A Comprehensive Review of Pediatric Tumors and Associated Cancer Predisposition Syndromes

An understanding of the role of inherited cancer predisposition syndromes in pediatric tumor diagnoses continues to develop as more information is learned through the application of genomic technology. Identifying patients and their relatives at an increased risk for developing cancer is an important step in the care of this patient population. The purpose of this review is to highlight various tumor types that arise in the pediatric population and the cancer predisposition syndromes associated with those tumors. The review serves as a guide for recognizing genes and conditions to consider when a pediatric cancer referral presents to the genetics clinic.     

Concurrent and Longitudinal Links Between Children’s Externalizing Behavior in School and Observed Anger Regulation in the Mother–Child Dyad

Two studies examined relations between children’s anger regulation and externalizing behavior utilizing community samples. The first study included 58 children from preschool through second grade and examined concurrent associations between regulation and externalizing behavior. The second study included 40 preschool and kindergarten children and examined regulation and externalizing behavior 2 years later. In both studies, anger reactivity and regulation strategies were assessed during home visits using the same observational task. In study 1, teachers completed a problem behavior checklist shortly after the home visit. In study 2, teachers completed a problem behavior checklist 2 years later. Results indicate that the dysregulation of anger is associated with externalizing problems concurrently and two years later. Findings also suggest that attention refocusing may be a successful strategy for reducing anger and externalizing problems among highly reactive children.     

Psychosocial functioning of borderline patients and axis II comparison subjects followed prospectively for six years

The purpose of this study was to determine the course of the psychosocial functioning of patients with borderline personality disorder (BPD) over 6 years of prospective follow-up. The psychosocial functioning of 290 patients meeting both DIB-R and DSM-III-R criteria for BPD and 72 patients meeting DSM-III-R criteria for another Axis II disorder (and neither criteria set for BPD) was assessed at baseline using a semistructured interview of demonstrated reliability. Over 94% of surviving patients were reinterviewed about their psychosocial functioning blind to all previously collected information at three distinct follow-up waves: 2-, 4-, and 6-year follow-up. The psychosocial functioning of borderline patients improved substantially over time, with the percentage meeting criteria for good overall psychosocial functioning increasing from 26% at baseline to 56% during the third wave of follow-up. Despite this improvement, borderline patients functioned significantly more poorly than Axis II comparison subjects, particularly in the area of vocational achievement. However, a more detailed examination revealed that borderline patients who had experienced a symptomatic remission during the course of the study functioned significantly better both socially and vocationally than never-remitted borderline patients. More specifically, they were significantly more likely to have a good relationship with a spouse/partner and at least one parent, good work/school performance, a sustained work/school history, a GAF score of 61 or higher (43% vs. 0% 6 years after their index admission), and to have good overall psychosocial functioning (66% vs. 27% at 6 year follow-up). Taken together, the results of this study suggest that psychosocial improvement is both common among borderline patients and strongly related to their symptomatic status.     

Daily emotional dynamics in depressed youth: a cell phone ecological momentary assessment study

This study used a new cell phone ecological momentary assessment approach to investigate daily emotional dynamics in 47 youths with major depressive disorder (MDD) and 32 no-psychopathology controls (CON) (ages 7-17 years). Information about emotional experience in the natural environment was obtained using answer-only cell phones, while MDD youths received an 8-week course of cognitive behavioral therapy and/or psychopharmacological treatment. Compared with CON youths, MDD youths reported more intense and labile global negative affect; greater sadness, anger, and nervousness; and a lower ratio of positive to negative affect. These differences increased with pubertal maturation. MDD youths spent more time alone and less time with their families than CON youths. Although differences in emotional experiences were found across social contexts, MDD youths were more negative than CON youths in all contexts examined. As the MDD participants progressed through treatment, diagnostic group differences in the intensity and lability of negative affect decreased, but there were no changes in the ratio of positive to negative affect or in measures of social context. We discuss methodological innovations and advantages of this approach, including improved ecological validity and access to information about variability in emotions, change in emotions over time, the balance of positive and negative emotions, and the social context of emotional experience.     

“I Survived”: The Content and Forms of Survival Narratives

Individuals impacted by violent crime are at risk for posttraumatic stress disorder and other comorbid conditions. Screening and early intervention are key to the detection and treatment of these consequences of victimization. A growing literature points to the diagnostic power of narratives; however, little is known about the narratives produced by survivors. This study assessed the content and forms of narratives told by survivors of violent crime. In our sample, narratives of growth and optimism, grief and loss, providence, self-reliance, and justice were common. These narratives also featured common lexical properties. The discussion articulates possible explanations for these findings.     

Retrospective measures of childhood abuse: concurrent validity and reliability in a nonclinical sample with borderline features

This study evaluated the psychometric properties of retrospective reports of childhood sexual and physical abuse by comparing two assessment formats, interview and questionnaire, and looking at both the concurrent validity and test-retest reliability over 2 years. Nonclinical participants completed the Family Experiences Interview (FEI; Ogata et al., 1990) and the Family Experiences Questionnaire (FEQ; Wheelock, Lohr, & Silk, 1997) at age 18 and the FEQ again at age 20. Both assessments evaluate individuals for sexual and physical abuse before age 18, and the two have similar formats and wording. There were no significant differences in the reported frequency of childhood abuse on the interview versus on the questionnaire when given at the same point in time, and the agreement between the two measures was high. The test-retest reliability in childhood abuse reports was moderate. Taken together, these results suggest that interview and questionnaire reports of childhood abuse are roughly equivalent.