The Treatment of Children Impacted by the World Trade Center Attack

Abstract

This article presents, from a developmental perspective, the authors' experiences treating children and families who were traumatized by and who lost relatives in the World Trade Center attack. The treatments took place within the Trauma Treatment Development Center, National Child Traumatic Stress Network (NCTSN) of the Division of Child and Adolescent Psychiatry, North Shore University Hospital, Manhasset, New York, of the North Shore-Long Island Jewish Health System. Case vignettes address treatments for toddlers, preschool, and school-age children and adolescents. Family, individual cognitive-behavioral, school, social, and parenting treatment strategies utilized are discussed.     

Feasibility and preliminary outcomes for Move-Into-Learning: An arts-based mindfulness classroom intervention

This feasibility study investigated teachers’ assessment of Move-Into-Learning (MIL), an eight-week school-based Mindfulness-based intervention (MBI), designed to reduce stress and improve behavior in at-risk elementary students. MIL was implemented with two classrooms of third-grade students (n?=?41) in a low income, urban neighborhood using a pretest to posttest single group design. One of the two classrooms (n?=?20) completed a two-month follow-up measure examining sustainability of results. The program included mindfulness meditation, yoga movement with breathing exercises, and Appreciative Inquiry (AI) exercises that invited students to express themselves in the written and visual arts. MIL was evaluated via semi-structured teacher interviews and the Connors’ Behavior Rating Scale. Pre/post intervention showed significant improvement in behaviors, such as hyperactivity (t[1,39?=?3.1; p?=?0.002), and highly significant differences in the attention-deficit/hyperactivity disorder index (t[1,39]?=?5.42; p?<?0.001) and cognitive/inattentiveness (t[1,39]?=?5.56; p?<?0.001) subscales. Teacher interview data supported these findings suggesting MIL as a feasible and acceptable MBI that can be implemented in a third-grade classroom.     

Effects of Training on Endurance in Hanging by The Hands

The effect of training on endurance in hanging by the hands from a horizontal bar was examined by timing the duration of such hanging in six male and five female subjects each weekday for 2 weeks. A significant increase in endurance was observed. The results, both subjective and objective, indicated the most important factors in the training to be increased psychological endurance of discomfort and increased muscular strength and efficiency.     

Effects of nitric oxide inhibition on avoidance learning in the chick are lateralized and localized

Bilateral administration of nitric oxide synthase inhibitors into the intermediate medial hyperstriatal (IMHV) region of the chick brain impairs memory formation for an avoidance task. The aim of the current study was to determine whether this effect was restricted to a particular location in the brain, and whether inhibition was equally effective in both hemispheres. White Leghorn x black Australorp chicks were administered 0.5 mM N(omega)-Nitro-L-arginine methyl ester bilaterally into the lobus parolfactorius (LPO), or unilaterally into the IMHV. Injections into the LPO between 5 min pre-training and 40 min post-training had no effect on retention. In contrast, unilateral injections into the IMHV impaired retention and memory loss occurred from 40 min post-training. The effective administration time was hemisphere-dependent, requiring left hemisphere administration around the time of training and right hemisphere administration between 15 and 25 min post-training. These data suggest that localized nitric oxide activity in each hemisphere of the chick brain is necessary for the consolidation of memory for this task.     

Diminished testing benefits in young adults with attention-deficit hyperactivity disorder

Memory retrieval has been shown to enhance the long-term retention of tested material; however, recent research suggests that limiting attention during retrieval can decrease the benefits of testing memory. The present study examined whether testing benefits are reduced in young adults with attention-deficit hyperactivity disorder (ADHD). College students with and without ADHD read three short prose passages, each followed by a free recall test, a restudy period or a distractor task. Two days later participants recalled the passages. Although participants without ADHD did not show a significant benefit of testing over restudying, testing did produce recall benefits relative to not taking a test. These testing benefits were diminished in participants with ADHD, who did not show any advantage of testing over either restudying or no test. The absence of testing benefits in the ADHD group is likely due in part to decreased recall on the initial test. These findings have implications for improving educational practices among individuals with ADHD and also speak to the need to examine individual differences in the effectiveness of testing as a learning strategy.     

Long-term retention of the differential values of Arabic numerals by chimpanzees (<Emphasis Type="Italic">Pan troglodytes</Emphasis>)

As previously reported (Beran and Rumbaugh, 2001), two chimpanzees used a joystick to collect dots, one-at-a-time, on a computer monitor, and then ended a trial when the number of dots collected was equal to the Arabic numeral presented for the trial. Here, the chimpanzees were presented with the task again after an interval of 6 months and then again after an additional interval of 3.25 years. During each interval, the chimpanzees were not presented with the task, and this allowed an assessment of the extent to which both animals retained the values of each Arabic numeral. Despite lower performance at each retention interval compared to the original study, both chimpanzees performed above chance levels in collecting a quantity of dots equal to the target numeral, one chimpanzee for the numerals 1-7, and the second chimpanzee for the numerals 1-6. For the 3.25-year retention, errors were more dispersed around each target numeral than in the original study, but the chimpanzees' performances again appeared to be based on a continuous representation of magnitude rather than a discrete representation of number. These data provide an experimental demonstration of long-term retention of the differential values of Arabic numerals by chimpanzees.     

Better the Devil You Know? High-Risk Individuals’ Anticipated Psychological Responses to Genetic Testing for Melanoma Susceptibility

Purpose: The psychological consequences of genetic testing for mutations among individuals at increased risk of developing melanoma remain unexamined. The present study aimed to explore anticipated emotional, behavioral, cognitive, and familial responses to hypothetical genetic testing for melanoma susceptibility. Methods: Forty semi-structured interviews were undertaken with affected (n=20) and unaffected (n=20) individuals at either high or average risk of developing melanoma due to family history. Results: In-depth thematic analysis revealed that, in response to being identified as a mutation carrier, most participants with a family history anticipated calmly accepting their increased risk; either increasing precaution adoption or maintaining already vigilant behavioral practices; perceiving such information as important and valuable; and communicating genetic test results to family members, despite the acknowledgement of potential difficulties. In response to being identified as a non-carrier, the majority of participants expected to feel relieved; to maintain current precautionary health practices; to still perceive themselves at some risk of developing melanoma; and to be wary of the potential negative behavioral consequences of disclosing such information to family members. Women appeared more likely than men to acknowledge the potential for depression and worry following genetic testing. In contrast, more males than females expected to carry a gene mutation, and viewed their current preventive practices as optimum. Conclusion: Genetic testing for melanoma risk is likely to elicit a complex array of emotional, behavioral, cognitive, and familial responses for both testees and their family members, and these responses are likely to bear subtle differences for males and females.     

Seeing the baby: The impact of ultrasound technology

This paper reports results of a study of prenatal diagnosis patients who underwent ultrasound examinations and lost their pregnancies through miscarriage or elective terminations. The majority of the women felt that viewing the ultrasound image influenced their relationship to the fetus and their coping with the pregnancy loss. The women commented on the power of ultrasound to make their pregnancies more real as well as the painful yet sometimes beneficial consequences of seeing the fetus. Clinical implications are considered for health professionals who provide prenatal diagnostic services or counseling after pregnancy loss.     

Long-term efficacy of exercise across diagnostically heterogenous mental disorders and the mediating role of affect regulation skills

BackgroundExercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects.MethodsPhysically inactive outpatients, with depressive disorders, anxiety disorders, insomnia or attention deficit hyperactivity disorder were randomized to a standardized 12-week exercise intervention, combining moderate exercise with behavior change techniques (BCTs) (n = 38), or a passive control group (n = 36). Primary outcome was global symptom severity (Symptom Checklist-90, SCL-90-R) and secondary outcomes were self-reported exercise (Physical Activity, Exercise, and Sport Questionnaire), exercise-specific affect regulation (Physical Activity-related Health Competence Questionnaire) and depression (SCL-90-R) assessed at baseline (T1), post-treatment (T2) and one year after post-treatment (T3). Intention-to-treat analyses were conducted using linear mixed models and structural equations modeling.ResultsFrom T1 to T3, the intervention group significantly improved on global symptom severity (d = −0.43, p = .031), depression among a depressed subsample (d = −0.62, p = .014), exercise (d = 0.45, p = .011) and exercise-specific affect regulation (d = 0.44, p = .028) relative to the control group. The intervention group was more likely to reveal clinically significant changes from T1 to T3 (p = .033). Increases in exercise-specific affect regulation mediated intervention effects on global symptom severity (ß = −0.28, p = .037) and clinically significant changes (ß = −0.24, p = .042).ConclusionsThe exercise intervention showed long-term efficacy among a diagnostically heterogeneous outpatient sample and led to long-lasting exercise behavior change. Long-term increases in exercise-specific affect regulation within exercise interventions seem to be essential for long-lasting symptom reduction.