Issues in the identification and long-term management of Munchausen by Proxy Syndrome within a clinical infant service

Munchausen by Proxy Syndrome is a version of Munchausen's Syndrome whereby a parent, usually the mother, simulates or fabricates disease in one or more of her children in order to seek medical attention. Because this disorder is usually identified in pediatric settings, current literature focuses on identification of the syndrome, with little discussion of treatment issues or management strategies other than confrontation of the parent and removal of the child from the home. With the increased availability of infant mental health services, infant clinicians are likely to be called on to evaluate and treat cases of this disorder. This paper reviews the Munchausen by Proxy literature for infant clinicians and describes the identification and long-term management of one Munchausen by Proxy case within the context of an infant home-visiting service. Pertinent issues that emerged included the difficulties inherent in documenting the mother's pathological behavior, the clinical tension between preventing flight from treatment but limiting harmful behavior, the need for a long-term collaborative relationship with a designated pediatrician, and the importance of further education of protective service workers about this syndrome.     

Serotonin metabolism and serotonergic receptors in Norway rats selected for low aggressiveness to man

Selection of Norway rats (24–27 generations) for low aggressiveness to man resulting in the loss of aggressive responding to handling markedly influences the brain serotonergic system. In “domesticated” Norway rats levels of serotonin in the midbrain and hypothalamus and 5-hydroxyindole acetic acid in the hypothalamus were higher than in non-selected aggressive rats. The activity of the key enzyme in serotonin biosynthesis, tryptophan hydroxylase, in midbrain of rats with genetically determined lack of aggressiveness to man was higher than in aggressive animals, although there was no difference in tryptophan hydroxylase activity in the hypothalamus. B_max and K_D of [³H]spiperone-specific binding in frontal cortex membranes were increased in tame rats. No significant differences in B_max and K_D were found between “domesticated” and aggressive rats in [³H]serotonin binding in the frontal cortex.     

Selection for reduced aggressiveness towards man and dopaminergic activity in Norway rats

The brain dopaminergic system is involved in the process of long-term selection for reduced aggressive reaction towards man in Norway rats. The dopamine levels in the striatum as well as the nucleus accumbens with the tuberculum olfactorium were significantly lower in domesticated rats than in their wild counterparts. A substantial decrease was found in homovanillic acid level in the n. accumbens and tuberculum olfactorium. Specific binding of [³H]spiperone which labels D-2 dopamine receptors was higher in the mesolimbic structure of tame rats, whereas binding of [³H]SCH 23390 (D-1 receptors) was unchanged in this area. No substantial differences were detected in D-1 and D-2 binding in striatum. Apomorphine (0.3 mg/kg) elicited less locomotion in tame animals, reflecting a decrease of sensitivity of postsynaptic dopamine receptors. Tame rats showed fewer aggressive contacts in a foot-shock test than wild rats and the D-2 receptor antagonist sulpiride (25 mg/kg) significantly decreased the foot-shock aggression only in wild rats. Therefore, domestication, which diminishes defensive behavior and emotional reactivity of animals, is associated with decreases of dopamine level in the striatum, changed metabolism of dopamine in mesolimbic system, and an alteration in density and senstivity of D-2 receptors.     

The role of identity in how whole‐blood donors reflect on and construct their future as a plasma donor

In the context of decreased demand for whole blood and increased demand for plasma‐derived products, donors in Australia are increasingly being asked to convert from whole‐blood to plasmapheresis donations. Plasmapheresis is a different type of donation to whole blood as the process takes longer and can be engaged in more frequently. What is unknown is whether whole‐blood donors view donating plasma as consistent with their donor identity and how they respond to the possibility of donating more frequently. To explore this, we undertook semistructured telephone interviews with 26 whole‐blood donors who had recently made their first plasma donation. Findings indicated that whereas donating plasma was viewed as a bigger ask than donating whole blood, the former was viewed as consistent with their identity as a donor because both behaviours were seen to benefit others and self and were located within the same institutional context. Donating plasma was an opportunity for donors to enhance their self‐concept as an altruistic giver. When contemplating their future donation behaviour, donors considered how their donor identity would fit alongside other salient roles. These findings have implications for how institutions can position their request of existing donors to give a different gift.     

Face value: testing the utility of contextual face cues for face recognition

The presence of multiple faces during a crime may provide a naturally-occurring contextual cue to support eyewitness recognition for those faces later. Across two experiments, we sought to investigate mechanisms underlying previously-reported cued recognition effects, and to determine whether such effects extended to encoding conditions involving more than two faces. Participants studied sets of individual faces, pairs of faces, or groups of four faces. At test, participants in the single-face condition were tested only on those individual faces without cues. Participants in the two and four-face conditions were tested using no cues, correct cues (a face previously studied with the target test face), or incorrect cues (a never-before-seen face). In Experiment 2, associative encoding was promoted by a rating task. Neither hit rates nor false-alarm rates were significantly affected by cue type or face encoding condition in Experiment 1, but cuing of any kind (correct or incorrect) in Experiment 2 appeared to provide a protective buffer to reduce false-alarm rates through a less liberal response bias. Results provide some evidence that cued recognition techniques could be useful to reduce false recognition, but only when associative encoding is strong.     

Cross-cultural differences in item and background memory: examining the influence of emotional intensity and scene congruency

After viewing a scene, individuals differ in what they prioritise and remember. Culture may be one factor that influences scene memory, as Westerners have been shown to be more item-focused than Easterners (see Masuda, T., & Nisbett, R. E. (2001). Attending holistically versus analytically: Comparing the context sensitivity of Japanese and Americans. Journal of Personality and Social Psychology, 81, 922–934). However, cultures may differ in their sensitivity to scene incongruences and emotion processing, which may account for cross-cultural differences in scene memory. The current study uses hierarchical linear modeling (HLM) to examine scene memory while controlling for scene congruency and the perceived emotional intensity of the images. American and East Asian participants encoded pictures that included a positive, negative, or neutral item placed on a neutral background. After a 20-min delay, participants were shown the item and background separately along with similar and new items and backgrounds to assess memory specificity. Results indicated that even when congruency and emotional intensity were controlled, there was evidence that Americans had better item memory than East Asians. Incongruent scenes were better remembered than congruent scenes. However, this effect did not differ by culture. This suggests that Americans’ item focus may result in memory changes that are robust despite variations in scene congruency and perceived emotion.     

Searching for the Self: An Identity Control Theory Approach to Triggers of Occupational Exploration

Identity control theory researchers have found evidence for two processes of identity development (identity defense and identity change) and have theorized a third process (identity exploration). College students (N = 123) self-rated as high or low in occupational identity certainty and importance received self-discrepant feedback to induce identity disturbance, and dependent measures of identity defense, identity change, and identity exploration were obtained. As predicted, high certainty about identity standards led to identity defense, while low certainty led to identity change. Although an interaction between certainty and importance was hypothesized to predict identity exploration, results showed that the two operated independently. Low certainty predicted exploration of additional occupational areas, whereas high importance predicted exploration of self, environment, and additional occupational areas.     

The ability to tap to a beat relates to cognitive,linguistic, and perceptual skills

Reading-impaired children have difficulty tapping to a beat. Here we tested whether this relationship between reading ability and synchronized tapping holds in typically-developing adolescents. We also hypothesized that tapping relates to two other abilities. First, since auditory-motor synchronization requires monitoring of the relationship between motor output and auditory input, we predicted that subjects better able to tap to the beat would perform better on attention tests. Second, since auditory-motor synchronization requires fine temporal precision within the auditory system for the extraction of a sound’s onset time, we predicted that subjects better able to tap to the beat would be less affected by backward masking, a measure of temporal precision within the auditory system. As predicted, tapping performance related to reading, attention, and backward masking. These results motivate future research investigating whether beat synchronization training can improve not only reading ability, but potentially executive function and auditory processing as well.