Comprehensive community-based education and neurorehabilitation for children and adolescents with traumatic brain injury

Children and adolescents who experience a traumatic brain injury (TBI) typically have sensory, cognitive, behavioral, and functional skill challenges that must be addressed in acute and post-acute rehabilitation settings. This article describes a community-based school that combines educational, medical, nursing, family, residential-living, and psychological services in a comprehensive program of pediatric neurorehabilitation. The operational, administrative, and clinical features of these service components are presented. A critical aspect of the program is an emphasis on applied behavior analysis procedures for purposes of assessment, treatment formulation, and evaluation. Data are reviewed to demonstrate demographics, patterns of service delivery, and outcome. The school program represents an educational alternative for students with TBI who are discharged from acute-care settings and require comprehensive support services to facilitate their transition and re-entry to public school and community living. © 1998 John Wiley & Sons, Ltd.     

Well‐being and pressures of daily life in two West Bank villages—Exploring context and history

Interest in the well‐being of people exposed to long‐term violence and conflict has tended to focus on measurable effects of acute traumatic events, while attention to the pressures of their daily living context is relatively new. Using qualitative and quantitative data from a 2005 survey of all female family caretakers in 2 neighbouring Israeli‐occupied West Bank villages (n = 820), we explored the associations of demographic, health‐related and contextual factors with reported pressures and WHO‐5 well‐being index scores. The final model explained 17.8% of the variance with negative associations between health‐related factors (“back‐aches,” “stomach aches” “psychological illness in the family”) and family‐related factors (“male head of household aggressive”, “male head of household physically violent”) and the WHO‐5 well‐being index scores. We found positive associations between socio‐economic factors (“standard of living”; “number of rooms”) and village‐related factors (“residency in village A/B”) and the WHO‐5 well‐being index score. Exploring the daily living context of villages A and B illuminated how the impact of historical and political events differed, even in villages that are geographically close. The paper lends support to calls for including politics and history in research on well‐being in contexts of long‐term violence and conflict.     

Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy

This study examined the effects of in utero exposure to maternal depression and Superstorm Sandy, a hurricane that hit metropolitan New York in 2012, on infant temperament at 6 months. Temperament was assessed using the Infant Behavior Questionnaire-Revised. Maternal depression was measured by the Edinburgh Postnatal Depression Scale. The main effects and the interaction of maternal depression and Sandy exposure on infant temperament were examined using a multivariable generalized linear model. Results show that prenatal maternal depression was associated with lower emotion regulation and greater distress. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero Sandy exposure. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related traumas to provide necessary services. As the frequency of natural disasters may increase due to climate change, it is important to understand the consequences of in utero stress on child development and to formulate plans for early identification.     

Neural substrates of the ‘low‐level’ system for speech articulation: Evidence from primary opercular syndrome

We describe a patient with progressive disorder of speech, without language impairment (opercular syndrome). Morphometric analysis confirmed asymmetric volume reduction of the precentral areas (>left). Diffusion imaging showed significant white matter changes in the left frontal lobe, with specific involvement of the left corticobulbar tract and connections between supplementary/pre‐supplementary motor areas and the frontal operculum (frontal aslant tract). We suggest that the organization of expressive language includes a ‘low level’ motor system principally distributed in the left hemisphere that shows specific susceptibility to neurodegeneration, distinct from neural systems subtending praxic, and cognitive aspects of language.     

Women,Human Rights,and Counseling: Crossing International Boundaries

As the world becomes more globalized, psychological and counseling issues have become more pronounced. As social justice issues become illuminated on a global scale, there is increased attention to women as identified victims of social injustices and human rights violations. This article examines the role of professional counselors working with women from an international perspective with the intention to heighten awareness and understanding of the interrelationship of global women's issues and effective counseling interventions.     

Predicting recidivism with the Psychopathy Checklist: are factor score composites really necessary?

In two previous studies on general and violent recidivism (Walters & Heilbrun, 2010; Walters, Knight, Grann, & Dahle, 2008), the summed composite antisocial facet of the Psychopathy Checklist displayed incremental validity relative to the other 3 facets (interpersonal, affective, lifestyle), whereas the other 3 facets generally failed to demonstrate incremental validity relative to the antisocial facet. Because summed composite scores do not account for ordinal item distributions, the 6 Walters et al. (2008) samples were reanalyzed with factor score composites derived from a 4-factor confirmatory factor analysis. The results, however, showed little change from what had been obtained earlier with summed composite scores. Two additional samples not previously included in any incremental validity analyses of the Psychopathy Checklist evidenced a 3-factor structure, with the lifestyle and antisocial facets merged into a single factor. This single factor displayed incremental validity relative to the interpersonal and affective facets, but the reverse was not true regardless of whether summed composite scores or factor score composites were used. A comparison of zero-order correlations from all 8 samples revealed that the antisocial summed composite score predicted significantly better than the summed composite scores for the other 3 facets and that a superordinate factor failed to improve on the performance of either the antisocial summed composite score or the antisocial factor score composite.     

Testing Factorial Structure and Validity of the PCL:SV in Lithuanian Prison Population

This study examined the factorial structure and validity of the Hare Psychopathy Checklist: Screening Version (PCL:SV) in a European forensic context. A random sample of 257 criminal offenders from the Lithuanian prison population were administered the PCL:SV (Hart et al. 1995). The pattern of validity coefficients in this sample was comparable to other North American and non-North American samples. Several theoretical factorial structures for the PCL:SV were tested and compared. The two-factor model was not supported, while three- and four-factor models provided an acceptable fit to Lithuanian data. The four-factor model showed significantly better fit compared to the two-factor model. Correlations between PCL:SV factors and demographic variables confirm construct validity. However in the four-factor model, when controlling for correlations of the remaining three factors, only the Antisocial factor significantly correlated with variables related to criminal activity. It was concluded that the overall results of the PCL:SV in a male sample of Lithuanian offenders support cross-cultural generalizability of the construct of psychopathy as measured by the PCL:SV.     

Differing effects of systemically administered rapamycin on consolidation and reconsolidation of context vs. cued fear memories

Rapamycin, an inhibitor of the mammalian target of rapamycin (mTOR) kinase, has attracted interest as a possible prophylactic for post-traumatic stress disorder (PTSD)-associated fear memories. We report here that although rapamycin (40 mg/kg, i.p.) disrupted the consolidation and reconsolidation of fear-potentiated startle paradigm to a shock-paired context, it did not disrupt startle increases to a 4-sec odor cue, even though post-training increases in amygdala mTOR activity were prevented by rapamycin (also 40 mg/kg, i.p.). Thus, while rapamycin may prove useful in retarding the development of some PTSD-associated memories, its relative ineffectiveness against cued fear memories may limit its clinical usefulness.     

Correlates of intellectual ability with morphology of the hippocampus and amygdala in healthy adults

Several prior imaging studies of healthy adults have correlated volumes of the hippocampus and amygdala with measures of general intelligence (IQ), with variable results. In this study, we assessed correlations between volumes of the hippocampus and amygdala and full-scale IQ scores (FSIQ) using a method of image analysis that permits detailed regional mapping of this correlation throughout the surface contour of these brain structures. We delineated the hippocampus and amygdala in high-resolution magnetic resonance images of the brain from 34 healthy individuals. We then correlated FSIQ with overall volumes and with the surface morphologies of each of these structures. Hippocampus volumes correlated significantly and inversely with FSIQ independently of gender, age, socioeconomic status, and whole brain volume. Left and right hippocampus volumes correlated respectively with verbal and performance IQ subscales. Higher IQs were significantly associated with large inward deformations of the surface of the anterior hippocampus bilaterally. These findings suggest that a smaller anterior hippocampus contributes to an increased efficiency of neural processing that subserves overall intelligence.