The Experience of Crisis in Families of Individuals with Autism Spectrum Disorder Across the Lifespan

It is well-established that parents of individuals with autism spectrum disorder (ASD) experience significant stress in their caregiving role, and research findings indicate that chronic stressors can act as a precipitant to crisis. In the present study, we examined the experience of crisis in families of individuals with ASD from early childhood to adulthood. One hundred and fifty-seven comments provided by family members in response to an online survey were coded using grounded theory methods. We explored three components of crisis drawn from the comments: antecedents (precipitating events and the context of crisis), behaviors (the nature of crisis), and consequences (outcomes and reactions to crisis). Similarities and differences in the crisis experiences among varying age groups are discussed, as well as implications for practice and future research.     

Docosahexaenoic Acid and Visual Functioning in Preterm Infants: A Review

Preterm children are at risk for a number of visual impairments which can be important for a range of other more complex visuocognitive tasks reliant on visual information. Despite the relatively high incidence of visual impairments in this group there are no good predictors that would allow early identification of those at risk for adverse outcomes. Several lines of evidence suggest that docosahexaenoic acid (DHA) supplementation for preterm infants may improve outcomes in this area. For example, diets deficient in the long-chain polyunsaturated fatty acid DHA have been shown to reduce its concentration in the cerebral cortex and retina, which interferes with physiological processes important for cognition and visual functioning. Further, various studies with pregnant and lactating women, as well as formula-fed infants, have demonstrated a general trend that supplementation with dietary DHA is associated with better childhood outcomes on tests of visual and cognitive development over the first year of life. However, research to date has several methodological limitations, including concentrations of DHA supplementation that have been too low to emulate the in utero accretion of DHA, using single measures of visual acuity to make generalised assumptions about the entire visual system, and little attempt to match what we know about inadequate DHA and structural ramifications with how specific functions may be affected. The objective of this review is to consider the role of DHA in the context of visual processing with a specific emphasis on preterm infants and to illustrate how future research may benefit from marrying what we know about structural consequences to inadequate DHA with functional outcomes that likely have far-reaching ramifications. Factors worth considering for clinical neuropsychological evaluation are also discussed.     

The Role of Neuropsychological Assessment in the Functional Outcomes of Children with ADHD

The value of evidence-based services is now recognized both within clinical communities and by the public at large. Increasingly, neuropsychologists must justify the necessity of often costly and time-consuming neuropsychological assessments in the diagnosis and treatment of common childhood disorders, such as Attention-deficit/Hyperactivity Disorder (ADHD). Published medical guidelines and prominent researchers, however, have argued against the need for formal neuropsychological assessment of ADHD. The present review examines the literature on developmental outcomes in childhood ADHD, with emphasis on the utility of formal neuropsychological assessment among children diagnosed and treated in primary care settings. The review yields three central findings: 1) adherence to published diagnostic guidelines for ADHD is poor among pediatric and primary care physicians; 2) ADHD most often co-exists with other disorders, thus diagnoses made without formal psychometric assessment can be incomplete or incorrect, ultimately increasing treatment costs; and, 3) untreated children with ADHD, and those who have untreated comorbidities, are at greater risk for poor outcomes in social, academic, vocational, and practical settings. The available literature suggests that neuropsychological assessment provides information that can potentially reduce risks for poor outcomes and improve quality of life among children with ADHD. Controlled studies directly examining the impact of neuropsychological assessments in improving outcomes among children with ADHD are needed.     

Some remarks on the bearing of model theory on the theory of theories

The present paper offers some remarks on the significance of first order model theory for our understanding of theories, and more generally, for our understanding of the “structuralist” accounts of the nature of theoretical knowledge that we associate with Russell, Ramsey and Carnap. What is unique about the presentation is the prominence it assigns to Craig’s Interpolation Lemma, some of its corollaries, and the manner of their demonstration. They form the underlying logical basis of the analysis.     

Self-regulatory efficacy and activity: Examining gradations of challenge

Objectives

This study examined different scheduling demands as a moderator of the self-regulatory efficacy (SRE)/physical activity relationship.

Design

A prospective design was used.

Method

Adolescents (N = 275) reported SRE and activity during times that reflected high and low scheduling demands.

Results

When scheduling demands were high, SRE predicted individual activity behavior (p < .001). During a period that reflected lower scheduling demands, however, SRE did not predict physical activity behavior (p = .25).

Conclusions

These findings support the idea that the level of challenge (demands) may be an important factor to consider when examining the SRE/activity behavior relationship.     

Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress

Background: Evidence linking fitness and decreased psychosocial stress comes from studies of athletes and typically relies upon self-report measures. Furthermore, there is little evidence regarding the impact of physical activity (PA) prior to a stressor. The aims of this study were to determine whether fitness and prior PA influence cortisol concentrations during psychosocial stress.

Methods: Seventy-five non-athletic participants took part in a submaximal walk prior to the Trier Social Stress Test for Groups (TSST-G). During the walk, fitness was assessed using heart rate (HR). A further 89 participants took part in the TSST-G without the walk. Stress responsiveness was assessed using salivary cortisol collected at 10-min intervals on seven occasions.

Results: Hierarchical multiple regression revealed that average walking HR accounted for 9% of the variance in cortisol secretion (P?=?.016), where a higher HR was associated with higher cortisol secretion. Between-subjects ANCOVA revealed that the walking group had a significantly lower cortisol secretion than the non-walking group (P?=?.009).

Conclusions: These findings indicate that fitter individuals have reduced cortisol secretion during psychosocial stress. They also indicate that prior PA can reduce cortisol concentrations during psychosocial stress and are suggestive of a role of PA in reducing the impact of stress on health.     

When Home Is Where the Harm Is: Family Betrayal and Posttraumatic Outcomes in Young Adulthood

Research on institutional betrayal has found that institutional wrongdoing that fails to prevent or respond supportively to victims of abuse adds to the burden of trauma. In this two-study investigation with young adult university students, we demonstrated parallels between institutional betrayal and ways that families can fail to prevent or respond supportively to child abuse perpetrated by a trusted other, a phenomenon we call family betrayal (FB). In Study 1, psychometric analysis of a new FB questionnaire provided evidence of its internal consistency, unidimensionality, and convergent and discriminant validity. The majority (approximately 72%) of young adults abused in childhood reported a history of FB, with an average of 4.26 FB events (SD = 4.45, range 0–14). Consistent with betrayal trauma theory, Study 2 revealed that FB was 4× more likely to occur in relation to childhood abuse by someone very close to the victim (vs. non-interpersonal victimization), with a particularly strong effect for female participants. FB history predicted significant delay to disclosure of a self-identified worst traumatic event (η_p² = .017) and significant increases in dissociation (?R² = .05) and posttraumatic stress (?R² = .07) symptoms in young adulthood. Moreover, with FB in the regression models, only FB—not child abuse nor recent interpersonal victimization—predicted dissociation and clinically significant elevations in posttraumatic stress. Findings suggest that FB is a prevalent phenomenon among young adults abused as children and that it explains unique, clinically significant variance in posttraumatic distress, warranting increased attention from trauma researchers and clinicians.