DSM-IV criteria for generalized anxiety disorder in older adults: distinguishing the worried from the well

This study compared 36 older adults with generalized anxiety disorder (GAD), 22 older adults with subsyndromal anxiety symptoms, and 32 normal controls on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) for GAD. GAD patients reported more frequent and uncontrollable worry, somewhat different worry content, higher prevalence of most associated symptoms, and more distress or impairment than the subsyndromal group or normal controls. Individuals with subsyndromal anxiety reported more excessive, frequent, and uncontrollable worry than asymptomatic individuals, along with more sleep disturbance, fatigue, and distress or impairment. Results indicate that the key features of late-life GAD are distress and impairment, frequency and uncontrollability of worry, muscle tension, and sleep disturbance and that clinicians treating older adults with GAD should monitor and treat residual symptoms.     

Next Steps in Research on Children Exposed to Domestic Violence

The papers in this special issue of Clinical Child and Family Psychology Review provided an overview of what is known about children's exposure to domestic violence, and include indications of gaps in extant research. These gaps and research needs are summarized in this conclusion. Specifically, there is need for further research in several broad areas: definition and measurement of children's exposure to domestic violence; development of research methods and statistical designs that provide detailed information and provide for evidence of intervention effectiveness; impact of domestic violence on parenting and family functioning; the role of child factors and exposure to violence factors in predicting developmental risk and resilience; medical and health consequences of exposure to violence; and the nature of child-system interaction in response to domestic violence. Research needs in these areas are discussed in greater detail, and specific questions are raised for further development.     

Next Steps in Research on Children Exposed to Community Violence or War/Terrorism

The articles in this special issue of Clinical Child and Family Psychology Review provide an overview of what is known about children's exposure to community violence and war/ terrorism, and indicate significant gaps in extant research. These gaps and research needs are summarized in this conclusion.     

Introduction

This issue of Clinical Child and Family Psychology Review, Children Exposed to Domestic Violence: Current Status and Research Directions, addresses the current status of our knowledge as well as critical research needs in the area of children exposed to domestic violence. Although much has been learned in recent years about children exposed to violence, significant research gaps remain, the identification of which may help to build a more complete and rigorous science base in this area. This journal issue represents the distillation of a 3-day workshop on children exposed to violence, held in July of 2002, that identified what is known about children exposed to violence and what this information tells us about future research directions. Although many federal agencies have supported some research in this area, there is a need for more targeted attention on the topic, particularly with regard to measurement, sampling, and interventions/services. The papers in this issue were selected with these themes in mind. Although no single issue could cover the entire field, we intend to offer a representative sample of where we are and where we need to go with the hope of stimulating additional thought, collaboration, and research in this important area.     

Disproportionate deficit in associative recognition relative to item recognition in global amnesia

In two experiments, we tested the hypothesis that medial temporal lobe (MTL) amnesic patients and, likewise, diencephalic (DNC) amnesic patients evidence a disproportionate deficit in memory for associations in comparison with memory for single items. In Experiment 1, we equated item recognition in amnesic and control participants and found that, under these conditions, associative recognition remained impaired both for MTL patients and for DNC patients. To rule out an alternative interpretation of the results of Experiment 1, in Experiment 2 we compared the performance of amnesic and control participants on a one-item recognition task and a two-item recognition task that required no memory for the association between members of word pairs. In the MTL group, when single-item recognition was equated to that of the controls, two-item nonassociative pair memory was equivalent as well. In the DNC group, nonassociative pair memory was impaired, but this impairment did not fully account for the impairment in associative memory. These findings indicate that memory for novel associations between items is disproportionately impaired in comparison with memory for single items in amnesia.     

Abortion, Intimacy, and the Duty to Gestate

In this article, I urge that mainstream discussions of abortion are dissatisfying in large part because they proceed in polite abstraction from the distinctive circumstances and meanings of gestation. Such discussions, in fact, apply to abortion conceptual tools that were designed on the premiss that people are physically demarcated, even as gestation is marked by a thorough-going intertwinement. We cannot fully appreciate what is normatively at stake with legally forcing continued gestation, or again how to discuss moral responsibilities to continue gestating, until we appreciate in their own terms the goods and evils distinctive of gestational connection. To underscore the need to explore further the meanings of gestation, I provide two examples of the difference it might make to legal and moral discussions of abortion if we appreciate more fully that gestation is an intimacy.     

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.