A systematic review of physical guidance procedures as an open‐mouth prompt to increase acceptance for children with pediatric feeding disorders

This article reviews behavioral treatments of pediatric feeding disorders using physical guidance procedures as an open‐mouth prompt (i.e., jaw prompt, finger prompt, Nuk prompt, side deposit) to increase food acceptance. We identified 9 articles containing 35 systematic evaluations. We coded participant and study characteristics and assessed the experimental rigor, quality, and outcomes of each evaluation. Of the high‐quality research present, the finger prompt variation and side deposit reliably increased acceptance. We found mixed results on the efficacy of the jaw prompt, although it was the most widely researched procedure. Further, authors reported interobserver agreement for 100% of the participants, procedural integrity for 60%, social validity for 80%, fading for 5%, and follow‐up for 55%. Based on the invasive nature of physical guidance, we provide recommendations for researchers and clinicians to increase the quality of their treatment evaluations. We discuss limitations, implications for practice, and future research.     

Teaching multiply controlled intraverbals to children and adolescents with autism spectrum disorders

Reciprocal conversations, instructional activities, and other social interactions are replete with multiply controlled intraverbals, examples of which have been conceptualized in terms of conditional discriminations. Although the acquisition of conditional discriminations has been examined extensively in the behavior‐analytic literature, little research has evaluated procedures to establish multiply controlled intraverbals. Thus, the purpose of this investigation was to evaluate the effects of procedures based on conditional discrimination training on the acquisition of multiply controlled intraverbals with 7 participants who had been diagnosed with autism spectrum disorders. We evaluated the effects of prompt delay with error correction, a differential observing response (DOR), and a DOR plus blocked trials on the acquisition of intraverbals using a multiple baseline design. Accuracy of intraverbal performance increased for at least 1 set of stimuli for all participants under prompt delay with error correction conditions; however, 4 participants required additional teaching (i.e., DOR, modified DOR, modified prompt delay with error correction). Based on these findings, when prompt delay with error correction is not sufficient to establish multiply controlled intraverbals, prompted DORs may be an effective alternative.     

Étude des liens entre la fréquence de pratique sportive et la santé des étudiants : mesure des effets de genre sur les troubles alimentaires et les consommations de substances

A number of previous studies have focused on the effect of sport practice on eating disorders and substance use. Most of these studies suggest that among students sport practice is related to low levels of health issues like eating disorders and substance use. However, there is a relative dearth of evidence for these relationships and previous findings are based on comparisons between people involved in sport practice and physical activity and sedentary or largely inactive people. The present study aims to test the effects of frequency of sport practice on college students’ eating disorders and substance use when also controlling for gender effects.MethodsOne thousand and seventy-three first year college students (35.6% boys, 64.4% girls) volunteered to participate in the study. Participants were divided into three groups according to the frequency of their sport practice: students who rarely participated in sport practice (less than one hour a week and not every week; 406 students, 26.4% boys vs 73.6% girls), students who frequently participated in sport practice (every week but less than eight hours a week; 173 students, 33.5% boys vs 66.5% girls), and students who had intensive sport practice (eight hours a week or more; 494 students, 43.9% boys vs 56.1% girls). Alcohol, tobacco and cannabis use were assessed using the Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Three different categories of eating disorders (Dieting, Bulimia, Oral control) were assessed using the EAT-26 inventory. ANOVAs were computed to test for gender differences across the three sport practice groups.ResultsResults of univariate ANOVAs revealed main effects for gender and sport practice on some of the substance use and eating disorder variables, ANOVA with multiple comparisons (Tamhan T Test) revealed a significant interaction effect of sport practice and gender on oral control and tobacco use. For girls, oral control and tobacco use do not vary within the three groups of sport practice whereas for boys the more frequent the sport practice, the lower their scores on oral control and tobacco use. For oral control, boys reported significantly higher scores than girls only when sport practice was rare. For tobacco use, boys reported significantly higher scores than girls when sport practice was rare and lower scores when sport practice was intensive.ConclusionThese results suggest that the positive effects of sport practice vary by gender and that the campaigns for promotion of physical activity might assist in the prevention of health issues amongst students but should be adapted according to the gender of the participants.     

Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation,stride characteristics,and ratings of perceived exertion during acute stroke rehabilitation

BackgroundIntensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1 month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase.ObjectiveTo examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure.DesignA prospective, repeated measures design was used.MethodsTen inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0 mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial.ResultsStride length, cadence, and paretic single limb support increased with faster walking speeds (p ⩽ 0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p ⩽ 0.001). RPE also was greatest at the fastest compared to two slowest speeds (p < 0.05).ConclusionsDuring the acute phase of stroke recovery, PBWSTT at the fastest speed (2.0 mph) promoted practice of a more optimal gait pattern with greater intensity of effort as evidenced by the longer stride length, increased between-limb symmetry, greater muscle activation, and higher RPE compared to training at the slowest speeds.     

A child’s loss becomes a young man’s violence

Abstract

This paper describes the contribution of earlier traumatic loss to the later violent eruptions, with fatal consequences, of two young men, one who killed his mother and one who killed an unknown woman. Their developing personalities became disordered during their disturbed childhoods and the link between these developing personality disorders and psychoses is referred to. The need for long-term treatments is emphasised, as well as the importance of communication between therapist and clinical team.     

Influence of maternal depression on children's brooding rumination: Moderation by CRHR1 TAT haplotype

There is growing evidence that brooding rumination plays a key role in the intergenerational transmission of major depressive disorder (MDD) and may be an endophenotype for depression risk. However, less is known about the mechanisms underlying this role. Therefore, the goal of the current study was to examine levels of brooding in children of mothers with a history of MDD (n = 129) compared to children of never depressed mothers (n = 126) and to determine whether the variation in a gene known to influence hypothalamic-pituitary-adrenal axis functioning—corticotropin-releasing hormone receptor 1 (CRHR1) —would moderate the link between maternal MDD and children's levels of brooding. We predicted children of mothers with a history of MDD would exhibit higher levels of brooding than children of mothers with no lifetime depression history but that this link would be stronger among children carrying no copies of the protective CRHR1 TAT haplotype. Our results supported these hypotheses and suggest that the development of brooding among children of depressed mothers, particularly children without the protective CRHR1 haplotype, may serve as an important mechanism of risk for the intergenerational transmission of depression.     

Declarative verbal memory impairments in middle-aged women who are caregivers of offspring with autism spectrum disorders: The role of negative affect and testosterone

Caring for offspring diagnosed with a chronic psychological disorder such as autism spectrum disorder (ASD) is used in research as a model of chronic stress. This chronic stress has been reported to have deleterious effects on caregivers' cognition, particularly in verbal declarative memory. Moreover, such cognitive decline may be mediated by testosterone (T) levels and negative affect, understood as depressive mood together with high anxiety and anger. This study aimed to compare declarative memory function in middle-aged women who were caregivers for individuals with ASD (n = 24; mean age = 45) and female controls (n = 22; mean age = 45), using a standardised memory test (Rey's Auditory Verbal Learning Test). It also sought to examine the role of care recipient characteristics, negative mood and T levels in memory impairments. ASD caregivers were highly sensitive to proactive interference and verbal forgetting. In addition, they had higher negative affect and T levels, both of which have been associated with poorer verbal memory performance. Moreover, the number of years of caregiving affected memory performance and negative affect, especially, in terms of anger feelings. On the other hand, T levels in caregivers had a curvilinear relationship with verbal memory performance; that is, increases in T were associated with improvements in verbal memory performance up to a certain point, but subsequently, memory performance decreased with increasing T. Chronic stress may produce disturbances in mood and hormonal levels, which in turn might increase the likelihood of developing declarative memory impairments although caregivers do not show a generalised decline in memory. These findings should be taken into account for understanding the impact of cognitive impairments on the ability to provide optimal caregiving.     

Asking for work adjustments or initiating behavioural changes – what makes a ‘problematic co-worker’ score Brownie points? An experimental study on the reactions towards colleagues with a personality disorder

People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues’ reactions towards a problematic worker dependent on the returning person’s reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.     

Trends in burnout syndrome and emotional factors: an assessment of anesthesiologists in Southern Brazil, 2012

Burnout syndrome (BOS) is the result of chronic stress at work, and is characterized by emotional exhaustion (EE), depersonalization (DP), and low professional accomplishment. Anesthesiologyis a stressful profession. The aim of this study was to assess the prevalence of burnout as well as the sociodemographic and working characteristics associated with this syndrome’s emotional factors, in anesthesiologists from Southern Brazil. We assessed burnout severity, depressive symptoms, and self-esteem using the Maslach burnout inventory, the Beck depression inventory, and the Rosenberg self-esteem scale, respectively. Of the 198 anesthesiologists included in this study, 48.7% were positive for burnout, 26.9% for EE, 41.3% for DP and 32.7% for low personal accomplishment. Trends in BOS was associated with a younger age, difficulty to conciliate family and work demands, low self-esteem, and depressive symptoms.     

“I find peace there”: how faith,church, and spirituality help mothers of colour cope with postpartum depression

This article reports the findings of 30 semi-structured, qualitative interviews with new African American and Latina mothers who have histories of postpartum depression (PPD) to learn how their faith, church participation, and spiritual practices helped them cope with PPD. Six themes emerged: relief from stress, feeling valued and less alone, experiencing gratitude, developing perspective and accepting God’s guidance, changing and developing relationships, and preventing self-harm. Specifically, mothers who adhered to their faith beliefs and engaged in spiritual practices described shifts in their perspectives on various life stressors known to contribute to PPD such as negative thoughts and feelings, and strained family relationships, which in turn led them to make positive changes in their lives.