Toward a synactive theory of development: Promise for the assessment and support of infant individuality

A theoretical model to understand and assess the individual infant is presented. Its focus is on the dynamic, continuous interplay of various subsystems within the organism: the autonomic system, the motor system, the state organizational system, the attentional-interactive system, and the self-regulatory system. The organism forges ahead negotiating emerging developmental agenda while simultaneously seeking to attain a new level of modulated, functional competence. Developmentally salient aspects of the environment are actively sought as fuel in this process. This synactive model of development promises to be helpful in identifying specific ingredients of the early developmental process and in structuring specific supports for preventive and ameliorative work when difficulties in differentiation and regulation are identified. An assessment procedure to systematically identify difficult areas of modulation integration is briefly described and examples of environmental structuring are given.     

Validation of the Revised Illness Perception Questionnaire (IPQ-R) in a sample of persons recovering from myocardial infarction--the Swedish version

When people's health is threatened, they generally develop illness perceptions to make sense of their illness. The Illness Perception Questionnaire (IPQ-R), developed by Moss-Morris et al (2002), has been widely used in many countries to measure such representations. However, since studies in this crucial research area are lacking in Sweden a Swedish version of IPQ-R was validated with a focus on the seven subscales: timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representations. Using confirmatory factor analysis, the aim of the present study was to validate the internal structure of the Swedish version in a sample of 202 persons (144 men and 58 women) who had been diagnosed with myocardial infarction four months earlier. Additionally, inter-correlations among the seven subscales and external concurrent validity were also investigated. The results of confirmatory factor analysis revealed that, in line with the English version of the IPQ-R, the specified seven-factor model had a satisfactory fit. One item was however not considered reliable and was therefore excluded from the instrument. The internal consistency (Cronbach's alpha coefficients) and the inter-factor correlations were relatively similar to those reported in the validation study of the original English IPQ-R. In tests of concurrent validity, the seven IPQ-R subscales were, as hypothesized, mainly associated with external variables. To conclude, the Swedish version of the IPQ-R's seven dimensions, with one item removed, (total 37 items) was found to be a reliable and valid measure of illness perception.     

General self-efficacy and health-related quality of life after myocardial infarction

Fatigue after myocardial infarction (MI) has been found to be distressing. A person's self-efficacy will influence his/her health behavior and plays an active role in tackling illness consequences. This study investigated associations between fatigue, disturbed sleep, general self-efficacy, and health-related quality of life (HRQoL) in a sample of 145 respondents admitted to hospital for MI two years earlier. The aim was to identify the predictive value of general self-efficacy and to elucidate mediating factors between self-efficacy and HRQoL. General self-efficacy measured four months after MI was positively related to HRQoL after two years. In tests of indirect effects, fatigue meditated the effects between self-efficacy and the physical and the mental dimension of HRQoL, respectively. The indirect effect of disturbed sleep went through that of fatigue. To conclude, patients who suffer from post-MI fatigue may need support aimed at helping them increase their self-efficacy as well as helping them adapt to sleep hygiene principles and cope with fatigue, both of which will have positive influences on HRQoL.     

Long-lasting semantic context effects in the spoken production of object names

A number of recent studies have found that objects are named more slowly in the context of same-category items than in the context of items from various semantic categories. Several experiments reported here indicated that this semantic effect is relatively persistent because it was essentially unaffected by the presence of interspersed filler items. The authors suggest that the effect is specific to the retrieval of lexical-semantic codes and characterize mechanisms that could support the effect at this processing level, such as incremental learning in the links between conceptual and lexical codes and the temporary increase of lexical resting levels. The results underscore the necessity of incorporating mechanisms of long-term adaptation into current models of spoken production.     

The Brazelton Neonatal Behavioral Assessment Scale (BNBAS)

Summary The Brazelton Neonatal Behavioral Assessment attempts to capture the behaviors of the neonate as he defends himself from intrusive, negative stimuli, and controls interfering motor and autonomic responses in order to attend to important social and nonsocial stimuli. In order to conceptualize the 26 behavioral items and 20 reflex scores, four clusters or typologies have been identified which help to reduce the data for analytic purposes with small numbers of subjects. So far few long-term validation studies have been completed, although the scale is in use in many different areas, such as obstetrical medication, predicting to neurological deficits, cross-cultural differences, and with low birth weight infants.This work was supported by grant # 7634-4 of the Grant Foundation, New York.This material appears in expanded form in Osofsky, J. (ed.),Handbook on Infancy, Wiley Interscience, 1977, in press.     

The Assessment of Preterm Infants' Behavior (APIB): furthering the understanding and measurement of neurodevelopmental competence in preterm and full-term infants

The Assessment of Preterm Infants' Behavior (APIB) is a newborn neurobehavioral assessment appropriate for preterm, at risk, and full-term newborns, from birth to 1 month after expected due date. The APIB is based in ethological-evolutionary thought and focuses on the assessment of mutually interacting behavioral subsystems in simultaneous interaction with the environment. The subsystems of functioning assessed include the autonomic (respiration, digestion, color), motor (tone, movement, postures), state organization (range, robustness, transition patterns), attention (robustness, transitions), and self-regulation (effort, success) systems as well as the degree of facilitation required to support reorganization and subsystem balance. The environment is represented by a sequence of distal, proximal, tactile, and vestibular challenges, derived from the BNBAS. The APIB conceptualizes infant competence as the degree of differentiation of subsystem function and degree of modulation of subsystem balance at any stage in infant development. Infants are understood as actively seeking their next differentiation, while counting on good enough environments to assure progressing developmental competence. In the case of interference such as premature birth, the mismatch of expectation and actual experience causes misalignment, which may become developmentally costly. The assessment is a finely tuned dialogue between examiner and infant, which requires training, skill and self-knowledge. The APIB has well established inter-rater-reliability, concurrent and construct validity, and is clinically relevant for behavioral intervention and individually appropriate and supportive care.