Social risk and protective factors for suicide attempts in low income African American men and women

A case-control study was conducted to examine a broad array of potential social risk and protective factors for suicide attempt among 200 African American men and women receiving care at a large, public, urban hospital. Specifically, we examined the effect of the following potential risk factors for suicide attempt: life hassles, partner abuse, partner dissatisfaction, and racist events; as well as the following potential protective factors: effectiveness of obtaining resources, social embeddedness, and social support. Using logistic regression, suicide attempter status was predicted by two independently significant social variables: one risk factor (life hassles) and one protective factor (social support). Male versus female suicide attempters were not distinguished by the social variables. These findings, which support the utility of an ecological conceptualization of risk and protective factors for suicide attempt, help to clarify the independently significant social environment risk and protective factors for suicide attempts among economically disadvantaged African Americans in particular. Research on both risk factors and protective factors provide a basis for culturally competent interventions aimed at reducing both the risk of future suicide attempts and completions.     

Young children with autism show atypical brain responses to fearful versus neutral facial expressions of emotion

Evidence suggests that autism is associated with impaired emotion perception, but it is unknown how early such impairments are evident. Furthermore, most studies that have assessed emotion perception in children with autism have required verbal responses, making results difficult to interpret. This study utilized high-density event-related potentials (ERPs) to investigate whether 3-4-year-old children with autism spectrum disorder (ASD) show differential brain activity to fear versus neutral facial expressions. It has been shown that normal infants as young as 7 months of age show differential brain responses to faces expressing different emotions. ERPs were recorded while children passively viewed photos of an unfamiliar woman posing a neutral and a prototypic fear expression. The sample consisted of 29 3-4-year-old children with ASD and 22 chronological age-matched children with typical development. Typically developing children exhibited a larger early negative component (N300) to the fear than to the neutral face. In contrast, children with ASD did not show the difference in amplitude of this early ERP component to the fear versus neutral face. For a later component, typically developing children exhibited a larger negative slow wave (NSW) to the fear than to the neutral face, whereas children with autism did not show a differential NSW to the two stimuli. In children with ASD, faster speed of early processing (i. e. N300 latency) of the fear face was associated with better performance on tasks assessing social attention (social orienting, joint attention and attention to distress). These data suggest that children with ASD, as young as 3 years of age, show a disordered pattern of neural responses to emotional stimuli.     

Role of Secondary Stressors in the Parental Death–Child Distress Relation

This study examined the psychological consequences and secondary stressors associated with death of a parent. The sample (N = 116) consisted of 26 youths who had lost a parent to homicide, 45 youths who had lost a parent to natural death, and 45 nonbereaved youths. Youngsters completed face-to-face interviews, while their guardians completed measures assessing the children's functioning. Results based on both child and guardian reports indicated that parental death was associated with an increase in secondary stressors, regardless of the mode of death. Findings based on guardian reports also revealed that parental death was related to increased internalizing distress, and that parental death due to homicide was related to increased externalizing distress. Furthermore, secondary stressors mediated the parental death–child distress relation such that parental death led to an increase in stressors, which in turn led to increased child distress. Implications for secondary and tertiary preventive interventions are discussed.     

Alexia without agraphia: An experimental case study

A 51-year-old right-handed male experienced reading difficulty and an upper right visual field cut after a head injury. The patient's letter naming was impaired and word naming was painstakingly slow. Words were decoded in a letter by letter sequence and performance varied directly with word length. Apart from his reading difficulties the patient was linguistically competent. He was sensitive to manipulations of word frequency and orthographic regularity. He wrote spontaneously and could identify the written counterpart to a spoken word with relative ease. Computerized axial tomography revealed damage to the posterior temporal-parietal region of the left hemisphere.     

The predictive power of combined neuropsychological measures for attention-deficit/hyperactivity disorder in children.

The present study explores the predictive power of seven neuropsychological assessment tools used in combination in classifying children with attention-deficit/hyperactivity disorder (ADHD). Twenty-one ADHD boys and 22 community control children participated. Group differences were significant on the continuous performance test only; however, battery analysis did increase overall predictive power, which was moderate. This study highlights the difficulty in identifying consistent mean differences on tests of frontal/executive functioning across studies, as well as the need to assess the predictive validity of these tests in classifying children with ADHD. The study suggests that these tests may provide greater predictive validity when used in combination. Inconsistencies in the literature are discussed, with consideration of research methodology, the heterogeneity of the ADHD population, and comorbid diagnoses.     

Ethically Allocating COVID-19 Drugs Via Pre-approval Access and Emergency Use Authorization

Abstract

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research. In conditions of scarcity, prioritization approaches should minimize harm, maximize benefit, and promote fairness. To promote continued data collection, patients seeking access to unproven COVID-19 drugs should receive lower priority for allocation when they decline to participate in clinical trials, either of the requested drug or other investigational products, offering a comparable balance of risks and benefits; special attention should be paid to concerns of voluntariness and distrust. In addition, institutional treatment protocols that can contribute more robust real world data should be preferred to single patient requests for access, with priority for inclusion based on traditional clinical allocation criteria relying on available evidence. Fairness demands distribution of these protocols across a diverse range of sites, particularly those serving marginalized populations, among other protections.     

It's what's on the outside that matters: an advantage for external features in children's word recognition

The relative importance of internal and external letter features of words in children's developing reading was investigated to clarify further the nature of early featural analysis. In Experiment 1, 72 6-, 8-, and 10-year-olds read aloud words displayed as wholes, external features only (central features missing, thereby preserving word shape information), or internal features only (central features preserved). There was an improvement in the processing of external features compared with internal features as reading experience increased. Experiment 2 examined the processing of the internal and external features of words employing a forward priming paradigm with 60 8-, 10-, and 12-year-olds. Reaction times to internal feature primes were equivalent to a nonprime blank condition, whereas responses to external feature primes were faster than those to the other two prime types. This advantage for the external features of words is discussed in terms of an early and enduring role for processing the external visual features in words during reading development.     

The role of self-criticism, dependency, and hassles in the course of depressive illness: a multiwave longitudinal study

The current study utilized a multiwave longitudinal design to examine whether dependency and/or self-criticism influence the course of depressive symptoms in a community sample of adults with a history of major depression. In addition, the authors examined whether self-esteem serves as a buffer against the development of depressive symptoms following increases in hassles in individuals possessing such traits. At Time 1, 102 participants completed measures assessing depressive symptoms, self-criticism, dependency, and self-esteem. Every 6 weeks for the next year, participants completed measures assessing depressive symptoms and hassles. High self-criticism was associated with greater elevations in depressive symptoms following elevations in hassles in low but not high-self-esteem individuals. Results with respect to dependency, however, were contrary to hypotheses. High dependency was associated with elevations in depressive symptoms following elevations in hassles in high-self-esteem individuals. In contrast, high dependency was associated with chronically elevated depressive symptoms in low-self-esteem individuals.