Exploring outcomes through narrative: the long-term impacts of Better Beginnings, Better Futures on the turning point stories of youth at ages 18-19

This study examined the long-term effects of the Better Beginnings, Better Futures project, a community-based early childhood development program, on 18–19 year-old youths’ narratives about turning points in their lives. The sample consisted of youth who participated in Better Beginnings from ages 4–8 (n = 62) and youth from a comparison community who did not participate in Better Beginnings (n = 34). Controlling for covariates, significant differences favoring youth from the Better Beginnings sites were found on several dimensions of the turning point stories: ending resolution, personal growth, meaning-making, coherence, and affect transformation. Effect sizes ranged from .45 to .76 for these outcome dimensions, indicating moderate to large effects. Also, turning point story dimensions were found to be significantly correlated with two standardized measures of well-being: youths’ self-esteem and community involvement. Youths’ self-esteem was directly related to story ending resolution, personal growth, and meaning making, and youths’ community involvement was directly related to story specificity, meaning making, and coherence. Family functioning was also examined in relation to these narrative dimensions but was not found to be significantly related to them. The findings suggest the utility of a narrative approach for the evaluation of the long-term outcomes of early childhood development programs.     

Telehealth for underserved families: An evidence-based parenting program

Families with a child diagnosed with attention-deficit hyperactivity disorder completed an 8-session parenting program, the Group Triple P Positive Parenting Program, provided by videoconferencing technology. Families reported improved child behavior (effect size of d = -1.23) and decreased parent distress (d = -0.34). Parent training implemented with videoconferencing technology can be an effective way of delivering evidence-based services to families with specialized needs. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Counselling, careers education and pastoral care: Beyond the National Curriculum

The National Curriculum and other recent educational reforms in the UK have had the effect of compartmentalising children's education into the measurable—usually the academic—and of undervaluing its socio-emotional aspects. A symposium presenting different views of the implications of these reforms is introduced. A plea is made for all professionals involved in education to move from a reductionist view to one which truly enhances the whole child.     

"I need to talk about it": a qualitative analysis of trauma-exposed women's reasons for treatment choice

A significant proportion of individuals suffering from posttraumatic stress disorder do not seek or receive effective treatment. Understanding the reasons why an individual chooses to seek treatment or prefers one treatment to another is a critical step to improve treatment seeking. To begin to understand these reasons, we conducted a qualitative analysis of the reasons women gave for choosing a cognitive-behavioral treatment, prolonged exposure (PE), or a pharmacological treatment, sertraline (SER). A community sample of women with trauma histories were asked to view standardized rationales, to choose among PE, SER, or no treatment, and to give 5 reasons for their choice. Women indicated that they were more likely to prefer the psychotherapy to the medication. Across reasons given, the most commonly cited reason for treatment preference highlighted why or how the treatment worked (e.g., I need to talk about it); and this reason emerged as the strongest predictor of preference for PE. Understanding this role of perceived treatment mechanism may aid clinicians and public health policy officials to identify and address help-seeking barriers regarding treatment.     

Treatment choice for PTSD

The impetus for seeking help for assault-related difficulties often rests upon the victims themselves. Yet, we know very little about what factors influence a woman's decision to seek a particular kind of help after an assault. To learn more about these factors, data from 273 women with varying degrees of trauma history and subsequent PTSD symptoms were collected. All participants read a standard, "if this happened to you, what would you do" scenario describing a traumatic event and subsequent trauma-related psychiatric symptoms. Participants were given the same trauma scenario (i.e., sexual assault) and three treatment options to choose from: sertraline (SER), prolonged exposure (PE), or no treatment. Ratings of treatment credibility, personal reactions to treatment options, and treatment choice were examined. Women were more likely to choose PE than SER for the treatment of chronic PTSD. Perceived credibility of the treatment and personal reactions coincided with women's choices. By better understanding who would choose which treatments for PTSD and why, we will improve our ability to tailor how we approach discussing treatment options with these women.     

Evaluating current deficit theories of poor reading: role of phonological processing, naming speed, balance automaticity, rapid verbal perception and working memory

To clarify the nature of cognitive deficits experienced by poor readers, 9-10-yr.-old poor readers were matched against 9 chronological age and 9 younger reading age-matched controls screened and selected from regular classrooms. Poor readers performed significantly more poorly than chronological age-matched peers on digit naming speed, spoonerisms, and nonsense word reading. Poor readers were also significantly poorer than reading age-matched controls on nonword reading but were significantly better than reading age-matched controls on postural stability. Analyses of effect sizes were consistent with these findings, showing strong effects for digit naming speed, spoonerisms, and nonword reading. However, effect size analysis also suggested that poor readers experienced moderate difficulties with balance automatisation but did not show verbal speech perception deficits relative to either control     

Treatment outcome for chronic PTSD among female assault victims with borderline personality characteristics: a preliminary examination

The present study examined the effect of the presence of borderline personality disorder characteristics (BPC) on patients' responses to cognitive behavioral treatment for chronic PTSD. Seventy-two female victims of sexual and non-sexual assault were randomly assigned to one of four treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE/SIT), and wait list control (WL). Treatment consisted of nine bi-weekly individual sessions. Seventeen percent of the patients met full (10%) or partial criteria (7%) for borderline personality disorder. A greater number of patients with BPC reported sexual assault in childhood compared to those without the symptomatology. Patients with BPC also reported more pre-treatment anger. In general, those with BPC benefited significantly from treatment, although at post-treatment, they were less likely to achieve good end-state functioning than those without such symptomatology. The relationship between BPC and treatment response will be discussed.     

Combining total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with subcutaneous mastectomy in trans men: The effect on safety outcomes

Abstract

Background: Masculinizing mastectomy is the most requested gender affirming surgery (GAS) in trans men, followed by genital GAS. Mastectomy and total laparoscopic hysterectomy, with or without bilateral salpingo-oophorectomy (TLH?±?BSO), can both be performed in one single operation session. However, data on complication rates of the combined procedure is scarce and no consensus exists on the preferred order of procedures.

Aims: To compare safety outcomes between mastectomy performed in a single procedure with those when performed in a combined procedure and assess whether the order of procedures matters when they are combined.

Methods: A retrospective chart review was performed of trans men who underwent masculinizing mastectomy with or without TLH?±?BSO in a combined session. The effects of the surgical procedure on complication and reoperation rate of the chest were assessed using logistic regression.

Results: In total, 480 trans men were included in the study. Of these, 212 patients underwent the combined procedure. The gynecological procedure was performed first in 152 (71.7%) patients. In the total sample, postoperative hematoma of the chest occurred in 11.3%; 16% in the combined versus 7.5% in the single mastectomy group (p?=?0.001). Reoperations due to hematoma of the chest were performed in 7.5% of all patients; 10.8% in the combined versus 4.9% in the single mastectomy group (p?=?0.017). The order of procedures in the combined group had no significant effect on postoperative hematoma of the chest (p?=?0.856), and reoperations (p?=?0.689).

Conclusion: Combining masculinizing mastectomy with TLH?±?BSO in one session was associated with significantly more hematoma and reoperations compared with separately performing mastectomy. This increased risk of complications after a combined procedure should be considered when deciding on surgical options. The order of procedures in a combined procedure did not have an effect on safety outcomes.