Correlates of household smoking bans in low-income families of children with and without asthma

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.     

Treating body dysmorphic disorder with medication: evidence, misconceptions, and a suggested approach

Body dysmorphic disorder (BDD) is a relatively common and often disabling disorder with high morbidity and mortality. Both psychotropic medication and cognitive behavioral therapy (CBT) are considered first-line treatments for BDD, and medication treatment is often essential for more severely ill and suicidal patients. In this practical overview of the pharmacotherapy of BDD, we briefly describe BDD's clinical features, associated morbidity, and how to recognize and diagnose BDD. We describe the importance of forming a therapeutic alliance with the patient, the need for psychoeducation, and other essential groundwork for successful treatment of BDD. We review available pharmacotherapy research, with a focus on serotonin-reuptake inhibitors (SSRIs, or SRIs), which are currently considered the medication of choice for BDD. Many patients have substantial improvement in core BDD symptoms, psychosocial functioning, quality of life, suicidality, and other aspects of BDD when treated with appropriate pharmacotherapy that targets BDD symptoms. We also discuss practical issues such as dosing, length of treatment, and potential side effects associated with the use of SRIs. In addition, we discuss pharmacotherapy approaches that can be tried if SRI treatment alone is not adequately helpful. Finally, some misconceptions about pharmacotherapy, gaps in knowledge about BDD's treatment, and the need for additional research are discussed.     

Connectedness: A Review of the Literature With Implications for Counseling,Assessment, and Research

In this article, the authors review the current conceptual and empirical literature from a variety of disciplines dealing with the construct of connectedness. A working definition of connectedness is provided along with a discussion of its multidimensional nature and major characteristics. Its relationship with a variety of other variables is also presented. Particular attention is given to gender and cultural considerations in the experience and operationalization of connectedness. Recommendations for counseling, assessment, and research related to connectedness are provided.     

Linking sounds to meanings: Infant statistical learning in a natural language

The processes of infant word segmentation and infant word learning have largely been studied separately. However, the ease with which potential word forms are segmented from fluent speech seems likely to influence subsequent mappings between words and their referents. To explore this process, we tested the link between the statistical coherence of sequences presented in fluent speech and infants’ subsequent use of those sequences as labels for novel objects. Notably, the materials were drawn from a natural language unfamiliar to the infants (Italian). The results of three experiments suggest that there is a close relationship between the statistics of the speech stream and subsequent mapping of labels to referents. Mapping was facilitated when the labels contained high transitional probabilities in the forward and/or backward direction (Experiment 1). When no transitional probability information was available (Experiment 2), or when the internal transitional probabilities of the labels were low in both directions (Experiment 3), infants failed to link the labels to their referents. Word learning appears to be strongly influenced by infants’ prior experience with the distribution of sounds that make up words in natural languages.     

Self-esteem in body dysmorphic disorder

Although studies indicate that poor body image is associated with poor self-esteem, few investigations have examined self-esteem in a clinical sample of individuals with body dysmorphic disorder (BDD). The present study examined self-esteem in 93 BDD patients and change in self-esteem with pharmacotherapy. Subjects completed the Rosenberg Self-Esteem Scale (RSES) and were assessed with other measures. Participants in a placebo-controlled fluoxetine trial completed measures at baseline and endpoint. The mean RSES score was approximately 1.5 SD units lower than means reported for nonclinical samples. Although poorer self-esteem was associated with more severe BDD and depression, as well as greater delusionality, the relationship between self-esteem and BDD severity was largely mediated by depressive symptoms. Self-esteem did not improve significantly more with fluoxetine than placebo, although it improved significantly more in fluoxetine responders than in nonresponders. It is unclear whether poor self-esteem predisposes to BDD and/or is a consequence of the disorder.     

Development of visuospatial short-term memory in the second half of the 1st year

Eighty 5.5- to 12.5-month-old infants participated in 4 delayed-response procedures challenging shortterm visuospatial memory (STVM), 2 that varied the time between presentation and search and 2 that varied the number of locations. Within each type of challenge, 1 task required a gaze response and 1 required a reach response. There was little improvement in STVM performance from 5.5 to 8 months and linear improvement in the percentage correct from 8 to 12 months, with overall STVM performance accounting for 66% of the variance in age. Improvement in searching multiple locations lagged behind improvement in spanning longer delays. Memory scores did not vary for the visual and manual tasks. Perseveration was greatest for reach responses, increased with challenge, and decreased with age. ((c) 2004 APA, all rights reserved)     

Learning across languages: bilingual experience supports dual language statistical word segmentation

Bilingual acquisition presents learning challenges beyond those found in monolingual environments, including the need to segment speech in two languages. Infants may use statistical cues, such as syllable‐level transitional probabilities, to segment words from fluent speech. In the present study we assessed monolingual and bilingual 14‐month‐olds’ abilities to segment two artificial languages using transitional probability cues. In Experiment 1, monolingual infants successfully segmented the speech streams when the languages were presented individually. However, monolinguals did not segment the same language stimuli when they were presented together in interleaved segments, mimicking the language switches inherent to bilingual speech. To assess the effect of real‐world bilingual experience on dual language speech segmentation, Experiment 2 tested infants with regular exposure to two languages using the same interleaved language stimuli as Experiment 1. The bilingual infants in Experiment 2 successfully segmented the languages, indicating that early exposure to two languages supports infants’ abilities to segment dual language speech using transitional probability cues. These findings support the notion that early bilingual exposure prepares infants to navigate challenging aspects of dual language environments as they begin to acquire two languages.