Social Function and Autism Spectrum Disorder in Children and Adults with Neurofibromatosis Type 1: a Systematic Review and Meta-Analysis

In light of the proliferation of recent research into social function in neurofibromatosis type 1 (NF1), a systematic review and meta-analysis is required to synthesise data and place findings within the context of a theoretical framework. This paper reviews findings from research into social function and autism spectrum disorder (ASD) in children and adults with NF1 and integrates these findings with the Socio-Cognitive Integration Abilities Model (SOCIAL). It also critically appraises links between social outcomes, internal and external factors moderating social functioning, cognitive domains implicated in social functioning, and underlying neural pathology in NF1. A systematic literature search conducted in MedLine (Ovid), PsycINFO (Ovid), Embase (Ovid), and PubMed electronic databases yielded 35 papers that met inclusion criteria for the systematic review. Out of these papers, 22 papers provided sufficient data for meta-analysis. Findings from this review and meta-analysis provide evidence that children and adults with NF1 exhibit significantly higher prevalence and severity of social dysfunction and ASD symptomatology. To date, very few studies have examined social cognition in NF1 but results indicate the presence of both perceptual and higher-level impairments in this population. The results of this review also provide support for age, gender, and comorbid ADHD as moderating factors for social outcomes in NF1. Suggestions for future research are offered to further our understanding of the social phenotype in NF1 and to facilitate the development of targeted interventions.     

Diagnosis of posttraumatic stress disorder with the MMPI: PK scale scores in somatization disorder

Clinic patients with diagnoses of either major depression or somatization disorder were given the MMPI. Women with somatization disorder had high scores on Keane's MMPI scale (PK) for posttraumatic stress disorder. Following the procedure for the MMPI-2 (46 of the 49 PK items and MMPI-2 norms), 59% of the women with somatization disorder and 21% of the women with major depression would have T scores > or = 65 on the MMPI-2 scale although none of them were known to have developed psychiatric disorder after exposure to a life threatening event. The PK scale has little use in the differential diagnosis of women patients with somatization disorder.     

Postdeployment Suicide Risk Increases Over a 6‐month Period: Predictors of Increased Risk among Midwestern Army National Guard Soldiers

National Guard (NG) soldiers returning from deployments in Iraq and Afghanistan were surveyed at 6 and 12 months following their return (N = 970). The overall prevalence of suicide risk at 6 and 12 months following their return was assessed, as were changes in suicide risk among soldiers initially at high or low risk. Factors associated with changes in risk were assessed. The percentage of NG soldiers with high suicide risk increased from 6.8% at 6 months to 9.2% at 12 months (odds ratio = 1.7, p = .02). In the 882 soldiers initially at low risk, 5.9% (52/882) became high risk at 12 months; in the 64 soldiers initially at high risk, 46.9% (30/64) became low risk at 12 months. Initial levels of depressive symptoms were predictive of changing to high risk; this association appeared to be partially explained by soldier reports of increased search in the meaning in life and higher levels of perceived stress. Because suicide risk increases over the first 12 months, continued risk assessments during this time period should be considered. Supporting soldiers to find meaning in their life after deployment and enhancing their capacity to cope with perceived stress may help prevent increases in suicide risk over time.     

Musical preferences during and after relaxation and exercise

Effects of the listening context on responses to music largely have been neglected despite the prevalence of music listening in our everyday lives. This article reports 2 studies in which participants chose music of high or low arousal potential during (Experiment 1) or immediately after (Experiment 2) exercise or relaxation. In Experiment 1, participants preferred appropriate arousal-polarizing music over arousal-moderating music. In Experiment 2, participants preferred arousal-moderating music over arousal-polarizing music, such that their listening times contrasted clearly with those in the first study even though the same music and methods were used. Thus musical preferences interact with the listening situation, and participants' music selections represent an attempt to optimize their responses to that situation. When motivated to maintain a state of polarized arousal, listeners use music to achieve this; when they have no such goal, they use music to moderate arousal.     

Perceiving patterns of play in dynamic sport tasks: investigating the essential information underlying skilled performance

The perceptual-cognitive information used to support pattern-recognition skill in soccer was examined. In experiment 1, skilled players were quicker and more accurate than less-skilled players at recognising familiar and unfamiliar soccer action sequences presented on film. In experiment 2, these action sequences were converted into point-light displays, with superficial display features removed and the positions of players and the relational information between them made more salient. Skilled players were more accurate than less-skilled players in recognising sequences presented in point-light form, implying that each pattern of play can be defined by the unique relations between players. In experiment 3, various offensive and defensive players were occluded for the duration of each trial in an attempt to identify the most important sources of information underpinning successful performance. A decrease in response accuracy was observed under occluded compared with non-occluded conditions and the expertise effect was no longer observed. The relational information between certain key players, team-mates and their defensive counterparts may provide the essential information for effective pattern-recognition skill in soccer. Structural feature analysis, temporal phase relations, and knowledge-based information are effectively integrated to facilitate pattern recognition in dynamic sport tasks.     

Documentary Bioethics: Visual Narratives for Generations X and Y

Narrative bioethics is primarily understood to involve storytelling through the use of literature. This article suggests that other forms of media are necessary to convey stories of an ethical nature to an audience broader than one being trained as medical professionals. "Documentary bioethics" is a manner to present and interpret stories of an ethical nature using forms of popular electronic media in a reality-based documentary style to society at large, specifically Generations X and Y.     

Structural family therapy with Mexican-American family systems

Characteristics of traditional Mexican-American families with consequent family rules that affect these family systems are discussed along with selected clinical cases. The specific cases discussed involve: (1) interactions with family of origin in intercultural marriages, (2) intracultural differences in levels of acculturation and traditional family rules, and (3) extended family impact in response to severe life crisis. The development of therapeutic processes from structural and strategic family therapy approaches, which reflect appreciation for cultural differences and strengths, is suggested.This material was presented at the annual meeting of the Texas Association for Marriage and Family Therapy, January, 1994, San Antonio, TX.     

Interrater reliability and coding guide for nonpsychotic formal thought disorder

Reliable and valid assessment of abnormal speech patterns may enable earlier recognition of nonpsychotic disorders through characteristic speech patterns. This study sought to establish interrater reliability using a standardized guide for scoring. A scoring guide defining 27 elements (e.g., inappropriate self-reference, simple loss of goal, circumstantiality) of disordered thought was developed. The seminal work of Andreasen's and Holzman's groups provided 12 elements, and 15 new elements were suggested by clinical literature. Audiotaped interviews with 12 psychiatric inpatients, adults of both sexes and various ages hospitalized for acute management of nonpsychotic psychiatric disorders, provided speech samples for observation of disordered thought by two independent raters. Using the guide's definitions and accompanying examples of elements of disordered thought, reliability in scoring was high (kappa of .85 for agreement on the presence of any abnormal speech element and kappa values from .66 to 1.00 for agreement on the presence of individual elements).     

Disaster mental health services following the 1995 Oklahoma City bombing: modifying approaches to address terrorism

How did the 1995 Oklahoma City bombing differ from prior disasters and what implications did it have for disaster mental health services and service delivery? The federal disaster mental health approach in this country developed largely out of experiences with natural disasters. The 1995 Oklahoma City bombing differed in several important ways, including the large number of human casualties, higher rates of psychopathology, and an extended period of concern due to the criminal investigation and trials, which suggested the need to consider modifications in the program. Outreach was extensive, but psychiatric morbidity of direct victims was greater than that of victims of natural disasters, emphasizing the need for attention to the triage and referral process. Other concerns that warrant consideration include practices related to record keeping and program evaluation.     

Is visual search really like foraging?

The visual-search paradigm provides a controlled and easy to implement experimental situation in which to study the search process. However, little work has been carried out in humans to investigate the extent to which traditional visual-search tasks are similar to more general search or foraging. Here we report results from a task in which search involves walking around a room and leaning down to inspect individual locations. Consistent with more traditional search tasks, search time increases linearly with display size, and the target-present to target-absent search slope is 1:2. However, although rechecking of locations did occur, compared to more traditional search it was relatively rare, suggesting an increased role for memory.