Characteristics of Child Maltreatment,Psychological Dissociation,and Somatoform Dissociation of Canadian Inmates

ABSTRACT

Data are presented on childhood maltreatment characteristics, psychological dissociation, somatoform dissociation, and offense types with a sample of 93 Canadian inmates (62 males and 31 females), with a mean age of 34 years (SD = 9.5). The present study includes findings based on the Child Maltreatment Interview Schedule-Short Form (CMIS-SF), the Detailed Assessment of Posttraumatic States (DAPS), the Multidimensional Dissociation Inventory (MDI), the Somatoform Dissociation Questionnaire (SDQ-20), and indices of violent and sexual offending during adulthood. Chi-square, Cohen's d, and regression analyses were conducted with the data. Results showed that women reported more childhood sexual abuse (CSA) than men, and men committed more violent and sexual offenses than women. Mean comparisons using Cohen's d statistic showed that inmates (N = 62) reported more trauma-related dissociation (DAPS) and more MDI dissociation compared to normative data for these instruments; however, inmates had lower somatoform dissociation scores when compared to published means of dissociative disorder, somatoform disorder, and eating-disorder patients. Inmates with CSA histories had higher SDQ-20 scores than those who did not. No differences were found between sex offenders and non-sex offenders in terms of probable PTSD, probable DID, MDI scales, or the SDQ-20. CSA that involved penetration predicted MDI dissociation and also predicted later sexual offending. Of the MDI scales, derealization and memory disturbance predicted sexual offending. Neither MDI scales nor any of the CMIS-SF maltreatment types predicted violent offending. Results are discussed in terms of treatment implications for incarcerated individuals with histories of child maltreatment.     

医学新生儿童期心理虐待与创造力、认知偏差的调查分析

目的:了解海南医学新生的儿童心理虐待状况;比较不同创造力、认知偏差类型的学生的儿童期心理虐待差异。方法:方便取样,采用儿童心理虐待量表、卡特尔多项人格量表-创造力、认知偏差问卷对365名自愿参与的海南省某医学院临床医学专业2014级新生进行测量,对数据进行t检验和方差分析。结果:男生的恐吓、贬损、干涉、纵容维度得分高于女生(t=2.38,2.17,2.40,2.72;P均0.05);独生子女医学新生的忽视维度得分低于非独生子女者,而干涉维度得分高于后者(t=-3.82,2.17;P均0.05);单亲家庭医学新生的忽视和贬损维度得分高于非单亲学生(t=2.80,3.24;P均0.05)。不同创造力等级的医学新生在儿童心理虐待得分上的差异无统计学意义。不同认知偏差类型的医学新生在贬损、干涉维度得分上的差异均有统计学意义(F=10.92,13.54;P均0.001)。结论:不同性别、是否独生、是否单亲的医学新生在儿童期遭受的心理虐待不一样;不同创造力的医学新生在儿童期遭受的心理虐待无差异;不同认知偏差类型的医学新生在童年期遭受的贬损和干涉高于其他类型者。     

早期干预对独生子女健全人格发展的对照研究

目的:探讨早期干预对儿童心身健康的全面发展和培养独生子女健全人格的影响.方法:采用由国内专家创建的独生子女健全人格培养方案对0～6岁独生子女进行干预指导,通过Achenbach儿童行为量表及幼儿性格发展趋向量表评定幼儿心理卫生状况、儿童社会适应行为量表测定社会适应能力、儿童气质量表评定气质类型、中国比奈测定智商,并设37例对照组.结果:研究组行为问题检出率为6.67%,低于对照组的13.5%和全国流调的14.3%;研究组智商高于对照组,差异有统计学显著性(t=3.752,P<0.001);社会适应能力气质评定两组差异无统计学显著性(P均>0.05).但V9维度(反应阈)研究组得分明显低于对照组,提示研究组趋于易养.结果:经对幼儿培养的早期干预,其健全人格指标优于非干预组.     

湖南省儿童青少年精神障碍现状调查与防治模式研究

应用临床流行病学方法，采用ＤＳＭ－Ⅲ－Ｒ标准，在湖南省城乡抽样调查８６４４名４～１６岁男女儿童青少年，发现精神障碍达３８种，总时点患病率为１４．８９％，发育性障碍、行为障碍、情绪障碍及躯体形式障碍等４大类精神障碍在城乡、男女与不同年龄阶段的分布有明显不同。调查发现患儿家庭的就医行为明显偏差，保健需求集中于学校心理卫生保健、家庭心理卫生教育与咨询和专科门诊等项目上。作者据此提出了儿少精神卫生的防治模式，并作了效益分析。文章就上述问题进行了讨论。     

Effect of a Web-Based Intervention to Promote Physical Activity and Improve Health Among Physically Inactive Adults: A Population-Based Randomized Controlled Trial

Background

Many people in Western countries do not follow public health physical activity (PA) recommendations. Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level.

Objective

To examine whether access to a website with individually tailored feedback and suggestions on how to increase PA led to improved PA, anthropometrics, and health measurements.

Methods

Physically inactive adults (n = 12,287) participating in a nationwide eHealth survey and health examination in Denmark were randomly assigned to either an intervention (website) (n = 6055) or a no-intervention control group (n = 6232) in 2008. The intervention website was founded on the theories of stages of change and of planned behavior and, apart from a forum page where a physiotherapist answered questions about PA and training, was fully automated. After 3 and again after 6 months we emailed participants invitations to answer a Web-based follow-up questionnaire, which included the long version of the International Physical Activity Questionnaire. A subgroup of participants (n = 1190) were invited to a follow-up health examination at 3 months.

Results

Less than 22.0% (694/3156) of the participants logged on to the website once and only 7.0% (222/3159) logged on frequently. We found no difference in PA level between the website and control groups at 3- and 6-month follow-ups. By dividing participants into three groups according to use of the intervention website, we found a significant difference in total and leisure-time PA in the website group. The follow-up health examination showed no significant reductions in body mass index, waist circumference, body fat percentage, and blood pressure, or improvements in arm strength and aerobic fitness in the website group.

Conclusions

Based on our findings, we suggest that active users of a Web-based PA intervention can improve their level of PA. However, for unmotivated users, single-tailored feedback may be too brief. Future research should focus on developing more sophisticated interventions with the potential to reach both motivated and unmotivated sedentary individuals.

Trial Registration

Clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01295203","term_id":"NCT01295203"}}NCT01295203; http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT01295203","term_id":"NCT01295203"}}NCT01295203 (Archived by WebCite at http://www.webcitation.org/6B7HDMqiQ)     

A Web-Based Program to Increase Knowledge and Reduce Cigarette and Nargila Smoking Among Arab University Students in Israel: Mixed-Methods Study to Test Acceptability

Background

Among Arab citizens in Israel, cigarette and nargila (hookah, waterpipe) smoking is a serious public health problem, particularly among the young adult population. With the dramatic increase of Internet and computer use among Arab college and university students, a Web-based program may provide an easy, accessible tool to reduce smoking rates without heavy resource demands required by traditional methods.

Objective

The purpose of this research was to examine the acceptability and feasibility of a pilot Web-based program that provides tailored feedback to increase smoking knowledge and reduce cigarette and nargila smoking behaviors among Arab college/university students in Israel.

Methods

A pilot Web-based program was developed, consisting of a self-administered questionnaire and feedback system on cigarette and nargila smoking. Arab university students were recruited to participate in a mixed-methods study, using both quantitative (pre-/posttest study design) and qualitative tools. A posttest was implemented at 1 month following participation in the intervention to assess any changes in smoking knowledge and behaviors. Focus group sessions were implemented to assess acceptability and preferences related to the Web-based program.

Results

A total of 225 participants—response rate of 63.2% (225/356)—completed the intervention at baseline and at 1-month poststudy, and were used for the comparative analysis. Statistically significant reductions in nargila smoking among participants (P=.001) were found. The intervention did not result in reductions in cigarette smoking. However, the tailored Web intervention resulted in statistically significant increases in the intention to quit smoking (P=.021). No statistically significant increases in knowledge were seen at 1-month poststudy. Participants expressed high satisfaction with the intervention and 93.8% (211/225) of those who completed the intervention at both time intervals reported that they would recommend the program to their friends, indicating excellent acceptability and feasibility of the intervention. This was further emphasized in the focus group sessions.

Conclusions

A tailored Web-based program may be a promising tool to reduce nargila smoking among Arab university students in Israel. The tailored Web intervention was not successful at significantly reducing cigarette smoking or increasing knowledge. However, the intervention did increase participants’ intention to quit smoking. Participants considered the Web-based tool to be an interesting, feasible, and highly acceptable strategy.

Trial Registration

Trial Registration: ISRCTN registry ISRCTN59207794; http://www.isrctn.com/ISRCTN59207794 (Archived by WebCite at http://www.webcitation.org/6VkYOBNOJ).     

Impact of the Interaction Between the 5HTTLPR Polymorphism and Maltreatment on Adolescent Depression. A Population-Based Study

Serotonin plays a central role in mood regulation and the development of depressive disorders. The present study investigated whether a functional polymorphism (5HTTLPR) of the serotonin transporter gene interacts with maltreatment in the prediction of depression. A cohort of 17–18 years old students (n = 1,482) anonymously completed the Survey of Adolescent Life and Health in Vestmanland 2006 and gave a saliva sample for DNA extraction. An association between maltreatment and adolescent depression was found independent of sex. When the whole population was analyzed, no main effect of 5HTTLPR in association with depression was found. When separated by sex, a significant main effect and a G × E interaction effect of the SS allele was found among girls. No gene main effect or G × E interaction effect was found among boys. The present study confirms previous findings of sex differences in interaction effects between the 5HTTLPR polymorphism and maltreatment in the prediction of adolescent depression. Edited by Peter McGuffin.     

The Child Vulnerability Scale: An Instrument to Measure Parental Perceptions of Child Vulnerability

Developed and validated an instrument for identifying childrenperceived as vulnerable. Mothers of 1,095 children, aged 4–8years, completed interviews that included the original 12-itemChild Vulnerability Scale. Eight items that correlated bestwith each of two major variables that contribute to vulnerabilitywere retained in the revised scale and a cutoff score was identifiedfor children perceived as vulnerable. The internal consistencyof the revised scale was good. Using the revised scale, 10.1%of children were identified as perceived vulnerable. Childrencategorized as perceived vulnerable had a significant increasein behavior problems and acute medical visits. The revised ChildVulnerability Scale should be useful in providing a better understandingof the causes and effects of an important factor in child development.     

Child neuromuscular disease in Southern Norway: Prevalence, age and distribution of diagnosis with special reference to "non-Duchenne muscular dystrophy"

The prevalence of child neuromuscular disease in Southern Norway by January 1st, 1983, was studied by collecting data from all available sources. All children born 1. 1. 1965 or later were included in the study. The total group consisted of 110 patients from 17 different diagnostic categories. Total prevalence on this group was found to be 24.9 X 10(5). Duchenne muscular dystrophy (DMD), with a prevalence of 10.89 X 10(5) constituted 29.2% of the total material. In the spinal muscle atrophy group (SMA), we found a significant increase in the number of boys affected, although an autosomal recessive mode of inheritance was found likely in all probands. Prevalence figures of child neuromuscular disease are hard to compare, as most studies deal with an adult population. The prevalences of common and well-known large categories of neuromuscular diseases in childhood are in agreement with previous studies. For less well known and mild diseases, our figures are low. This may be due in part to a later onset and in part to a health system not sensitive to parents' complaints.     

Face-to-face versus computer-delivered alcohol interventions for college drinkers: A meta-analytic review, 1998 to 2010

Alcohol misuse occurs commonly on college campuses, necessitating prevention programs to help college drinkers reduce consumption and minimize harmful consequences. Computer-delivered interventions (CDIs) have been widely used due to their low cost and ease of dissemination but whether CDIs are efficacious and whether they produce benefits equivalent to face-to-face interventions (FTFIs) remain unclear. Therefore, we identified controlled trials of both CDIs and FTFIs and used meta-analysis (a) to determine the relative efficacy of these two approaches and (b) to test predictors of intervention efficacy. We included studies examining FTFIs (N = 5237; 56% female; 87% White) and CDIs (N = 32,243; 51% female; 81% White). Independent raters coded participant characteristics, design and methodological features, intervention content, and calculated weighted mean effect sizes using fixed and random-effects models. Analyses indicated that, compared to controls, FTFI participants drank less, drank less frequently, and reported fewer problems at short-term follow-up (d₊s = 0.15–0.19); they continued to consume lower quantities at intermediate (d₊ = 0.23) and long-term (d₊ = 0.14) follow-ups. Compared to controls, CDI participants reported lower quantities, frequency, and peak intoxication at short-term follow-up (d₊s = 0.13–0.29), but these effects were not maintained. Direct comparisons between FTFI and CDIs were infrequent, but these trials favored the FTFIs on both quantity and problem measures (d₊s = 0.12–0.20). Moderator analyses identified participant and intervention characteristics that influence intervention efficacy. Overall, we conclude that FTFIs provide the most effective and enduring effects.     

Mental Health Checkups for Children and Adolescents: A Means to Identify, Prevent, and Minimize Suffering Associated With Anxiety and Mood Disorders

Early identification of disease and intervention when necessary are a cornerstone of contemporary medical practice. This approach has been successful in reducing suffering associated with the progression of unchecked medical problems to full-blown disease. Many healthcare systems, in turn, support this approach via routine checkups. The same cannot be said for mental health care. This article evaluates a school-based mental health checkup approach in the context of anxiety and depression in children and adolescents. We outline how checkups can identify children with emotional disorders, along with risk factors that, if left unchecked, may contribute to eventual onset. We conclude by discussing the benefits and limitations of this approach.     

Child Sexual Abuse in Asian American Families: An Examination of Cultural Factors That Influence Prevalence, Identification, and Treatment

Child sexual abuse affects thousands of families each year. Issues pertaining to the prevalence, identification, and treatment of sexual abuse have been relatively well explored in the literature as they pertain to the dominant European American culture. These issues, however, are still relatively unexplored in terms of how sexual abuse affects Asian American families and the Asian American community. We review the relevant literature in Asian American families. These matters are explored in the context of Asian American values such as collectivity, conformity, inconspicuousness, middle position virtue, shame, self-control, and fatalism. Attitudes toward family, sexuality, and the mental health system are also discussed. Cultural and institutional barriers to underutilizing mental health services are also explored, and suggestions for overcoming these barriers are offered.     

自闭儿童治疗中的象征性发展个案报告

目的探讨系统沙盘治疗对自闭症儿童的治疗效果。方法对1位非典型孤独症患儿的自闭症状进行了系统沙盘游戏治疗。结果沙盘游戏影射出儿童发展中的内心秘密,在游戏中通过象征意象其心理不断得以成长和提高。然而,对治疗师来说,这是一个需要耐心、爱心和逐步自我成长的过程。结论沙盘治疗可应用于对自闭症儿童的治疗中。     

Promoting Child Passenger Safety: A Comparison of Two Positive Methods

The present investigation examined the comparative influenceon increasing usage of child safety devices (CSD) by rewardingchildren for their use of the devices and by informing parentsabout possible improved behavior exhibited by children whenthey are buckled up. The subjects were children aged 6 monthsthrough 6 years at two day care centers. The mean age of thechildren at Center I was 3.8 and 3.7 years at Center II. Observationsof safety device use were conducted when children arrived atthe centers in the morning. Four stages of the study were implementedat each center with se quential combinations of conditions:Baseline, Reward, Behavioral Improve ment Emphasis, and Returnto Baseline. The procedure of informing parents about possibleimproved behavior exhibited by secured children had minimaleffect on increasing the number of children in CSDs. However,rewarding children for their use of CSDs significantly influencedusage. Rewarding children for being in CSDs also positivelyinfluenced driver rates of seat belt use.     

A Pre-Post Study on the Appropriateness and Effectiveness of a Web- and Text Messaging-Based Intervention to Reduce Problem Drinking in Emerging Adults

Background

Problem drinking, particularly risky single-occasion drinking (RSOD), also called “binge drinking”, is widespread among adolescents and young adults in most Western countries. Few studies have tested the effectiveness of interventions to reduce RSOD in young people with heterogeneous and particularly lower educational background.

Objective

To test the appropriateness and initial effectiveness of a combined, individually tailored Web- and text messaging (SMS)–based intervention program to reduce problem drinking in vocational school students.

Methods

The fully automated program provided: (1) online feedback about an individual’s drinking pattern compared to the drinking norms of an age- and gender-specific reference group, and (2) recurrent individualized SMS messages over a time period of 3 months. Generalized Estimating Equation (GEE) analyses were used to investigate the longitudinal courses of the following outcomes over the study period of 3 months: RSOD, alcohol-related problems, mean number of standard drinks per week, and maximum number of standard drinks on an occasion.

Results

The program was tested in 36 school classes at 7 vocational schools in Switzerland. Regardless of their drinking behavior, 477 vocational school students who owned a mobile phone were invited to participate in the program. Of these, 364 (76.3%) participated in the program. During the intervention period, 23 out of 364 (6.3%) persons unsubscribed from participating in the program. The GEE analyses revealed decreases in the percentage of persons with RSOD from baseline (75.5%, 210/278) to follow-up assessment (67.6%, 188/278, P<.001), in the percentage of persons with alcohol-related problems (20.4%, 57/280 to 14.3%, 40/280, P=.009), and in the mean number of standard drinks per week: 13.4 (SD 15.3) to 11.3 (SD 14.0), P=.002. They also revealed a trend toward a decrease in the mean of the maximum number of drinks consumed on an occasion: 11.3 (SD 10.3) to 10.5 (SD 10.3), P=.08.

Conclusions

The results show high acceptance and promising effectiveness of this interventional approach, which could be easily and economically implemented within school classes.