A comparison of working memory profiles in school-aged children with Specific Language Impairment,Attention Deficit/Hyperactivity Disorder,Comorbid SLI and ADHD and their typically developing peers

The association between specific language impairment (SLI), attention deficit/hyperactivity disorder (ADHD), and working memory (WM) was examined. WM has been implicated in language acquisition and models of ADHD; however, evidence for WM deficits in SLI and ADHD has been inconsistent. The components of Baddeley's WM model were investigated in 18 children with SLI, 16 children with ADHD, 11 children with comorbid SLI+ADHD, and 24 typically developing (TD) children. The presence of SLI resulted in deficits in more components of WM than the presence of ADHD indicating that children with SLI are more vulnerable to WM deficits than those with ADHD.     

Autism characteristics in children with fetal alcohol spectrum disorders

Background: Children with fetal alcohol spectrum disorders (FASD) exhibit difficulties in many cognitive and behavioral domains and also have high comorbidity with other disorders such as attention deficit/hyperactivity disorder (ADHD) and conduct disorder as well as autism. Although the FASD profile is shown to be distinct from ADHD and conduct disorder, far less is known about the commonalities with autism. The current study used a parent-rated questionnaire containing an autism subscale to explore the autistic-like features that children with FASD exhibit. Methods: Studied were 25 children with FASD (age: M = 10.3 years) and 17 normal controls (NCs; age: M = 10.2 years). As part of a larger study, all parents/caregivers completed the Social Skills Improvement System (SSIS; Gresham & Elliot, 2008), which in addition to evaluating social skills and behavior problems globally, includes an Autism subscale. Results: Between-group comparisons showed the FASD group not only scored significantly lower in social skills and significantly higher in behavior problems than the NC group but children with FASD also scored significantly higher on the Autism subscale. Item analysis revealed they showed the most difficulty in terms of social and communicative functioning and the least in repetitive and restrictive behaviors. Conclusion: Current findings signify that FASD and autism share similarities with regard to social and communicative functioning. These findings, which further our knowledge of the FASD phenotype, may be useful in specifying the particular interventions these children need.     

Enhancing recovery rates: Lessons from year one of IAPT

BackgroundThe English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines.MethodData from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7).ResultsData completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff.ConclusionsCompliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.     

Individual and institutional defences against primitive anxieties: Counselling in prison

Abstract

This paper describes a counsellor's attempts to understand the unconscious dynamics affecting the process of counselling women in prison. The social system of the prison serves to defend both prisoners and officers against powerful anxieties about the potential for sadistic attack originating from primitive states of mind, that is persecution, helplessness and destructiveness. The implications of the rigid means of defence are considered, and die role of unconscious guilt motivating the need for external punishment is briefly explored. Emphasis is placed on the role of splitting and projection in the management of potentially overwhelming feelings of guilt, and fear of punishment. The author develops the premise that there is in effect an institutional requirement that prisoners remain in the paranoid-schizoid position because of the feared consequences were they to experience depressive anxieties.     

Well Children Living with Diabetic Siblings

Abstract

This article examines the psychological adjustment of well children who live with diabetic siblings. A sample of 28 well siblings between the ages of 8 and 12 were studied, utilizing standard tests and a semi-structured interview. Standard tests demonstrated that well siblings had adjustment difficulties manifested by internal stressors that originated from anxiety and low self-concept. This report emphasized the qualitative results of well siblings living with diabetic siblings. The findings conclude that well siblings have difficulties negotiating emotions, communications, and activities with their diabetic siblings. The report interprets sibling issues from a psychodynamic orientation, suggesting that many of the healthy psychological functions performed by the sibling relationship are interrupted by the introduction of a chronic illness. Recommendations based on the findings are offered to professionals who work with diabetic children and their families.     

Mourning the Loss of the Idealized Self: A Transsexual Passage

Abstract

The few published psychoanalytic writings that exist regarding transsexual men and women tend to focus on the etiology of their gender identities and almost invariably define these patients as inherently pathological. Such myopic viewpoints leave no room for analysis and discussion of the transsexual patient's normal developmental process. In this paper, I use a Kleinian framework to depathologize the coping strategies employed by transsexual patients and to illustrate the importance of mourning in the development of a positive transsexual identity. A clinician who is able to sit comfortably with contradiction may facilitate the transsexual patient's mourning process—saying goodbye to the persecutory object of the past and letting go of the idealized image of the future.     

A Review of Eating Disorders in Athletes

SUMMARY

The current review aims to evaluate the literature on eating disorders and athletes with the purpose of making recommendations for sport psychologists and other relevant personnel on how to proceed in identifying, managing, and preventing eating disorders in school settings. Whereas the intention of this review is to make recommendations for secondary educational settings, research on other populations such as collegiate and young adult athletes was also reviewed where helpful or where information on adolescent athletes was not available. Recommendations for prevention and intervention include ongoing education of athletes and coaches regarding nutrition, body composition, and performance, using appropriate screening to detect eating disorders, and use of a sport management team to aid in athlete recovery.     

Inclusion and Students with Emotional/Behavioral Disorders

Summary

This article presents a point/counterpoint approach to the issue of full inclusion of all students with emotional/behavioral disorders. To set the stage for the discussion that follows, the academic, social, and behavioral characteristics of these students pertinent to classroom performance are reviewed. The pros and cons of these four issues are then presented: (a) appropriateness of the general education curriculum for students with EBD; (b) social acceptance and other social competence issues; (c) mental health interventions and supports in general education settings; and (d) legality of full inclusion. Under the legality issue, case law on full inclusion pertaining to students with EBD is briefly reviewed. The basic premise of the authors who are full inclusion opponents is that a continuum of placements, including full-time placement in general education classrooms, should be preserved so that decisions about appropriate settings can be made on an individual basis. The basic premise of the author who is a full inclusion proponent is that, rather than maintaining two separate systems, we should direct our energies toward correcting the inadequacies of the general education classroom for the benefit of all students, including those with EBD.     

The Effectiveness of Cognitive Behavioral Therapy for Generalized Anxiety Disorder in a Frontline Service Setting

The goal of the current study was to test the generalizability of cognitive behavioral therapy (CBT) for generalized anxiety disorder (GAD) in a frontline service setting. Twenty‐nine patients who presented to treatment clinics with problematic worry were provided CBT for GAD. Among the intent‐to‐treat sample, there were no significant changes in worry or depression from pre‐ to posttreatment. Treatment completers showed significant pre‐ to posttreatment reductions on measures of worry and depression. The magnitude of change was smaller than has been reported in randomized control trials (RCTs). Although the frontline service setting differed from RCT settings in multiple ways, treatment completers nonetheless achieved moderate to large decreases in self‐reported worry and depression.     

Beteendeterapi vid ångestneuros. En evaluerande översikt

Abstract

De olika kontrollerade gruppstudier och okontrollerade fallstudier som finns publicerade rörande beteendeterapeutiska metoder vid ångestneuros presenters och evalueras. Studierna har uppenbara brister vad gäller presentation av patientmaterialet, mätmetoderna och tillämpningen av vissa behandlingsmetoder. Resultaten visar i allmänhet på relativt små och sällan kliniskt signifikanta förbättringar. Artikeln avslutas med rekommendationer för fortsatt forskning framför allt rörande andra behandlingsmetoder än de hittills prövade.