Decisions to Seek Healthcare Based on Family Health History Among Urban Appalachian Women

Family health history (FHH) is a valuable health promotion tool that can be used to assess disease risk and make lifestyle and screening recommendations. However, few FHH resources exist for medically underserved populations such as the urban Appalachian community in Cincinnati Ohio. Women of Appalachian heritage with less than a college education who did and did not participate in a prior FHH education session were interviewed by phone in a semi-structured format. Interviewees were asked to discuss their understanding of FHH and the role FHH played in seeking (or not seeking) medical care. Analysis of their discussion identified four overarching themes as well as a model identifying conditions that facilitated or impeded the choice to seek medical care based on FHH. Findings from this study may be used to develop targeted FHH educational interventions in the urban Appalachian and other communities.     

Impact of Traumatic Life Events in a Community Sample of Toddlers

Toddlers may be at particularly high risk for a number of psychiatric, developmental and neurobiological consequences in the aftermath of trauma. The social and emotional impact of potentially traumatic life events experienced between 6 and 36-months of age was assessed in an epidemiological birth cohort of 18- to 36-month-olds from the Greater New Haven Area. Event-exposed toddlers evidenced greater symptom severity on the ITSEA Internalizing, Externalizing, Dysregulation, Atypical and Maladaptive scales, as well on the CBCL Internalizing and Externalizing scales than those not exposed. Approximately one-fifth of event-exposed toddlers were reported by their parents to have experienced a dramatic change in functioning following the event, and were described as experiencing higher levels of symptoms consistent with Post-Traumatic Stress Disorder (PTSD), namely re-experiencing and arousal, than exposed toddlers whose parents did not report a change in their functioning. Implications for clinicians and child care providers working with toddlers and their parents are discussed.     

Performance benefits and costs in forced choice perceptual identification in amnesia: Effects of prior exposure and word frequency

Accuracy in identifying a perceptually degraded word (e.g., stake) can be either enhanced by recent exposure to the same stimulus or reduced by recent exposure to a similar stimulus (e.g., stare). In the present study, we explored the mechanisms underlying these benefits and costs by examining the performance of amnesic and control groups in a forced choice perceptual identification (FCPI) task in which briefly flashed words (that were identical to studied words, similar to studied words, or new) had to be identified, and two response choices were provided that differed from each other by one letter. Control participants showed a performance benefit and cost in FCPI with both high- and low-frequency words. Amnesic participants showed a benefit (but no cost) with high-frequency words and a benefit and a cost with low-frequency words. The benefit/cost pattern with low-frequency words in amnesia was obtained even when the to-be-identified stimulus in the FCPI task was eliminated (Experiment 2), suggesting that this effect was driven by processes operating at the level of the response choices. Our findings suggest that implicit memory effects in FCPI reflect the operation of multiple mechanisms, the relative contributions of which may vary with the frequency of the test stimuli. The results also highlight the need for caution in interpreting results from normal participants in the FCPI task, since those findings may reflect a contribution of explicit memory processes.     

Maternal aggression in mice and rats towards male and female conspecifics

Although postpartum aggression is primarily studied in laboratory mice and rats, it is unclear how the two species compare in terms of the factors associated with peak levels of aggressive behavior. Using the same experimental protocol, we assessed the relative effect of intruder sex and time since parturition on the frequency of maternal aggression in Long-Evans rats and CFW mice. Females were studied for 2 consecutive cycles of pregnancy and lactation. During the first lactation, aggression was tested 2 times per week for 3 weeks in order to select animals that attacked at least once. During the second lactation, both pup care and aggressive behavior were assessed in detail. Testing occurred twice in each lactation week, with postpartum days 1–7, 8–14, and 15–21 considered weeks 1, 2, and 3, respectively. Maternal behavior towards 3 pups was observed for 5 minutes, followed by a confrontation with an intruder. Lactating females encountered female intruders once per week, and male intruders in the alternate weekly test. The same behaviors were measured in the 2 species, except for the tail rattle exhibited by mice and the aggressive posture shown by rats. Lactating rats and mice show similar decreases in pup care behavior as lactation progresses in time; yet the factors associated with peak levels of aggression differ between species. In Long-Evans rats, female intruders receive more attacks, threats, and aggressive postures than males. Frequency of attack bite and sideways threat declines in each passing week of lactation. Lactating mice are more aggressive toward male intruders throughout the lactation period. Mice still attack and threaten during the third week of lactation, but less often in comparison to the first week. Therefore, peak levels of aggression vary in mice and rats both as a function of intruder sex and lactation week.     

Family dynamics as predictors of infant disposition

In this longitudinal study of mothers, their families, and their infants, both discriminant and regression analyses showed that prenatal reports of family dynamics predicted infant disposition at 8 months with considerable accuracy. The most important predictive component was organization and consistency within the family unit as well as the dependability of other family members. Possible mechanisms by which family dynamics might affect the infant's developing disposition are discussed.     

Infant psychiatry clinic grand rounds. Unresolved grief: A two-year-old brings her mother for treatment

Rebecca was a 2 ¹/₂ -year-old Caucasian female who was brought to the Infant Psychiatry Clinic by her 28-year-old widowed mother. Her mother's chief concern was around parenting issues as well as how to explain to Rebecca the death of her father. This loss occurred when Rebecca was 6 months old and was a source of great pain and unresolved grief to her mother. Central to this case was the chaotic history of Rebecca's mother, who was a victim of incest from the time she was 13 until she was 23 years old. Both of her parents struggled with chronic alcoholism during much of her childhood. It appeared that a factor precipitating the mother's request for help was her struggle to move out of her own mother's home. This outpatient Infant Clinic case involved two primary goals: (1) the assessment of the parent-child relationship and (2) the development of confidence in this “good enough” mother. Vitally important to the process of treatment was the mother's modulation of timing and frequency of sessions. The issue of pacing was carefully monitored as this mother could have been overwhelmed by delving precipitously into her incestuous history. The use of a structured videotape interview to address mother-child interaction and parenting issues was particularly helpful. Referral to an AlAnon group provided the mother with social support as she separated herself from her alcoholic mother and moved toward autonomy in her own parenting role.     

Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.