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Childhood social anxiety disorder: from understanding to treatment.

Childhood social anxiety disorder is a condition of complex origins. Longitudinal studies of shyness and behavioral inhibition, and twin and family history studies, support a genetic component, but experiences such as family environment, parenting, and traumatic conditioning also are observed. Many children with significant shyness and behavioral inhibition do not develop social anxiety disorder, reinforcing the need for longitudinal studies exploring resiliency and risk factors that can be incorporated into diathesis stress models. Efficacy data regarding cognitive and behavioral therapies and pharmacotherapy are promising, and their effectiveness awaits further research. These studies will need to incorporate a multiplicity of perspectives to ensure the long-term sustainability of interventions for social anxiety disorder in children and adolescents.

Adolescent↗

Lights, camera, action: using feature films to stimulate emancipatory learning in the RN to BSN student.

Nurse educators are continually challenged to develop and implement effective activities to stimulate reflective learning in the RN to BSN student. The authors discuss the successful use of the feature film My Life as a reflective learning activity for a family health systems course.While feature films have been used constructively to teach family systems and social development, there is scant literature on the use of feature film as a teaching strategy within the discipline of nursing. The authors present evidence of how a film promoted stimulating and powerful transformative learning.

Education, Nursing↗

Advocacy for a new global health development paradigm: building alliances for global public health.

The past 25 years have produced a contradictory and conflicting context for health development. While global NGOs were enunciating a progressive political discourse promoting equity in health and development, elected conservative governments put in place measures that not only impoverished developing countries but also reduced international aid from richer countries. As a result, the structural adjustment policies of the past 25 years have decimated health and education services in poor countries. Recent international documents indicate a strong will by NGOs to regain leadership in the area of support to social development. In this effort to promote health as a human right and development as an avenue for achieving that goal, public health associations throughout the world should prepare for a leading advocacy role to rally partners in this endeavour.

Financing, Government↗

Unipolar and bipolar schizoaffective disorders: a comparative study. III. Long-term outcome.

Seventy-two schizoaffective patients were investigated longitudinally (mean follow-up period 25.6 years). Long-term outcome of unipolar (N = 37) and bipolar (N = 35) schizoaffectives was compared. Different aspects of outcome were investigated separately using standardized instruments of evaluation. No differences were found between unipolar and bipolar schizoaffective patients with regard to global functioning (GAS), disability (WHO/DAS) or psychopathological symptomatology at follow-up. There were also no differences in social consequences of the illness, i.e. downward occupational and downward social drift, premature retirement and achievement of the expected social development.

Adult↗

Field-dependence and facial expressions.

Facially expressive and nonexpressive subjects (40 undergraduate women) were compared on a measure of field-dependence--independence. Expressives were significantly more field-independent than non-expressives. It was suggested that both social development and the situational context play important roles in determining the effects of perceptual style on nonverbal behavior.

Child Rearing↗

Health implications of increased coal use in the Western States.

The National Energy Plan proposed by President Carter provides for the rapid development of coal resources in the United States, particularly in the West. The potential consequences for health of this development were considered by the Advisory Committee on Health and Environmental Effects of Increased Coal Utilization, reporting to the Department of Energy. Their report recommended rigid adherence to pertinent existing regulations, improved environmental monitoring, expanded research in selected relevant topics and development of procedures for selecting the sites of new coal-fired power plants. Although the report was a major exercise in technology assessment, it is fundamentally a cautious document that proposes no new solutions or approaches. A review of occupational and community health problems associated with coal mining and coal utilization suggests that lessons from past experiences, especially in Appalachia, cannot be applied to the West uncritically. The two regions are fundamentally different in scale, topography and social development. In the West, future problems related to coal are likely to derive from unknown risks associated with coal processing technologies, land reclamation and water quality at the sites of power generation, and extensive social and demographic changes at centers of industrial activity that may have secondary effects on health. Additional considerations should supplement the recommendations of the Advisory Committee report.

Coal↗

Is early occupational therapy in extremely preterm infants of benefit in the long run?

A total of 126 infants with extremely low birth weight (ELBW; <1000 g) were enrolled in a prospective case-control study in order to examine the effect of occupational therapy based on sensory integration (SI) and neurodevelopmental therapy (NDT) on neurological development. The children were grouped as matched pairs on the basis of determined developmental risk scores assessed at the age of 3 months. The intervention children had a 6-month period of weekly occupational therapy from the corrected age of 6-12 months. The follow-up showed that the social development of the intervention children was significantly better at the age of 12 months, but at the age of 2 years the groups had equal developmental scores in neurological, neuropsychological and speech therapy assessments. The Miller assessment for pre-schoolers (MAP) performed in a total of 96 (92%) of the study children at the age of 4 years failed to demonstrate any significant differences between the groups. It is concluded that this amount of occupational therapy in ELBW infants does not have any detectable effect on long-term neurological development.

Cognition↗

Predicting depression, social phobia, and violence in early adulthood from childhood behavior problems.

OBJECTIVE: This study examined childhood behavior problems at ages 10 and 11 years as predictors of young adult depression, social phobia, and violence at age 21 years. METHOD: Data were collected as part of the Seattle Social Development Project, a longitudinal study of 808 elementary school students from high-crime neighborhoods of Seattle. Reports of childhood behavior problems were obtained from parents and children in fall 1985 and from teachers in spring 1986. Follow-up reports of violence and DSM-III-R depression and social phobia were collected from 765 respondents using standard survey items and the Diagnostic Interview Schedule in 1996. RESULTS: The past-year prevalences of depressive episode and social phobia were 20% and 17%, respectively. Twenty-one percent of the respondents reported two or more violent acts in the past year at age 21 years. Several available measures of childhood behavior problems as reported by parents, teachers, and children predicted violence (e.g., conduct problems, oppositional defiance); the strongest positive predictor of young adult violence was self-reported conduct problems, whereas self-reported shyness inhibited later violence. Relatively few child behavioral problems predicted social phobia (e.g., shyness). Results showed that children who reported higher, relative to lower, levels of conduct problems were nearly four times more likely to experience a depressive episode in early adulthood. CONCLUSIONS: Findings suggest the potential value of intervening to reduce childhood conduct problems as a prevention strategy for not only violence but also depression.

Adult↗

Autistic social dysfunction: some limitations of the theory of mind hypothesis.

This study examined the extent to which the social disabilities found in autism can be accounted for by the "Theory of Mind" hypothesis. Items related to social development from the Vineland Adaptive Behavior Scales were administered to 29 CA-, MA- and IQ-matched pairs of young autistic and non-autistic, developmentally disabled children. These items were evaluated in relation to expected ages of acquisition based on the Vineland standardization database. Our results indicate that the social dysfunction in autism affects very basic and early emerging social behaviors which are typically present prior to the time at which even the earliest precursors of a theory of mind apparently emerge.

Age Factors↗

Psychosocial moderators of substance use among middle school-aged adolescents.

Recent statistics show a decrease in the overall use of drugs and alcohol in the general population [1]. In sharp contrast to this trend is the indication that adolescents' use of drugs and alcohol is increasing [2]. Because the use of drugs and alcohol can have serious implications for adolescents' physical, emotional, and social development, it is important that human service practitioners working with them understand those factors that influence their substance use, in order to develop effective interventions to deal with this growing problem. This article reports the findings of a study of drug and alcohol use among a sample of 779 adolescents who attended middle schools in a large urban city in the southwest United States. The study examines the relationships between substance use, social support, and a variety of other psychosocial factors. The implications of those relationships for human service practice and research are discussed.

Adolescent↗

[Veterinarians, and agriculture. Views of an agriculturist who taught at the veterinary school in Munich].

This article reflects on future developments in the relationship between farmer and veterinarian by an agricultural expert who lectured at Munich Veterinary Faculty from 1970 to 1993. The first chapter gives the reasons for the changes in this relationship over a period of 200 years. The present agricultural crisis is mainly caused by economic and social developments and by political decisions. The effects of these rapid developments on animal husbandry and veterinarians are discussed. History and new technologies in animal husbandry (for example micro electronics) lead to the thesis that the trend to larger and more specialised herds in family farms will continue. Assuming this thesis to be correct, veterinary herd health management and computerised health programmes will gain more importance in veterinary practice whereas therapy of individual animals will decrease.

Agriculture↗

The effects of a school program on teenage mothers and their children.

The need for educational opportunity and health care provision for the increasing number of teenage mothers is discussed. An educationally-based program for inner-city school-age mothers is described, and an evaluation of its effectiveness reported. Mothers in the program completed significantly more education than did control mothers, and their children showed superior social development compared to the children of control mothers.

Adolescent↗

Social functioning in children with a chronic illness.

Behavioural, cognitive, and affective aspects of social functioning of 107 children with a chronic illness were studied. The aim of the study was twofold: (1) to describe peer interaction of children with a chronic illness in comparison with normative data of healthy children; (2) to examine whether peer interaction was related to the illness characteristics physical restrictions and pain. Peer interaction was assessed with measures of social activities (CBCL), parent-reported social skills (CABS), child-reported social skills (MESSY), social self-esteem (SPPC), and social anxiety (SASK). Results showed no differences between diagnosis groups, suggesting that the social consequences of chronic illness are not diagnosis specific. Compared with healthy norms, chronically ill children reported less aggressive behaviour. The parent-report measures suggested a similar trend. Children with chronic illness also tended to display more submissive behaviour than healthy norms, as perceived by their parents. With regard to illness characteristics, both physical restrictions and pain were associated with restricted social activities, but not with other measures of social peer interaction. Children who display submissive behaviour and children who are restricted in their social activities should receive extra attention because they are especially vulnerable for problems in their social development.

Adaptation, Psychological↗

Recent mortality patterns associated with economic development in eastern Europe and the USSR.

Adult male mortality has turned sharply upward in Eastern Europe and the Soviet Union. Excluding the German Democratic Republic, for which data are not available, agestandardized death rates for men aged 40 to 69 years increased an average of 12 percent from the early 1960s to the mid-1970s. These secular trends were associated with consistent economic growth. At least for adult men, this period of social development has led to a marked deterioration in health.

Adult↗

Policy at the grassroots: community-based participation in health care policy.

American Health Decisions is a developing social movement that aims to work at the grassroots level to educate people about issues and problems in health care and to promote public involvement in decision making about health policy. The movement offers nurses opportunities to expand their traditional commitment to involving people in decisions about their health. By promoting the development of the movement, nurses can contribute to the creation of a structured process of direct public participation in policy decisions related to health care. Nurses may have a special role to play in the movement by promoting the participation of low-income people.

Community Participation↗

Social relationships and intravenous drug use among methadone maintenance patients.

This study examined the extent to which social relationships were associated with continued injection drug use and needle sharing among 252 methadone maintenance patients. Logistic regression analyses indicated that drug use was highest among persons who had a substance using live-in partner and among those with more drug-using social relationships. Among injectors, whites and those who had more people present during IV drug use were more likely to share needles, while those with more emotional support were less likely to do so. These findings suggest that personal relationships strongly influence continued injection drug use and that methadone programs should help patients develop social networks of non-users.

Adult↗

[Role of the mentally retarded graduates of special schools].

The purpose of this investigation was to establish approaches that match a scientific knowledge of the role played by the mentally retarded person who has completed his studies at a Special School. The idea is to learn if he is able to play differents roles in the society, to form a family, to integrate himself in a stable job and to incorporate and participate in a responsive manner in different social groups. Thus, they have been compared with a normal group of similar characteristics. The principal results of the study have shown: Once the person has completed his studies at a special school which used every effort for rehabilitating and capaciting the individual for a responsible social development in life, to enable him to perform a remunerated activity, he discovers that he is "stigmatized", that it is very difficult to find work and of course to be incorporated to the occupational structure. This contributes to the person's anxiety and an increasing insecurity which derives in isolation and lack of social interchange with other people and transform him into a marginal person.

Education of Persons with Intellectual Disabilitie↗

Reestablishing health: factors influencing the child's recovery in pediatric intensive care.

This article presents a conceptual framework that examines five factors affecting the rate of recovery and return to health for critically ill children in pediatric intensive care. Stress, coping, development, social support, and immunocompetence are analyzed from a biopsychosocial perspective to gain a clearer understanding of how these variables interrelate to affect the child's ability to recover. The conceptual framework will assist the nurse in recognizing which children are at greatest risk for setbacks and delays in recovery.

Adaptation, Psychological↗