The utility of the Kessler Screening Scale for Psychological Distress (K6) in two American Indian communities

The Kessler Screening Scale for Psychological Distress (K6; Kessler et al., 2002) has been used widely as a screener for mental health problems and as a measure of severity of impact of mental health problems. However, the applicability and utility of this measure for assessments within American Indian communities has not been explored. Data were drawn from a large-scale epidemiological study conducted in cooperation with 2 American Indian populations. Participants (N = 3,084) were 15-54 years of age and living on or near their home reservations; each completed an interview that included a version of the Composite International Diagnostic Interview (Robins, Wing, Wittchen, & Helzer, 1988) and the K6. A measure of both physical- and mental-health-related quality of life-the Medical Outcome Study's Short Form-36 (Ware & Sherbourne, 1992)-was used to examine the importance of the K6 over and above psychiatric diagnoses. The K6 was shown to be an appropriate screening and severity measure for mood disorders in these 2 samples. It also predicted health-related quality of life over and above that predicted by diagnoses alone. Inclusion of a measure such as the K6 as a complement to more traditional dichotomous diagnoses in both research and clinical practice is recommended.     

Children reorient using the left/right sense of coloured landmarks at 18-24 months

In previous studies, children disoriented in small enclosures used room shape, but not wall colours, to find hidden objects. Their reorientation was said to depend solely on a "geometric module" informationally encapsulated with respect to colour. We argue that previous studies did not fully evaluate children's use of colour owing to a bias in the enclosures' design. In this study, disoriented 18-24 month olds searched for toys in small square enclosures with two blue and two white walls. Children successfully reoriented using wall colour. This shows that they can make location judgments based on the left/right sense of the colours of adjoining landmarks. Performance was no different when symmetric colourful shapes were added to walls, but improved with asymmetric shapes which could be used without left/right judgments. The relatively poor use of colour in previous studies may be explained partly by a bias in their design, and partly by children's limited ability to discriminate the left/right sense of nongeometric features.     

Developmental trajectories for spatial frames of reference in Williams syndrome

Williams syndrome (WS) is a genetic disorder associated with severe visuocognitive impairment. Individuals with WS also report difficulties with everyday wayfinding. To study the development of body-, environment-, and object-based spatial frames of reference in WS, we tested 45 children and adults with WS on a search task in which the participant and a spatial array are moved with respect to each other. Although individuals with WS showed a marked delay, like young controls they demonstrated independent, additive use of body- and environment-based frames of reference. Crucially, object-based (intrinsic) representations based on local landmarks within the array were only marginally used even by adults with WS, whereas in typical development these emerge at 5 years. Deficits in landmark use are consistent with wayfinding difficulties in WS, and may also contribute to problems with basic localization, since in typical development landmark-based representations supplement those based on the body and on self-motion. Difficulties with inhibition or mental rotation may be further components in the impaired ability to use the correct reference frame in WS.     

Religiosity and Spiritual Engagement in Two American Indian Populations

Social scientific investigation into the religiospiritual characteristics of American Indians rarely includes analysis of quantitative data. After reviewing information from ethnographic and autobiographical sources, we present analyses of data from a large, population-based sample of two tribes (n = 3,084). We examine salience of belief in three traditions: aboriginal, Christian, and Native American Church. We then investigate patterns in sociodemographic subgroups, determining the significant correlates of salience with other variables controlled. Finally, we examine frequency with which respondents assign high salience to only one tradition (exclusivity) or multiple traditions (nonexclusivity), again investigating subgroup variations. This first detailed, statistical portrait of American Indian religious and spiritual lives links work on tribal ethnic identity to theoretical work on America's "religious marketplace." Results may also inform social/behavioral interventions that incorporate religiospiritual elements.     

Asymmetrical cortical processing of radial expansion / contraction in infants and adults

We report asymmetrical cortical responses (steady‐state visual evoked potentials) to radial expansion and contraction in human infants and adults. Forty‐four infants (22 3‐month‐olds and 22 4‐month‐olds) and nine adults viewed dynamic dot patterns which cyclically (2.1 Hz) alternate between radial expansion (or contraction) and random directional motion. The first harmonic (F1) response in the steady‐state VEP response must arise from mechanisms sensitive to the global radial motion structure. We compared F1 amplitudes between expansion‐random and contraction‐random motion alternations. F1 amplitudes for contraction were significantly larger than those for expansion for the older infants and adults but not for the younger infants. These results suggest that the human cortical motion mechanisms have asymmetrical sensitivity for radial expansion vs. contraction, which develops at around 4 months of age. The relation between development of sensitivity to radial motion and cortical motion mechanisms is discussed.     

Experiencing menopause in the context of cancer: Women’s constructions of gendered subjectivities

Objective: Many women experience premature menopause following cancer treatment, accompanied by psychological distress, and poor health-related quality of life. In this qualitative study, we examined how women construct their gendered subjectivities – their sense of self as a woman – in the context of premature menopause after cancer.

Design: We analysed data from open-ended survey items and semi-structured interviews with women who had experienced cancer. Six hundred and ninety-five women completed the online survey and 61 took part in a semi-structured interview. A thematic decomposition was conducted to identify the subject positions associated with menopause taken up by the women.

Results: Three overall themes were identified: ‘The Incomplete Woman,’ ‘The Abject, Asexual Woman’ and ‘Out of Time and Social Isolation.’ Menopause was predominantly constructed as a negative experience, similar to older post-menopausal women and dissimilar to peers, contributing to experiences of social isolation. Menopause also signified the presence of a medically diagnosed cancer condition, and uncertainty around cancer prognosis.

Conclusion: It is important for cancer support group leaders and other service providers to be sensitive to women’s negotiation of menopause following cancer, in the context of broader cultural constructions, in order to provide appropriate information and support.     

Religio‐Spiritual Participation in Two American Indian Populations

Following a previous investigation of religio‐spiritual beliefs in American Indians, this article examined prevalence and correlates of religio‐spiritual participation in two tribes in the Southwest and Northern Plains (N = 3,084). Analysis suggested a “religious profile” characterized by strong participation across three traditions: aboriginal, Christian, and Native American Church. However, sociodemographic variables that have reliably predicted participation in the general American population, notably gender and age, frequently failed to achieve significance in multivariate analyses for each tradition. Religio‐spiritual participation was strongly and significantly related to belief salience for all traditions. Findings suggest that correlates of religious participation may be unique among American Indians, consistent with their distinctive religious profile. Results promise to inform researchers’ efforts to understand and theorize about religio‐spiritual behavior. They also provide tribal communities with practical information that might assist them in harnessing social networks to confront collective challenges through community‐based participatory research collaborations.     

Boarding School Attendance and Physical Health Status of Northern Plains Tribes

Our hypothesis was that boarding school attendance among Northern Plains tribal members was associated with lower self-reported physical health status controlling for demographic, socioeconomic variables, the number of mental health and physical health problems. This secondary analysis used the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project data collected from 1997 to 1999. This analysis included (n = 1638) Northern Plains tribally enrolled members, aged 15–54, who lived on or within 20 miles of their reservations. Using linear regression and path analysis we examined the indirect, direct, and combine associations of boarding school attendance and physical health status. Results confirm boarding school attendance contributed indirectly (beta = ?.83, CI = ?1.33,-.33, p. ≤ .001) through number of physical health conditions to lower physical health status. Combined direct and indirect results (beta = ?.39, CI = ?1.20, .42) show American Indians who attended boarding school have lower physical health status (beta = ?1.22, CI = ?2.18,-.26, p. ≤ .01) than those who did not. The relationship of American Indian boarding school attendance and physical health status is complex with more than one path existing. We need to better understand the relationship of boarding school attendance and American Indian health, identify risk factors, and develop interventions for families and younger generations.     

Attention in Williams syndrome and Down's syndrome: Performance on the new early childhood attention battery

Attentional problems are commonly reported as a feature of the behavioural profile in both Williams syndrome (WS) and Down's syndrome (DS). Recent studies have begun to investigate these impairments empirically, acknowledging the need for an approach that considers cross‐syndrome comparisons and developmental changes across the different component functions of attention. The present study assessed children with WS and DS using a new preschool attention battery (ECAB: early childhood attention battery), designed to be suitable for mental age 3–6 years including groups with developmental disorders. The ECAB has the advantage of giving an individual profile of attentional abilities for each child, covering different components of attention. In relation to test norms for their mental age, both groups showed a profile of strengths and weaknesses in the attention domain. Both syndrome groups performed relatively well on tests of sustained attention and poorly on aspects of selective attention and attentional control (executive function). The DS group showed a specific strength in auditory sustained attention, whilst the WS group showed a particular deficit in visuo‐spatial response control. There was also evidence for considerable differences in the developmental trajectory of these abilities across the two groups. The results provide evidence for syndrome‐specific patterns of impairment, and distinct profiles of strengths and weaknesses that may be useful in understanding the nature of everyday attention difficulties in these groups and tailoring interventions to meet these needs.