Individual differences in neural regions functionally related to real and imagined stuttering

Recent brain imaging investigations of developmental stuttering show considerable disagreement regarding which regions are related to stuttering. These divergent findings have been mainly derived from group studies. To investigate functional neurophysiology with improved precision, an individual-participant approach (N = 4) using event-related functional magnetic resonance imaging and test–retest reliability measures was performed while participants produced fluent and stuttered single words during two separate occasions. A parallel investigation required participants to imagine stuttering or not stuttering on single words. The overt and covert production tasks produced considerable within-subject agreement of activated voxels across occasions, but little within-subject agreement between overt and covert task activations. However, across-subject agreement for regions activated by the overt and covert tasks was minimal. These results suggest that reliable effects of stuttering are participant-specific, an implication that might correspond to individual differences in stuttering severity and functional compensation due to related structural abnormalities.     

Exact and resampling probability values for weighted kappa

Permutation procedures to compute exact and resampling probability values for weighted kappa are described. Comparisons with asymptotic probability values demonstrate that exact permutation procedures are advantageous for sparse data sets, whereas resampling permutation procedures are appropriate for both sparse and nonsparse data sets.     

The role of religion in heart-transplant recipients' long-term health and well-being

While religion has long been recognized clinically to provide important coping strategies in the face of serious health problems, there has been little systematic consideration of its role in organ transplant recipients' long-term reactions and adjustment to this experience. This study examines these issues through qualitative and quantitative evaluation of longitudinal data collected from 40 adult heart recipients followed during their first year post-transplant. Large proportions of recipients expressed strong beliefs and were able to increase religious participation over the 12-month study period. They delineated specific ways in which their faith had provided them support, as well as ways in which the transplant experience itself further strengthened their beliefs. We found empirical evidence that recipients with strong beliefs who participated in religious activities had better physical and emotional well-being, fewer health worries, and better medical compliance by the final 12-month assessment. The findings suggest the development of specific nursing, social-service, or pastoral-involvement strategies, continuing staff education about the role of religion in patient care. The implications of such interventions for maximizing quality of life in transplant recipients are discussed.This study was funded by grants from the National Institute of Mental Health.     

Outpatient groups for chronic psychiatric patients

Long-term support groups have been utilized at the University of Alberta Hospitals since 1977 in order to meet the needs of chronic psychiatric patients who are unwilling or unable to commit to insight-oriented therapy. These groups meet once weekly for one hour and are intended to be drop-in groups, which patients can use regularly or only while in crisis. It is hypothesized that the institution or style of therapy practiced at an institution, rather than the specific therapists, provides a source of stability and support to these patients. Our experience suggests these groups are beneficial and cost-efficient, but research is necesssary to evaluate them to determine components of therapeutic effectiveness.Linda McAuley, M.A., was a staff therapist at the Psychiatric Walk-in Clinic and is currently in private practice.An earlier version of this paper was presented at a meeting of the Canadian Group Psychotherapy Association in Banff, Alberta, October, 1987.     

Chain of Care for Patients with Intentional Self‐Harm: An Effective Strategy to Reduce Suicide Rates?

Chain of care for patients with intentional self‐harm was important in the Norwegian national action plan to prevent suicide. In this study there were two aims: (1) to calculate the potential effects of chain of care on reducing suicide rates, and (2) to assess whether suicide rates decreased more in areas where chain of care had been implemented than in other areas. We observed no differences in changes in suicide rates between areas with and without the intervention. The calculated potential effects of chain of care on national suicide rates were very small, even under unrealistically favorable conditions.     

Suicidality,Self‐Harm,and Body Dissatisfaction in Transgender Adolescents and Emerging Adults with Gender Dysphoria

Prevalence of suicide attempts, self‐injurious behaviors, and associated psychosocial factors were examined in a clinical sample of transgender (TG) adolescents and emerging adults (n = 96). Twenty‐seven (30.3%) TG youth reported a history of at least one suicide attempt and 40 (41.8%) reported a history of self‐injurious behaviors. There was a higher frequency of suicide attempts in TG youth with a desire for weight change, and more female‐to‐male youth reported a history of suicide attempts and self‐harm behaviors than male‐to‐female youth. Findings indicate that this population is at a high risk for psychiatric comorbidities and life‐threatening behaviors.