and both wildtype and APPswe+PSEN1Delta9 mice show beneficial effects of P(4) in cortical function and similar capacity to form 3alpha,5alpha-THP in the cortex.     

Being distinctive versus being conspicuous: The effects of numeric status and sex-stereotyped tasks on individual performance in groups

Being in the numeric minority (e.g., being a solo woman in a group of men) influences how well a person performs within a work group. But being the solo member is only one way in which people can be atypical in a group; a person can also represent a social or demographic category that has not typically been associated with the task that the group is working on. Using a design with four categories of group composition (minority, balanced, majority, homogeneous) and two categories of tasks (sex-typical, sex-atypical) we found that the sex composition of the group interacted with the sex typicality of the task to influence both positive deferrals by group members and individual performance in groups. But, rather than consistently reducing performance as prior research has suggested, being numerically atypical enhanced individual performance when the task was typical for that person’s sex. Further, positive deferrals mediated between the interaction of numeric composition and task typicality in influencing individual performance suggesting that both majority group members and the solo member affect one another’s performance in groups. We conclude by discussing why understanding the interplay between these two sources of stereotyping, numeric composition and task typicality, is important for understanding the social nature of individual performance in groups.     

Detoxification at Home: A Brief Solution-Oriented Family Systems Approach

The authors propose an outpatient, solution-oriented, family systems approach to detoxification from alcohol and/or drugs. Research indicates that outpatient detoxification is a viable option, one that will likely be utilized even more frequently as health care costs continue to rise. Nontraditional assumptions about the process of detoxification are suggested that challenge traditional notions about detoxification being only a biomedical, pretreatment event. Criteria are provided for determining the appropriateness of clients for outpatient detoxification and offer information about typical withdrawal symptoms and guidelines for the detoxification environment at home. A case example illustrates the application of this approach in a community mental health program. Suggestions for adapting this approach to various settings are also offered.