CTPI和CTA在椎底动脉系统TIA诊断中的互补性

研究CT灌注成像(CTPI)和CT血管造影(CTA)对椎底动脉系统短暂性脑缺血发作(TIA)的诊断价值.采用64排螺旋CT对30例患者进行常规CT、CT灌注成像和CT血管造影检查.30例CT平扫无责任病灶.CT灌注成像正常14例,异常16例.CTA正常4例,异常26例,CT灌注成像和CT血管造影联合应用有利于椎底动脉系统短暂性脑缺血发作的诊断和治疗方案的选择.     

Suicide Ideation and Attempts among Low‐Income African American Adolescents

We examined the impact of risk and protective factors on the odds that African American adolescents seriously think about or attempt suicide. Data from students in grades 5–12 in a mostly urban, southeastern U.S. school district were analyzed. Findings support earlier work documenting differences in gender and grades. Risk factors were uniformly significant in understanding both ideation and attempts. Protective factors were not consistent predictors; the lowering role of religious protective factors was limited, though student's belonging to or their perception of belonging to a spiritual community was a significant factor in lowering the odds of suicide ideation.     

Early risk pathways to physical versus relational peer aggression: The interplay of externalizing behavior and corporal punishment varies by child sex

Children who aggress against their peers may use physical or relational forms, yet little research has looked at early childhood risk factors and characteristics that uniquely predict high levels of relational versus physical aggression in preadolescence. Accordingly, the main aim of our study was to link early corporal punishment and externalizing behavior to children's physical and relational peer aggression during preadolescence and to examine how these pathways differed by sex. Participants were 193, 3‐year‐old boys (39%) and girls who were reassessed following the transition to kindergarten (5.5 years) and preadolescence (10.5 years). A series of autoregressive, cross‐lagged path analyses were conducted to examine the relationships between child externalizing problems and corporal punishment at ages 3 and 5.5 years, and their association with physical and relational aggression at age 10.5. Multiple group analysis was used to determine whether pathways differed by sex. Three developmental pathways were identified: (i) direct associations between stable childhood externalizing problems and later physical aggression; (ii) a direct pathway from early corporal punishment to preadolescent relational and physical peer aggression; and (iii) an indirect pathway from early corporal punishment to later physical aggression via continuing externalizing problems in middle childhood. Child sex moderated the nature of these pathways, as well as the direction of association between risk and outcome variables. These data advance our understanding of the etiology of distinct forms of peer aggression and highlight the potential for more efficacious prevention and intervention efforts in the early childhood years.

     

Role of Comorbid Depression and Co-occurring Depressive Symptoms in Outcomes for Anxiety-Disordered Youth Treated with Cognitive-Behavioral Therapy

This study examined the role of comorbid depressive disorders (major depressive disorder or dysthymic disorder) and co-occurring depressive symptoms in treatment outcome and maintenance for youth (N = 72, aged 7–14) treated with cognitive-behavioral therapy for a principal anxiety disorder (generalized anxiety disorder, separation anxiety disorder, or social phobia). Hierarchical linear modeling examined treatment outcome and maintenance in terms of severity of the principal anxiety disorder. Results indicated that higher levels of child-reported depressive symptoms predicted less favorable treatment outcome. Higher levels of mother-reported depressive symptoms predicted less favorable treatment maintenance at a 1-year follow-up. Results suggest that co-occurring depressive symptoms play a role in effective treatment for anxiety-disordered youth and support the merits of treatment adaptations for these youth.     

Evaluation of Peer Training for Teaching Abduction Prevention Skills

Child abduction is a serious problem, with approximately 100 children killed each year by nonfamily abductors. Training programs to teach children the correct skills to use if they ever come into contact with a stranger can be effective when they incorporate behavioral skills training (BST) and in-situ training (IST) into their protocol. However, these methods can be rather time and energy consuming. The current study evaluated the effectiveness and efficiency of a peer tutoring approach to teaching abduction prevention skills. Peer trainers implemented BST sessions and IST sessions with their younger peers. Children successfully acquired the target safety behaviors taught by the peer trainers, and use of the skills generalized to their natural environment.     

Behavior Problems in Toddlers With and Without Developmental Delays: Comparison of Treatment Outcomes

The purpose of this study is to examine the effectiveness of an in-home parent management program for toddlers with behavior problems and developmental delays by comparing outcomes for a group of toddlers with developmental delays (n = 27) and a group of toddlers without developmental delays (n = 27). The majority of children lived in single parent, low-income homes. Results suggest that the parent management program is equally effective for children with and without developmental delays. Parents from both groups reported clinically significant improvement in their children's behavior and parenting practices. Clinical implications regarding the importance of these findings for improving outcomes for toddlers with behavior problems and developmental delays living in poverty were discussed.