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Birthweight and behavioural problems in children: a modifiable effect?

BACKGROUND: Low birthweight has been shown to predict behavioural problems in children. Less is known about the effect of birthweight, and how this may interact with the social environment in determining behaviour in a general population sample. We have examined the relationship between birthweight and social factors on childhood psychological well-being. METHODS: Cross-sectional analysis of data on 5181 children aged 4-15 years from a randomly selected household population, the 1997 Health Survey for England. The main outcome measures were behavioural problems as defined by the Strengths and Difficulties Questionnaire (SDQ) in relation to birthweight and social environmental factors. RESULTS: Birthweight was a significant predictor of total difficulties score (odds ratio [OR] = 1.27, 95% CI : 1.07, 1.49), hyperactivity in boys (OR = 1.25, 95% CI : 1.05, 1.51), and peer problems in girls (OR = 1.24, 95% CI : 0.99, 1.53). There was a strong social class gradient in the prevalence of behavioural problems for all birthweight tertiles. Bivariate analysis showed that high total difficulties score was significantly more common in lower birthweight tertiles for social classes III non-manual and III manual (P:-value for trend 0.05 and 0.03, respectively). There were smaller, non-significant effects of birthweight on the prevalence of behavioural problems in social class I and II, and IV and V. Statistical tests for an interaction between birthweight and social class were not significant. CONCLUSIONS: Early life factors, such as birthweight and social class have important influences on psychological well-being in children. The birthweight effect is influenced by social factors, with the possibility that an advantaged social environment protects against the development of behavioural problems, and a disadvantaged environment increases the risk of behavioural problems, regardless of birthweight.

Adolescent↗

Relapse-onset factors in Project MATCH: the Relapse Questionnaire.

Previously, items on the relapse-onset section of the Relapse Questionnaire have been grouped together based on face validity. In the present article, an empirical scoring method for this measure is derived through a factor analysis of Project MATCH data. Three factors replicate the factor solutions of other measures of alcohol relapse onset and relapse risk. The three factors found in this study include the following: Negative Affect/Family Influences, Craving/Cued, and Social Pressure. This study also replicates earlier findings that social pressure relapses are most likely to repeat, and that negative affect relapses are more severe. Earlier studies typing relapses have hypothesized that this may be one method to detect treatment effects that might otherwise be missed if relapses are not differentiated and only generic measures (such as time to first drink) are used. This hypothesis is tested in the present article, and Motivational Enhancement Therapy is revealed to offer protection against social pressure relapses that is less than those offered by Cognitive-Behavioral Coping Skills Therapy or Twelve-Step Facilitation Therapy.

Adult↗

[Psychohygienic problems of development in early childhood (author's transl)].

For a "social environmental protection" as one of the most urgent problems in infantile psychohygiene, the following conclusions should be taken into consideration: 1. In particular during the first years of life the development of the child is, within certain limits, sensitive to influences from the environment and therefore it can be fostered or disturbed from the outside. Congenital, prenatal, perinatal and postnatal injuries to the brain and sensory organs must be given great attention psychohygienically. 2. The social influences exercised on the child by persons of his environment, their availability, their emotional relationships and the development of a durable link predominate psychohygienically. In addition, the material security of young families and their type of accommodation (e.g. granting of loans to help set up a home) must be considered. 3. The possibilities of exercising a positive educational influence on a mentally and psychically sound development of the child as a person and member of society are greatest at the beginning of life and diminish during childhood. The effectiveness of negative educational and social interference factors is also subject to this rule from which again the necessity of adopting psychohygienic measures for the young child is derived. 4. The phenomenon of increasingly imbalanced behaviour of older children and juveniles which cause concern today, are as a rule symptoms of a chiefly environmentally determined disturbance upsetting the personality, which often originates in early childhood. Psychohygienic measures must be concentrated on this. 5. The inadequate care of young children accounting for one third of the population, a phenomenon which can be read in the statistical records and which has risen sharply during the last few years, makes it possible to forecast a further increase in developmental and behavioral disturbances of both an intellectual and psychological nature as well as in infantile and juvenile criminality in the coming years to an at present unimaginable extent. 6. In contrast to general opinion, the situation calls for an urgent fundamental revaluation of the importance of intrafamiliar social conditions of development and of the parental educational work on the small child, which to date, have been underestimated and neglected. At the same time many of the presently overrated extrafamiliar institutions of education and training for the older child need to be relativised. 7. The advances in developmental biology which allow us to realize the basic dependence of the future social fate of the individual - and thus the extent of disturbed social relationships in society - on the intrafamily conditions must become a political issue, if psychohygiene as ameans to prevent avoidable disturbances is to be taken seriously. Thus the securement of adequate intrafamily conditions with respect to development and upbringing, in particular of the young child, must head the list of social political priorities, also in times when money is in short supply. 8...

Child Behavior Disorders↗

Keynote Presentation at the Eight International Congress of Behavioral Medicine: the Pittsburgh common cold studies: psychosocial predictors of susceptibility to respiratory infectious illness.

This article provides a selected overview of 20 years of research on the role of psychosocial factors in susceptibility to upper respiratory infections. We present evidence from our laboratory that psychological stress is associated with increased risk for developing respiratory illness for persons intentionally exposed to a common cold virus, that the longer the duration of the stressor the greater the risk, and that stress association with susceptibility may be mediated by stress-induced disruption of the regulation of proinflammatory cytokines. We further provide evidence that social relationships (social integration and social support) are also associated with risk for respiratory illness: Social integration is associated with reduced risk irrespective of stress level and social support protects persons from the pathogenic influences of stress. Finally, we report recent evidence that lower levels of early childhood socioeconomic status (SES) are associated with greater risk of viral-induced illness during adulthood, independent of adult SES.

Cytokines↗

Decree creating a childhood fund, 9 May 1988.

This Decree creates a childhood fund within the budget of the German-speaking Community of Belgium. The Fund is to cover the expenses necessary for the accomplishment of the following: 1) exercising and promoting activities responding to the needs of families, mothers, and children, notably those who are particularly threatened; 2) approving, subsidizing, or creating, as the case may be, undertakings, institutions, and services; exercising over them administrative and technical control; and furnishing them with aid and counseling; 3) sustaining and organizing initiatives in the area of prevention and education, seeing these through to a successful conclusion, and collecting documentation on all the concerned subjects; 4) requesting advice on all questions relating to the protection of mother and child; 5) organizing the supervision of children less than seven years old housed outside of their family setting and taking care of them; and 6) ensuring the training and informing of concerned persons, notably parents. The Decree also provides that no one may house children under the age of seven for payment without prior authorization. Such children may be housed free-of-charge by notifying certain official bodies and agreeing to certain medical and social controls. Relatives to the fourth degree and legal representatives of such children may house them free-of-charge without complying with these requirements.

Adolescent↗

[Improvement of protection given by vaccination for socially underprivileged groups on the basis of "key persons approach" -- results of an intervention based on cultural and language aspects for children of immigrants in Altlander Viertel provided by the Health Department of Stade].

In January 2002, a vaccination campaign against measles, mumps and rubella was carried out in the Altlander Viertel, a district in Stade, Germany. The campaign was directed towards children of immigrants, a group often at a disadvantage in terms of health. This campaign was organised and carried out by the public health department in Stade for the first time in September 2002. During regular health screenings when children were enrolled for school it was found that they children were poorly protected by vaccination against measles, mumps and rubella. Since several attempts to improve the situation, for example by organising information events, had not been successful, it was decided to develop special measures for this particular group in order to improve their health. Together with the Ethno-Medical Centre in Hanover the concept of a vaccination campaign considering the special situation of immigrants was developed. The core measures were to find, train and use key persons within the groups of immigrants are living in the Altlander Viertel in Stade. These key persons helped to inform and motivate the immigrants to go to the vacciantion stations set up in the district. In this way it was possible to carry out a successful intervention (vaccination campaign).

Age Factors↗

Boys' behavioral inhibition and the risk of later delinquency.

BACKGROUND: In some studies, shyness and anxiety have protected at-risk boys from developing delinquency. In others, shyness and withdrawal have increased risk. We argue that this is because behavioral inhibition, which is the protective factor, has been confounded with social withdrawal and other constructs. Our study addresses 3 major questions: (1) is behavioral inhibition, as distinguished from social withdrawal, a protective factor in the development of delinquency; (2) does the protective effect depend on whether disruptiveness is also present; and (3) does inhibition increase the risk of later depressive symptoms even if it protects against delinquency? METHODS: The subjects were boys from low socioeconomic status areas of Montreal, Quebec. Age 10- to 12-year predictors were peer-rated inhibition, withdrawal, and disruptiveness; age 13- to 15-year outcomes were self-rated depressive symptoms and delinquency. Eight age 10- to 12-year behavioral profiles were compared with 4 age 13- to 15-year outcome profiles. RESULTS: Inhibition seemed to protect disruptive and nondisruptive boys against delinquency. Disruptive boys who were noninhibited were more likely than chance to become delinquent; disruptive boys who were inhibited were not. Inhibition did not increase the risk for depression among disruptive boys. Among nondisruptive boys, only nondisruptive-inhibited boys were significantly less likely than chance to become delinquent. However, withdrawal was not protective. Disruptive-withdrawn boys were at the greatest risk for delinquency or delinquency with depressive symptoms. CONCLUSION: Inhibition and social withdrawal, although behaviorally similar, present different risks for later outcomes and, therefore, should be differentiated conceptually and empirically.

Adolescent↗

The combat soldier.

The Gulf War illness problem is seen as a post-war syndrome related to veteran discontent rather than as a new phenomenon. It is here proposed that application of social psychiatric thinking and workmen's compensation experience can help in understanding the problem. Social psychiatry has been neglected in the training of so many psychiatrists that many of them fail to understand the Army as a community and to recognize that a community's parts may develop symptom neuroses. Most psychiatrists, however, do know that a symptom neurosis will not disappear until it no longer serves its purpose. The young soldier may know that he is being trained for combat duty but manages to distance himself from the terrible realities of military combat by creating a psychic reality that protects him. Social psychiatric emphasis is used to describe his response when brought face to face with himself as a combatant with overwhelming responsibilities and genuine lethal danger. The brilliance and relevance of social thinking is demonstrated by examples from the works of Gustave LeBon and Georg Simmel so that its application to present--and future--military problems may be brought into focus.

Attitude↗

Re Baby R, 5 August 1988.

The petitioner sought cancellation of an order confirming the apprehension of her newborn child and ordering permanent guardianship over it. The child had been apprehended under authorization of the Superintendent of Family and Child Services while still unborn when the mother refused to undergo a Cesarean section in order to give birth. The Supreme Court of British Columbia granted the petition, ruling that an unborn child is not a child within the meaning of the Family and Child Service Act and, thus, can not be apprehended as a child apparently in need of protection under the Act. It noted, however, that the Superintendent was free to reapprehend the child if there was sufficient evidence to warrant doing so.

Americas↗

Effects of social support in the stressor-strain relationship: a Dutch sample.

Social support may be defined as the social ties an individual has, and which lead the subject to believe that he is cared for. The present study describes research on the hypothesis that social support protects the person against the noxious effects of job stress and will keep the strain and health effects low. A short review of relevant literature is given and 6 hypotheses about the role of support are tested; 3 about the interactive effects and 3 about the main effects. The study resembles the work of LaRocco, House and French, although there are some differences. Like these authors, a moderated regression technique was used on data from a sample of 1246 employees of 13 different industrial organizations. The analysis shows that social support buffers the impact of work-related stressors on psychological and behavioral strains but that there is no such a buffering effect on health strains. A very striking result was the strong buffering effect against employee's high blood pressure (SBP and DBP), of the supervisor giving support in the case of psychological problems.

Adult↗

Public Law 100-300, International Child Abduction Remedies Act, 29 April 1988.

This Act establishes procedures for the implementation of the 1980 Hague Convention on the Civil Aspects of International Child Abduction. The Convention was ratified by the US in 1986 and its instrument of ratification deposited with the Government of the Netherlands on 30 April 1988. Among other things, the Act grants States and the Federal Government concurrent jurisdiction over most actions, allows courts to take provisional measures to protect the well-being of a child or prevent the child's removal or concealment, and provides for the exchange of information in order to locate children.

Americas↗

Regional Law No. 40, 2 November 1988.

This Italian Law is designed to aid repatriated emigrants from Marche, foreign non-European Community workers, and their families. It provides subsidies for the initiation of economic activities and for residential lodging. It also makes provision for the children of emigrants to reside in Marche and for activities to maintain and protect the cultural identity of emigrants and immigrants.

Culture↗

Civil Code, 11 December 1987.

Article 162 of this Mexican Code provides, among other things, that "Every person has the right freely, responsibly, and in an informed fashion to determine the number and spacing of his or her children." When a marriage is involved, this right is to be observed by the spouses "in agreement with each other." The civil codes of the following states contain the same provisions: 1) Baja California (Art. 159 of the Civil Code of 28 April 1972 as revised in Decree No. 167 of 31 January 1974); 2) Morelos (Art. 255 of the Civil Code of 26 September 1949 as revised in Decree No. 135 of 29 December 1981); 3) Queretaro (Art. 162 of the Civil Code of 29 December 1950 as revised in the Act of 9 January 1981); 4) San Luis Potosi (Art. 147 of the Civil Code of 24 March 1946 as revised in 13 June 1978); Sinaloa (Art. 162 of the Civil Code of 18 June 1940 as revised in Decree No. 28 of 14 October 1975); 5) Tamaulipas (Art. 146 of the Civil Code of 21 November 1960 as revised in Decree No. 20 of 30 April 1975); 6) Veracruz-Llave (Art. 98 of the Civil Code of 1 September 1932 as revised in the Act of 30 December 1975); and 7) Zacatecas (Art. 253 of the Civil Code of 9 February 1965 as revised in Decree No. 104 of 13 August 1975). The Civil Codes of Puebla and Tlaxcala provide for this right only in the context of marriage with the spouses in agreement. See Art. 317 of the Civil Code of Puebla of 15 April 1985 and Article 52 of the Civil Code of Tlaxcala of 31 August 1976 as revised in Decree No. 23 of 2 April 1984. The Family Code of Hidalgo requires as a formality of marriage a certification that the spouses are aware of methods of controlling fertility, responsible parenthood, and family planning. In addition, Article 22 the Civil Code of the Federal District provides that the legal capacity of natural persons is acquired at birth and lost at death; however, from the moment of conception the individual comes under the protection of the law, which is valid with respect to the individual as far as the effects of this law provides as if the individual were already born.

Abortion, Induced↗

Regional Law No. 1, 20 January 1988.

This Law is designed to protect the physical and mental health of women and the unborn in Basilicata, Italy. It provides for activities related to information, birth preparation courses, means of organization and assistance that favor childbirth with respect to the mental needs of the woman giving birth and the unborn child, and rules for the protection of hospitalized newborn children.

Communication↗

In re the Adoption (Amendment) Bill 1987, 26 July 1988.

The President of Ireland referred to the Supreme Court the question whether Section 3 of the Adoption (Amendment) Bill was repugnant to family rights contained in Articles 41 and 42 of the Constitution. Section 3 authorizes a child of parents who were married to each other to be adopted under exceptional circumstances, i.e., when the parents have totally failed their duty to their child, when that failure arises from "physical and moral" reasons and continues for more than a year prior to application, and when such failure constitutes abandonment. The Court found the Bill constitutional. It held that, under Articles 40.3 and 42.5 of the Constitution, the rights of the child within the family could in extraordinary circumstances be supplied by placing a child in an alternative family, and that the preconditions set forth in the Bill were sufficient to protect the constitutional guarantees afforded to the family. After the Supreme Court reached its decision, this Bill was signed into law as the Adoption (Amendment) Act 1988.

Adolescent↗