Psychotropic Medication Patterns in Medicaid-Insured Youth Based on Clinician-Reported Maltreatment Status

The main objective of this study is to explore the relationship of psychotropic medication use patterns and clinician-reported maltreatment status in Medicaid-insured youth. This cross-sectional study analyzed computerized outpatient claims for youth aged 2–17 years who were continuously enrolled for ≥10 months in a mid-Atlantic state Medicaid program in 2006. Bivariate analyses and multivariable logistic modeling were employed to assess patterns of any psychotropic drug use, and specifically for antipsychotics, antidepressants, and stimulants by clinician-reported maltreatment status and according to other study covariates. Child maltreatment status was assessed using ICD-9 codes for maltreatment. Other covariates included age group, gender, race/ethnicity, region, Medicaid-eligibility categories, and clinician-reported psychiatric diagnostic groups. Among 274,490 youth, 901 had a clinician-reported child maltreatment indicator for a prevalence of 3.3 per 1,000. These youth were more likely to be older, female, African American, and Medicaid eligible by foster care or disability. Youth with clinician-reported maltreatment compared to youth without identified maltreatment had a significantly higher prevalence of antipsychotic use (14.1 vs. 3.4 %), antidepressant use (12.1 vs. 3.4 %) and stimulant use (15.8 vs. 7.8 %). After adjusting for the study covariates, the odds of antipsychotic use (2.6 [2.0, 3.2]), antidepressant use (2.0 [1.6, 2.6]), and any psychotropic use (1.5 [1.3, 1.9]) were comparatively higher among youth with clinician-reported maltreatment. By contrast, the adjusted-odds of stimulant use was comparable between the groups. The findings from this exploratory study from one state’s Medicaid outpatient data suggest that youth with maltreatment indicators have an increased likelihood of antipsychotic and antidepressant medication dispensings.     

How Could There Be True Causal Claims Without There Being Special Causal Facts in the World?

Some philosophers of physics recently expressed their skepticism about causation (Norton 2003b, 2007). However, this is not new. The view that causation does not refer to any ontological category perhaps can be attributed to Hume, Kant and Russell. On the other hand, some philosophers (Wesley Salmon and Phil Dowe) view causation as a physical process and some others (Cartwright) view causation as making claims about capacities possessed by objects. The issue about the ontological status of causal claims involves issues concerning the ontological status of capacity, modality and dispositional claims. In this paper, my goal is to show that without engaging metaphysical debates about the ontological status of causal claims, it can be shown that we can objectively assign truth values to these statements. I argue that for causal claims to be objective we don't need to postulate the existence of special facts (specific to causal claims) in addition to ordinary physical facts described by physical theories. This, I think, is enough to justify the usefulness of this concept in certain branches (may be all) of science. Once this is achieved, there is no need to engage in unnecessary metaphysical debates. So, even if advanced physical theories don't mention this notion, causal reasoning can still be important in understanding the world not in the sense that science discovers special ontological category called causation but in the sense that we come to know certain facts about the world.     

Fluency in L2: Read and Spontaneous Speech Pausing Patterns of Turkish,Swahili, Hausa and Arabic Speakers of English

Journal of Psycholinguistic Research - Language learners’ actual speech performances constitute an essential aspect of studies on second language learning and teaching. Although there is...     

Spirituality and Well-Being of Children,Adolescent, and Adult Students: A Scientific Mapping of the Literature

Journal of Religion and Health - This study aims to map the selected literature on students’ spirituality and well-being to reveal the current and historical research trends in the relevant...     

Age-related changes in discrimination of unfamiliar odors

If odor perception involves mnemonic processes, differences in olfactory experience should affect discriminative ability. This was examined here by comparing discriminative performance in children and adults. Using an oddity test of discrimination, in Experiment 1 we tested 6-year-olds (G1), 11-year-olds (G6), and adults (A) on their ability to discriminate unfamiliar odors that varied either in quality (Q) or in quality and intensity (QI). G1 participants were poorer at discriminating the QI set, relative to G6 and A. In Experiment 2, we used an analogous visual procedure and confirmed that this age-related difference was olfactory specific. In Experiment 3, we repeated Experiment 1 but used an articulatory suppression task. G1 participants were poorer than G6 and A participants for both the Q and the QI sets. The implications of these findings for experiential accounts of odor perception and olfactory working memory are discussed.