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PubMed1989

Subtypes of suicidal and assaultive behaviors in adolescent psychiatric inpatients: a research note.

Among 129 adolescent psychiatric inpatients, four subgroups of suicidal and/or assaultive behaviors were identified. A suicidal-only subgroup with no evidence of assaultive behavior was characterized by depression, drug abuse and environmental stresses. An assaultive-only subgroup with no evidence of suicidal behavior exhibited aggressive symptoms and violence at home. A subgroup with both suicidal and assaultive behaviors experienced accidents and family violence. A fourth subgroup had neither suicidal nor assaultive behavior. This subgroup showed eating disorders, depression, minimal assaultiveness and few peer friendships.

Adolescent↗

PubMed1993

Practitioner review: problems in children's peer relations: what can the clinician do?

This paper describes the assessment and treatment of children with peer relationship problems. The first part of the paper is organized around five topics: peer rejection, peer neglect, the absence of friendships, reputation in the peer group, and peer group affiliations. Next, a series of assessment methods is delineated, including peer, teacher, parent and self reports, as well as direct observational procedures. Finally, we suggest a number of treatment options, including social skills training, social cognitive interventions, and co-operative group interventions.

Behavior Therapy↗

PubMed1994

Prosocial development.

The foregoing review has been organised in terms of five developmental hypotheses--let us now summarise the evidence bearing on each hypothesis. The first hypothesis, that a general prosocial impulse arises in the first year of life, is well-supported by the data. Some dispute remains about the point at which children are capable of responding sympathetically to companions in distress, with some investigators claiming that this takes place around the time of the second birthday (Kochanska, 1993), others placing this achievement earlier in development (Hoffman, 1975). The second, more controversial hypothesis, that the frequency of prosocial behaviour declines thereafter, is supported by cross-sectional data and by the burgeoning literature on the ways in which prosocial responding comes to be regulated cognitively and emotionally during the preschool years. Actual evidence for a decline and tests of hypotheses that the decline is associated with the acquisition of particular "display rules" and the regulation of empathic responding and guilt requires appropriately designed longitudinal studies. In general, our understanding of the normal course of prosocial development is limited due to the paucity of longitudinal data and the tendency of particular investigators to concentrate on single constructs--empathy, sharing, moral judgement or whatever--and not examine the interrelations of different types of prosocial behaviours in the same sample, tested under the same conditions. It is also not completely clear whether findings about empathic responding in experimental procedures (e.g. Miller et al., 1989) can be used to explain age changes in the selective display of prosocial behaviour under natural conditions. However, it is clear that future studies of prosocial development must examine the contributions of empathy, guilt and children's awareness of moral and conventional standards to children's overt prosocial actions with friends and family members. The contribution of children's close personal relationships, particularly their attachment relationships and close friendships, to prosocial behaviours, deserves increased attention. The third hypothesis was a claim that, during the childhood years, prosocial behaviour becomes differentiated in terms of gender, with females and males showing their prosocial tendencies in qualitatively different ways. Evidence bearing on this point is beset with measurement problems; it seems clear that girls report more empathy and are reputed by others to be more prosocial than boys, but direct observations do not always support such conclusions. Much more information is needed about ways in which boys in particular are prosocial--for example, co-operating with teammates whilst competing against other teams, in athletic contests.(ABSTRACT TRUNCATED AT 400 WORDS)

Altruism↗

PubMed2004

Institutional care: associations between overactivity and lack of selectivity in social relationships.

BACKGROUND: The behaviour of children raised in institutional care in their early years is typified by heightened levels of inattention and overactivity irrespective of the quality of the care. There is some evidence that this behaviour may be specifically associated with forms of attachment disorder behaviours, but to date studies have been restricted to institutions characterised by high levels of malnutrition and lack of active experiences. METHODS: Nineteen primary school age children admitted to good quality residential group care before the age of 1 year were compared with 19 children of the same gender reared in a foster family from the same age. A combination of observational, questionnaire, interview and psychometric measures was employed. RESULTS: A fifth of the institutional children but none of the foster-family children showed a marked lack of selective attachment relationships with their caregivers. The same proportions were found for a lack of selectivity in friendships with their peers but the children showing these features were not identical. A lack of selectivity in relationships was strongly associated with inattention/overactivity, both as observed and reported. The pattern of a marked lack of selectivity and inattention/overactivity was evident only in the boys in the institution-reared group. CONCLUSIONS: It is concluded that the pattern represents a relatively specific response to some feature of an institutional rearing; nevertheless, it occurred in only just over a third of the institutional children, so that it is a far from universal consequence.

Caregivers↗

PubMed2005

Developmental language disorders--a follow-up in later adult life. Cognitive, language and psychosocial outcomes.

BACKGROUND: Little is known on the adult outcome and longitudinal trajectory of childhood developmental language disorders (DLD) and on the prognostic predictors. METHOD: Seventeen men with a severe receptive DLD in childhood, reassessed in middle childhood and early adult life, were studied again in their mid-thirties with tests of intelligence (IQ), language, literacy, theory of mind and memory together with assessments of psychosocial outcome. They were compared with the non language disordered siblings of the DLD cohort to control for shared family background, adults matched to the DLD cohort on age and performance IQ (IQM group) and a cohort from the National Child Development Study (NCDS) matched to the DLD cohort on childhood IQ and social class. RESULTS: The DLD men had normal intelligence with higher performance IQ than verbal IQ, a severe and persisting language disorder, severe literacy impairments and significant deficits in theory of mind and phonological processing. Within the DLD cohort higher childhood intelligence and language were associated with superior cognitive and language ability at final adult outcome. In their mid-thirties, the DLD cohort had significantly worse social adaptation (with prolonged unemployment and a paucity of close friendships and love relationships) compared with both their siblings and NCDS controls. Self-reports showed a higher rate of schizotypal features but not affective disorder. Four DLD adults had serious mental health problems (two had developed schizophrenia). CONCLUSION: A receptive developmental language disorder involves significant deficits in theory of mind, verbal short-term memory and phonological processing, together with substantial social adaptation difficulties and increased risk of psychiatric disorder in adult life. The theoretical and clinical implications of the findings are discussed.

Activities of Daily Living↗

PubMed1989

An epidemiological study of children's attitudes toward disability.

In this epidemiological study the authors recorded the attitudes of children in Hamilton, Ontario, to physically disabled and mentally handicapped children. Univariate analyses confirmed the importance of female gender, friendship and contact with handicapped persons as determinants of more accepting attitudes. Type of disability and the presence or absence of disabled children in respondents' schools were not found to influence attitudes in a systematic manner. Correlations between attitudes and children's self-esteem or sociometric ratings were not significant, nor were parent-child attitude correlations. Maternal language of origin was found to influence children's attitudes, in favour of children of English-speaking mothers. These results are discussed with reference to their practical applications by community and educational systems seeking to foster integration of disabled children.

Attitude↗

PubMed2005

Strangers or friends? A proposal for a new spirituality-in-medicine ethic.

We argue that debate regarding whether and how physicians should engage religious concerns has proceeded under inadequate terms. The prevailing paradigm approaches dialogue regarding religion as a form of therapeutic technique, engaged by one stranger, the physician, upon another stranger, the patient. This stranger-technique framework focuses the debate on questions of physicians' competence, threats to patients' autonomy, and neutrality regarding religion, and in so doing, it too greatly circumscribes the scope of physician-patient dialogue. In contrast, we argue that dialogue regarding religion is better approached as a form of philosophical discourse about ultimate human concerns. Such moral discourse is often essential to the patient-physician relationship, and rather than shrinking from such discourse, physicians might engage patients regarding religious concerns guided by an ethic of moral friendship that seeks the patient's good through wisdom, candor, and respect.

Adult↗

PubMedDate not supplied

Epilepsy and psychosis: a comparison of societal attitudes.

Pioneer investigators in Nigeria have presented a gloomy picture of epilepsy as a highly infectious and disastrous disease in the eyes of the public. As a result, epileptic persons suffer untold social deprivations and discrimination in education, employment, housing, marital life, etc. These assertions have been repeated over the years more as a result of incidental observations while reviewing hospital cases than as products of attitude research on the subject. We assumed, therefore, that these statements should be considered as impressive hypotheses needing to be tested. By employing the Osgood semantic differential and the behavioral differential of Triandis, we assessed the attitude of the normal literate general public toward persons with epilepsy and "cured" psychotic patients and how closely the public would associate or socialize with these people. We also inquired into the public's opinion about the causes of epilepsy and psychosis, since this knowledge is necessary for attitude formation and change. On the whole, the general attitude toward epileptic patients is negative, and toward "cured" psychotic patients, positive. There are sex differences, in that males perceive epileptic patients more favorably than females do. However, both males and females would discriminate against both the epileptic and "cured" psychotic person in terms of employment, residential accommodation, friendship, and marital relations. The major perceived causes of epilepsy reported were heredity, witchcraft, and brain damage, in that order, not infection. About 25% admitted ignorance of the cause of epilepsy, as against 1% for psychosis. The psychoses were reportedly caused mainly by Indian hemp smoking, drug abuse, brain damage, and witchcraft, in that order.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2005

Proc, Dr. Sam, Uncle Henry, and the "Little Green Book". Interview by Charles F. Wooley.

During his house staff training before World War II, Dr. W. Proctor Harvey encountered Dr. Samuel A. Levine at the Peter Bent Brigham Hospital in Boston. Following military service, Harvey returned to Boston and became Levine's first cardiology fellow. The book Clinical Auscultation of the Heart--the Little Green Book by Levine and Harvey in 1949 combined Levine's clinical wisdom with Harvey's objective phonocardiographic methods and brought an important objective dimension to the art of cardiac auscultation. Both Levine and Harvey shared experiences and friendship with Henry Christian, the first Physician-in-Chief when the new Brigham Hospital Opened in 1913. Christian, appointed Dean of the Harvard Medical School in 1908 at the age of 32, was referred to as the "Boy Dean." He held the Hersey Chair of Theory and Practice of Physic from 1908 until 1939, was one of the founding group of the American Society for Clinical Investigation, and a major force in academic medicine. Levine served as intern to Christian and then joined the Brigham medical staff in 1915. Proctor Harvey followed Henry Christian's path from their mutual hometown of Lyunchburg, VA to the Peter Bent Brigham Hospital. A series of illuminating and respectful professional interactions--initially between Christian and Levine, between Levine and Harvey in the early 1940s, and between Harvey and Christian in the 1950s--provide the background for the genesis of the Little Green Book and a remarkable example of academic heritage.

Cardiology↗

PubMed1983

Communication styles and marital satisfaction in Israeli and American couples.

This study examined the conflict-related communication styles of American and Israeli couples and how these communication styles related to marital satisfaction in the two groups. An Israeli sample was recruited from Israeli couples currently living in New York City; the American sample was selected from the friendship circles of the Israeli couples. In spite of the close social ties of the two groups, we predicted that the conflict-related communication styles of the Israelis would be less calm and rational than those of the Americans and that such rational modes of communication would be positively associated with marital satisfaction for the Americans but not for the Israelis. The principle instruments were Straus' Conflict Tactics Scale, Ryder's Imagined Situation Inventory, and Spanier's Dyadic Adjustment Scale. Results largely confirmed the hypotheses. Israeli couples were more apt to be verbally aggressive (but less physically violent) and less apt to behave calmly during marital conflict, but these communication styles did not relate to marital satisfaction as strongly for the Israelis as for the Americans. These findings are discussed as a demonstration of the importance of considering cultural context when treating families.

Adult↗

PubMed1984

Fusion, compression, diversion, and the workings of paradox: a theory of therapeutic/systemic change.

This paper describes a geodynamic balance theory of family process. It attempts to synthesize temporal/spatial patterning, movement, interpersonal structure, and the family developmental process. The family system is portrayed in terms of the pattern of interpersonal orbits among its members and the interface between these and "external" systems such as friendship networks, neighborhoods, and therapists. It is proposed that therapeutic/systemic change can be induced through either of two interventional mechanisms: diversion (e.g., behavioral techniques, restructuring, differentiating) or compression (e.g., paradoxical technique, returning home, grief work). Such processes share a number of similarities with analogues from the physical sciences. These formulations may assist clinicians in determining the most appropriate operations and directions for treatment.

Adolescent↗

PubMed1993

Characteristics of chronic outpatients with unipolar depression.

Among the long-term clinic attenders with unipolar depression, there are some who continue to visit the hospital after their affective symptoms have long abated. They constitute "new chronic" psychiatric outpatients and remain consumers of medical resources. We studied these patients' characteristics through a case-control study with former patients who received treatment for the same diagnosis but are currently not under treatment and not depressed. The long-term clinic attenders tended to show fewer psychomotor symptoms and criteria symptoms than the control group. Although the groups were similar in terms of the severity of current depressive symptoms, the patients showed significantly poorer functioning in many areas of social adjustment. With regard to premorbid psychosocial variables, the chronic clinic attenders reported poorer friendship relationships during their adolescence, poorer premorbid global functioning and higher extraversion scores. These findings support the hypothesis that the social maladjustment of the chronic clinic attenders is not a sequela of their affective disorders but represents the patients' enduring characteristics.

Adult↗

PubMed1994

Recent life events, social support and suicide.

The occurrence of recent life events during the last 3 months, and social support received were studied in a nationwide suicide population (N = 1,067) in Finland. Recent life events were reported in 80% of the suicides. Job problems (28%), family discord (23%), somatic illness (22%), financial trouble (18%), unemployment (16%), separation (14%), death (13%) and illness in family (12%) were the most common life events. Sex differences were found in recent life events: any life event, separation, financial trouble, job problems and unemployment were more common among males. The mean number of life events was also higher among males. Living alone was more common among female victims. Females had children more often than males. In terms of friendships, more females had a close friend, whereas more males had friends sharing common interests. Females had complained of loneliness more often than males. Those females who had lived alone had encountered a recent death more often than other females. The male victims who had lived alone had experienced separation, financial trouble and unemployment during the last 3 months more frequently than other males, suggesting a concurrent stressor effect of these recent life events with living alone in male suicides.

Adolescent↗

PubMed1984

An investigation into the response of subjects to a plaque control programme as influenced by friends and relatives.

The aim of the present study was to assess the response of patients to a course of instruction in plaque control as influenced by friends and relatives. The subjects in the study were 41 patients who had been referred to a dental hospital for treatment. There was a major reduction in plaque and gingivitis levels in the subjects at both the 10th and 14th weeks of the study. There was a greater proportional reduction in gingivitis levels in those subjects who had a higher number of reported discussions with their friends. The effect of discussions with members of the family was less clear. Lower values for gingivitis levels at 10 weeks were associated with a higher number of discussions with parents. However the levels of gingivitis tended to be adversely affected by discussions between the subjects and their spouses. The importance of recognising the influence of family and friendship networks needs to be understood when preventive programmes are designed, especially where high levels of self-care are sought as outcomes. Further work is in progress on a group of office workers being treated in a dental practice environment. This will allow the type of advice being obtained from the various contacts to be investigated in more detail.

Adult↗

PubMed1999

Quality of life in Turner syndrome is related to chromosomal constitution: implications for genetic counselling and management.

Issues of self-appraisal, friendships and academic attainments are uniquely salient for all adolescents. For girls with Turner syndrome, social problems and learning difficulties often become more serious at this time, yet may be unacknowledged by those responsible for paediatric care because their focus is on growth and sexual maturation. Data on the social and educational adjustment of 110 45,X (monosomic) females aged between 6 and 25 years is presented. Detailed information on the patients' precise karyotype was used to demonstrate systematic differences in adjustment between those whose single X chromosome was maternally derived and those in whom it was paternal. Implications for educational support and parental guidance are discussed.

Adolescent↗

PubMed1983

An epidemic of group A, type 4 streptococcal carriers among school children and their desk location at school.

During a follow-up study of pharyngeal carrier of beta-hemolytic streptococci among school children in three classes (ages 8-9) in Sapporo City, an epidemic of group A, T4 streptococcal carrier was observed. The epidemic started in February 1978 in class II (35 pupils) and spread to class I (36 pupils) in May. Class III developed only three carriers during the course. Information on the desk location of those children at school and those on some host factors or on several environmental factors were collected. Monthly sociometric tests were performed on those pupils and corresponding sociograms were constructed. New T4 carrier rate by month was calculated for class I and class II by pupil's desk location (adjacent vs. remote) or by degree of pupil's friendship (best friends vs. others, based on the sociogram). More new carriers were detected from susceptibles adjacent to previous carriers then from those remote to them. There was no significant difference with carrier rate between best friends and others. The T4 carriers did not significantly differ from the remaining noncarriers in terms of status with host or environmental factors examined.

Carrier State↗

PubMed2006

Comparisons between Thai adolescent voices and Thai adolescent health literature.

Thai adolescents are hesitant to openly talk to adults; however, they are avid users of the Internet. In 2002, faculty of the Boromarajonani College of Nursing, Nopparat Vajira, Thailand, established a webboard to reach out to high school students for questions and answers on adolescent health. Adolescents pose health questions, which are answered by nursing faculty and students. A total of 106 questions were selected for content analysis. Thai adolescent studies for the years 1992 to 2004 were identified from searches of CINAHL, ERIC, MEDLINE, and PsycINFO databases. The selection criteria required that chosen articles have a Thai adolescent health focus, be written in English, and be retrievable. Of the 68 citations identified, 23 studies met inclusion criteria. Content of the Thai adolescent webboard was compared with a content analysis of the retrieved Thai adolescent research. Physiological development, sexuality, and risky behaviors were common literature themes, whereas Thai adolescents expressed concerns about love and dating relationships. Parenting and parent-child relationships were discussed on the webboard but not in the literature. Analysis of the mental health revealed differences between the literature that covered psychosocial change, and the webboard questions concerned with body image, the need for emotional support, and satisfaction and conflicts of friendship. It is recommended that investigators consider incorporating adolescents as research team participants, particularly as they examine mental health promotion, adolescent and family relationships, and concerns of Thai adolescents.

Adolescent↗

PubMed1989

Regulation of the mitochondrial multienzyme complexes in complex metabolic systems.

During the past two decades, I and the members of my laboratory have enjoyed very much contributing to the body of knowledge concerning the alpha-keto acid dehydrogenase complexes. We would hope that some of our work has allowed those interested in this area a perception as to how these interesting enzyme complexes are regulated in intact metabolic systems. And last, but certainly not least, I have treasured both my professional relationship and my personal friendship with Lester Reed. His work and his presence in this field of inquiry serve as a gold standard for all of us.

3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide)↗