Comprehensive community-based education and neurorehabilitation for children and adolescents with traumatic brain injury

Children and adolescents who experience a traumatic brain injury (TBI) typically have sensory, cognitive, behavioral, and functional skill challenges that must be addressed in acute and post-acute rehabilitation settings. This article describes a community-based school that combines educational, medical, nursing, family, residential-living, and psychological services in a comprehensive program of pediatric neurorehabilitation. The operational, administrative, and clinical features of these service components are presented. A critical aspect of the program is an emphasis on applied behavior analysis procedures for purposes of assessment, treatment formulation, and evaluation. Data are reviewed to demonstrate demographics, patterns of service delivery, and outcome. The school program represents an educational alternative for students with TBI who are discharged from acute-care settings and require comprehensive support services to facilitate their transition and re-entry to public school and community living. © 1998 John Wiley & Sons, Ltd.     

Bicriteria cost versus service analysis of a distribution network—a case study

In order to improve the distribution system for the Nordic countries the BASF AG considered 13 alternative scenarios to the existing system. These involved the construction of warehouses at various locations. For every scenario the transportation, storage, and handling cost incurred was to be as low as possible, where restrictions on the delivery time were given. The scenarios were evaluated according to (minimal) total cost and weighted average delivery time. The results led to a restriction to only three cases involving only one new warehouse each. For these, a more accurate model for the cost was developed and evaluated, yielding results similar to a simple linear model. Since there were no clear preferences between cost and delivery time, the final decision was chosen to represent a compromise between the two criteria. Copyright © 1999 John Wiley & Sons, Ltd.     

Different Disgust Domains Specifically Relate to Mental and Contact Contamination Fear in Obsessive-Compulsive Disorder: Evidence From a Path Analytic Model in an Italian Clinical Sample

Both contact contamination (CC) and mental contamination (MC) fears—which combined represent the most common manifestation of obsessive-compulsive disorder (OCD)—have been widely associated with disgust propensity. However, extant research explored this relationship using measures assessing only pathogen-related disgust, not taking into account the potential role played by sexual and moral disgust, despite literature about MC suggesting that this might be particularly relevant. In Study 1, the psychometric properties of the Italian version of the Three Domains of Disgust Scale (TDDS) were assessed in a large Italian community sample. Exploratory and confirmatory factor analyses confirmed the three-factor structure of the TDDS. The scale also showed good internal consistency and construct validity. In Study 2, the differential patterns of relationships between CC and MC and the three disgust domains were explored in an Italian clinical OCD sample using a path analytic approach. The TDDS-Pathogen subscale was a unique predictor of CC while the TDDS-Sexual subscale was a unique predictor of MC, after controlling for anxiety and depression. Surprisingly, the TDDS-Moral subscale was not a predictor of either domain of contamination fear. Limitations and clinical implications are discussed.     

Is Heightened Disgust Propensity Truly a Risk Factor for Contamination-Related Obsessive-Compulsive Disorder?

Disgust propensity (DP) has been conceptualized as a stable personality trait that confers risk for contamination-related OCD (C-OCD). However, the extent to which DP leads to the subsequent development of C-OCD is unclear. In fact, the presence of C-OCD might lead to an increase in DP rather than the inverse. The present study was aimed to test this hypothesis in a large clinical sample of OCD patients (≥ 21 years of age) with (C-OCD; n = 56) and without (NC-OCD; n = 103) contamination-related symptoms that completed measures of OCD symptoms, depression, anxiety, and DP. DP was assessed twice, in reference to the present situation (T1) and to when the participant was 18 years old (T0). The two groups did not significantly differ in DP at T0. However, C-OCD participants reported higher DP scores than NC-OCD at T1. Furthermore, the T1 vs T0 difference in DP was significant only in the C-OCD group. Subsequent analyses also showed that T1 DP levels, but not T0 levels, significantly predicted contamination-related symptoms. Despite study limitations, these findings question the role of DP as a risk factor for C-OCD.     

Sex differences in facial emotion perception ability across the lifespan

Perception of emotion in the face is a key component of human social cognition and is considered vital for many domains of life; however, little is known about how this ability differs across the lifespan for men and women. We addressed this question with a large community sample (N?=?100,257) of persons ranging from younger than 15 to older than 60 years of age. Participants were viewers of the television show “Tout le Monde Joue”, and the task was presented on television, with participants responding via their mobile devices. Applying latent variable modeling, and establishing measurement invariance between males and females and across age, we found that, for both males and females, emotion perception abilities peak between the ages of 15 and 30, with poorer performance by younger adults and declining performance after the age of 30. In addition, we show a consistent advantage by females across the lifespan, which decreases in magnitude with increasing age. This large scale study with a wide range of people and testing environments suggests these effects are largely robust. Implications are discussed.     

Variability of attention bias in socially anxious adolescents: differences in fixation duration toward adult and adolescent face stimuli

Prior research on attention bias in anxious youth, often utilising a visual dot probe task, has yielded inconsistent findings, which may be due to how bias is assessed and/or variability in the phenomenon. The present study utilises eye gaze tracking to assess attention bias in socially anxious adolescents, and explores several methodological and within-subject factors that may contribute to variability in attention bias. Attention bias to threat was measured in forty-two treatment-seeking adolescents (age 12–16 years) diagnosed with Social Anxiety Disorder. Bias scores toward emotional stimuli (vigilant attention) and bias scores away from emotional stimuli (avoidant attention) were explored. Bias scores changed between vigilance and avoidance within individuals and over the course of stimulus presentation. These differences were not associated with participant characteristics nor with self-reported social anxiety symptoms. However, clinician rated severity of social anxiety, explained a significant proportion of variance in the bias scores for adult, but not the adolescent, stimuli. Variability in attention bias among socially anxious adolescents is common and varies as a function of stimulus duration and type. Results may inform stimulus selection for future research.     

Longitudinal Pathways to Reading Achievement at Age 7 Years: Child and Environmental Influences

Using a bioecological perspective, this longitudinal study examined the contribution of child and environmental factors to the prediction of reading achievement at age 7. Participants were 99 boys and their parents. Child factors included 24-month temperament (reactivity and self-regulation), 36-month language level, and 7-year ADHD symptoms; environmental factors included quality of the home environment (54 months), maternal education, and learning disability (LD) in the family. There were direct and indirect pathways to reading achievement. Direct pathways included language skills, home environment, ADHD symptoms, and LD in the family. Unexpectedly, the direct pathway from self-regulation was negative. Indirect pathways included self-regulation, maternal education, and reactivity. Given the stability of the trajectory of reading skills and academic performance from first grade onward, the early identification of those children most at risk for reading difficulties has implications for the type of intervention most appropriate for individual children.     

Impact of maternal adverse childhood experiences on child socioemotional function in rural Kenya: Mediating role of maternal mental health

Mothers in low‐ and middle‐income countries (LMIC) suffer heightened vulnerability for adverse childhood experiences (ACEs), which is exacerbated by the multitude of risk factors associated with poverty and may lead to increased risk of psychiatric disorder. The constellation of complex, co‐occurring biological, environmental, social, economic and psychological risk factors are in turn transmitted to her child, conferring vulnerability for adverse development. This study examines the association between maternal intra‐ and extra‐familial ACEs, maternal education and the mental health of her child, mediated by maternal mental health. Mother‐child dyads (n = 121) in Machakos, Kenya were examined cross‐sectionally using self‐report measures of ACEs, maternal mental health and child internalizing and externalizing mental health problems. The four models proposed to examine the relationship between intra‐ and extra‐familial maternal ACEs and child internalizing and externalizing problems demonstrated indirect pathways through maternal mental health. These effects were found to be conditional on levels of maternal education, which served as a protective factor at lower levels of maternal ACEs. These models demonstrate how the impact of ACEs persists across the lifespan resulting in a negative impact on maternal mental health and conferring further risk to subsequent generations. Elucidating the association between ACEs and subsequent intergenerational sequelae, especially in LMIC where risk is heightened, may improve targeted caregiver mental health programs for prevention and intervention.