Demographic characteristics,social competence,and behavior problems in children with gender identity disorder: a cross-national,cross-clinic comparative analysis

This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study—the first cross-national, cross-clinic comparative analysis of children with gender identity disorder—found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.     

Hormones and Cognition: Current Concepts and Issues in Neuropsychology

This article provides an extensive and comprehensive review of the effects of hormones on cognition. Studies detailing specific neurocognitive functions affected by variation in hormone levels across the life span are presented. Dysregulation of hormone levels is considered from models of both normal and diseased functioning. Patterns of cognitive dysfunction are described for a range of syndromes involving the neuroendocrine system, and evidence of specific neurophysiological mechanisms that can account for these findings is outlined. This review includes discussion of treatment outcomes and the permanency of endocrine-related cognitive dysfunction. The authors present a set of guidelines for clinical neuropsychologists to use for assessment of patients with neuroendocrine system dysfunction. Clinical and methodological issues in research and treatment settings are discussed.     

Parents' Attitudes and Expectations About Children's Cross-Gender Behavior

The goals of the present study were to assessparents' attitudes toward crossgender boys and girls, aswell as to explore possible reasons for differentialevaluations. A total of 224 White parents of five-year old children completed questionnaires probingtheir attitudes toward cross-gender behavior inchildren, and their expectations regarding the futureadult behavior of typical boys, typical girls,cross-gender boys and cross-gender girls. The resultsrevealed that cross-gender boys were more negativelyregarded than crossgender girls and thatmen perceivedmore societal acceptance of cross-gender boys thanwomen. Cross-gender children were predicted tocontinue to show cross-gender behavior in adulthood andto be less psychologically welladjusted as adults thantypical boys and girls. Cross-gender boyswere expected to be less psychologicallywell-adjusted than cross-gender girls. When predictingfuture sexual orientation, cross-gender boys were deemedto have a greater likelihood of being gay thancross-gender girls of being lesbian. Men expectedcross-gender boys to be more likely to show male-malesexual behavior than typical boys inadulthood while women predicted typicalgirls to be more likely to show female-female sexual behavior in adulthoodthan cross-gender girls.     

The role of memory in the Tower of London task

The Tower of London (TOL) task is widely used as a neuropsychological test of planning. Relatively little is known of the cognitive components of the task, and in particular the role of memory in performance. The current studies on normal adults looked at the role of verbal and spatial working memory in the TOL. The effects of verbal and visuospatial dual-task manipulations on TOL performance were examined in an experiment with 36 participants. Both verbal and visuospatial executive secondary tasks caused poorer performance on the TOL; however, concurrent articulatory suppression enhanced performance. The results suggest that executive and spatial components are important in the task, and raise questions about the role of preplanning in the TOL.     

Mental Health and Incarcerated Youth. I: Prevalence and Nature of Psychopathology

The incarceration of mentally ill youth is a serious problem not receiving the same attention as in adults. In this study, we examine the prevalence of psychopathology and level of behavioral symptomatology in incarcerated youth versus youth receiving community mental health services or hospitalization. We randomly recruited youth from middle South Carolina served by a local CMHC (n = 60), youth served by the state adolescent inpatient program (n = 50), and youth in the S.C. Dept. of Juvenile Justice facilities from the same region (n = 75). We used the DISC-PC 2.3 to evaluate DSM-III-R diagnoses and the CBCL and YSR to evaluate behavioral symptomatology. On the DISC, incarcerated youth had significantly higher mean number of diagnoses and symptoms than CMHC youth, but lower numbers than hospitalized youth. Level of caseness (at least one diagnosis) was 86% in hospital youth, 72% in incarcerated youth, and 60% in CMHC youth. The groups differed in CBCL mean total T, internalizing T, and externalizing T scores as well as mean YSR internalizing T scores. Our results indicate the comparability in level of psychopathology in incarcerated and community-treated populations of youth, and the need to develop diversionary programs to prevent the entry of such youth into the juvenile justice system.     

Law and lamb: AKEDAH and the search for a deep religious symbol for an ecumenical bioethics.

This essay looks at the concept of AKEDAH, the essence of which is the travail of the human condition and the trust in vindication and victory, as a salient and deep metaphor for bioethics. The author first delineates the symbol, then shows its theological and ethical significance, and finally suggests its bioethical applications.     

Rethinking a Familiar Model: Psychotherapy and the Mental Health of Refugees

This paper examines with a somewhat critical eye the primary role that psychotherapy and other clinic-based services currently play in addressing the mental health needs of political refugees in the industrialized countries. Two factors are considered which suggest that refugee mental health needs might be better served by complementing clinic-based treatments with a variety of community-based interventions. The first factor concerns the pervasiveness of psychological distress within refugee communities, coupled with the reluctance of many refugees to utilize formal psychological and psychiatric services. This calls into question both the adequacy and appropriateness of clinical-based services as cornerstones of our response to the mental health needs of refugees. More precisely, it suggests the need to complement such services with a variety of culturally grounded, community-based strategies that do not require attendance in formal mental health settings. Second, recent findings have shown consistently that a considerable amount of the distress reported by refugees is related not to prior exposure to violent events, but to a constellation of exile-related stressors such as the loss of one's community and social network, the loss of important life projects, changes in socioeconomic status and related concerns about economic survival, the loss of meaningful structure and activity in daily life, and the loss of meaningful social roles. It is suggested that while psychotherapy can play an important adjunctive role in helping people confront these exile-related stressors, they may most effectively be addressed through targeted community-based interventions. Examples of such community-based approaches are briefly described, and suggestions are offered for community-level strategies that might be explored. The paper concludes by emphasizing the complementary nature of clinical and community-based programs, and by suggesting that psychotherapy might best be conceptualized as one component of a more comprehensive approach to addressing the mental health needs of refugee communities.     

Abstract Planning and Perceptual Chunks: Elements of Expertise in Geometry

We present a new model of skilled performance in geometry proof problem solving called the Diagram Configuration model (DC). While previous models plan proofs in a step-by-step fashion, we observed that experts plan at a more abstract level: They focus on the key steps and skip the less important ones. DC models this abstract planning behavior by parsing geometry problem diagrams into perceptual chunks, called diagram configurations, which cue relevant schematic knowledge. We provide verbal protocol evidence that DC's schemas correspond with the step-skipping inferences experts make in their initial planning. We compare DC with other models of geometry expertise and then, in the final section, we discuss more general implications of our research. DC's reasoning has important similarities with Larkin's (1988) display-based reasoning approach and Johnson-Laird's (1983) mental model approach. DC's perceptually based schemas are a step towards a unified explanation of (1) experts' superior problem-solving effectiveness, (2) experts' superior problem-state memory, and (3) experts' ability, in certain domains, to solve relatively simple problems by pure forward inferencing. We also argue that the particular and efficient knowledge organization of DC challenges current theories of skill acquisition as it presents an end-state of learning that is difficult to explain within such theories. Finally, we discuss the implications of DC for geometry instruction.