Measuring Shaken Baby Syndrome awareness: preliminary reliability of a caregiver attitudes and beliefs survey

Recent estimates of Shaken Baby Syndrome awareness suggest that approximately half of all American adults have not heard of the often devastating risks of shaking an infant. Using a sample of 288 undergraduate students, we developed a measure of attitudes around infant care practices. A total of 264 community participants completed a revised survey. Between-group comparisons, exploratory factor analyses, and internal consistency tests were employed to determine the directionality and reliability of any scale structure present in the data. A five factor structure fits the data reliably, and each of these factors seems to represent a unique dimension. Implications for using this measure clinically and preventatively are discussed.     

Estimating rates of chronic fatigue syndrome from a community-based sample: A pilot study

Most of the Chronic Fatigue Syndrome (CFS) epidemiological studies have relied on physicians who refer patients having at least 6 months of chronic fatigue and other symptoms. However, there are a number of potential problems when using this method to derive prevalence statistics. For example, some individuals with CFS might not have the economic resources to access medical care. Other individuals with CFS might be reluctant to use medical personnel, particularly if they have encountered physicians skeptical of the authenticity of their illness. In addition, physicians that are skeptical of the existence of CFS might not identify cases. In the present pilot study, a random community sample (N=1,031) was interviewed by telephone in order to identify and comprehensively evaluate individuals with symptoms of CFS and those who self-report having CFS. Different definitions of CFS were employed, and higher rates (0.2%) of CFS were found than in previous studies. Methodological benefits in using more rigorous epidemiological methods when estimating CFS prevalence rates are discussed. The authors appreciate the generous financial support of the CFIDS Association and Minnan, Inc. We also are grateful for many helpful suggestions provided by Judith A. Richman, William McCready, Wendell Richmond, and Stephen E. Goldston. Finally, we are very thankful to the many undergraduate volunteers who helped us complete this study, and they include Cheryl Stenzel, Georgina DeLa Torre, Vickie Chrisos, Don Banik, Hillary Loeb, Leslie Ramesack, Ellen Diamond, Rob Bleeker, Gib Garza III, Mindy Silverstein, Kadip Sen, Meredith Lombrazo, Brian Miller, Caroline Marsden, Lorraine Whitmore, Stan Gayot, Karen Costakis, and Dave Sobotka.     

Fathers' views of the effects on their families of children with Down syndrome

This study examined fathers' views about the effects of children with Down syndrome on themselves and their families. Taped interviews were obtained from 90 fathers of children aged from 7 to 14 years. Qualitative analysis of the interview data revealed 28 categories of comments made by fathers. The most frequent comment, made by 46% of fathers, was about the cheerful personality of their child with Down syndrome. About 42% of fathers talked about the initial trauma they experienced following the diagnosis; 43% of them bemoaned the restrictions imposed on the family, and 30% commented that the child had minimal effects on family life. The greatest concern expressed by fathers was the long-term provision for their children. More fathers commented on the positive effects on their marriage than on negative effects. The results of this study provide a somewhat different view of fathers' experiences to that found in the existing literature.     

Parent Alienation Syndrome: A Two Step Approach Toward a Solution

This paper deals with the steps involved in mediation before or while legal action and the courts intervene to force a solution by law to often tragic, acrimonious human interaction between former partners. Professionals such as qualified psychologists or psychiatrists should be able to offer a full course of mediation before partners begin divorce proceedings or decisions regarding the placement of children with one party or the other. A 10-year study involving 16 cases provides evidence that the initial use of mediation may well be superior to the initial use of the adversarial system on its own.     

Vulvar pain: a phenomenological study of couples in search of effective diagnosis and treatment

Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of ... the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships.     

An analysis of vocal stereotypy and therapist fading

A functional analysis for a boy with Down syndrome and autism suggested that vocal stereotypy was maintained by automatic reinforcement. The analysis also showed that instructions and noncontingent attention suppressed vocal stereotypy. A treatment package consisting of noncontingent attention, contingent demands, and response cost effectively reduced vocal stereotypy. The treatment package remained effective even when noncontingent attention was removed, making the procedure easier to implement. Also, the presence of the therapist in the room with the participant was faded systematically. After completion of fading, vocal stereotypy remained low during conditions similar to the no-consequence phase of the functional analysis.     

Orientation perception in Williams Syndrome: Discrimination and integration

Williams Syndrome (WS) is a rare neurodevelopmental disorder, which stems from a genetic deletion on chromosome 7 and causes a profound weakness in visuospatial cognition. Our current study explores how orientation perception may contribute to the visuospatial deficits in WS. In Experiment 1, we found that WS individuals and normal 3–4 year olds had similar orientation discrimination thresholds and had similar prevalence of mirror-reversal errors for diagonal targets (±45 deg). In Experiment 2, we asked whether this immaturity in orientation discrimination would also be reflected in a task requiring integration of oriented elements. We found that sensitivities of WS individuals for detecting orientation-defined contours were higher than sensitivities of normal 3–4 year olds, and were not significantly different from sensitivities of normal adults. Together, these results suggest that orientation discrimination and orientation integration have different maturational trajectories in normal development and different susceptibilities to damage in WS. These may reflect largely separate visuospatial mechanisms.     

Marriage and Family Therapists’ Ability to Diagnose Asperger’s Syndrome: A Vignette Study

The purpose of this study was to determine the degree to which AAMFT clinical members can accurately diagnose Asperger’s Syndrome. 171 AAMFT clinical members were surveyed using a vignette methodology. Participants were asked to read the vignette and provide a diagnosis for the child in the vignette. Four out of five participants were unable to correctly diagnose the vignette child with Asperger’s Syndrome. Analyses found that the ability to correctly diagnose Asperger’s Syndrome did not vary based on the participants: gender, years of clinical experience, or specialized clinical population (e.g., individuals, couples, families, children). Thomas Stone Carlson is an associate professor and Christi McGeorge is an assistant professor in the couple and family therapy program at North Dakota State University. Sarah Halvorson is a graduate of the couple and family therapy program at North Dakota State University and is in clinical practice in Illinois.     

An experimental approach to detecting dementia in Down syndrome: a paradigm for Alzheimer's disease

Measures developed from animal models of aging may detect dementia of the Alzheimer's type in a population at-risk for Alzheimer's disease (AD). Although, by middle age, individuals with Down syndrome (DS) show an extraordinarily high prevalence of AD-type pathology, their severe idiopathic cognitive deficits tend to confound the clinical diagnosis of AD. The current study was designed to improve detection of AD in DS by using measures of learning and memory derived from animal models of aging. Adults with DS (N=34) were assessed and reassessed (n=19) approximately one year later using stimulus-response (S-R) test methods derived from experimental literature, as well as standardized informant-based tests. Results demonstrated high validity and reliability of select tests. The implication of early symptom detection in a population at-risk for AD-type dementia was discussed in terms of potential brain regions of interest.     

Family Impact of Tourette's Syndrome

Tourette's syndrome (TS) is a neuropsychological disorder characterized by vocal and motor tics. TS is also associated with several behavior disorders such as Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, conduct disorder, and Obsessive-Compulsive Disorder. We examined the impact of Tourette's syndrome with and without comorbid psychiatric disorders on the family. TS complicated by comorbid disorders had a greater impact on the family than uncomplicated TS. Tourette's symptom severity was significantly correlated with the level of impact on the family and with the number of comorbid disorders. TS is a disorder with effects that extend beyond motor and vocal tics.