The Moderating Effect of Anxiety on Development in Atypically Developing Toddlers

In typically developing children, researchers have found that anxiety disorders are associated with poorer intellectual abilities (Davis et al. Journal of Psychopathology and Behavioral Assessment 30:43–51, 2008). The aim of the current study was to examine the impact anxiety symptoms had on the developmental quotients of toddlers. A total of 170 toddlers ranging in age from 17 to 37 months were selected for inclusion in this study, all of whom were at risk for or had a developmental delay. Two factors indicative of behavioral symptoms of anxiety from the Baby and Infant Screen for Children with aUtIsm Traits-Part2 were utilized as the independent variables and the total developmental quotient from the Battelle Developmental Inventory, 2nd Edition was utilized for the dependent variable. Examination of results revealed that atypically developing toddlers with symptoms of anxiety had significantly lower developmental quotients when compared to toddlers without any anxiety symptoms. A discussion of the implications and limitations of this study are included.     

Generalizability of evidence-based assessment recommendations for pediatric bipolar disorder

Bipolar disorder is frequently clinically diagnosed in youths who do not actually satisfy Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; DSM-IV-TR; American Psychiatric Association, 1994) criteria, yet cases that would satisfy full DSM-IV-TR criteria are often undetected clinically. Evidence-based assessment methods that incorporate Bayesian reasoning have demonstrated improved diagnostic accuracy and consistency; however, their clinical utility is largely unexplored. The present study examines the effectiveness of promising evidence-based decision-making strategies compared with the clinical gold standard. Participants were 562 youths, ages 5 to 17 and predominantly African American, drawn from a community mental health clinic. Research diagnoses combined a semistructured interview with youths' psychiatric, developmental, and family mental health histories. Independent Bayesian estimates that relied on published risk estimates from other samples discriminated bipolar diagnoses (area under curve = .75, p < .00005). The Bayes and confidence ratings correlated at rs = .30. Agreement about an evidence-based assessment intervention threshold model (wait/assess/treat) was κ = .24, p < .05. No potential moderators of agreement between the Bayesian estimates and confidence ratings, including type of bipolar illness, were significant. Bayesian risk estimates were highly correlated with logistic regression estimates using optimal sample weights (r = .81, p < .0005). Clinical and Bayesian approaches agree in terms of overall concordance and deciding next clinical action, even when Bayesian predictions are based on published estimates from clinically and demographically different samples. Evidence-based assessment methods may be useful in settings in which gold standard assessments cannot be routinely used, and they may help decrease rates of overdiagnosis while promoting earlier identification of true cases.     

The effect of communication deficits on anxiety symptoms in infants and toddlers with autism spectrum disorders

Autism spectrum disorders (ASDs) are life-long developmental disorders characterized by impairments in the development of reciprocal social and communication skills, abnormal language development, and a restricted repertoire of behaviors and interests. While it has been known for some time that children with ASD can evince elevated rates of anxiety symptoms, little research has been conducted on whether deficits in communication skills affect the range of anxiety symptoms in infants and toddlers with ASD. This study represents a first attempt to determine whether deficits in communication skills have an effect on the expression of anxiety in infants and toddlers with autistic disorder and pervasive developmental disorder-not otherwise specified. Seven hundred thirty-five infants were evaluated with respect to the nature and extent of anxiety symptoms and developmental functioning. Both receptive and expressive communication skills appeared to play a significant role in the manifestation of anxiety symptoms.     

Perceived Versus Predicted Risks of Colorectal Cancer and Self-Reported Colonoscopies by Members of Mismatch Repair Gene Mutation-Carrying Families Who Have Declined Genetic Testing

People carrying germline mutations in mismatch repair genes are at high risk of colorectal cancer (CRC), yet about half of people from mutation-carrying families decline genetic counselling and/or testing to identify mutation status. We studied the association of quantitative measures of risk perception, risk prediction and self-reported screening colonoscopy in this elusive yet high-risk group. The sample of 26 participants (mean age 43.1 years, 14 women) in the Australasian Colorectal Cancer Family Registry were relatives of mutation carriers; had not been diagnosed with any cancer at the time of recruitment and had declined an invitation to attend genetic counselling and/or testing. A structured elicitation protocol captured perceived CRC risk over the next 10 years. Self-reported colonoscopy screening was elicited during a 45-minute semi-structured interview. Predicted 10-year CRC risk based on age, gender, known mutation status and family history was calculated using “MMRpro.” Mean perceived 10-year risk of CRC was 31 % [95 % CI 21, 40], compared with mean predicted risk of 4 % [2, 7] (p?<?0.001); this was independent of age and sex (p?=?0.9). Among those reporting any medical advice and any screening colonoscopy (n?=?18), those with higher risk perception had less frequent colonoscopy (Pearson’s r?=?0.49 [0.02, 0.79]). People who decline genetic testing for CRC susceptibility mutations perceive themselves to be at substantially higher risk than they really are. Those with high perceived risk do not undertake screening colonoscopy more often than those who perceive themselves to be at average risk.     

Hegel on Space: A Critique of Kant's Transcendental Philosophy

This paper considers Hegel's views on space and his account of Kant's theory of space. I show that Hegel's discussions of space exhibit a deep understanding of Kant's apriority argument in the first Critique , commit him to the central premise of that argument, and separate his concerns from the familiar problem of the neglected alternative. Nevertheless, Hegel makes two objections to Kant's theory of space. First, he argues that the theory is internally inconsistent insofar as Kant's identification of space with an a priori intuition is incompatible with the doctrine of productive imagination in the transcendental deduction of the categories. Second, Hegel argues that the apriority argument is insufficiently critical insofar as it relies upon an unexamined theory of subjectivity as a set of representational capacities. I conclude by outlining Hegel's strategy for undermining the assumptions concerning subjectivity that give form to Kant's transcendental philosophy. Because Hegel's positive views on space depend upon his articulation of an alternate notion of subjectivity, the account of Hegel's position on space offered here remains incomplete. On the other hand, considering Hegel's discussions of space demonstrates both the nature and the importance of his examination of subjectivity in the Phenomenology.     

Robert E. Shaw: The Minnesota Years: 1966-1975

After receiving his doctorate, Robert Shaw spent 10 years at the University of Minnesota, first as a postdoctoral fellow at the newly formed Center for Research in Human Learning, and then as a faculty member of the Department of Psychology. During that decade, Shaw and the Center profoundly influenced each other's development in many ways. This article briefly describes some events of that period.     

Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services

This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and interviews, including: 4 therapist focus groups (n = 26), 3 parent focus groups (n = 14), and 10 youth (10–13 years) semi-structured interviews. Data analysis followed inductive, iterative processes typical of qualitative research using an editing style and thematic content analysis approach. Therapist, parent, and youth stakeholder participants discussed perceived barriers to effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention, etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with services within and across multiple stakeholder groups, including inadequate service system support, lack of family involvement and feeling overwhelmed with the complexities of families’ needs; however, parents and therapists, in particular, identified different contributing factors to these barriers. Therapists highly endorse using family-focused therapy and desire parent participation; however, parents feel unsupported by their child’s therapist. Parents’ report feeling blamed and not heard by service providers which negatively impacts their attitude about service delivery, causing discomfort and resistance to participation in their youth’s treatment. Youth also discussed dissatisfaction with mental health services, specifically related to their direct experiences in therapy, and desired more active, directive family-focused approaches. Overall, stakeholders reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings can inform service provision, intervention development, and future research.     

Two Sociological Approaches to Religion in Modern Britain

This article compares the approach adopted by two recent sociological accounts of religion in modern Britain (by Bruce and Davie). Attention is drawn in broad terms to the parallels between sociological and religious approaches, and a contrast made specifically between a sociology of religion cast in terms of a narrative of decline and diversity (or an account of the place of religion in the perspective of modernity), and one that pays primary attention to indigenous patterns of meaning. Conclusions are drawn as to the limitations of method and apprehension of the one approach, and the openness and potential for comparison of the other.