The Value of Measuring Impact Alongside Symptoms in Children and Adolescents: A Longitudinal Assessment in a Community Sample

The impact that psychiatric symptoms have on the lives of young people is central to clinical practice and classification. However, there is relatively little research on impact and its association with symptoms. This paper examines how well impact can be measured and how it relates to psychiatric outcomes. On four separate occasions over 3 years, symptoms and impact were assessed in a UK epidemiological sample (n?=?4,479; 51.5 % boys) using the Strengths and Difficulties Questionnaire (SDQ) as reported by parents, youths and teachers. Disorders were ascertained using the Development and Well-Being Assessment. An impact scale made of items about distress and impairment demonstrated considerable internal consistency, cross-informant correlations, and longitudinal stability by all reporting sources. Impact at baseline was a strong predictor of psychiatric disorder 3 years later after accounting for psychiatric disorders and symptoms measured at baseline: odds ratio OR?=?2.10, 95 % Confidence Interval (CI) [1.50, 2.94] according to parent-rated impact and OR?=?1.71, CI [1.08, 2.72] according to teacher-rated impact. Changes in impact over time were predicted, but not fully accounted for, by symptoms measured at baseline. Impact can be reliably and easily measured across time, and it may be clinically useful as an independent predictor of future symptoms and psychiatric disorders. More studies are needed to understand inter-individual variation in the impact caused by equivalent symptoms.     

The experiential foundations of mathematical knowledge

A view of the sources of mathematical knowledge is sketched which emphasizes the close connections between mathematical and empirical knowledge. A platonistic interpretation of mathematical discourse is adopted throughout. Two skeptical views are discussed and rejected. One of these, due to Maturana, is supposed to be based on biological considerations. The other, due to Dummett, is derived from a Wittgensteinian position in the philosophy of language. The paper ends with an elaboration of Gödel's analogy between the mathematician and the physicist.     

Analytical Buddhism: The Two-Tiered Illusion of Self

In the contemporary debate on the nature of autonomy, it is generally taken for granted that autonomy is to be understood as rule by the self, with the debate centring on how that self is to be identified. Garnett [2013b Garnett, Michael 2013b. The Autonomous Life: A Pure Social View, Australasian Journal of Philosophy 91/4. [Google Scholar]] has recently proposed a theory that rejects the dominant understanding of autonomy as rule by the self and views it instead as resistance to rule by others. According to that theory, an autonomous agent is one whose various ‘autonomy traits’ render her sufficiently resistant to subjection to foreign wills. I argue that Garnett has not given us good reason to abandon the understanding of autonomy as rule by the self. His account is plausible only if it is understood to require for autonomy the possession of at least one trait with which the agent can be identified. And the best explanation of the necessity of some such trait(s) is offered, not by Garnett's, but by the dominant understanding of autonomy he rejects.     

PSYCHOANALYSIS AND INFERTILITY MYTHS AND REALITIES

Psychoanalysis, long interested in infertility, and a valuable treatment for men and women suffering with this affliction, has also helped to create and support a myth of psychogenic infertility. Multiple causes of infertility exist across the physiological - psychological spectrum. There is no simple psychodynamic causality. Advances in assisted reproductive technologies provide treatments that create emotional stress and outpace psychological preparedness of patients and analysts. This paper is based on the experience of a unique study group in Boston. An analytic case illustrates some of the ways analysis can be a treatment of choice for people using assisted reproduction. In fact, analysis offers a unique opportunity to elaborate fully the complex realities and dilemmas faced by people and their therapists throughout the infertility experience. More generally, this study of the concept of psychogenic infertility explores a valuable role for psychoanalysis in the treatment of medical conditions.     

Neuropsychological Performance in Gulf War Era Veterans: Traumatic Stress Symptomatology and Exposure to Chemical–Biological Warfare Agents

Because complaints of diminished concentration and memory are among the most common health symptoms reported by Gulf War (GW) veterans with unexplained illnesses, this study investigated neuropsychological functions among GW veterans and controls. Relationships between neuropsychological performance, severity of posttraumatic stress disorder (PTSD) symptomatology, and exposure to chemical–biological warfare agents (CBW) were assessed. Participants were 225 veterans recruited from three cohorts: GW-deployed veterans from Ft. Devens, MA ( n = 141) and New Orleans, LA (n = 37), and Germany-deployed veterans from a Maine National Guard unit (n = 47). A comprehensive evaluation was completed. Severity of subclinical PTSD symptomatology was significantly related to scores on specific neuropsychological tests. PTSD symptom severity in GW-deployed veterans was found to be greater and associated with a broader range of neuropsychological deficits than in Germany-deployed veterans. PTSD severity was associated with lower performance on a range of neuropsychological tasks, whereas CBW exposure contributed to performance deficits on specific cognitive tasks.     

Neuropsychological Functioning in Danish Gulf War Veterans

Research has shown that Danish Gulf War (GW) veterans reported a significantly higher prevalence of neuropsychological symptoms than did military controls 6 years after GW deployment. To explore the possible central nervous system determinants of these complaints, neuropsychological tests were administered to stratified, random samples of the Danish cohort of 916 GW-deployed veterans and 236 non–GW-deployed participants. Multivariate analyses of covariance were used to analyze neuropsychological test outcomes among the 215 male participants (143 GW-deployed and 72 non–GW-deployed soldiers). No significant differences in neuropsychological test performances were found between the GW-deployed and non–GW-deployed groups. Troops deployed to the GW reported significantly more mood complaints (i.e., fatigue and confusion) than their nondeployed counterparts. Because they were assigned to the Gulf region during the postcombat phase, Danish GW soldiers differed from the majority of American GW-deployed troops in military assignments and possible toxicant exposures.     

Cognitive Functioning in Treatment-Seeking Gulf War Veterans: Pyridostigmine Bromide Use and PTSD

Gulf War (GW) deployed veterans have reported health symptoms since returning from the war that suggest dysfunction of the central nervous system (CNS). These symptoms include memory and concentration difficulties, fatigue, and headaches. Leading hypotheses for the etiology of these cognitive complaints include psychological factors and/or exposures to chemicals with neurotoxic properties. In this study, cognitive functioning was compared in treatment-seeking GW-deployed veterans and a treatment-seeking non–GW-deployed veteran control group. Results indicated that GW-deployed veterans performed significantly worse than the comparison group on tests of attention, visuospatial skills, visual memory, and mood. GW-deployed veterans who reported taking pyridostigmine bromide (PB) performed worse than GW-deployed veterans without PB use on executive system tasks. Treatment-seeking GW-deployed veterans with diagnoses of posttraumatic stress disorder (PTSD) did not differ on cognitive test measures compared with GW-deployed veterans without PTSD. No interaction effect of PTSD and PB use was found.     

Predictors of representational aggression in preschool children of low‐income urban African American adolescent mothers

Responses to five doll‐story stems thematically related to attachment experiences with the mother were videotaped in the home and used to evaluate child, maternal, and environmental predictors of representational aggression in 93 preschool children of African American women receiving public assistance who had become pregnant as teenagers. Significant correlations were found between representational aggression and child's gender (male), birth weight, maternal depressive affect, maternal educational attainment, recent employment, mother's historical residence with her own mother, and felt social support, accounting for 40% of the variance in representational aggression. A significant Felt Social Support × Gender interaction effect suggested that girls of mothers who perceive higher levels of felt social support are more likely to represent less aggression in their stories; felt social support was not associated with boys' representational aggression. A significant Felt Social Support × Employment interaction effect suggested that representational aggression is associated with lower levels of felt social support only among employed mothers. Findings suggest that different pathways exist for representational aggression in children of low‐income adolescent mothers, which nevertheless share predictors associated with poverty.     

Effects of gender in social control of smoking cessation.

This study of 93 men and 117 women smokers during an ongoing quit attempt examined the roles of gender and social network influences on quitting. For men, social influences appeared to positively affect their ability to reduce their smoking but were less effective for women. Specifically, increased reports of a spouse or partner's influence, and family and friends' influence, were associated with greater reductions in men's smoking 2 days and 4 months post quit date, respectively. In contrast, for women, greater reports of spouse or partner influence and of family and friends' influence were associated with smaller reductions in smoking. Sex differences in social control strategies and perceived autonomy supportiveness of those strategies are discussed as possible explanations for these results.