Peer influence processes for youth delinquency and depression

This study explores the multiple factors that account for peer influence processes of adolescent delinquency and depression using data from Waves I and II of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Random-effects longitudinal negative binomial models were used to predict depression and delinquency, controlling for social connection variables to account for selection bias. Findings suggest peer depression and delinquency are both predictive of youth delinquency, while peer influences of depression are much more modest. Youth who are more connected to parents and communities and who are more popular within their networks are more susceptible to peer influence, while self-regulating youth are less susceptible. We find support for theories of popularity-socialization as well as weak-ties in explaining social network factors that amplify or constrain peer influence. We argue that practitioners working with youth should consider network-informed interventions to improve program efficacy and avoid iatrogenic effects.     

Social reciprocity and health: new scientific evidence and policy implications

The work contract is based on the norm of social reciprocity where appropriate rewards are provided for efforts and achievements at work. The effort-reward imbalance model of work stress maintains that contractual non-reciprocity in terms of high efforts spent and low rewards received is frequent if people have no alternative choice in the labour market, if they are exposed to heavy competition or if they are intrinsically motivated to engage in excessive work-related commitment. According to the model, long-term exposure to effort–reward imbalance increases the risk of stress-related disorders. An overview of results from prospective epidemiological investigations testing the model is given. Overall, people who experience failed reciprocity at work are twice as likely to suffer from incident cardiovascular disease, depression or alcohol dependence compared to those who are not exposed. Associations are stronger for men than for women. Policy implications of findings for improved worksite health promotion are discussed.     

Sex differences in adolescent psychopathology

The patterns of sex differences in psychiatric morbidity are reviewed and hypothesis for the empirical study formulated. Psychiatric treatment and registration for social problems are thoroughly examined in a prospective longitudinal study of a representative birth cohort of 6,482 adolescents. Mental health and psychiatric symptomatology are also checked by a questionnaire. The data obtained are analysed for males and females separately. The results clearly show that there are major sex differences in the pattern of psychopathology in adolescence. These differences are complex and seem related to sex role expectations among parents, adolescents and mental health professionals, and to social factors and the changes experienced in life. The results give some guidelines for the future development of psychiatric care for adolescents.     

Correlation between ultrastructure and histochemistry of lafora bodies

Summary Lafora bodies are composed of fibrillar and granular components in various concentrations. They are located in neuronal cell processes and perikarya and are frequently clearly intermingled with cytoplasmic elements. These components are electron-lucent, show a variable affinity for osmium, and are weakly stained by classical uranyl acetate stain following lead citrate. They exhibit a strong affinity for lead hydroxide and are periodic-acid reactive. They are not stained by the PTA technic for basic protein and/or acidic mucopolysaccharides. These results are in agreement with chemical studies according to which L. B are mostly composed of polyglucosans and suggest that both the granular and fibrillar ultrastructural components contain vic-glycol groups. The ultrastructure of L. B. is very similar to that of corpora amylacea, to deposits in basophilic degeneration of myocardium and in glycogenosis type IV.This work was supported by the Belgian National Fund for Medical Research (Grant No. 576) and by the national multiple sclerosis society.     

Legal guardianship and other alternatives in the care of elders with Alzheimer's disease

This paper discusses planned instructional and proxy interventions for incapacity, legal guardianship, and supplements to care for people with Alzheimer's disease (AD). Service providers are encouraged to identify and initiate care decisions that are consistent with the client's care preferences. Case examples are discussed. Practitioners are encouraged to educate clients, particularly those in the early stages of Alzheimer's disease, to create evidence for care preferences through planning. Service providers' concerns for liability are briefly discussed.     

Mortality variations among public mental health patients

Earlier studies of mortality of psychiatric patients are reviewed, and agreements and inconsistencies related to age, sex, diagnosis and cause of death are noted. The authors then analyze 5,268 deaths during a 5-year period of current or former patients in Missouri public psychiatric hospitals and mental health clinics, calculating mortality ratios that are simultaneously age-, sex-, diagnostic-, and cause-specific. The results are used to construct a quantitative model. The ratios vary most with cause, then diagnosis, least with sex. Influenza and pneumonia contribute most to patient mortality; patient death rates for cancer are lower than population rates at all ages. There are substantial interactions of diagnosis with cause and sex. Among those diagnosed organic brain syndrome, who have the highest overall ratios, the ratios are extra high for females and for influenza and pneumonia, relatively low for external causes.     

Intrinsic and Extrinsic Barriers to Health Care: Implications for Problem Gambling

To establish guidelines for research into help for problem gambling, this paper reviews literature on barriers to access and utilisation of health care for alcohol abuse, substance abuse and mental health problems. Research findings from international and New Zealand studies are examined, highlighting gender differences and cultural aspects. Intrinsic factors are presented within the transtheoretical model of change (TTM). Extrinsic barriers consist of predisposing, enabling and need factors, according to the socio-behavioral model (SBM). The dynamic interaction between intrinsic and extrinsic factors is explained by the network-episode model (NEM) which emphasises the importance of social networks and events. Personal, socio-cultural and institutional reasons for delays in seeking help are presented. The greatest barriers to seeking health care are intrinsic. Specific research questions regarding the implications for barriers to help for problem gamblers and their families are proposed. In conclusion, the SBM and the NEM seem to explain barriers to health care access and utilisation for addictive disorders and mental health problems better than the TTM. Barriers to health care access and utilisation for substance abuse and mental health problems may have some relevance to similar barriers for problem gamblers and their families.     

New anticoagulants in children: a review of recent studies and a look to the future

Thromboembolic complications are increasing in children and the use of anticoagulation has seen a dramatic increase. The most widely used agents in children, heparin, low molecular weight heparin, and warfarin all have limitations which are exaggerated in children. This has led to the study of newer agents with improved pharmacologic properties such as bivalirudin, argatroban, and fondaparinux. In addition, clinical trials are under way to assess several new oral anticoagulants that are in late phase studies or already licensed in adults. Based on the completed studies in children, several recommendations for the use of currently available agents (bivalirudin, argatroban, and fondaparinux) are suggested for clinical use today. Additional studies need to be conducted for the above agents which will lead to their expanded use in selected indications. Furthermore, new regulatory requirements are leading to a number of studies in the newer anticoagulants that are yet to be licensed in adults for treatment of venous thromboembolism. Pediatric thrombosis is entering a fruitful era of research in the area of anticoagulation management which is sure to lead to significant changes in how children are treated in the next 10 years.     

Therapists’ perspectives on suicide: A conceptual model of connectedness

Background: A sense of disconnection for people who are suicidal seems to be a key construct of previous literature. Therapists’ ways of encountering and understanding people who are suicidal have not been previously researched in depth using qualitative methodologies. Aims: The current study aims to develop a theoretical framework for the role played by connectedness in relation to suicide based on the perspectives of psychotherapists working in the field of suicide intervention. Method: Psychotherapists (N?=?12) from a suicide intervention service in Ireland were interviewed in relation to connectedness and suicide. The interviews were analysed using Constructivist Grounded Theory. A tentative theoretical model for connectedness in relation to suicide was developed. Results: Therapists view self-disconnect as at the core of suicidality and note that toxic relationships also play a critical role. Therapeutic connection can present as a life-saving paradox for people who are suicidal. Risk of death and therapeutic endeavour may present as challenging dynamics for working with people who are suicidal. Some discussion points include the worth of self-compassion development for people who are suicidal, the rephrasing of “psychotherapy” when trying to save someone’s life and the emphasis on relationship skills for all healthcare professionals who encounter people who are suicidal.

Clinical or methodological significance of this article: This article is one of the first in which therapists are interviewed about their understandings of suicide and the processes of suicide in the therapeutic space. It offers novel insights about how people who are suicidal present in therapy and what may be contributing to this presentation. The research also gives insights on the struggles for therapists working with people who are suicidal and who may be ambiguous about the prospect of therapy and connecting. The study also offers important direction for future studies in relation to what requires further discussion and exploration regarding engaging in therapy with people who are suicidal. In addition, the current study can offer previously unexplored insights regarding suicide and therapy that may have the potential to assist in future intervention for people who are risk of killing themselves.     

Multi-Systemic Intervention for School Refusal Behavior: Integrating Approaches across Disciplines

School refusal behavior is defined as ‘child-motivated refusal to attend school or difficulties remaining in school for an entire day’ (Kearney & Silverman, 1996 p365). Evidence exists indicating that the etiological and sustaining factors in cases of school refusal behavior are often multi-systemic in nature. Nevertheless, intervention approaches in the psychological literature have remained largely individual-focused. Similarly, literatures (for example education) in which school refusal behavior is conceptualized as ‘truancy’ are more likely to address the problem by intervening in multiple systems. The current paper argues for the utility of a multi-systemic approach to interventions for school refusal behavior that integrates multiple disciplines. Using an ecological systems framework, intervention options for school refusal behavior are detailed at the exosystemic, mesosystemic and microsystemic levels. Attention to systemic factors is intended to complement existing individual-focused approaches. Implications for diverse groups of young people who are exhibiting or at risk for school refusal behavior are also discussed.     

Obsessive-compulsive disorder:Evidence-based treatments and future directions for research

Over the past three decades, obsessive-compulsive disorder(OCD) has moved from an almost untreatable,life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children and adults with this disorder as, thanks to advances in both pharmacological and psychological therapies, prognosis for those afflicted with OCD is quite good in the long term, even though most have comorbid disorders that are also problematic. We still have far to go, however, until OCD can be described as either easily treatable or the effective treatments are widely known about among clinicians. This review focuses on the current state of the art in treatment for OCD and where we still are coming up short in our work as a scientific community. For example, while the impact of medications is quite strong for adults in reducing OCD symptoms, current drugs are only somewhat effective for children. In addition, there are unacceptably high relapse rates across both populations when treated with pharmacological alone. Even in the cognitive-behavioral treatments, which show higher effect sizes and lower relapse rates than drug therapies, drop-out rates are at a quarter of those who begin treatment. This means a sizable portion of the OCD population who do obtain effective treatments(which appears to be only a portion of the overall population) are not effectively treated.Suggestions for future avenues of research are also presented. These are primarily focused on(1) increased dissemination of effective therapies;(2) augmentation of treatments for those with residual symptoms, both for psychotherapy and pharmacotherapy; and(3) the impact of comorbid disorders on treatment outcome.     

Violence in the Schools: Clinical Issues and Case Analysis for High-Risk Children

School violence in rural communities has gained considerable attention nationally. Examined are theoretical considerations involving escape theory, the risk and protective factors for school violence, case analyses of recent case studies, and discussion of recent school violence involving fatal injuries to others. Also discussed are diagnostic issues in understanding children who are at-risk for school violence and ways school violence maybe managed in the schools. Suggestions and recommendations including recommendations provided by the National School Safety Center for school personnel are offered, as are steps to be taken in creating a safe school environment. This information may be helpful to child psychiatry and clinical personnel who provide services to school aged children.     

Infantile spasms and Lennox-Gastaut syndrome

Infantile spasms and Lennox-Gastaut syndrome are rare but are important to child neurologists because of the intractable nature of the seizures and the serious neurologic comorbidities. New antiepileptic drugs offer more alternatives for treating both infantile spasms and Lennox-Gastaut syndrome. Selected children with infantile spasms are candidates for epilepsy surgery. Vagus nerve stimulation, corpus callosotomy, and the ketogenic diet are all options for selected children with Lennox-Gastaut syndrome. The epidemiology, clinical manifestations of the seizures, electroencephalographic characteristics, prognosis, and treatment options are reviewed for infantile spasms and Lennox-Gastaut syndrome. Additional therapies are needed for both infantile spasms and Lennox-Gastaut syndrome as many children fail to achieve adequate seizure control in spite of newer treatments.     

The regulation of LHRH action at the pituitary and gonadal receptor level: a review

Luteinizing hormone releasing-hormone (LHRH) and its highly active agonists are under clinical investigation for the control of reproductive function and for suppression of hormone dependent tumours. The regulation of LHRH action by pituitary receptors and expression of the biological LHRH effect by gonadotropin release and activation of steroid biosynthesis are discussed in this context. Pituitary LHRH receptors are controlled by autoregulation via endogenous LHRH secretion. The gonadal response to LHRH stimulation is regulated by LH action on receptors for LH, prolactin and FSH. Pituitary and gonadal inhibition are achieved by different mechanisms. Continuous exposure to LHRH blocks gonadotropin release and reduces pituitary LH/FSH content, whereas inhibition of steroid biosynthesis requires daily LH release to maintain receptor down-regulation. Pituitary enzymes involved in LHRH degradation at the receptor site are required for terminating hormone action, but their role in modulating hormonal responsiveness is secondary to receptor regulation. Direct gonadal effects of LHRH are exerted in the presence of gonadotropins by modulating the gonadotropin effect, e.g. in hypophysectomized animals. The presence of specific receptors for LHRH agonists in ovarian and testicular tissue suggests local control mechanisms for gonadotropin activation of steroid biosynthesis.     

Clinically Relevant Measures of Children’s Theory of Mind and Knowledge about Thinking: Non‐Standard and Advanced Measures

Measures of Theory of Mind (ToM) in clinical disorders and conditions are reviewed, focusing on non‐standard and advanced measures. Relevant studies linking these measures to social problems and cognitive symptoms are reviewed. The multifaceted nature of ToM is stressed and clinically relevant aspects of ToM are suggested. Strategies to select relevant measures for clinical research and practice are presented and examples are discussed in more detail. It is recommended to consider specific aspects of ToM in relation to specific clinical conditions and symptoms. Relationships between ToM and other cognitive deficits, and implications for clinical practice and intervention are also discussed.     

A glue-based, screw-free method for implantation of intra-cranial electrodes in young mice

Intra-cranial electroencephalographic recordings are increasingly employed in mice because of the availability of genetically manipulated mouse models. Currently, dental acrylic and anchoring screws are used to cement implanted electrodes. This technique works well for adult animals but often encounters difficulty when employed in young mice because their skulls are not strong enough to bear the anchoring screws. Here we describe a novel method favorable for implantation of intra-cranial electrodes in mice as young as postnatal 18 days and suitable for long-term intra-cranial electroencephalographic recordings. Our approach is to construct a multi-electrode assembly according to the desired stereotaxic coordinates of intra-cranial recordings and to secure the implanted electrode assembly to the skull via glue rather than dental acrylic/anchoring screws. The surgical operation for such electrode implantation is relatively quick and rarely associated with complications such as infection, bleeding, neurological deficits, spontaneous seizures or behavioral disturbances. The implanted electrodes are stable, allowing repeated monitoring for several months. Data obtained by simultaneous intra-hippocampal and intra-cortical recordings indicate that our method is suitable for the examination of behaviorally related electroencephalographic activities and experimentally induced seizures. Technical aspects of our methods are discussed, and the procedures for constructing the electrode assembly are presented in detail.     

A standardized psychiatric assessment scale for rating chronic psychotic patients

Simple 5-point scales are described together with the method used to study their reliability, the results of which are shown. The scales are short, easy to administer and sensitive to change, therefore particularly applicable where there is the need for screening chronic psychotic populations. Some uses for the scales are suggested.     

Computational cognitive models of spatial memory in navigation space: A review

Spatial memory refers to the part of the memory system that encodes, stores, recognizes and recalls spatial information about the environment and the agent’s orientation within it. Such information is required to be able to navigate to goal locations, and is vitally important for any embodied agent, or model thereof, for reaching goals in a spatially extended environment.In this paper, a number of computationally implemented cognitive models of spatial memory are reviewed and compared. Three categories of models are considered: symbolic models, neural network models, and models that are part of a systems-level cognitive architecture. Representative models from each category are described and compared in a number of dimensions along which simulation models can differ (level of modeling, types of representation, structural accuracy, generality and abstraction, environment complexity), including their possible mapping to the underlying neural substrate.Neural mappings are rarely explicated in the context of behaviorally validated models, but they could be useful to cognitive modeling research by providing a new approach for investigating a model’s plausibility. Finally, suggested experimental neuroscience methods are described for verifying the biological plausibility of computational cognitive models of spatial memory, and open questions for the field of spatial memory modeling are outlined.     

Comparison of operant escape and reflex tests of nociceptive sensitivity

Testing of reflexes such as flexion/withdrawal or licking/guarding is well established as the standard for evaluating nociceptive sensitivity and its modulation in preclinical investigations of laboratory animals. Concerns about this approach have been dismissed for practical reasons – reflex testing requires no training of the animals; it is simple to instrument; and responses are characterized by observers as latencies or thresholds for evocation. In order to evaluate this method, the present review summarizes a series of experiments in which reflex and operant escape responding are compared in normal animals and following surgical models of neuropathic pain or pharmacological intervention for pain. Particular attention is paid to relationships between reflex and escape responding and information on the pain sensitivity of normal human subjects or patients with pain. Numerous disparities between results for reflex and operant escape measures are described, but the results of operant testing are consistent with evidence from humans. Objective reasons are given for experimenters to choose between these and other methods of evaluating the nociceptive sensitivity of laboratory animals.