A prospective study of the distribution of illness within the menstrual cycle

The cyclic physiological variations during the menstrual cycle are thought to be associated with change in emotional state, in susceptibility to illness, and in frequency of illness-related behavior. Variations in frequency of illness with the phases of the menstrual cycle were examined using data from a 3-year prospective study of social and psychological antecedents of viral illness in 94 student nurses. Reported illnesses, accidents, medical consultations, and hospital admissions were randomly distributed throughout the menstrual cycle. Subjects took more medication on the 1st day of menses than on any other day of the cycle; howeverreported menstrual symptoms were infrequent, with only 4% of the population reporting two or more such episodes. It was concluded that there was an increase in discomfort on the data of onset of menses which was self-medicated but not defined as illness. There was no discernible relationship of illness or disability to any phase of the cycle.This work was supported in part by Center for Oral Health Research (COHR) grant DEO 2116, and Oral Medicine Training Grant ST01-DE-77. The authors wish to recognize the contribution of Carol Ram, R. N., who was the administrator of this study and responsible for the collection and organization of the large bank of information from which the material for this paper was abstracted. Without her care, diligence, and intelligent management, this study could not have been completed. We also wish to acknowledge the consultive advice of Dr. Larry Laster, Director, Division of Biometrics, School of Dental Medicine, in choice of analytic techniques, and the help of Dr. Arthur Segal in the early stages of data analysis.     

Longitudinal Pathways to Reading Achievement at Age 7 Years: Child and Environmental Influences

Using a bioecological perspective, this longitudinal study examined the contribution of child and environmental factors to the prediction of reading achievement at age 7. Participants were 99 boys and their parents. Child factors included 24-month temperament (reactivity and self-regulation), 36-month language level, and 7-year ADHD symptoms; environmental factors included quality of the home environment (54 months), maternal education, and learning disability (LD) in the family. There were direct and indirect pathways to reading achievement. Direct pathways included language skills, home environment, ADHD symptoms, and LD in the family. Unexpectedly, the direct pathway from self-regulation was negative. Indirect pathways included self-regulation, maternal education, and reactivity. Given the stability of the trajectory of reading skills and academic performance from first grade onward, the early identification of those children most at risk for reading difficulties has implications for the type of intervention most appropriate for individual children.     

MOTHER–CHILD AND FATHER–CHILD PLAY INTERACTION: THE IMPORTANCE OF PARENTAL PLAYFULNESS AS A MODERATOR OF THE LINKS BETWEEN PARENTAL BEHAVIOR AND CHILD NEGATIVITY

Based on the premise that father–child play is an important context for children's development and that fathers “specialize” in play, similarities and differences in the role of playfulness in the father–child and mother–child relationship were examined. Participants in this study included 111 families (children's age: 1–3 years). Father–child and mother–child play interactions were videotaped and coded for parental playfulness, sensitivity, structuring, and nonintrusiveness as well as child negativity. Results indicated that mothers and fathers did not differ in playfulness and that mothers and fathers who were higher in playfulness had children with lower levels of negativity. However, playfulness differently moderated the links between parents’ and children's behaviors for mothers and fathers. A double‐risk pattern was found for mothers, such that the links between child negativity and maternal sensitivity, structuring, and nonintrusiveness were significant only for the subgroup of mothers with low levels of playfulness. When mothers had high levels of playfulness, these effects were negligible. For fathers, a double‐buffer pattern was revealed, indicating that the links between child negativity and paternal sensitivity and structuring were significant only for fathers with high levels of playfulness. When fathers had low levels of playfulness, these effects were negligible. These findings demonstrate the important role that parental playfulness has on parent–child interaction as well as the need to examine moderation patterns separately for fathers and mothers.     

Parenting of 7‐month‐old infants at familial risk for attention deficit/hyperactivity disorder

Patterns of interaction between parents and 7‐month‐old boys at familial risk for attention deficit/hyperactivity disorder (ADHD) and a comparison group were studied during a warm‐up and two play episodes. The sample included 78 (47 at‐risk, 31 comparison) mother–child and 45 (27 at‐risk, 18 comparison) father–child dyads. A coding system developed by G. Kochanska (1997, 1998) was used. Infants in the risk group did not differ from the comparison group in the rate of emission of infant‐related events. However, they received less adequate responsivity from both their fathers and their mothers to these events, and specifically to negative emotions or distress, than did the comparison group. Maternal psychopathology did not account for these findings. Mothers were more adequately responsive than were fathers, especially for physiological needs. The association between nonoptimal interaction in infancy and the development of ADHD is discussed.     

Sleep patterns of 7‐week‐old infants at familial risk for attention deficit hyperactivity disorder

Sleep patterns of 26 seven‐week‐old boys at familial risk for attention deficit hyperactivity disorder (ADHD) and 18 control infants were compared by objective (actigraph) and subjective (maternal sleep diary) measures, over five consecutive 24‐hr periods. Actigraph findings indicated that the groups differed on stability (SD) of quiet sleep only during the day. Reports in maternal sleep diaries indicated that they also differed on stability of waking and stability of sleep duration, again only during the day. No group differences were found in terms of average scores, whether calculated for the entire 24‐hr periods, for nights, or for days. Mothers in the risk group reported that fathers were less involved in infant care than did those in the control group. These findings suggest that as early as 7 weeks of age, infants at risk for ADHD differ from controls only on stability of their sleep patterns during the day, when environmental regulatory factors are more intensive.     

Violent offenses associated with co‐occurring substance use and mental health problems: Evidence from CJDATS

The present study examines the relationship between substance use, mental health problems, and violence in a sample of offenders released from prison and referred to substance abuse treatment programs. Data from 34 sites (n = 1,349) in a federally funded cooperative, the Criminal Justice Drug Abuse Treatment Studies (CJDATS), were analyzed. Among parolees referred to substance abuse treatment, self‐reports for the six‐month period before the arrest resulting in their incarceration revealed frequent problems with both substance use and mental health. For most offenders with substance use problems, the quantity of alcohol consumed and the frequency of drug use were associated with a greater probability of self‐reported violence. Mental health problems were not indicative of increases in violent behavior, with the exception of antisocial personality problems, which were associated with violence. The paper emphasizes the importance of providing substance abuse treatment in relation to violent behavior among offenders with mental health problems being discharged to the community. Copyright © 2009 John Wiley & Sons, Ltd.     

A cry unheard: sudden reductions in blood pressure while talking about feelings of hopelessness and helplessness.

This paper describes sudden extreme drops in blood pressure in both experimental and clinical situations when a person is talking about or describing situations of hopelessness and helplessness. These changes are discussed in the context of historical perspectives about the cardiovascular system. A new perspective is introduced, one in which these blood pressure changes are seen as part of an unheard cry for understanding. It is hypothesized that such changes do not occur in response to a person's attempts to communicate a sense of hopelessness, but rather are the biological foundations of the hopelessness itself. Viewed from such a context an entirely new therapeutic approach is outlined regarding the treatment of patients suffering from a wide variety of psychosomatic as well as psychological disturbances.     

A cry unheard: Sudden reductions in blood pressure while talking about feelings of hopelessness and helplessness

This paper describes sudden extreme drops in blood pressure in both experimental and clinical situations when a person is talking about or describing situations of hopelessness and helplessness. These changes are discussed in the context of historical perspectives about the cardiovascular system. A new perspective is introduced, one in which these blood pressure changes are seen as part of an unheard cry for understanding. It is hypothesized that such changes do not occur in response to a person’s attempts to communicate a sense of hopelessness, but rather are the biological foundations of the hopelessness itself. Viewed from such a context an entirely new therapeutic approach is outlined regarding the treatment of patients suffering from a wide variety of psychosomatic as well as psychological disturbances.     

The Ward and the Womb: An Integrated Therapeutic Approach for Treatment Resistant Adolescents

ABSTRACT

In mental health settings, we often meet traumatized and volatile youth who resist treatment and do not respond to engagement attempts. For such patients, the treatment refusal may be a representation of their level of personality organization; it can represent difficulties to relate to others, to regulate affective experiences, and to integrate different self-states. Using a case study of a treatment resistant adolescent in residential care, I discuss the limitations of engagement techniques with patients at the lower end of personality organization and argue that engaging “difficult to treat” adolescents requires a clinical shift from the therapeutic encounter to the development of a system-based “holding” environment. I present a modified intervention model that integrates psychodynamic formulation of personality development with process-oriented systemic work. The model described emphasizes the role of the therapist as the initiator and facilitator, helping to construct a coherent and attuned environment within the residential care system. Through case vignettes, I provide examples for the clinical shift from the therapeutic encounter to the environment of the ward and demonstrate how developing a holding environment can overcome engagement barriers and support the development of the patient’s ego capacities, sense of self, and object relations.