Use of Out-of-Home Care Among a Statewide Population of Children and Youth Enrolled in Medicaid

System-wide research on the use of out-of-home care among children and youth is needed to inform the development of policies and services. We used Medicaid claims from North Carolina to examine patterns of out-of-home care, identify demographic and diagnostic differences between those who received care in residential treatment, psychiatric hospitals, or general hospitals, and determine whether demographic or diagnostic characteristics were associated with having more than one out-of-home stay during the year. Among those who received out-of-home care during a 1 year period, 36% received care in residential treatment only, 32.4% in general hospitals only, and 17.6% in psychiatric hospitals only, while 14.0% used more than one sector of out-of-home care. Boys, teenagers, and youth in foster care or diagnosed with emotional disturbance or hyperkinetic syndrome had higher odds of receiving care in residential treatment only whereas girls, youth age 19–21, and those with depressive and stress and adjustment disorders had higher odds of receiving care from hospitals only. Teenagers and youth in foster care had higher odds of having more than one stay. Among those with more than one stay, there were 300 patterns of care and nearly half received care from more than one service sector. The implications for services and policy are discussed. Further research is needed to understand patterns of out-of-home care and the factors that influence placement decisions.     

Neural and behavioral effects of interference resolution in depression and rumination

Individuals diagnosed with major depressive disorder (MDD) often ruminate about their depression and their life situations, impairing their concentration and performance on daily tasks. We examined whether rumination might be due to a deficit in the ability to expel negative information from short-term memory (STM), and fMRI was used to examine the neural structures involved in this ability. MDD and healthy control (HC) participants were tested using a directed-forgetting procedure in a short-term item recognition task. As predicted, MDD participants had more difficulty than did HCs in expelling negative, but not positive, words from STM. Overall, the neural networks involved in directed forgetting were similar for both groups, but the MDDs exhibited more spatial variability in activation in the left inferior frontal gyrus (a region critical for inhibiting irrelevant information), which may contribute to their relative inability to inhibit negative information.     

Evidence of blocking with geometric cues in a virtual watermaze

Three computer based experiments, testing human participants in a non-immersive virtual watermaze task, used a blocking design to assess whether two sets of geometric cues would compete in a manner described by associative models of learning. In stage 1, participants were required to discriminate between visually distinct platforms. In stage 2, additional spatial information was provided by the shape or the color of the walls of the pool. In a test trial, the platforms were removed and the spatial knowledge acquired regarding the position of the platform was assessed. Experimental groups were compared against control groups which did not receive stage 1 training. The unique color of the correct platform, in Experiments 1 and 3, disrupted learning about the colored walls but not the geometry of the pool. In Experiment 2, the correct platform was identifiable from its position within the three platform array. Learning the relative position of the correct platform within the array disrupted learning about its position relative to the geometry of the pool, but not to the colored walls. The results suggest that learning the position of a goal in relation to the geometry of the environment can be blocked but only by an alternative geometric cue.     

Pyrrhonism in the Political Philosophy of Thomas Hobbes

The importance of Pyrrhonism to Hobbes's political philosophy is much greater than has been recognized. He seems to have used Pyrrhonist arguments to support a doctrine of moral relativity, but he was not a sceptic in the Pyrrhonist sense. These arguments helped him to develop his teaching that there is no absolute good or evil; to minimise the purchase of natural law in the state of nature and its restrictions on the right of nature; virtually to collapse natural law into civil law; and to make the sovereign the political, moral and theological epicenter of his political system.     

Chronic stress and coping styles: a comparison of male and female undergraduates

Male and female coping behaviors were compared in order to test the theory that men use instrumental coping strategies more frequently than women, who are thought to use emotion-focused coping solutions. We interviewed 51 female and 39 male first-year undergraduates by telephone three times a week for 8 weeks, using an inventory developed for 28 chronic stressors. Analyses of variance were used to test gender differences in frequency of daily stressors, concomitant perceptions of stress, and utilization of problem-solving behaviors. The majority of analyses showed no gender differences. The implications of these findings are discussed in light of cultural expectations.     

Newborn Screening for Cystic Fibrosis: Parents’ Preferences Regarding Counseling At the Time of Infants’ Sweat Test

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents’ preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents’ preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents’ distress while mismatched counseling tended to increase parents’ worry about their infant.     

The historical context of G. Stanley Hall's Adolescence (1904)

G. Stanley Hall's magnum opus, Adolescence, published in 1904 in two hefty volumes I herein submit to historical analysis. I am concerned with how it did "fit" into the notions and practices of the larger culture as well as into the discourses of science and of child nurture of that time. There is plenty of evidence of Hall's ethnic, racial, and gender attitudes as expressed in the book being typical of the white, Anglo-Saxon Protestant middle class stratum to which he belonged. His discussions of the extant discourses of science and of child nurture show a man quite conversant with these discourses, and not merely in American and British, but also in French and German publications as well. Probably any book, idea, or historical circumstance or phenomenon is chiefly a historical artifact, and we should not bend it much to "prove" that it is in any important sense a part of a different age. It is one thing to say that a certain idea has a contemporary resonance; to claim there is a straight line from it to today is problematic and meaningless.     

Dopamine D2 receptors mediate reversal learning in male C57BL/6J mice

Dopamine is critical for directing goal-oriented behavior. We investigated dopamine D₂ receptor involvement in reversal learning and reinforcement efficacy in mice lacking functional dopamine D₂ receptors and their heterozygous and wild-type littermates. Mice discriminated between two odors to receive a food reinforcer: One odor signaled a reinforcer (S⁺); the other odor signaled no reinforcer (S⁻). After mice learned the S⁺/S⁻ relationship, we inverted the reinforcement contingencies. The necessary number of trials to relearn the new reinforcement contingencies served as our index of reversal learning. Mice lacking functional dopamine D₂ receptors repeatedly failed to inhibit previously reinforced responses during reversal trials. In a separate experiment, mice responded for reinforcers on a progressive ratio schedule of reinforcement. Mice lacking functional dopamine D₂ receptors earned significantly fewer reinforcers than did heterozygous mice. Our results suggest that dopamine D₂ receptors regulate reversal learning and influence the reinforcing efficacy of natural rewards.