Factors associated with the socioemotional development of preterm infants

Preterm birth is a risk factor for problems in interactions with others. We compared the difference in socioemotional development between hospital discharge and at six months of corrected age of infants born ≤32 weeks and assessed the impact of maternal and infantile factors on socioemotional development rate within a 6 month’s period. Mother-child dyads (n = 144) were assessed by the Mother-Baby Observation Protocol 0–6 months through a video microanalysis. Multivariate model was built. Neonatal, maternal and child factors were associated with interactive gaze, initiate contact, responsiveness, infantile vocalization, and thus contributed to the socioemocional development of preterm infants with their mothers.     

Genetic Counseling for Fragile X Syndrome: Updated Recommendations of the National Society of Genetic Counselors

These recommendations describe the minimum standard criteria for genetic counseling and testing of individuals and families with fragile X syndrome, as well as carriers and potential carriers of a fragile X mutation. The original guidelines (published in 2000) have been revised, replacing a stratified pre- and full mutation model of fragile X syndrome with one based on a continuum of gene effects across the full spectrum of FMR1 CGG trinucleotide repeat expansion. This document reviews the molecular genetics of fragile X syndrome, clinical phenotype (including the spectrum of premature ovarian failure and fragile X-associated tremor-ataxia syndrome), indications for genetic testing and interpretation of results, risks of transmission, family planning options, psychosocial issues, and references for professional and patient resources. These recommendations are the opinions of a multicenter working group of genetic counselors with expertise in fragile X syndrome genetic counseling, and they are based on clinical experience, review of pertinent English language articles, and reports of expert committees. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

Effectiveness of cognitive behavioral therapy on the signs,symptoms and clinical consequences of premature ejaculation

The purpose of this research was to assess the effectiveness of cognitive behavioral therapy (CBT) on the signs, symptoms, and clinical‐sexual consequences of premature ejaculation, including sexual esteem, sexual anxiety, sexual depression, sexual fear, and sexual satisfaction of patients and their wives. Fifteen patients with premature ejaculation were selected and received cognitive behavioral therapy of eight to 12 sessions. Finally, the data collected from 12 patients were analyzed using paired t‐tests. The results of the analysis showed that all of the variables changed after the treatment. All of the changes were statistically significant with a tendency towards improvement. CBT can be a more popular and effective treatment provided to patients suffering from premature ejaculation.     

Premature twins on a neonatal intensive care unit

This paper presents observations of boy and girl twins on a neonatal intensive care unit, following them through from 10 days old to return home. The observer hypothesizes about the experience of the twins as they progress, based on detailed notes of their actions. The preoccupations of the parents are incorporated, as are reactions and interventions of staff. The place and possible functions of such observation by a child psychotherapist attached to such a unit are elaborated in the concluding section.     

早产儿预防性应用抗生素的临床决策思路

近年来,随着对滥用抗生素所引起的细菌耐药性和二重感染的认识的逐步深入,预防性应用抗生素在临床上越来越受到限制。但由于早产儿感染的临床隐匿性和易并发严重并发症等特点,预防早产儿感染的发生和进一步的发展,就显得尤为重要。通过对早产儿发生感染的易感因素、感染诱因和临床特点的分析研究,来探讨早产儿临床预防应用抗生素的必要性、合理性及临床决策思路。     

Parent Expectancies for Child Therapy: Assessment and Relation to Participation in Treatment

Two studies examined parents' pre-treatment expectancies for their child's psychotherapy among children (N = 405, ages 2–15) referred for oppositional, aggressive, and antisocial behavior. Study I focused on the development of a measure to assess expectancies. The results indicated that the measure was internally consistent. Moreover, socioeconomic disadvantage and ethnic minority status, severity of child dysfunction, child age, and parental stress and depression were significant predictors of lower parent expectancies for child therapy. Study II examined the relation of parent expectancies and participation in therapy. The results indicated that parent expectancies predicted subsequent barriers to treatment participation, treatment attendance, and premature termination from therapy. Overall, these findings have implications for the study of expectancies for therapy, for identifying families at risk for premature termination from treatment, and for the development of interventions designed to increase parent participation in child therapy.     

Infant state in relation to its environmental context

Two neonatal intensive care units (NICU) were observed every 15 minutes for at least 72 consecutive hours. Although infants on both NICUs were exposed to considerable amounts of stimulation, there were differences between the units for each environmental measure in the amount of stimulation and/or the pattern of circadian periodicity. The two NICUs also differed in the amount of time infants spent in various states and in the pattern of state periodicity. In general, the diurnal rhythms of the infant states were associated with the diurnal rhythms of different environmental events; furthermore, the patterns of association were not the same on the two NICUs. The results point to potential problems in depicting a “typical” NICU. More importantly, they suggest that the environmental of NICUs has a recognizable influence on aspects of their inhabitants' behavior and that the nature of influence is different from NICU to NICU. The effects are potentially significant for physical, social, and cognitive development.     

‘It's not supposed to be this way’: Psychological aspects of a premature menopause

Background: Premature menopause (menopause diagnosed at 40 years or under) is a challenging condition with no prevention or cure. Causes can be the result of surgical intervention or spontaneous and largely unknown. It affects 1–6% of women aged 14–40. Aim: This study investigated women's experience of diagnosis, perception of cause, treatment received, main concerns, perceived long‐term consequences and impact on psychological wellbeing. Method: A cross‐sectional single group design questionnaire study that included both quantitative and qualitative measures was used. It was distributed to women on the database of two specialist London clinics and an internet‐based patient support group. A thematic analysis was undertaken. Findings: The response rate was 62%. Women's experiences varied but showed common themes regardless of timing of diagnosis and services accessed. Improved understanding by health professionals could help this group accept and adjust to the condition more effectively as could psychological support. Fertility was a primary concern regardless of parity and there were several secondary impacts both physiological and psychological. Discussion: A clear need for the offer of emotional support was indicated for all, but particularly for teenage girls and single women who tended not to access support from their own social network. Conclusion: Young women with this diagnosis could benefit from the offer of counselling, though uptake may be influenced by individual factors and vary according to age and circumstances. A good understanding of the physical aspects of this condition is important in the counselling of this group.     

Black holes: Some notes on time,symbolization, and perversion in the psychodynamics of addiction

Abstract

The existence of man is distinguished by its split state: man stands in the middle of life yet still has an awareness of his own death. He has to compensate whatever is missing in him naturally at the societal level, created as culture, and at the individual level through creativity. Rank investigated the human ‘creative drive’, the anthropological aspiration to express oneself in creative works, and to overcome the fear of death with its help. Freud admired poets and artists, whose achievements he could not psychoanalytically access, but he considered science superior to the harmless and naïve arts. There are two anthropological radicals: premature birth and the consciousness of death. Freud's massive fear of death made it difficult for him to acknowledge the problem of death appropriately. In Rank's concept, the development of human creativity contributes towards the fear of death being alleviated so that the knowledge of death can be integrated into life; creativity belongs to the fundamental opportunities of man that may enable him to find a way through neurosis. Failure is as much a part of life as is creativity: those who do not experience and accept life in its tragic dimension are denied creativity. Only a creative person who accepts his partial failure finds the strength to continue to be creative without his imperfect work leading to the ritual repetition of the same thing again and again, that is, getting stuck in recidivism.     

The Impact of Periventricular Brain Injury on Reading and Spelling Abilities in the Late Elementary and Adolescent Years

The present study was designed: (1) to investigate the long-term consequences of both the presence and the severity of periventricular brain injury (PVBI) on intellectual, academic, and cognitive outcome in extremely-low-birthweight (ELBW: < 1,000 grams) children at a mean age of 11 years; and (2) to determine the nature of the underlying difficulties associated with academic problems in these children. The results indicated that ELBW children without PVBI performed as well as full-term children on intelligence, academic, and cognitive ability tests. In contrast, ELBW children with mild and severe PVBI achieved significantly lower scores than either ELBW children without PVBI or children who were born at term. A second analysis indicated that, after accounting for Full Scale IQ, working memory and phonological processing were significant predictors of reading and spelling performance in ELBW children. These findings suggest that the presence and severity of PVBI, and not ELBW status alone, is associated with performance on tests of intelligence, and academic and cognitive functioning, and that some of the same factors known to be associated with learning disabilities in full-term children contribute to learning disabilities in ELBW children.