The lived experiences of individuals with Tourette syndrome or tic disorders: A meta‐synthesis of qualitative studies

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta‐synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over‐arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self‐acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted.     

Establishing the feasibility of direct observation in the assessment of tics in children with chronic tic disorders

Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods.     

FUNCTIONAL ANALYSIS AND TREATMENT OF ELOPEMENT ACROSS TWO SCHOOL SETTINGS

The elopement of a child with Asperger syndrome was assessed using functional analyses and was treated in two school settings (classroom and resource room). Functional analyses indicated that elopement was maintained by access to attention in the resource room and obtaining a preferred activity in the classroom. Attention- and tangible-based interventions were compared in an alternating treatments design in both settings. Results validated the findings of the functional analyses. Implications for the assessment and treatment of elopement are discussed.     

Belief in a just world and subjective well-being: mothers of normal and Down syndrome children

A cross-sectional study examined the relationship between three dimensions of the belief in a just world and the subjective well-being of Pakistani mothers of normal and Down syndrome children (n = 100 each). Personal belief in a just world and two dimensions of general belief in a just world-beliefs in immanent and ultimate justice-were assessed along with four dimensions of subjective well-being: life satisfaction, mood, state anxiety, and depression. It was hypothesized that personal belief in a just world and belief in ultimate justice would be positively associated with subjective well-being for both groups of mothers. Results were obtained through moderated regression analyses. In line with our hypothesis, personal belief in a just world positively predicted life satisfaction and mood level and negatively predicted state anxiety and depression in both groups of mothers. In contrast, beliefs in immanent and ultimate justice were not consistently adaptive. In particular, the more the mothers of a Down syndrome child believed in immanent justice, the more anxiety they experienced the previous week. In addition, the more the mothers of normal children believed in ultimate justice, the more they experienced anxiety. The pattern of results persisted when controlled for mothers' education, the total number of their children and marital status. Overall, the results support the role of personal belief in a just world as a personal resource in adverse as well as normal life circumstances.     

Alcohol‐related violence defined by ultimate goals: a qualitative analysis of the features of three different types of violence by intoxicated young male offenders

Based upon a functional approach to understanding aggression, we aimed to identify the occurrence of and to describe the features of three types of alcohol‐related violence defined a priori by ultimate goals: (1) violence in pursuit of nonsocial profit‐based goals, (2) violence in pursuit of social dominance goals, and (3) violence as defence in response to threat. A sample of 149 young men with offences of violence that were alcohol related was interviewed. Cases were classified and detailed information from the first ten cases in each class (N=30) was subjected to thematic analysis. Intoxicated violence in pursuit of nonsocial profit‐based goals was opportunistic and motivated by the desire for more alcohol or drugs. Violence, in these cases, although serious, appeared to be brief. Intoxicated violence in pursuit of social dominance goals was typically precipitated by past or current insult or injury, and was accompanied by strong anger and an adrenaline rush. Attacks were ferocious, and robbing the victim was not uncommon, perhaps to inflict additional humiliation. Feelings of pride and satisfaction were typical and expressions of remorse were uncommon. Regarding intoxicated violence as defence in response to threat, attacks were often expected, and in some cases the respondent made a pre‐emptive strike. Weapon use was common in this group. Fear was experienced, but so too was anger. Feelings of excitement were not reported and remorse was common. Further validation of these types is warranted, and the potential implications of these findings for prevention and treatment are discussed. Aggr. Behav. 36:67–79, 2010. © 2009 Wiley‐Liss, Inc.     

False memories in obstructive sleep apnoea syndrome: evidence from the divided attention paradigm at encoding or retrieval

ABSTRACT

Patients with obstructive sleep apnoea syndrome (OSAS) exhibit impaired retrieval of item-specific information, increasing their propensity to generate false recognitions. The present study investigated the effect of OSAS on false recognition, using a divided-attention paradigm to examine whether reducing the availability of attentional resources during encoding or retrieval in healthy participants mimics the effect of OSAS. We tested four groups of participants, using the Deese – Roediger – McDermott paradigm: patients with OSAS and controls, either under full attention or under divided attention at encoding or retrieval. Results showed that divided attention at retrieval, but not at encoding, mimicked the effects of OSAS on memory performance, as controls in this group exhibited a higher level of false recognition than those under full attention, but a similar level of correct recognition. Our results suggest that the greater susceptibility of patients with OSAS to false recognition may be due to a limited availability of attentional resources, which may specifically disrupt retrieval processes.     

阻塞性睡眠呼吸暂停低通气综合征与舒张性心力衰竭相关性研究进展

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)可诱发舒张性心力衰竭,引起多种临床症状,对患者预后及生活质量产生更多不良影响.其主要病理生理学变化为慢性间歇性或持续性乏氧和高碳酸血症.舒张性心力衰竭发生机制复杂,OSAHS可通过乏氧、神经系统功能改变、炎症反应及水钠潴留而诱发或加重舒张性心力衰竭.OSAHS与舒张性心力衰竭有密切关系,OSAHS可引起并加重心衰,而心衰患者可能会伴发OSAHS,其互为因果,互相促进.在临床治疗方面,我们应充分重视两者相关性及其危害性,制定合理治疗方案.     

Alcohol Use Among Older Adults

Alcohol use problems among older adults have been called the "invisible epidemic." As the population of older adults continues to grow, there is an increased need to reexamine alcohol use in this population. The authors provide an overview on alcohol use in the over-60 age group. The main areas of focus included research on the prevalence of drinking in that population, as well as comments on the best practices in assessment and psychological treatment. Several screening assessments have been recommended for use with older adults, such as the CAGE questionnaire, Michigan Alcohol Screening Test-Geriatric version, Alcohol-Related Problems Survey, and the Alcohol Use Disorders Identification Test. The authors note age-appropriate psychological treatment interventions that include brief interventions, family interventions, motivational counseling, and cognitive behavioral therapies. Barriers to assessment and treatment are also discussed.     

The Question of Higher Education for the Blind

Building on the theory of reasoned action (I. Ajzen & M. Fishbein, 1973, 1980; M. Fishbein & I. Ajzen, 1975) and expectancy theory, the authors examined the mediating role of alcohol expectancies in adolescent drinking behaviors by testing whether alcohol expectancy outcomes and valuations (the extent to which these outcomes are perceived as good or bad) mediate the association between peer influences and lifetime alcohol use. Early adolescents (N = 904) from 2 public middle schools in western Michigan completed a battery of questionnaires. Overall, results showed that alcohol expectancies and valuations partially mediated the relations between peer influences (peer use and peer approval) and lifetime alcohol use. The findings suggest that associating with peers who are perceived as using alcohol and approving of drinking may influence adolescents’ alcohol expectancies. The authors briefly discuss future research directions and implications for prevention.