Comparison of the Hamilton Depression Rating Scale and the Geriatric Depression Scale: detection of depression in dementia patients.

The present longitudinal prospective study compared results from the Geriatric Depression Scale with those from the Hamilton Depression Rating Scale for 30 dementia patients. The criterion measure was presence of depression as indicated by the psychiatric diagnosis. The psychiatrist and physician's assistant made the Hamilton ratings while the psychology staff administered the Geriatric Depression Scale. The two measures were statistically unrelated from Times 1 and 2 (rs = .26 and .41). Eleven (37%) patients were depressed and nine received antidepressant medications. Sensitivity ratings were 82% and 9%, respectively, and specificity ratings were 88% and 92%, respectively. Possible explanations for the success of the Geriatric Depression Scale and lack of success of the Hamilton ratings in detecting depression in this population are discussed.     

When does measurement error in covariates impact causal effect estimates? Analytic derivations of different scenarios and an empirical illustration

The average causal treatment effect (ATE) can be estimated from observational data based on covariate adjustment. Even if all confounding covariates are observed, they might not necessarily be reliably measured and may fail to obtain an unbiased ATE estimate. Instead of fallible covariates, the respective latent covariates can be used for covariate adjustment. But is it always necessary to use latent covariates? How well do analysis of covariance (ANCOVA) or propensity score (PS) methods estimate the ATE when latent covariates are used? We first analytically delineate the conditions under which latent instead of fallible covariates are necessary to obtain the ATE. Then we empirically examine the difference between ATE estimates when adjusting for fallible or latent covariates in an applied example. We discuss the issue of fallible covariates within a stochastic theory of causal effects and analyse data of a within-study comparison with recently developed ANCOVA and PS procedures that allow for latent covariates. We show that fallible covariates do not necessarily bias ATE estimates, but point out different scenarios in which adjusting for latent covariates is required. In our empirical application, we demonstrate how latent covariates can be incorporated for ATE estimation in ANCOVA and in PS analysis.     

Genetic Counseling and Screening of Consanguineous Couples and Their Offspring: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic counseling and screening for consanguineous couples (related as second cousins or closer) and their offspring with the goals of1. providing preconception reproductive options2. improving pregnancy outcome and identifying reproductive choices3. reducing morbidity and mortality in the 1st years of life, and4. respecting psychosocial and multicultural issues.The recommendations are the opinions of a multicenter working group (the Consanguinity Working Group (CWG)) with expertise in genetic counseling, medical genetics, biochemical genetics, genetic epidemiology, pediatrics, perinatology, and public health genetics, which was convened by the National Society of Genetic Counselors (NSGC). The consensus of the CWG and NSGC reviewers is that beyond a thorough medical family history with follow-up of significant findings, no additional preconception screening is recommended for consanguineous couples. Consanguineous couples should be offered similar genetic screening as suggested for any couple of their ethnic group. During pregnancy, consanguineous couples should be offered maternal–fetal serum marker screening and high-resolution fetal ultrasonography. Newborns should be screened for impaired hearing and detection of treatable inborn errors of metabolism. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

Treatment of menopause-related mood disturbances

More than 1.7 million American women are expected to reach menopause each year. Recent Canadian statistics show that a 50-year-old woman can now expect to live until her mid-80s, which implies living at least one-third of her life after menopause. The menopausal transition is typically marked by intense hormonal fluctuations, accompanied by vasomotor symptoms (eg, hot flashes, night sweats), sleeps disturbance, and changes in sexual function, as well as increased risk for osteoporosis, cardiovascular disease, and cognitive decline. More importantly, recent studies have demonstrated a significant association between menopausal transition and a higher risk for developing depression. In the post-Women's Health Initiative Study era, physicians and patients are questioning the safety and efficacy of long-term hormone therapy use. This article reviews the current literature on the benefits and risks of using hormone therapy for the treatment of menopause-related mood disturbances and alternate strategies currently available for the management of menopause-related problems, including antidepressants, complementary and alternative medicine, and selective estrogen receptor modulators.     

Proactive coping, gratitude, and posttraumatic stress disorder in college women

This study investigated relationships among proactive coping, positive emotions, and posttraumatic stress disorder (PTSD) symptom severity for 182 undergraduate women with trauma histories. Participants were administered the Life Events Checklist (LEC), PTSD Checklist, Proactive Coping Inventory, Proactive Attitude Scale, General Perceived Self-Efficacy Scale, and measures of posttrauma gratitude and emotional growth. An Exploratory Factor Analysis (EFA) with proactive coping, proactive attitude, and self-efficacy items indicated a one-factor solution. The proactive coping style factor and posttrauma gratitude were independently negatively associated with current PTSD symptom level, above and beyond the effects of trauma severity, trauma history, and time elapsed since the trauma. The implications of these results for future research and understanding of the development of PTSD and its treatment are discussed.     

Psychopharmacologic strategies for the treatment of aggression in juveniles

Maladaptive aggression in youth is one of the most common and troublesome reasons for referrals to child psychiatrists. It has a complex relationship with psychopathology. There are several syndromes, which are primary disturbances of clustered maladaptive aggression, most notably oppositional defiant disorder and conduct disorder. However, problems with aggression also appear in a wide range of other disturbances, such as bipolar disorder, posttraumatic stress disorder, and mood disorders. Additionally, aggression is normative, serves an adaptive purpose and can be situationally induced. These complexities need to be carefully addressed before targeting maladaptive aggression psychopharmacologically. We summarize the literature on the psychopharmacology of maladaptive aggression in youth, focusing on disorders without cognitive impairment. We delineate the subtypes of aggression which are most likely to respond to medication (reactive-affective-defensive-impulsive in their acute and chronic form) and conclude with a discussion of specific medication strategies which are supported by controlled clinical trials and clinical experience.     

From autonomy to heteronomy (and back): The enaction of social life

The term “social cognition” can be construed in different ways. On the one hand, it can refer to the cognitive faculties involved in social activities, defined simply as situations where two or more individuals interact. On this view, social systems would consist of interactions between autonomous individuals; these interactions form higher-level autonomous domains not reducible to individual actions. A contrasting, alternative view is based on a much stronger theoretical definition of a truly social domain, which is always defined by a set of structural norms; moreover, these social structures are not only a set of constraints, but actually constitute the possibility of enacting worlds that would just not exist without them. This view emphasises the heteronomy of individuals who abide by norms that are impersonal, culturally inherited and to a large extent independent of the individuals. Human beings are socialised through and through; consequently, all human cognition is social cognition. The article argues for this second position. Finally, it appears that fully blown autonomy actually requires heteronomy. It is the acceptance of the constraints of social structures that enables individuals to enter new realms of common meaningfulness. The emergence of social life marks a crucial step in the evolution of cognition; so that at some evolutionary point human cognition cannot but be social cognition.