The Use of the Devereux Scales of Mental Disorders in the Assessment of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder

The present study was designed to gather validity data on the Devereux Scales of Mental Disorders (DSMD) for distinguishing among children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 32), Conduct Disorder (CD; N = 34), or no clinical diagnosis (NC; N = 65). Three types of indicators were compared: (a) DSMD scale, composite, and total scores, (b) the number of ADHD or CD-related items endorsed, and (c) diagnostic efficiency statistics (e.g., sensitivity, positive and negative predictive power). The clinical groups did not differ significantly from each other, but both were significantly higher than the NC group on all DSMD scales. Moreover, there were significant differences between the ADHD and the CD groups on the number of respective ADHD and CD-related items endorsed. A cut-off of seven to eight items yielded the best discrimination between the two diagnostic groups. Diagnostic efficiency statistics indicate that the DSMD may be effective at differentiating between similar disruptive behavior disorders.     

Perceived teasing experiences in body dysmorphic disorder

Individuals with body dysmorphic disorder (BDD) are excessively concerned about imagined or slight defects in their appearance (e.g., asymmetrical facial features). Cognitive-behavioral models of BDD propose that several factors, including dysfunctional appearance-related beliefs and life experiences, such as teasing, contribute to the avoidance behaviors or rituals (e.g., mirror checking, grooming) characteristic of BDD. Previous research has demonstrated an association between perceived teasing and body dissatisfaction. In the current study, we examined whether individuals with BDD (n = 16) report to have been teased more often than do mentally healthy controls (n = 17). The group comprising individuals with BDD reported more appearance- and competency-related teasing than did control participants. This study provides preliminary evidence for the association between perceived teasing and BDD.     

Hemispheric lateralization of bilaterally presented homologous visual and auditory stimuli in normal adults, normal children, and children with central auditory dysfunction

Two experiments were conducted to examine the performance of normal adults, normal children, and children diagnosed with central auditory dysfunction presumed to involve the interhemispheric pathways on a dichotic digits test in common clinical use for the diagnosis of central auditory processing disorder (CAPD) and its corresponding visual analog. Results of the first experiment revealed a significant right ear advantage (REA) for the dichotic listening task and a left-visual-field advantage (LVFA) for the corresponding visual analog in normal adults and children. In the second experiment, results revealed a significantly larger REA in the children with CAPD as compared to the normal children. Results also revealed a reversed cerebral asymmetry (RVFA) for the children with CAPD on the visual task. Significant cross-modal correlations suggest that the two tasks may reflect, at least in part, similar interhemispheric processing mechanisms in children. Findings are discussed in relation to differential diagnosis and modality-specificity of CAPD.     

制度伦理与社会转型期的医德建设

市场经济的发展,多元价值观的形成,各种伦理价值观念之间发生了冲突,医疗道德失范现象成为我国社会转型期的一个重要社会问题。制度伦理对道德建设起着基础性和根本性的作用,以制度伦理建设为契机,并辅以正确的激励手段等,可以让医务人员树立正确的道德理念,引导和强化医务人员的价值选择和行为规范,重塑良好医德医风。     

Marriage and the Public Good

In this article I seek to address some misunderstandings inarguments about same sex-marriage. I do this by evaluating severalviews on homosexuality and marriage. My central aim is to showthat a rejection of same-sex marriage does not depend upon theview that homosexual acts are immoral or disordered. Rather,one must examine sexual acts in light of public goods that areat stake. I also argue that the Christian understanding of marriageand sexuality offers more than a set of prohibitions againstcertain sexual acts. Rather, it offers reasonable principlesby which to evaluate the relationship between sexual acts andthe public good.     

Developmental coordination disorder and internalizing problems in children: The environmental stress hypothesis elaborated

There is a growing literature connecting poor motor coordination to physical and mental health outcomes in children and adolescents. These studies suggest that children with disorders such as developmental coordination disorder (DCD) are at greater risk for depression and anxiety, as well as obesity, and poor physical fitness. With regard to internalizing problems (symptoms of depression and anxiety), there is also evidence to suggest that the environment may play an important role in the etiology of psychological distress in this population. Cairney, Veldhuizen, & Szatmari, 2010 used the phrase “environmental stress hypothesis” to highlight the role that negative exposure to personal and interpersonal stressors might play in accounting for higher rates of internalizing symptoms in children with DCD. In this paper, we elaborate further on this basic premise, offering a model linking DCD to internalizing problems based on Pearlin’s stress process framework. In addition to stressors (risk) and protective factors, we incorporate both physical activity and obesity into our stress model. Next, we review the existing literature to see if there is evidence supporting specific components (pathways) of the model. In doing so, areas in need of further research are identified. Implications for intervention are also provided.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

Revisiting ‘What works for whom?’: A qualitative framework for evaluating clinical effectiveness in child psychotherapy

This paper describes a framework for evaluating the effectiveness of child psychotherapy used by child psychotherapists in an inner city Child and Adolescent Mental Health Service (CAMHS). The Hopes and Expectations for Treatment Approach (HETA) involves using the assessment for psychotherapy that normally precedes treatment to derive a baseline from which to generate a set of hopes/expectations as regards the effects of the treatment on the part of parents and the psychotherapist, to be revisited one year after the start of the psychotherapy and/or at its completion. The Strength and Difficulties Questionnaire, for parents and schools, was also administered before and after the treatment. The characteristics of the first 30 children referred for psychotherapy over a particular time period are described. Of the first 15 children in this group to complete one year of individual psychotherapy, all showed change or significant change in the areas concerning parents' and therapists' hopes at the end-of-year review, as rated by parents and psychotherapists. A case of a child with conduct disorder is used to describe how the assessment generated a psychoanalytic formulation, how the therapist's understanding was fed back to the parents, and how the parents' and therapist's hopes and expectations were derived and recorded. This case illustrates powerfully the impact of trauma in the parents' backgrounds on the internal world of the child, and how the method provides a useful bridge between parent and child work. Feedback from the psychotherapists, the parents and the referrers using the framework is reviewed, and in conclusion the paper argues for the framework's value in promoting good practice in the treatment and management of complex cases and in enhancing awareness of the nature and scope of the psychotherapy process.     

The Relationships Among Sensory Processing Styles,Personality Traits,and Body Mass Index: A Pilot Study

The purpose of the authors in this study is to explore the possible relationships among sensory processing styles, possible sensory processing disorders, personality traits, and body mass index. There is research on the relationship between obesity as defined by body mass index and temperament, and sensory processing and temperament; however, no information could be found on the relationship between body mass index and sensory processing styles, or the role that temperament and personality styles may play in these relationships. The 50 female participants were recruited from the University of New England community. The sample included women between the ages of 19 and 59 years, and of various weights. None of the participants had a history of thyroid problems, diabetes, or any physical disabilities that would limit daily physical activity. None had been diagnosed with sensory processing disorder. All participants filled out two self-reports and a demographic questionnaire. The Adult/Adolescent Sensory Profile (Brown &; Dunn, 2002 Brown , C. E. , &; Dunn , W. ( 2002 ). Adult/Adolescent Sensory Profile . San Antonio , TX : The Psychological Corporation . [Google Scholar]) determines a person's sensory processing style and possible sensory processing disorder, and the Basic Personality Inventory (Jackson, 1996 Jackson , D. N. ( 1996 ). Basic Personality Inventory Manual , (2nd ed.) . Port Huron , MI : Sigma Assessment  [Google Scholar]) focuses on everyday behaviors to describe temperament and “adult behavioral syndromes” (p. 5). Through this study the authors show only tentative relationships between body mass index and sensory processing styles and personality traits. The data could be interpreted to support both discriminant and convergent validity between the Adult/Adolescent Sensory Profile and the Basic Personality Inventory. There were, however, significant correlations between aspects of sensory processing and aspects of personality that appeared to strengthen the idea that differences in sensory processing result in predictable types of behavior, indicating that sensory processing disorders are a separate diagnostic category.     

Confounding of Big Five Personality Assessments in Emotional Disorders by Comorbidity and Current Disorder

Foremost cross‐sectional studies of personality in common mental disorders show similar Big Five trait profiles [i.e. high neuroticism (N), low conscientiousness (C) and low extraversion (E)]. It remains undecided whether this lack of distinct personality profiles is partly due to comorbidity among disorders or contamination by current state. Using data from the Netherlands Study of Depression and Anxiety, we investigated 1046 participants with panic disorder (PD), social anxiety disorder (SAD) and/or major depressive disorder (MDD) and 474 healthy controls. Personality traits at baseline and two‐year follow‐up were assessed with the NEO‐Five Factor Inventory. The Composite International Diagnostic Interview was used to determine the presence of emotional disorders at baseline and at two‐year follow‐up; the Life Chart Interview determined symptom severity in the month prior to baseline and during follow‐up. By analysing pure cases and investigating the effects in remitted cases, PD participants were found to be higher in N, but not lower in E and C than controls. Pure PD participants were also lower in N and higher in E than SAD and MDD participants. Both SAD and MDD participants were characterized by high levels of N and low levels of E, irrespective of comorbidity or current disorder state. Future studies should be more attentive to confounding of personality profiles by comorbidity and state effects. Copyright © 2012 John Wiley & Sons, Ltd.