Recommendations from Multi-disciplinary Focus Groups on Cascade Testing and Genetic Counseling for Fragile X-associated Disorders

The purpose of this paper is to report the outcome of a collaborative project between the Fragile X Research and Treatment Center at the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at the University of California at Davis, the National Fragile X Foundation (NFXF), and the Centers for Disease Control and Prevention (CDC). The objective of this collaboration was to develop and disseminate protocols for genetic counseling and cascade testing for the multiple disorders associated with the fragile X mental retardation 1 (FMR1) mutation. Over the last several years, there has been increasing insight into the phenotypic range associated with both the premutation and the full mutation of the FMR1 gene. To help develop recommendations related to screening for fragile X-associated disorders, four, two day advisory focus group meetings were conducted, each with a different theme. The four themes were: (1) fragile X-associated tremor/ataxia syndrome (FXTAS); (2) premature ovarian failure (POF) and reproductive endocrinology; (3) psychiatric, behavioral and psychological issues; and (4) population screening and related ethical issues.     

吸毒者的成瘾程度与其抑郁程度的关系研究

目的探讨吸毒人群的生活状况、成瘾程度、抑郁程度以及成瘾程度与抑郁程度之间的关系。方法采用抑郁自评量表,阿片成瘾严重程度量表,对200名吸毒者进行调查。结果吸毒人群总体抑郁水平远远高出正常人群,吸毒者的抑郁与成瘾程度中的社会功能因子有高度相关性。结论提高吸毒者的社会支持对降低其抑郁情绪有重要意义。     

应用PSA筛查前列腺癌的争论焦点

前列腺癌是最常见的导致欧美国家男性死亡的疾病之一,我国男性前列腺癌发病率呈明显上升趋势。血PSA检测作为筛查前列腺癌的手段被广泛应用于临床。然而PSA筛查的价值还是成为当今泌尿和肿瘤学界争论最多的问题之一。本文着重介绍了男性接受PSA筛查前列腺癌的重要性以及前列腺癌筛查的潜在危害。     

Drug Abuse and Hepatitis C Infection as Comorbid Features of HIV Associated Neurocognitive Disorder: Neurocognitive and Neuroimaging Features

Substance abuse and co-infection with hepatitis C (HCV) are two highly relevant determinants of neurocognitive and neuroimaging abnormalities associated with HIV. Substance abuse and HCV are common in the HIV population and there is increasing evidence that the CNS is directly compromised by these comorbid conditions via additive or synergistic processes. In this article we review the current literature regarding mechanisms of neuronal injury as well as the neuropsychological and neuroimaging signatures associated with substance abuse and HCV status among HIV patients. We discuss specific methodological challenges and threats to validity associated with studies of HIV and comorbid substance use disorders or HCV and review potential strategies for minimizing their confounding effects. Efforts to understand the interactions between HIV, substance abuse and HCV co-infection will lead to more complete models of neuropathogenesis of HIV and a greater understanding of the variability in neuropsychological expression of HIV Associated Neurocognitive Disorder.

Topographies and functions of emerging problem behavior and appropriate requests in neurotypical preschoolers

The current study builds on a small but growing body of research evaluating the formal and functional characteristics of emerging problem behavior before it becomes harmful and requires costly treatment. The researchers tested 21 preschool children's sensitivity to establishing operations that commonly precede severe problem behavior. Sensitivity tests were embedded in a small group play context to optimize safety, efficiency, and ecological validity. The tests screened several levels of problem-behavior severity as well as the presence of adaptive alternatives (i.e., communication) to problem behavior. Overall, outcomes suggested sources of reinforcement for minor- and moderate-severity problem behavior in 86% of children. Only 17% of children exhibiting problem behavior also engaged in appropriate requests in the same condition(s) as problem behavior. The present data are compared to published functional analyses of severe behavior. The results are discussed as a preliminary step towards a function-based model of risk identification and behavioral prevention of severe problem behavior.     

Development and initial reliability and validity of a new measure of distorted maternal representations: The Mother–Infant Relationship Scale

Distorted maternal representations (DMRs)—mother's ideas, understanding, and feelings about the infant—shape early interaction and the emerging relationship. Distorted interactions reportedly affect infant attachment and socioemotional development and may be associated with maternal early adversity and trauma. Limited measures are available that could be used as screening tools of DMRs. The aims of this study were to (a) describe the development of the Mother–Infant Relationship Scale (MIRS) and (b) to evaluate its psychometric properties. The development and validation of the MIRS closely followed standard guidelines for the development of psychometric tests. Psychometric properties were examined across two samples: 78 adult psychiatric patients with features of borderline personality and 86 individuals from a nonclinical sample (N = 164). The scale demonstrated excellent internal consistency (Cronbach's α = .91) for the clinical sample and adequate internal consistency (.78) for the nonclinical sample, excellent test-retest reliability (intraclass correlation coefficient = .81), and good concurrent validity with an observational (Pearson's correlation coefficients = −.35 to −.54) and a representational measure (.53). Factor analysis revealed three components: DMRs specific to (a) maternal hostility/rejection of the infant, (b) issues about parenting/attachment, and (c) anxiety/helplessness about infant care. Findings suggest that the MIRS is a reliable and valid screening tool of DMRs. Potential uses in clinical and research settings are discussed.     

成瘾药物心理依赖及复发的脑机制研究

围绕学习、记忆、情绪及应激等心理因素与复发的关系,应用阿片类物质心理依赖研究条件性位置偏爱,条件性位置厌恶,Morris水迷宫量化觅药动机模型,行为及条件性行为敏感化等多种动物行为模型,从情绪相关学习、记忆在成瘾行为中的作用,不同神经核团与神经递质系统活动性的改变,应激相关因素易化的成瘾易感性,自然奖赏与成瘾药物奖赏相关记忆的比较研究等方面,对应激与记忆相关的吗啡心理依赖及复发的脑机制进行了系列研究     

Pragmatic Screening of Anxiety,Depression, Suicidal Ideation,and Substance Misuse in Older Adults

Older adults’ mental health needs are often unmet across care settings (e.g., primary or residential care) for a variety of reasons, such as mental health stigma and mental health care professionals’ lack of awareness of age-related changes in mental disorders. Screening, when coupled with access to evidence-based interventions, is effective at identifying and reducing anxiety, depression, suicidal ideation, and substance misuse in older adults across care settings. Unfortunately, due to lack of training many mental health care professionals may be unsure about what or how to screen, as well as which screening measures are available for use with older adults. Following professional guidelines recommended for older adults, we provide an overview of screening measures for anxiety, depression, suicidal ideation, and substance misuse that are evidence-based and meet pragmatic criteria identified by stakeholder research. Specific pragmatic criteria include screening measures developed with older adults (unless unavailable) as well as brief in length (items ≤30), time for administration (≤15 minutes), scoring (<5 minutes), and interpretation (<5 minutes). Other pragmatic criteria include screening measures readily available on the internet at no cost and usable across diverse settings (e.g., community, primary care, and/or residential care). For each measure, we also review relevant psychometric properties (e.g., reliability, cut-scores, sensitivity, specificity, and construct validity). Lastly, we discuss strategies to facilitate screening with older adults and direct mental health care providers to internet resources that can be used to learn more about assessment with older adults.