The Tourette's Disorder Scale (TODS): development, reliability, and validity

To address the lack of a simple and standardized instrument to assess overall illness severity of Tourette's disorder (TD), the authors developed and tested a 15-item scale to measure a broad range of common symptoms including tics, inattention, hyperactivity, obsessions, compulsions, aggression, and emotional symptoms. Independent investigators used the 15-item Tourette's Disorder Scale (TODS) to assess 60 TD patients who were taking part in a double-blind placebo-controlled multicenter 8-week treatment study. Interrater reliability, internal consistency, convergent and discriminant validity, and sensitivity to change were examined. The TODS was associated with good interrater reliability, excellent internal consistency, and favorable levels of validity and sensitivity to change. Individual TODS items showed good convergent and discriminant validity against other measures. The TODS is a simple, efficient way for clinicians and parents to rate the severity of multiple symptoms commonly found in patients with Tourette's disorder.     

The ‘Medical Body’ As Philosophy's Arena

Medicine, as Byron Good argues, reconstitutes thehuman body of our daily experience as a medical body,unfamiliar outside medicine. This reconstitution can be seen intwo ways: (i) as a salutary reminder of the extent to which thereality even of the human body is constructed; and (ii) as anarena for what Stephen Toulmin distinguishes as theintersection of natural science and history, in which many ofphilosophy's traditional (and traditionally abstract) questionsare given concrete and urgent form.This paper begins by examining a number of dualities between themedical body and the body familiar in daily experience. Toulmin's epistemological analysis of clinical medicine ascombining both universal and existential knowledge is thenconsidered. Their expression, in terms of attention,respectively, to natural science and to personal history, isexplored through the epistemological contrasts between themedical body and the familiar body, noting the traditionalphilosophical questions which they in turn illustrate.     

A model for brief assessment of attachment and its application to women in inpatient treatment for trauma-related psychiatric disorders

We adapted self-report measures of attachment style to the psychological assessment of women in specialized inpatient treatment for trauma-related disorders. The study employed 2 measures of adult attachment style, the Relationship Questionnaire (Bartholomew & Horowitz, 1991) and the Adult Attachment Scale (Collins & Read, 1990) as well as our Current Attachment Relationships questionnaire, which assesses the extent of social support in secure attachments. We administered these measures to 99 patients and to a convenience sample of 154 women in the community. We found modest correspondence between the 2 attachment style measures and substantial relations between attachment styles and range of secure attachment relationships. Women in the trauma sample reported insecure attachment styles and relatively few secure attachment figures. We discuss the implications of these findings for clinical assessment.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

Wisdom and Life Experience: How Grandfathers Mentor Their Grandchildren

This exploratory study uses qualitative methods to focus on the largely unexamined role of the grandfather and to examine men's experiences as grandfathers. We gathered information through both surveys and individual interviews to explore men's feelings and attitudes toward the grandfather role. Of the 51 grandfathers that completed a survey, 20 participated in interviews. Our examination of the data collected reveals the life lessons men teach their grandchildren. The grandfathers in this study expressed strong desires for purposeful involvement in their grandchildren's lives and indicated desires for transferring values to grandchildren and teaching interpersonal relationships. Through this involvement, they educate through life experiences and serve as mentors for their grandchildren. We suggest that this mentoring role makes a positive contribution to the lives of grandchildren and to the identity of grandfathers.     

A remote-controlled device for long-term blood collection from freely moving, socially housed animals

A remote-controlled device was developed for injection of fluids and collection of blood samples from freely moving, socially housed animals via an indwelling catheter. Samples are collected at times chosen by the investigator, and the animal is not aware that sampling is occurring. This technique allows measurement of plasma catecholamines and other substances that fluctuate rapidly, are affected by psychosocial stimuli, and are altered by capture and other stressful activities that often accompany sample collection. Rapid retrieval of samples is facilitated by remote-controlled injection of an anesthetic. The device has been used to collect blood from dominant and subordinate male baboons before and during events such as chases and presentation of food treats. Heart rate and blood pressure were measured via radio telemetry, and behavior was recorded on videotapes. This technique allowed construction of multifaceted physiological profiles of social roles and behaviors.     

COMPETITION BETWEEN POSITIVE AND NEGATIVE REINFORCEMENT IN THE TREATMENT OF ESCAPE BEHAVIOR

We compared the effects of reinforcing compliance with either positive reinforcement (edible items) or negative reinforcement (a break) on 5 participants' escape-maintained problem behavior. Both procedures were assessed with or without extinction. Results showed that compliance was higher and problem behavior was lower for all participants when compliance produced an edible item rather than a break. Treatment gains were achieved without the use of extinction. Results are discussed regarding the use of positive reinforcement to treat escape behavior.     

Childhood poverty and young adults' allostatic load: the mediating role of childhood cumulative risk exposure

Childhood poverty is linked to a host of physical and psychological disorders during childhood and later in life. In the study reported here, we showed that the proportion of childhood spent in poverty from birth to age 9 was linked to elevated allostatic load, a marker of chronic physiological stress, in 17-year-olds. Furthermore, this prospective longitudinal relationship was mediated by cumulative risk exposure at age 13. The greater the duration of early life spent in poverty, the greater the exposure to cumulative risk. This, in turn, leads to elevated allostatic load. Multiple psychological, biological, and neurological pathways likely account for the social patterning of psychological and physical disease.     

Civilian Response Corps Force Review: The Application of Multi‐Criteria Decision Analysis to Prioritize Skills Required for Future Diplomatic Missions

Created by the State Department's Office of the Coordinator for Reconstruction and Stabilization, the Civilian Response Corps (CRC) contains a diverse pool of qualified and ready‐to‐deploy civilian professionals that support conflict prevention and response efforts in countries or regions that are at risk of, are currently in, or are transitioning from conflict or civil strife. As such, it is vital to optimize the CRC's skill groupings to maximize adaptability and responsiveness to highly uncertain and trying political conditions and crises across the globe. The nature of the CRC value proposition is such that determining which skill set compositions deliver the greatest benefit requires a multi‐faceted perspective that looks at a number of attributes and factors, both tangible and intangible. To meet these needs, an organizational decision‐making approach utilizing multi‐criteria decision analysis (MCDA) was applied to ensure that skill‐grouping allocations were determined in a logical and robust manner. The MCDA analysis allowed for a wide range of worldviews and perspectives, drawn from select members of academia and partner agencies of the CRC who provided their expert opinions on the expected demand for skill groupings commonly identified as most necessary in a civilian ‘surge’ capacity. These skills were assessed with reference to a values hierarchy of representative country scenarios, missions and sub‐missions identified by the Office of the Coordinator for Reconstruction and Stabilization. Of particular interest was the use of the MCDA method to prioritize CRC skill groupings and to help inform the Department of State's understanding of the ‘ideal’ proportion and types of civilian skills for inclusion in the CRC. Copyright © 2012 John Wiley & Sons, Ltd.