More than the Terrible Twos: The Nature and Severity of Behavior Problems in Clinic-Referred Preschool Children

The primary goals of this study are to describe the nature and severity of disruptive behavior problems in clinic-referred preschoolers from low-income environments and to explore the validity of DSM-IV disruptive disorders for young children. We examine the relation between DSM-IV symptoms, standardized behavior checklists, and observational ratings as a means of exploring measurement validity in this age group. Seventy-nine clinic-referred preschoolers (ages 2 through 5 years) from low-income environments were assessed. To examine whether clinic-referred preschool children have symptoms that are consistent with DSM-IV disruptive behavior disorders, parents were administered a semistructured diagnostic interview, modified for developmentally appropriate usage. In addition, parents completed the Child Behavior Checklist (CBCL) and children's behavior problems were assessed with observational ratings during parent–child interaction. Nearly half of the sample met criteria for conduct disorder, and three quarters met criteria for oppositional defiant disorder. Preliminary evidence for the validity of DSM-IV disruptive disorders in preschool children was demonstrated through association with CBCL scores, behavior ratings, and significant levels of impairment. Future efforts aimed at validating these diagnoses in preschoolers and implications for prevention are discussed.     

Working Memory and Learning in Early Alzheimer’s Disease

Cognitive deficits associated with early Alzheimers disease (AD) have been recently operationalised in terms of an acquisition deficit and the research supporting this view is presented. However, there is still debate concerning the nature of this deficit and how underlying cognitive processes may be detrimentally affecting the ability to acquire new information in early AD. This review argues that the pattern of cognitive deficits contributing to the acquisition impairment in early AD patients may be readily interpreted within the context of a working memory model. Isolating the component processes of working memory that underlie the acquisition deficit in early AD patients will aid in the design of clinical applications that are focussed at enhancing the ability to acquire new information in everyday life.     

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.     

Discovering the Alphabetic Principle: A Lost Opportunity for Educational Reform

We review the recently published report by the Committee on the Prevention of Reading Difficulties in Young Children from a behavior analytic perspective. The authors prescribe what children should learn to be successful readers based on the correlates of reading and the developmental progression of reading errors. The report offers no discussion of theoretical models that can be used by teachers and parents to reform reading instruction or specific procedures that have been shown to be effective at promoting various reading skills. We discuss these omissions in terms of the level of research included in the review, the authors' structural approach to synthesizing this research, and the constructivist orientation common to many early childhood educators. The paper concludes by identifying models and strategies from the behavior analysis literature that can be used to guide instruction and offers a modest suggestion for future reviews of reading research.     

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Determinants of ethnic identity development in adulthood: A longitudinal study

Ethnic identity is defined in terms of the interaction between exploration of and commitment to a given cultural background. The present study investigated the effect of individual background, role transitions, and the social environment on the development of ethnic identity in a sample of German adults aged 21–73 years (N = 2,940). Additionally, identity transitions and the moderating effect of disequilibrating life events on identity over time were examined (N = 827). Overall, results are consistent with findings for other identity domains: Respondents could be assigned to one of four identity stages, ranging from unexamined to achieved identity. Particularly, the individual background and the extent of community involvement affected ethnic identity formation in adulthood. Longitudinal analyses revealed that only one-third of respondents had remained in the same identity stage; most individuals had transitioned forward or backward. Changes in ethnic identity were not moderated by disequilibrating life events.     

Dreaming the other's past: Why remembering may still be relevant to psychoanalytic therapy,at least in some traditions

Against the background of a reconstruction of the reasons for the vanishing role of remembering in the history of psychoanalysis, Botella's (2014, Int J Psychoanal, 95 ) arguments regarding the therapeutic significance of reconstruction and remembering and of the therapist's role are discussed. The difference between intellectual reconstruction and actual emotional remembering are underlined, the term regredience is compared to competing concepts such as equally suspended attention, countertransference and reverie. It is argued that to conceptualize the use of countertransferential associations for reconstructing past traumatic events is difficult with a monadic conception of the unconscious and problematic both in terms of truth claims and in terms of achieving a shared creative atmosphere in which therapist and patient participate alike. It is concluded that historical truth may be important for traumatic experiences, and that biographical reconstruction and change in the subjective life story help to make sense of neurotic patterns and integrate diachronic identity.     

Developmental trajectory in the relationship between calculation skill and finger dexterity: A longitudinal study

A 2‐year longitudinal study of 33 children aged 4–6 years was conducted to clarify the developmental relationship between calculation skill and finger dexterity, as well as the selectivity of the predictive power of finger dexterity on later calculation skill. We examined individual developmental change in the relationship between addition performance and finger dexterity and observed whether children fit a linear developmental pattern. Multiple regression analysis showed that participants' performance on addition tests was strongly predicted by their finger dexterity. However, their performance on vocabulary tests was not strongly influenced by finger dexterity. These findings suggest that calculation skill in children aged 4–6 years is strongly related to finger dexterity.     

Long‐Term Outcomes of Traumatic Brain Injury in Early Childhood

Mild traumatic brain injury (mTBI) is a leading cause of injury among children, with approximately 15% of children experiencing a TBI prior to 15 years of age. Acutely, mTBI has been associated with a range of cognitive, physical, emotional and behavioural impairments. However, few studies have examined outcomes beyond five years post injury, long before the developmental process is complete and the full extent of any deficits may manifest. Our group had the unique opportunity to use data from a longitudinal birth cohort of 1265 children (Christchurch Health and Development Study) to examine the long term outcomes of early injury (0–5 years). Information about these children, including mTBI events, had been collected at birth, 4 months and at yearly intervals until age 16, and again at ages 18, 21 and 25 years. We found that even after statistical control for a wide range of child and family confounds, children who had been hospitalized for an mTBI had increased inattention/hyperactivity and conduct as rated by mothers and teachers over ages 7–13 years. Increased rates of psychiatric disorders were over 14–16 years for those injured in the preschool, including symptoms consistent with Attention Deficit/Hyperactivity Disorder (ADHD), Odds Ratio = 4.6, Conduct Disorder (CD), Odds Ratio = 5.6 and Substance Abuse (Odds Ratio = 9.1). Over ages 21–25 ongoing behaviour problems were assessed using self‐reported arrests, violent offenses and property offenses. Compared to non‐injured individuals, mTBI groups were more likely to be arrested, involved in property, and violent offences. We controlled for a wide range of factors and there was still clear evidence of ongoing problems for individuals who had experienced a mTBI compared to their non injured counterparts. These findings provide compelling evidence of long term psychosocial and psychiatric outcomes following mTBI.     

根据血压昼夜节律选择服药时间控制血压晨峰

根据血压昼夜节律,观察给药时间对血压晨峰的影响。256例原发性高血压患者,经24h动态血压监测分为超杓型（n＝49）、杓型（n＝127）和非杓型（n＝80）3组;各组再分为清晨服药组和晚上服药组。用药6周,比较用药前后血压昼夜节律及血压晨峰的变化,发现在改变血压昼夜节律及降低血压晨峰方面,超杓型组清晨服药优于晚上服药,非杓型组晚上服药优于清晨服药;杓型组清晨服药与晚上服药均能降低晨峰值,提示根据个体血压昼夜节律选择服药时间能更好地控制血压晨峰。