An educational intervention improves developmental progress of young children in a Romanian orphanage

From 1991 to 1994, a group of Romanian and American colleagues undertook an experimental and humanitarian effort to try to improve the quality of life, mental health, and developmental progress of young children in a Romanian orphanage. In the context of institutional care, we experimentally introduced stable adult–child relationships, small group size, and a protocol of enriched caregiving and educational activities. These procedures were adapted from an intervention in childcare centers in the United States that had been proven effective in reducing intellectual decline in at‐risk children. Developmental scores for orphanage children were derived from the Denver II (a revision of the Denver Developmental Screening Test; Frankenburg & Dodds, 1990), which was translated into Romanian and administered as a pre‐ and posttest to the experimental subjects and comparison groups in the same institution. Mixed models combining both within‐ and between‐subject heterogeneous variance‐covariance structures were utilized to analyze the impacts of time, intervention/control group assignment, child sex, child age, and interaction of Group × Time on the developmental scores. For the developmental outcome variables, the effects of group assignment (experimental vs. comparison) were highly significant. There also was a Group × Time interaction effect. We conclude that an educational intervention which includes the addition of resources and training can be initiated and sustained in an orphanage for young children as a way of improving institutional care. ©2005 Michigan Association for Infant Mental Health.     

Self-Defining Memories of Body Image Shame and Binge Eating in Men and Women: Body Image Shame and Self-Criticism in Adulthood as Mediating Mechanisms

Despite the growing evidence of the association between shame experiences and eating psychopathology, the specific effect of body image-focused shame memories on binge eating remains largely unexplored. The current study examined this association and considered current body image shame and self-criticism as mediators. A multi-group path analysis was conducted to examine gender differences in these relationships. The sample included 222 women and 109 men from the Portuguese general and college student populations who recalled an early body image-focused shame experience and completed measures of the centrality of the shame memory, current body image shame, binge eating symptoms, depressive symptoms, and self-criticism. For both men and women, the effect of the centrality of shame memories related to body image on binge eating symptoms was fully mediated by body image shame and self-criticism. In women, these effects were further mediated by self-criticism focused on a sense of inadequacy and also on self-hatred. In men, only the form of self-criticism focused on a sense of inadequacy mediated these associations. The present study has important implications for the conceptualization and treatment of binge eating symptoms. Findings suggest that, in both genders, body image-focused shame experiences are associated with binge eating symptoms via their effect on current body image shame and self-criticism.