Assessment and Diagnosis of DSM-IV Anxiety Disorders

Anxiety disorders, the 2nd most common type of mental disorders, are among the most frequently missed or misdiagnosed disorders (Frances & Ross, 1996). Once they are diagnosed, effective treatments exist for them. This article provides a review of current knowledge on the assessment and diagnosis of anxiety disorders classified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (American Psychiatric Association, 1994). Emphasis is on the recognition of anxiety as a dominant symptom, frameworks for determining specific anxiety disorders, and patterns of comorbidity.     

Do Background Stressors Influence Reactivity to and Recovery From Acute Stressors?1

This review examines the effect of background stressors with acute stressor reactivity and recovery in the 19 available studies. Background stressors were associated with increased acute stressor reactivity in slightly over half of the studies of ongoing stressors. However, a substantial minority of studies demonstrated reduced acute stressor reactivity, suggesting habituation for certain people in certain situations. Background stressors were associated with delayed blood-pressure and immunological recovery from acute stressor events, but were not associated with delayed heart-rate recovery. Possible mechanisms underlying the association between background stressors and acute stressor reactivity and recovery are discussed. Background stressors should be measured thoroughly in future acute stress research to understand the meaning of the acute stress responses.     

Cultural Effects Rather Than a Bilingual Advantage in Cognition: A Review and an Empirical Study

The bilingual advantage hypothesis contends that the management of two languages in the brain is carried out through domain‐general mechanisms, and that bilinguals possess a performance advantage over monolinguals on (nonlinguistic) tasks that tap these processes. Presently, there is evidence both for and against such an advantage. Interestingly, the evidence in favor has been thought strongest in children and older adults, leading some researchers to argue that young adults might be at peak performance levels, and therefore bilingualism is unable to confer an improvement. We conducted a large‐scale review of the extant literature and found that the weight of research pointed to an absence of positive evidence for a bilingual advantage at any age. We next gave a large number of young adult participants a task designed to test the bilingual advantage hypothesis. Reasoning from the literature that young adults from an East Asian (Korean) culture would likely outperform those from a Western (British) culture, we also compared participants on this factor. We found no evidence for a bilingual advantage but did find evidence for enhanced performance in the Korean group. We interpret these results as further evidence against the bilingual advantage hypotheses.     

Who knows what's good to eat? Infants fail to match the food preferences of antisocial others

Humans gather most of their knowledge about the world, including objectively true facts and specific cultural norms, by observing and being taught by others. Some individuals are worthy teachers and objects of imitation, having knowledge of cultural practices and positive intentions to inform. Others are better ignored because they are ignorant, because they mean us harm, or simply because we do not wish to be “like them.” This study examines whether 16-month-olds are sensitive to the pro- or antisocial behavior of a source that demonstrates preference for two novel foods. Infants took the emotional reactions displayed by novel and previously prosocial sources, but not antisocial sources, into account when deciding what to eat. These results suggest that others’ social behavior influences infants’ likelihood to match their preferences, illustrating the influence of social evaluation on social learning.     

The Laboratory-Clinician Team: A Professional Call to Action to Improve Communication and Collaboration for Optimal Patient Care in Chromosomal Microarray Testing

The International Standards for Cytogenomic Arrays (ISCA) Consortium is a worldwide collaborative effort dedicated to optimizing patient care by improving the quality of chromosomal microarray testing. The primary effort of the ISCA Consortium has been the development of a database of copy number variants (CNVs) identified during the course of clinical microarray testing. This database is a powerful resource for clinicians, laboratories, and researchers, and can be utilized for a variety of applications, such as facilitating standardized interpretations of certain CNVs across laboratories or providing phenotypic information for counseling purposes when published data is sparse. A recognized limitation to the clinical utility of this database, however, is the quality of clinical information available for each patient. Clinical genetic counselors are uniquely suited to facilitate the communication of this information to the laboratory by virtue of their existing clinical responsibilities, case management skills, and appreciation of the evolving nature of scientific knowledge. We intend to highlight the critical role that genetic counselors play in ensuring optimal patient care through contributing to the clinical utility of the ISCA Consortium's database, as well as the quality of individual patient microarray reports provided by contributing laboratories. Current tools, paper and electronic forms, created to maximize this collaboration are shared. In addition to making a professional commitment to providing complete clinical information, genetic counselors are invited to become ISCA members and to become involved in the discussions and initiatives within the Consortium.     

The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers

Primary care providers (PCPs) offered input regarding the incorporation of a family health history (FHH) risk assessment tool into a community health care system (CHCS). Sixteen PCPs participated in one of three focus groups. Perceived impediments included the lack of standard screening guidelines, effective screening tests, genetic counseling resources, and services for high-risk patients. The PCPs were concerned about their level of expertise, the cost of preventive health care, and genetic discrimination. They also were concerned about the use of a FHH tool by oncologists within the CHCS because of communication gaps between oncologists and PCPs, lack of clarity regarding follow-up and legal liability, and reimbursement issues. To integrate a FHH tool into a CHCS, PCPs will need consultation and referral services, evidence-based recommendations, and "just-in-time" educational resources. Oncologists who use the tool will need to develop a streamlined communication system with PCPs, establish clearly defined roles, and ensure patient follow-up.     

The relationship between performance-based self-esteem and self-reported work and health behaviors among Danish knowledge workers

Since knowledge intensive work often requires self-management, one might fear that persons who are dependent on work success for self-esteem will have difficulties in finding a healthful and sustainable balance between internal needs and external demands. Accordingly, we examined to what degree work-related performance-based self-esteem (PBS) was linked to work and health behaviors in 392 knowledge workers (226 women, 166 men). In the women group, multiple binary logistic regression analyses with repeated measurements showed that the PBS score was associated with 10 of the 17 examined work and health behaviors. For men the corresponding figure was 3 of 17. In both men and women, higher PBS scores were positively associated with reports of efforts and strivings for work as well as attending work while ill. In conclusion, statistically significant relationships between PBS and work and health behaviors were more clearly visible among women than men. Whether this gender difference is dependent on the study design, or on true inherent differences between women and men, cannot be concluded with any certainty. However, persons who described themselves as being relatively more dependent on work accomplishments for a high self-esteem, as expressed by the PBS score, seem to display work behaviors that may lessen their restitution time. In addition, they also seem to be more prone to work while sick.     

The Relationship between Temperamental Negative Affect,Effortful Control,and Sensory Regulation: A New Look

Temperamental negative affectivity (NA) and effortful control (EC) have long been of interest to psychologists, but sensory regulation (SR) has received less attention. Using confirmatory factor analysis, the present study reexamined the Rothbart model of EC and NA using the Children's Behavior Questionnaire (CBQ; M.K. Rothbart, S.A. Ahadi, K.L. Hershy, & P. Fisher, 2001), along with alternative models of EC, NA, and SR using the CBQ and Short Sensory Profile. The results failed to replicate the Rothbart model of EC and NA, which includes SR within the EC and NA factors. A good fit was found for a three‐factor model (EC, NA, and SR) that was replicated in a holdout sample. A three‐factor model also showed a good fit when EC, NA, and SR items similar to symptoms of behavior problems were eliminated.     

Carry on: spontaneous object carrying in 13-month-old crawling and walking infants

Carrying objects requires coordination of manual action and locomotion. This study investigated spontaneous carrying in 24 walkers who were 13 months old and 26 crawlers who were 13 months old during 1-hr, naturalistic observations in the infants' homes. Carrying was more common in walkers, but crawlers also carried objects. Typically, walkers carried objects in their hands, whereas crawlers multitasked by using their hands simultaneously for holding objects and supporting their bodies. Locomotor experience predicted frequency of carrying in both groups, suggesting that experienced crawlers and walkers perceive their increased abilities to handle objects while in motion. Despite additional biomechanical constraints imposed by holding an object, carrying may actually improve upright balance: Crawlers rarely fell while carrying an object, and walkers were more likely to fall without an object in hand than while carrying. Thus, without incurring an additional risk of falling, spontaneous carrying may provide infants with new avenues for combining locomotor and manual skills and for interacting with their environments.