Cigarette Smoking Among Youth with Attention-Deficit/Hyperactivity Disorder: Clinical Phenomenology, Comorbidity, and Genetics

Cigarette smoking and other forms of tobacco use among children and adolescents is a significant public health concern. The negative consequences of prolonged exposure to such substances are numerous, and include higher prevalence rates of cardiopulmonary dysfunction and certain cancers, and may lead to other forms of drug use. Identifying subgroups of youth who may be at greater risk than others to develop a nicotine habit is an important step forward in preventing smoking initiation, and controlling tobacco use. One such subgroup is children with attention-deficit/hyperactivity disorder (ADHD). This is because the prevalence of smoking among these youngsters is nearly twice as high as it is among those who are unaffected with ADHD. However, the etiology of this association is not known. It is possible that a constellation of social, behavioral, and biological factors influences this process, resulting in higher prevalence rates. To further our understanding of this problem, we reviewed each of these factors in relationship to smoking and to ADHD. Using the primary care population as a model, we then discuss clinical research methods that may shed additional light on this topic, as well as the strengths and limitations of current smoking prevention and cessation options for ADHD-affected youth who are assessed and treated in medical settings.     

Biosocial studies of antisocial and violent behavior in children and adults: a review

Despite increasing knowledge of social and biological risk factors for antisocial and violent behavior, we know surprisingly little about how these two sets of risk factors interact. This paper documents 39 empirical examples of biosocial interaction effects for antisocial behavior from the areas of genetics, psychophysiology, obstetrics, brain imaging, neuropsychology, neurology, hormones, neurotransmitters, and environmental toxins. Two main themes emerge. First, when biological and social factors are grouping variables and when antisocial behavior is the outcome, then the presence of both risk factors exponentially increases the rates of antisocial and violent behavior. Second, when social and antisocial variables are grouping variables and biological functioning is the outcome, then the social variable invariably moderates the antisocial–biology relationship such that these relationships are strongest in those from benign home backgrounds. It is argued that further biosocial research is critical for establishing a new generation of more successful intervention and prevention research.     

Genetic and environmental influences on individual differences in printed word recognition

The genetic and environmental etiologies of individual differences in printed word recognition and related skills were explored in 440 identical and fraternal twin pairs between 8 and 18 years of age. A theoretically driven measurement model identified five latent variables: IQ, phoneme awareness, word recognition, phonological decoding, and orthographic coding. Cholesky decomposition models on these five latent constructs revealed the existence of both common and independent genetic effects, as well as non-shared environmental influences. There was evidence for moderate genetic influences common between IQ, phoneme awareness, and word-reading skills, and for stronger IQ-independent genetic influences that were common between phoneme awareness and word-reading skills, particularly phonological decoding. Phonological and orthographic coding skills in word recognition had both significant common and significant independent genetic influences, with implications for "dual-route" and "connectionist" reading models, subtypes of reading disabilities, and the remediation of reading disabilities.     

Gene therapy: ethical issues

To discern the ethical issues involved incurrent gene therapy research, to explore theproblems inherent in possible future genetherapies, and to encourage debate within thescientific community about ethical questionsrelevant to both, we surveyed American Societyof Human Genetics scientists who engage inhuman genetics research. This study of theopinions of U.S. scientific experts about theethical issues discussed in the literature ongene therapy contributes systematic data on theattitudes of those working in the field as wellas elaborative comments. Our survey finds thatrespondents are highly supportive of thepotential use of somatic cell gene therapy tocure serious diseases in adults and children aswell as prospective offspring. A clearmajority, however, believe that using suchgenetic techniques for enhancement purposes isunacceptable. Delineating the line betweendisease/disorder and improvement/enhancementposes a problem not easily resolved and oneconducive to the growth of slippery-slopeapprehensions. The majority of respondents alsoadvocate germ-line therapy, in theory at least,and under similar restrictions, but theyrecognize the roadblock that the existence ofunanticipated negative consequences currentlypresents. Another complex matter involvestrying to determine appropriate reasons forchoosing target diseases for research, forwhich the dichotomy between rare single-geneand common multifactorial diseases reveals anongoing dilemma.     

Addressing the needs of new mothers in a multi-cultural setting: an evaluation of home visiting support for new mothers – Mom to Mom (Negev)

This study evaluated the Mom to Mom (M2M) program operating in the Negev region of Israel, an area with a high proportion of immigrants. M2M helps women cope with the first year of parenting through home visits of volunteer mothers. Specific objectives were to evaluate (1) Participants’ motivations for joining M2M; (2) Gains from participation; and (3) The effect of participation on post-partum depression (PPD). Three stages included (1) Analysis of demographics of all 440 mothers in M2M; (2) A telephone survey of 51 mothers to assess gains from participation; and (3) 137 mothers filled out the Edinburgh Post-Natal Depression Scale (EPDS) and were followed for one year. Most mothers in M2M were first time mothers, with a high rate of perinatal complications (54.4%) and positive EPDS scores (38.7%). Two major reasons for participation were being an immigrant and having low income. The greatest gains from home visits were increased self-confidence, improved parenting skills and communication with the partner. Seventy-nine percent of mothers with PPD symptoms were functioning at work and at home after a year from joining the program. Our findings suggest that M2M has the capacity to address challenges in the post-natal period among women from diverse cultures.     

Genetic Virtue Program: An Unfeasible Neo-Pelagian Theodicy?

In his article, “Genetic Engineering, Virtue-First Enhancement, and Neo-Irenaean Theodicy,” Mark Walker has ventured farther into science more than most when it comes to exploring theodicy. After exposing the Achilles heel of the traditional free-will defense, Walker develops the Irenaean and Augustinian responses to the anthropic problem. Most importantly for this discussion, Walker proceeds to propose Genetic-First-Enhancement as part of his neo-Irenaean theodicy formulation. Overall, there are two major concerns I raised: the impossibility of a gradient morality in the presence of free will, and the scientific impossibility of Genetic Virtue Program. However, my claims are falsifiable if future genetic modifications do indeed improve morality. Before that is proven, I agree with Walker that, yes, we should play God, albeit, with his proposed virtue-first program.     

EVOLUTION OF RELIGIOUS CAPACITY IN THE GENUS HOMO: ORIGINS AND BUILDING BLOCKS

The large, ancient ape population of the Miocene reached across Eurasia and down into Africa. From this genetically diverse group, the chimpanzees, bonobos, gorillas, and humans evolved from populations of successively reduced size. Using the findings of genomics, population genetics, cognitive science, neuroscience, and archaeology, the authors construct a theoretical framework of evolutionary innovations without which religious capacity could not have emerged as it did. They begin with primate sociality and strength from a basic ape model, and then explore how the human line came to be the most adaptive and flexible of all, while coming from populations with reduced genetic variability. Their analysis then delves into the importance of neurological plasticity and a lengthening developmental trajectory, and points to their following article and the last building block: the expansion of the parietal areas, which allowed visuospatial reckoning, and imagined spaces and beings essential to human theologies. Approximate times for the major cognitive building blocks of religious capacity are given.     

EVOLUTION OF RELIGIOUS CAPACITY IN THE GENUS HOMO: TRAIT COMPLEXITY IN ACTION THROUGH COMPASSION

In this third and last article on the evolution of religious capacity, the authors focus on compassion, one of religious expression's common companions. They explore the various meanings of compassion, using Biblical and early related documents, and derive general cognitive components before an evolutionary analysis of compassion using their model. Then, in taking on neural reuse theory, they adapt a model from linguistics theory to understand how neural reuse could have operated to fix religious capacity in the human genome. They present a teaching tool on “Religious Capacity in Action,” and develop an example of compassionate decision making in very early Homo sapiens in North Africa. They round out their analysis of compassion by exploring theory in neuroscience on a standard decision‐making model, and investigate what goes on in the human brain when a values‐based decision is made.     

The Fear of Understanding Schizophrenia and Iatrogenic Myths

Empirically, psychotherapy with a competent therapist is the optimal, but rarely offered treatment, for schizophrenia. Medication or ECT produces less disturbing, lifelong cripples. Within 25 years one-third spontaneously recover completely (unless they stay on medication), and another third socially recover. Nazi Germany sterilized and annihilated patients without decreasing mental disorders in the next generation. Schizophrenia is a terror syndrome. The therapist must create a therapeutic alliance by creating hope and tolerating not understanding. Hallucinations are waking dreams. Delusions are transferences, defenses against pseudohomosexuality, family-specific meanings, or attempts to make sense out of strange experiences.     

Ethical and Professional Challenges Posed by Patients with Genetic Concerns: A Report of Focus Group Discussions with Genetic Counselors, Physicians, and Nurses

Ninety-seven physicians, nurses, and genetic counselors from four regions within the United States participated in focus groups to identify the types of ethical and professional challenges that arise when their patients have genetic concerns. Responses were taped and transcribed and then analyzed using the Hill et al. (1997, Counsel Psychol 25:517–522) Consensual Qualitative Research method of analysis. Sixteen major ethical and professional domains and 63 subcategories were identified. Major domains are informed consent; withholding information; facing uncertainty; resource allocation; value conflicts; directiveness/nondirectiveness; determining the primary patient; professional identity issues; emotional responses; diversity issues; confidentiality; attaining/maintaining proficiency; professional misconduct; discrimination; colleague error; and documentation. Implications for practitioners who deal with genetic issues and recommendations for additional research are given.