The Relative Contribution of Sibling Deviance and Peer Deviance in the Prediction of Substance Use Across Middle Childhood

This study investigated the quality of sibling relationships and sibling deviancy in a sample of children at-risk for substance use and antisocial behavior. Based on a history of empirical and theoretical models suggesting strong associations between children's development in the context of relationships and the emergence of delinquency and drug use, this research extends previous efforts by including sibling relationships in this developmental model, linking siblings with later substance use. Sibling relationship quality as well as peer deviance were examined using a multirater, multimethod assessment procedure. We tested 3 constructs (deviancy, warmth, and conflict) related to sibling behavior. Only sibling deviance and peer deviance directly predicted substance use. When both sibling deviance and peer deviance were examined as predictors of changes in substance use over time, only sibling deviance was significant. Implications for the development of substance use behavior in middle childhood are discussed.     

Choosing or Being Chosen by Aggressive–Disruptive Peers: Do They Contribute to Children's Externalizing and Internalizing Problems?

The goal of this study was to investigate the extent to which aggressive-disruptive peers contribute to the development of externalizing and internalizing problems in children, while controlling for children's own behavior. We examined 2 sets of peers: (1) those that the child nominated as friends, and (2) those that nominated the child as a friend. The participants were 236 boys and girls attending 3rd to 5th grade at the beginning of the study, who were followed over a period of 2 years. Results showed that choosing more aggressive peers on the nomination procedure was associated with more externalizing problems and self-reported depressive symptomatology over time. On the other hand, being liked by more aggressive children generally was not associated with elevated externalizing or internalizing problems.     

Parental Discipline and Externalizing Behavior Problems in Early Childhood: The Roles of Moral Regulation and Child Gender

We tested whether individual differences in a component of early conscience mediated relations between parental discipline and externalizing behavior problems in 238 3.5-year-olds. Parents contributed assessments of discipline practices and child moral regulation. Observations of children's behavioral restraint supplemented parental reports. Parents and teachers reported on child externalizing symptoms. Parental induction, warm responsiveness, and less frequent use of physical punishment generally were associated with higher levels of moral regulation and fewer externalizing problems. Moreover, moral regulation partially mediated relationships between discipline and externalizing symptoms, with the clearest case of mediation involving induction. However, relationships were found for boys only. Results support a mediation model wherein inductive and physical discipline may influence the expression of boys' externalizing behavior through effects on conscience. Finally, results suggest that different developmental processes may be associated with early externalizing problems in boys and girls, and confirm that fathers' reports contribute to our understanding of the origins of child externalizing problems.     

Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes

This study extends the data on the efficacy of cognitive interventions for patients with chronic medical problems and describes the case of a 37-year-old woman with an anxiety disorder related to diabetes. The effects on panic frequency, use of safety behaviour and related beliefs were investigated after the introduction of two main cognitive-behavioral interventions. The results are consistent with predictions from the cognitive model of panic. This case demonstrates the usefulness of directly challenging the 'meaning' of the feared situation in order to produce clinically significant improvements in the management of physical disease.     

Hostility and facial affect recognition: effects of a cold pressor stressor on accuracy and cardiovascular reactivity

The effects of hostility and a cold pressor stressor on the accuracy of facial affect perception were examined in the present experiment. A mechanism whereby physiological arousal level is mediated by systems which also mediate accuracy of an individual’s interpretation of affective cues is described. Right-handed participants were classified as high hostile (N=28) or low hostile (N=28) using the Cook Medley Hostility Scale. The high-hostile group met joint selection criteria. Only high-hostile participants who showed cardiovascular reactivity to the cold pressor, with systolic BP change exceeding the group mean were included. Groups were further subdivided into cold pressor and non-cold pressor test conditions. It was predicted that high-hostile men, relative to low-hostile men, would show decreased perceptual accuracy when presented with happy, angry, and neutral facial configurations within the left visual field (LVF). Results indicated that high-hostile men were less accurate than low-hostile men in the LVF. Further, pre-stress accuracy scores in the high-hostile men were similar to the post-stress accuracy scores of the low-hostile men. The lateralization of affective function and the role of physiological arousal in affective facial perception are discussed.     

The relationship between disgust sensitivity, anxiety and obsessions

Three hundred participants, including volunteers from an obsessional support group, filled in questionnaires relating to disgust sensitivity, health anxiety, anxiety, fear of death, fear of contamination and obsessionality as part of an investigation into the involvement of disgust sensitivity in types of obsessions. Overall, the data supported the hypothesis that a relationship does exist between disgust sensitivity and the targeted variables. A significant predictive relationship was found between disgust sensitivity and total scores on the obsessive compulsive inventory (OCI; Psychological Assessment 10 (1998) 206) for both frequency and distress of symptomatology. Disgust sensitivity scores were significantly related to health anxiety scores and general anxiety scores and to all the obsessional subscales, with the exception of hoarding. Additionally, multiple regression analyses revealed that disgust sensitivity may be more specifically related to washing compulsions: frequency of washing behaviour was best predicted by disgust sensitivity scores. Washing distress scores were best predicted by health anxiety scores, though disgust sensitivity entered in the second model. It is suggested that further research on the relationship between disgust sensitivity and obsessionality could be helpful in refining the theoretical understanding of obsessions.     

Analysis of precurrent skills in solving mathematics story problems

We conducted an analysis of precurrent skills (responses that increase the effectiveness of a subsequent or "current" behavior in obtaining a reinforcer) to facilitate the solution of arithmetic word (story) problems. Two students with developmental disabilities were taught four precurrent responses (identifying the initial value, change value, operation, and resulting value) in a sequential manner. Results of a multiple baseline design across behaviors showed that the teaching procedures were effective in increasing correct performance of each of the precurrent behaviors with untaught problems during probes and that once the precurrent behaviors were established, the number of correct problem solutions increased.     

Making faces: testing the relation between child behavior problems and mothers' interpretations of child emotion expressions

We examined the relations between preschool boys' behavior problems and mothers' interpretations of children's emotion expressions. A sample of 31 mothers of oppositional boys and 28 control mothers responded to standard stimuli depicting child emotional reactions to maternal control attempts; mothers were instructed to think of the stimuli as either (a) their own child or (b) an unfamiliar child. Mothers of oppositional boys were more likely to generate negative interpretations than were control mothers when thinking of their own children; however, this difference did not generalize to the explicitly unfamiliar child condition. Mothers of oppositional boys demonstrated negative and comparison mothers demonstrated positive interpretive tendencies toward their own children. Findings suggest that child emotion cues may trigger biased maternal cognitions even in the absence of child misbehavior.     

Demographic characteristics,social competence,and behavior problems in children with gender identity disorder: a cross-national,cross-clinic comparative analysis

This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study—the first cross-national, cross-clinic comparative analysis of children with gender identity disorder—found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.     

卫生资源优化配置的伦理要求

卫生资源是稀缺资源,卫生资源只有优化配置,才能达到我们的医学目的。卫生资源的优化配置的以公平为优先,坚持公平和效率相结合的原则。就目前所存在的和我们的医学目的不相适应的卫生资源配置方式的现状和主要问题进行分析,并提出了相应的改进方法。