Peer Difficulties in Children with Epilepsy: Association with Seizure,Neuropsychological, Academic,and Behavioral Variables

Purpose/Objective: A developmental psychopathology framework was used to examine variables associated with peer problems in children with epilepsy (CWE). Variables commonly associated with peer difficulties in typically developing children, such as inattentive behavior, anxious behavior, and academic achievement were investigated. Neuropsychological functioning, age at epilepsy onset, and seizure status were also examined.

Research Method/Design: Participants were 173 CWE, ages 8–15. Structural equation modeling (SEM) was used to determine which variables predicted peer problems in CWE and to test hypothesized interrelations among variables.

Results: The SEM revealed that anxious behavior mediated relations between neuropsychological functioning and peer difficulties and seizure status and peer difficulties. Inattentive behavior mediated the association between neuropsychological functioning and peer difficulties. Neuropsychological functioning mediated the relation between age at epilepsy onset and inattentive behavior, anxious behavior, and academic achievement.

Conclusions/Implications: As seen with typically developing children, inattentive and anxious behaviors are related to peer difficulties in CWE. Neuropsychological functioning, age at epilepsy onset, and seizure status are indirectly associated with peer difficulties; therefore, these variables are important to examine in CWE who are experiencing peer problems.     

Visual orientation in hospitalized boys with early onset conduct disorder and borderline intellectual functioning

The aim of the present study is to investigate visual orientation in hospitalized boys with severe early onset conduct disorder and borderline intellectual functioning. It is tested whether boys with the dual diagnosis have a stronger action-oriented response style to visual-cued go signals than the norm. To this end, boys with the dual diagnosis were compared with a peer control group on Posner's (1980) Posner, M. I. 1980. Orienting of attention. Quarterly Journal of Experimental Psychology, 32: 3–25. [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar] visual-spatial detection test. Here, on each trial, a visual cue points either in the direction of the location of a subsequent go signal (valid cue), or points in the opposite direction away from the location of the subsequent go signal (invalid cue). Findings indicated superior orientation (a strong action-oriented response style) of children with the dual diagnosis in valid-cued trials as well as in invalid-cued trials in both the left and the right visual hemifield. Findings were controlled for attention scores on the Child Behavior Checklist -Teacher Form and IQ scores.     

Executive Functioning in Children and Adolescents with Major Depressive Disorder

The present investigation examined neurocognitive functioning, focusing on executive functioning (EF), in 39 children and adolescents with Major Depressive Disorder (MDD) and 24 healthy control subjects all ages 8 to 17 years. The Wechsler Intelligence Scale for Children-Third Edition along with several measures of executive functioning including the Wisconsin Card Sorting Task, Trail Making Test, Controlled Oral Word Association Test, and the Stroop Color Word Test were administered. The neurocognitive profiles for the group of depressed children and adolescents were grossly intact as most scores on intellectual and EF measures fell within the average range and did not differ from the comparison group. Mental processing speed was decreased in the MDD versus normal control group and 27% of the depressed group performed below average on the Trail Making Test. This investigation provided a good base from which to compare future literature on EF in outpatients with early-onset MDD.     

Parent Report of Attention Problems Predicts Later Adaptive Functioning in Children with Brain Tumors

Children with brain tumors are at risk for psychological and behavioral difficulties. This study examined the ability of parent report of attention problems, withdrawal, anxiety, and depression, as well as IQ, to predict later adaptive functioning in 42 children treated for brain tumors. Age at diagnosis, SES, gender, and scores on the Neurological Predictor Scale (NPS) also were examined as predictors. Parent report of attention problems, SES, and NPS were significant predictors of later adaptive functioning across domains. This finding highlights the ability of parent report of attention problems to predict later adaptive functioning in children treated for brain tumors.     

The Reconstruction of Psychic Trauma

The author discusses the difficulties that arose in the analysis of a female patient suffering from a delusional disorder, where traditional criteria of suitability for psychoanalytic treatment were initially lacking and had to be established as part of the process. The transference-countertransference interaction came to a deadlock, understood by the analyst as due to the patient’s pathological dyadic relating. She was lacking in her capacity of reflective functioning, and there was no potential space to foster a fruitful therapeutic dialogue between analyst and patient. The analyst adopted a bystander perspective as a vantage point from which to comment on the patient’s narrative, whereby she succeeded in gradually altering the dysfunctional dyadic exchange into an interaction where a triadic perspective was introduced as a means to making possible meaningful communication between patient and analyst. Substantial changes were achieved with this procedure as a point of departure. The case study highlights aspects of dyadic versus triadic functioning of the analytic pair, and serves to illustrate theoretical points pertaining to the ongoing debate between professionals on how the basic structural elements of the analytic relationship should be conceptualised.     

Parental reflective functioning is associated with tolerance of infant distress but not general distress: Evidence for a specific relationship using a simulated baby paradigm

Parental reflective functioning represents the capacity of a parent to think about their own and their child's mental states and how these mental states may influence behavior. Here we examined whether this capacity as measured by the Parental Reflective Functioning Questionnaire relates to tolerance of infant distress by asking mothers (N = 21) to soothe a life-like baby simulator (BSIM) that was inconsolable, crying for a fixed time period unless the mother chose to stop the interaction. Increasing maternal interest and curiosity in their child's mental states, a key feature of parental reflective functioning, was associated with longer persistence times with the BSIM. Importantly, on a non-parent distress tolerance task, parental reflective functioning was not related to persistence times. These findings suggest that parental reflective functioning may be related to tolerance of infant distress, but not distress tolerance more generally, and thus may reflect specificity to persistence behaviors in parenting contexts.     

Defining recovery from an eating disorder: Conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity

Conceptually, eating disorder recovery should include physical, behavioral, and psychological components, but such a comprehensive approach has not been consistently employed. Guided by theory and recent recovery research, we identified a “fully recovered” group (n = 20) based on physical (body mass index), behavioral (absence of eating disorder behaviors), and psychological (Eating Disorder Examination-Questionnaire) indices, and compared them with groups of partially recovered (n = 15), active eating disorder (n = 53), and healthy controls (n = 67). The fully recovered group was indistinguishable from controls on all eating disorder-related measures used, while the partially recovered group was less disordered than the active eating disorder group on some measures, but not on body image. Regarding psychosocial functioning, both the fully and partially recovered groups had psychosocial functioning similar to the controls, but there was a pattern of more of the partially recovered group reporting eating disorder aspects interfering with functioning. Regarding other psychopathology, the fully recovered group was no more likely than the controls to experience current Axis I pathology, but they did have elevated rates of current anxiety disorder. Results suggest that a stringent definition of recovery from an eating disorder is meaningful. Clinical implications and future directions regarding defining eating disorder recovery are discussed.     

Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder

Hellvin, T., Sundet, K.,Vaskinn, A., Simonsen, C.,Ueland, T., Andreassen, O.A. & Melle, I. (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology 51, 525–533. Studies of social functioning in severe mental disorders are disadvantaged by the multitude of different assessment instruments in use. The present study aims to establish reliability and validity of the Norwegian version of the Social Functioning Scale (SFS) and to examine social functioning in bipolar disorder (BD) compared to schizophrenia (SZ) and healthy controls (HC). SFS, a 76 item questionnaire divided into seven subscales measuring various aspects of daily life functioning, was administered to samples diagnosed with BD (n = 100) or SZ (n = 100) and to HC (n = 100), recruited from the ongoing Tematic Organized Psychosis (TOP) study. Reliability analyses prove adequate psychometric properties both for the composite full scale score (α: 0.81) as well as for the seven subscale scores (α: 0.60–0.88). Principal component analysis of the subscales confirms a one‐component structure, explaining 59% of the variance. Although significantly correlated with the Global Assessment of Functioning, our results indicate that the SFS measures different aspects of social functioning, is less influenced by demographic and clinical characteristics, but differentiates at the same time significantly BD from SZ. Thus, SFS adds valuable information as a supplement to standard clinician‐rated assessment tools of social functioning, suited both for research and clinical work.     

THE ELUSIVENESS OF MASCULINITY: PRIMORDIAL VULNERABILITY,LACK, AND THE CHALLENGES OF MALE DEVELOPMENT

Reaching beyond the Oedipus prototype to address the unrepresentable vulnerability founded on the boy's infantile helplessness in contact with the mother's body, the author aims to identify the inherent tensions and enigmas of being male. He proposes that both the repudiation of femininity and the overvaluation of phallicity are unconsciously constructed to withstand the fundamental deficiency grounded in the asymmetry of the boy's prephallic relation with his primary object. This bodily based primordial vulnerability, marked by absence and lack, remains elusive—an unsymbolizable experience that provides the archaic matrix for adaptive and defensive phallicism, the oedipal complex, and genital progression. A clinical vignette is presented to illustrate these concepts.