Reducing Psychotropic Medications in an Intensive Residential Treatment Center

Medication rates in behaviorally disordered children and youth have greatly increased to current high levels and are very controversial. This study examined changes in psychotropic medication use, levels of behavioral disturbance, and use of personal restraint and seclusion in a population of youth with serious behavioral disorders receiving medically directed cognitive-behavioral treatment in an intensive residential setting. The hypothesis was that there would be significant reductions in medication rates, without the unintended consequences of increased rates of problem behavior or offsetting increases in the use of seclusion or personal restraint. Results showed significant reductions in both the number of youth on medication and the average number of psychotropic medications during the residential stay. There were also significant reductions in behavioral disturbance, seclusions, and personal restraints. These results demonstrate that psychotropic medication can be significantly reduced without increases in problem behavior or the use of seclusions or personal restraints. We conclude that it is possible to significantly reduce psychotropic medication rates to far more conservative levels within the context of a clinically directed cognitive-behavioral treatment milieu.     

Caregiving Arrangements and Caregiver Well-being when Infants are Born to Mothers in Prison

Journal of Child and Family Studies - Each year in the United States, over 1000 women give birth while in prison. Little is known about who cares for the infants after they are separated from their...     

Brief pitch-priming facilitates infants’ discrimination of pitch-evoking noise: Evidence from event-related potentials

Pitch is derived by the auditory system through complex spectrotemporal processing. Pitch extraction is thought to depend on both spectral cues arising from lower harmonics that are resolved by cochlear filters in the inner ear, and on temporal cues arising from the pattern of action potentials contained in the cochlear output. Adults are capable of extracting pitch in the absence of robust spectral cues, taking advantage of the temporal cues that remain. However, recent behavioral evidence suggests that infants have difficulty discriminating between stimuli with different pitches when resolvable spectral cues are absent. In the current experiments, we used the mismatch negativity (MMN) component of the event related potential derived from electroencephalographic (EEG) recordings to examine a cortical representation of pitch discrimination for iterated rippled noise (IRN) stimuli in 4- and 8-month-old infants. IRN stimuli are pitch-evoking sounds generated by repeatedly adding a segment of white noise to itself at a constant delay. We created IRN stimuli (delays of 5 and 6 ms creating pitch percepts of 200 and 167 Hz) and high-pass filtered them to remove all resolvable spectral pitch cues. In experiment 1, we did not find EEG evidence that infants could detect the change in the pitch of these IRN stimuli. However, in Experiment 2, after a brief period of pitch-priming during which we added a sine wave component to the IRN stimulus at its perceived pitch, infants did show significant MMN in response to pitch changes in the IRN stimuli with sine waves removed. This suggests that (1) infants can use temporal cues to process pitch, although such processing is not mature and (2) that a short amount of pitch-priming experience can alter pitch representations in auditory cortex during infancy.     

Response interference between functional and structural object‐related actions is increased in patients with ideomotor apraxia

We report data from two left hemisphere stroke patients with moderate‐to‐severe ideomotor apraxia who exhibited deficits in positioning their hands to use ‘conflict’ objects (objects grasped and used with different hand postures) relative to controls and patients with mild apraxia. These novel data support the claim that actions to common objects are subject to interference between multiple responses, and suggest that errors in apraxia may be attributed to deficient resolution of competition between appropriate and inappropriate actions.     

Infants prefer higher-pitched singing

Female singers were recorded singing a song in a high and/or a low range. Infants preferred to listen to the higher-pitched versions, suggesting that infants' preference for infant-directed singing and speech is mediated in part by a preference for higher pitch.     

The Interplay Between Housing Stability and Child Separation: Implications for Practice and Policy

Greater understanding of how residential stability affects child separation and reunification among homeless families can guide both child welfare and homeless policy and practice. This article draws upon two longitudinal studies examining services and housing for homeless families and their relationship to family and housing stability. Both studies were conducted in the same state at roughly the same time with similar instruments. The first study, examining families’ experiences and outcomes following entry into the homeless service system in three counties in Washington State, found that at 18 months following shelter entry, families that are intact with their children were significantly more likely to be housed in their own housing (46%) than families that were separated from one or more of their children (31%). The second study, a quasiexperimental evaluation of a supportive housing program for homeless families with multiple housing barriers, found that the rates of reunification for Child Protective Services (CPS)‐involved families receiving supportive housing was comparable to that for families entering public housing without services, but significantly higher than the rate of reunification for families entering shelter. Taken together, the findings from both studies contribute to the evidence underscoring the importance of housing assistance to homeless families involved in the child welfare system.     

Family processes in the midst of urban poverty: What does the trauma literature tell us?

Consistent with a family systems framework, this paper examines the clinical and research literatures to clarify the connection between chronic trauma exposure and family processes with a focus on the social ecology of low-income, urban neighborhoods. Strong empirical evidence demonstrates the impact of chronic trauma on individual family members and, in turn, on multiple family subsystems. Additionally, there is evidence that living under chronically harsh, traumatic circumstances slowly erodes family processes, specifically structure, relations, and coping. However, existing research reflects the problems inherent in sorting out relationships among multiple, often interrelated factors. Future research requires comprehensive theoretical models, such as systemic, transactional, or ecodevelopmental, along with sophisticated research designs, prospective, longitudinal or intervention, and multilevel analytic methods.     

Understanding Choice Behaviours: Pathways from School to University with Changing Aspirations and Opportunities

A socio-ecological approach to explain choice behaviour highlights salient personal and social factors in the context of changing aspirations and opportunities. The population databases are five cohorts of all school leaver applicants for university places in a state of Australia and a survey for one cohort. Results highlight common behaviour patterns across cohorts, with diverse outcomes for specific social groups. Offers of university places relate course preferences and school achievement. In addition, decisions to apply, accept and enrol vary with social experience by socio-economic indicators, geographic location and school type. Student explanations for their decisions to defer or let the offer lapse entail particular social factors as well as personal factors of self concepts, interests and financial needs. Findings contribute to a better understanding of choice behaviour, with a general model of the personal and social factors that explain diverse pathways to higher education.     

Perceived discrimination and mental health symptoms among Black men with HIV

People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., reexperiencing, avoidance, and arousal subscales; all p values < .05). The multivariate model for depression yielded a three-way interaction among all three discrimination types (p < .01), indicating that perceived racial discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p < .05). Findings suggest that some types of perceived discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmata when developing interventions to improve mental health among PLWH.     

Cognitive culture: theoretical and empirical insights into social learning strategies

Research into social learning (learning from others) has expanded significantly in recent years, not least because of productive interactions between theoretical and empirical approaches. This has been coupled with a new emphasis on learning strategies, which places social learning within a cognitive decision-making framework. Understanding when, how and why individuals learn from others is a significant challenge, but one that is critical to numerous fields in multiple academic disciplines, including the study of social cognition.