An Occupational Therapy Support Service for University Students With Asperger's Syndrome (AS)

Students with Asperger's Syndrome (AS) face challenges, within third-level education, related to the person, environment, and occupation. This study describes an occupational therapy (OT) service that aims to enhance the interplay between the person (i.e., the student) and his/her occupation within a given context (i.e., college environment). A chart review and Student Satisfaction Survey was used to identify the demographics, concerns, and goals of the students using it. It was found that goals and concerns shift according to students' stage in college and recommends that services employ a student-centered, flexible approach responsive to the particular concerns of these students.     

Parents of children with Down Syndrome: Do resilience and social support matter to their experience of carer stress?

The study investigated personal resilience influences on the relationship between social support and parenting-stress among parents of children with Down syndrome (DS) in a Nigerian sample. One hundred and ninety three parent-carers of children with DS participated in the study (mothers?=?59%; mean age?=?46.47, age range?=?21 to 67, SD?=?10.42). The parent-carers responded to the measures of parenting-stress, perceived social support, and resilience. The result of the moderated multiple linear regression showed that parents with high social support and resilience have lower level of parenting-stress. Higher personal resilience significantly moderated the relationship between social support and parenting-stress so that parent-carers with low level of social support and higher personal resilience had lower level of parenting-stress. Resilience and social support oriented therapy appears to have efficacy for helping parent-carers of children with DS to manage their stress arising from raising such children.     

Development and Open Trial of a Psychosocial Intervention for Young Children With Chronic Tics: The CBIT-JR Study

The Comprehensive Behavioral Intervention for Tic Disorders (CBIT) has demonstrated efficacy in large randomized controlled trials for children (≥9 yrs), adolescents and adults with Tourette Syndrome and Chronic Tic Disorders. Given the early age of onset for tic disorders, a large portion of affected individuals with chronic tic disorders are less than 9 years of age and appropriate developmental adaptations of behavioral treatment have not yet been tested. The goal of this study was to adapt and evaluate the acceptability and utility of a family-based adaptation of CBIT for children under 9 years of age. Children 5–8 years of age (N = 15) with chronic tics were recruited from three study sites. CBIT was adapted for use with young children and included habit reversal strategies introduced in a developmentally appropriate game format and function-based interventions to reduce family accommodation of and attention to tic symptoms.Children and parents described high level of treatment satisfaction and study retention rate was 100%. Treatment response rate was 54% (CGI-I = 1 or 2) with a significant decrease in the YGTSS total score (Cohen’s d = 0.73) that was largely maintained at 3-month and 1-year follow-up assessments. Treatment was associated with reduction of some symptoms of tic-related comorbid syndromes and with changes in parental accommodation and attention to tics.Future research should determine if parental attention to tics and symptom accommodation are important mediators of treatment outcome, or if participating in this intervention at a younger age may prevent the chronic course of tic symptoms.     

Battered Woman Syndrome Questionnaire (BWSQ) Subscales: Development,Reliability, and Validity

ABSTRACT

The current study describes the development and evaluation of the reliability and validity of four components of a comprehensive assessment designed for the purpose of identifying women who manifest symptoms due to an intimate partner violence (IPV) relationship: The Battered Woman Syndrome Questionnaire (BWSQ). More specifically, the purpose of this study was to evaluate the factor structure, validity, temporal stability and internal consistency of four instruments for measuring current functioning of IPV survivors; (a) Interpersonal relationship (BWSQ-IR), (b) Sexual Dysfunction (BWSQ-SD), (c) Body Image (BWSQ-BI), and (d) Post-Traumatic Stress Checklist (BWSQ-PTSC). Overall, results indicate the BWSQ subscales have good temporal stability and internal consistency. Exploratory factor analysis of the four subscales indicate that each has a unidimensional factor structure. Internal consistency was high for each of the subscales. A two-way mixed effects model, intraclass correlation was used to demonstrate a high degree of test-retest reliability. Convergent and discriminant validity was demonstrated by comparing each subscale with the Revised Adult Attachment Scale (AAS), the Derogatis Interview of Sexual Functioning – Sexual Response (DISF-SR), the Objectified Body Consciousness Scale (OBCS) and the Trauma Symptom Inventory (TSI). The four instruments demonstrate sound psychometric properties as standalone measures as well as subscales of the BWSQ.     

The minimal self hypothesis

For millennia self has been conjectured to be necessary for consciousness. But scant empirical evidence has been adduced to support this hypothesis. Inconsistent explications of “self” and failure to design apt experiments have impeded progress. Advocates of phenomenological psychiatry, however, have helped explicate “self,” and employed it to explain some psychopathological symptoms. In those studies, “self” is understood in a minimalist sense, sheer “for-me-ness.” Unfortunately, explication of the “minimal self” (MS) has relied on conceptual analysis, and applications to psychopathology have been hermeneutic, allowing for many degrees of interpretive latitude. The result is that MS’s current scientific status is analogous to that of the “atom,” at the time when “atom” was just beginning to undergo transformation from a philosophical to a scientific concept. Fortunately, there is now an opportunity to promote a similar transformation for “MS.” Discovery of the brain’s Default Mode Network (DMN) opened the door to neuroimaging investigations of self. Taking the DMN and other forms of intrinsic activity as a starting point, an empirical foothold can be established, one that spurs experimental research and that enables extension of research into multiple phenomena. New experimental protocols that posit “MS” can help explain phenomena hitherto not thought to be related to self, thereby hastening development of a mature science of self. In particular, targeting phenomena wherein consciousness is lost and recovered, as in some cases of Unresponsive Wakefulness Syndrome (UWS), allow for design of neuroimaging probes that enable detection of MS during non-conscious states. These probes, as well as other experimental protocols applied to NREM Sleep, General Anesthesia (GA), and the waking state, provide some evidence to suggest that not only can self and consciousness dissociate, MS might be a necessary precondition for conscious experience. Finally, these findings have implications for the science of consciousness: it has been suggested that “levels of consciousness” (LoC) is not a legitimate concept for the science of consciousness. But because we have the conceptual and methodological tools with which to refine investigations of MS, we have the means to identify a possible foundation—a bifurcation point—for consciousness, as well as the means by which to measure degrees of distance from that foundation. These neuroimaging investigations of MS position us to better assess whether LoC has a role to play in a mature science of consciousness.     

Towards modern post-coma care based on neuroscientific evidence

BackgroundUnderstanding the mechanisms underlying human consciousness is pivotal to improve the prognostication and treatment of severely brain-injured patients. Consciousness remains an elusive concept and the identification of its neural correlates is an active subject of research, however recent neuroscientific advances have allowed scientists to better characterize disorders of consciousness. These breakthroughs question the historical nomenclature and our current management of post-comatose patients.MethodThis review examines the contribution of consciousness neurosciences to the current clinical management of severe brain injury. It investigates the major impact of consciousness disorders on healthcare systems, the scientific frameworks employed to identify their neural correlates and how evidence-based data from neuroimaging research have reshaped the landscape of post-coma care in recent years.ResultsOur increased ability to detect behavioral and neurophysiological signatures of consciousness has led to significant changes in taxonomy and clinical practice. We advocate for a multimodal framework for the management of severely brain-injured patients based on precision medicine and evidence-based decisions, integrating epidemiology, health economics and neuroethics.ConclusionsMajor progress in brain imaging and clinical assessment have opened the door to a new era of post-coma care based on standardized neuroscientific evidence. We highlight its implications in clinical applications and call for improved collaborations between researchers and clinicians to better translate findings to the bedside.