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PubMed2007

Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection.

PURPOSE: Posterior fossa syndrome (PFS) occurs in approximately 20% of patients after resection of a tumor from the posterior fossa. Few descriptions of persistent psychosocial consequences exist. We assessed whether the development of PFS is associated with increased risk for emotional, behavioral, and social problems after the cessation of cancer treatment. PROCEDURES: Medical charts and neuropsychological data from 21 children (range = 6-17 years old, median = 9.8) were reviewed. All participants were survivors of childhood medulloblastoma and had been treated with surgical resection of the tumor, craniospinal radiation, +/- chemotherapy, and had comprehensive neuropsychological evaluations 1-2 years post-treatment. Six of the 21 were diagnosed with PFS. A series of chi-square tests were conducted to determine whether a relationship existed between PFS and clinically significant levels of emotional, behavioral, and social problems as measured by parent-report on the Achenbach Child Behavior Checklist (CBCL) and Conners' Parent Rating Scale-93 (CPRS-93). RESULTS: Children who developed PFS were significantly more likely to exhibit obsessive-compulsive type (i.e., perfectionistic) behaviors, withdrawal behaviors, social problems, and internalizing problems (all P < 0.05) than those who did not develop PFS. Additionally, children with PFS were more likely to evidence anxious-shy behaviors, attention problems, and somatic complaints, although these differences were not statistically significant. CONCLUSION: Results from the current preliminary study suggest that PFS may place children at increased risk for emotional, behavioral, and social problems long after completion of their cancer treatment.

Adolescent↗
PubMed2002

Problems in diagnosing and deciding on compensation for PTSD in Japan.

In Japan, the diagnosis of posttraumatic stress disorder (PTSD) has attracted wide attention after the Great Hanshin Earthquake and the subway sarin gas attack in 1994. Compensation problems about PTSD diagnosis has became a social problem now. So we felt the necessity to create a clear criteria to be used by Japanese psychiatrists for diagnosis PTSD. We send out a questionnaire about diagnosis and compensation for PTSD. We received back 764 questionnaire which equaled 21.7% of total that we send out. In the questionnaire we set up fictitious examples based on real cases, and asked the psychiatrists who participated in the survey whether these cases could cause PTSD. 1 explain the criteria used by Japanese psychiatrists for diagnosis PTSD and also to report PTSD examples which became to be social problem.

Compensation and Redress↗
PubMed1993

Impact of social problem-solving training on aggressive boys: skill acquisition, behavior change, and generalization.

This study examined the impact of social problem-solving training on the behavior of five aggressive boys. Acquisition of problem-solving skills and changes in classroom behavior were evaluated using multiple-baseline designs within and across subjects. A generalization-programming procedure to promote the use of problem-solving skills in the natural environment was introduced across children in multiple-baseline fashion. Direct observation and behavior ratings were used to evaluate the treatment. Results indicated that each subject acquired the problem-solving skills at levels comparable to well-adjusted peers. Only one child showed behavioral improvement coincident with problem-solving skill acquisition. Three others showed moderate behavior change after the generalization-programming procedure was introduced. Only one child's gains on teacher ratings were maintained at the 6-month followup. The results suggest that cognitive-behavioral treatment of childrens' aggressive behavior may produce changes of limited magnitude and durability.

Aggression↗
PubMed2003

Identity, activity, and the well-being of adolescents and youths: lessons from young people in a Micronesian society.

Comparative studies of the health, well-being, and social functioning of adolescents and youths have, in the past two decades, been focused on young people in developing countries where rapid social, cultural, and economic changes have been associated with dramatic increases in the rates of social problems indicative of poorer mental health. Young people in many Pacific Island societies suffer from some of the highest rates of social problems like suicide and substance abuse in the world. It is generally agreed that the increases in rates of social problems among youths in this region result from increases in psychosocial stress, anger, and frustration surrounding intergenerational conflict within the family. Much less is known about the aspects of everyday experiences of young people in the Pacific that can lead to psychosocial stress and the angry episodes of interpersonal conflict that often precede suicide attempts and binge drinking. This paper examines 40 cases of interpersonal conflict in young men's and women's experiences in the islands of Chuuk of the Federated States of Micronesia to better understand what can lead to elevated levels of psychosocial stress for youths in the Pacific. This study shows that the emotional crises of young people in Chuuk often emerge from the incongruence in their pursuit of valued personal and social identities within the family, the community, and the peer group. Thus youths who experience more incongruity in their engagements across the multiple activity settings of everyday life are at greater risk for stressful experiences.

Adolescent↗
PubMed2004

The Brief Infant-Toddler Social and Emotional Assessment: screening for social-emotional problems and delays in competence.

OBJECTIVE: To examine the reliability and validity of the 42-item Brief Infant-Toddler Social and Emotional Assessment (BITSEA), a screener for social-emotional/behavioral problems and delays in competence. METHOD: Parents in a representative healthy birth cohort of 1,237 infants aged 12 to 36 months completed the Infant-Toddler Social and Emotional Assessment (ITSEA)/BITSEA, the Child Behavior Checklist (CBCL)/1.5-5, the MacArthur Communication Developmental Inventory vocabulary checklist, and worry questions. In a subsample, independent evaluators rated infant-toddler behavior. RESULTS: Test-retest reliability was excellent and interrater agreement (mother/father and parent/child-care provider) was good. Supporting validity, BITSEA problems correlated with concurrent evaluator problem ratings and CBCL/1.5-5 scores and also predicted CBCL/1.5-5 and ITSEA problem scores one year later. BITSEA measures of competence correlated with concurrent observed competence and predicted later ITSEA competence measures. Supporting discriminant validity, only 23% of high BITSEA problem scorers had delayed vocabulary. Moreover, the combined BITSEA problem/competence cutpoints identified 85% of subclinical/clinical CBCL/1.5-5 scores, while maintaining acceptable specificity (75%). CONCLUSIONS: Findings support the BITSEA as a screener for social-emotional/behavioral problems and delays in social-emotional competence.

Child Behavior Disorders↗
PubMed1999

Family trauma and its association with emotional and behavioral problems and social adjustment in adolescent Cambodian refugees.

OBJECTIVE: The main aim of this study was to investigate the effect of war-related trauma on the subsequent social adjustment and functioning of young Cambodian refugees. METHOD: This longitudinal study of 67 young Cambodian refugees in Montreal interviewed in the first year of high school and then 2 years later examines a family's exposure to war related premigration trauma and its association with an adolescent's emotional and behavioral problems and social adjustment. Emotional and behavioral problems were assessed using the Youth Self-Report and an inventory of risk behavior. Social adjustment was assessed in terms of academic achievement, peer relations, and feeling of competence. RESULTS: The trauma a family suffered before leaving their homeland and prior to the teenager's birth seems to play a protective role at various times in adolescence with regard to externalized symptoms, risk behavior, and school failure in boys, and foster positive social adjustment in girls. CONCLUSIONS: These reactions may be understood as overcompensation by the children of the survivors of a massacre, to whom the implicit duty to succeed has been passed on. They suggest that a broader range of posttraumatic responses to war situations should be investigated and that trauma's dual nature as both burden and source of strength should be examined more closely.

Adolescent↗
PubMed2004

[Drug abuse as social-medical problem].

Drug abuse in the region of Sarajevo is in the worrying increase. It is not only about the increase of number of the dependents and death cases because of the overdosage, lowering of the age limit of the dependents to younger age groups and similar, but also about the absence of the severe long-term senseful and efficient collection of society in the solving of this problem. The aim of the research was to examine the attitudes and practice connected for abuse of drug in Sarajevo region. In connection with this was questionnaired 987 young people: students, middle age pupils of the eighth classes. We had also the controlled group of the examinees selected according the system of accidental sample (102). Also were performed the interviews with the experts for this problem: to psychologists, doctors, paedagogists, social workers, teachers, including also one number of the earlier and present dependents.

Adolescent↗
PubMed2003

Early predictors of school-age behavior problems and social skills in children with intraventricular hemorrhage (IVH) and/or extremely low birthweight (ELBW).

RESEARCH FINDINGS: Child and family characteristics from early infancy (birth-3 months adjusted age, AA) and toddler period (24-30 months) were examined as potential predictors of behavior problems and social skills at 7.5 years of age in 90 LBW infants with IVH and/or ELBW who were part of a longitudinal study of early intervention effectiveness. Severity of medical problems at birth and child temperament at 3 months AA were associated with future social skill levels, but not with behavior problems. Family variables in the first months of the child's life including low income, single parent household, and high parenting stress were significantly correlated with behavior problems at 7.5 years of age. Difficult temperament and elevated parenting stress in the toddler period were strongly associated with later behavior problems. Toddler developmental quotient (DQ) was a strong predictor of future social skills. PRACTICE OR POLICY: These data highlight the importance of early intervention that targets child behavior and emotional adjustment along with cognitive development, especially in low income and single parent households. Interventions that target parent-child interaction and parent stress are also crucial in these populations, even beyond the birth-three period.

Cerebral Hemorrhage↗
PubMed2001

Mothers' emotional expressivity and children's behavior problems and social competence: mediation through children's regulation.

The relations between mothers' expressed positive and negative emotion and 55-79-month-olds' (76% European American) regulation, social competence, and adjustment were examined. Structural equation modeling was used to test the plausibility of the hypothesis that the effects of maternal expression of emotion on children's adjustment and social competence are mediated through children's dispositional regulation. Mothers' expressed emotions were assessed during interactions with their children and with maternal reports of emotions expressed in the family. Children's regulation, externalizing and internalizing problems. and social competence were rated by parents and teachers, and children's persistence was surreptitiously observed. There were unique effects of positive and negative maternal expressed emotion on children's regulation. and the relations of maternal expressed emotion to children's externalizing problem behaviors and social competence were mediated through children's regulation. Alternative models of causation were tested; a child-directed model in which maternal expressivity mediated the effects of child regulation on child outcomes did not fit the data as well.

Affect↗
PubMed1992

Evaluation of social problem-solving abilities in rural home health visitors and visiting nurses.

A number of studies have shown the value of using home health visitors and visiting nurses in intervention outreach programs designed to provide pre- and postnatal care for low-income women. The purpose of this study was to compare the abilities of a selected sample of professionally trained nurses and nonprofessionally trained home health visitors to suggest and prioritize solutions to a medical dilemma. Data were gathered by the use of a Practical Solutions Test and a Ranking Solutions Procedure. The subjects for the study were 77 females residing in rural counties in West Alabama. The four study groups were comprised of: (a) trained home visitors with 0 to 6 months of experience, (b) trained home visitors with more than 6 months of experience, (c) professionally trained nurses, and, (d) a control group of women with no training or experience. Data were analyzed using one-way analysis of variance (ANOVA). The findings suggest that all of the trained groups were able to generate more solutions to a typical client medical dilemma than could the control group: F(3.76) = 11.79; p = .0001. Faced with the same medical dilemma, the nursing group was more likely to suggest medical options over socioemotional solutions than were the home visitors: chi 2(3.76) = 9.41; p = .02. The nurses also prioritized the solutions differently by ranking them in a different sequence.

Adult↗
PubMed2001

Maternal depression and comorbidity: predicting early parenting, attachment security, and toddler social-emotional problems and competencies.

OBJECTIVE: To examine relations between maternal depression (in pure and comorbid forms) and mother-infant interactions, infant attachment, and toddler social-emotional problems and competencies. A second objective was to explore sex differences. METHOD: Sixty-nine mother-infant dyads were followed from pregnancy to 30 months postpartum. Depression was measured at multiple times with self-report and interview assessments. Play was assessed at 4 months and attachment status at 14 months postpartum. At 30 months, mothers completed the Child Behavior Checklist and Infant-Toddler Social and Emotional Assessment. RESULTS: Lifetime maternal depression predicted less optimal mother-infant interactions and insecure infant attachment. However, this "depression effect" was accounted for by mothers with comorbid diagnoses, who had less optimal interactions, and infants with higher rates of insecurity than either mothers with depression only or mothers with no psychopathology. Prenatal and postpartum depressive symptoms were associated with problem behaviors and lower competencies for boys. In contrast, quality of early interactions predicted problem behaviors in girls. CONCLUSIONS: It is important to examine the context of maternal depression with respect to additional psychopathology and environmental risks. Maternal depression in the presence of other psychopathology confers risk to the mother-child dyad. Consistent with previous work, risk pathways appear to differ for boys and girls. Early identification and prevention efforts are warranted.

Adult↗
PubMed2002

Emotional and behavioral problems in children and adolescents with and without intellectual disability.

BACKGROUND: The main objective of this study was to assess and compare the prevalence of a wide range of emotional and behavioral problems in children with and without intellectual disability (ID). METHODS: We studied 1,041 non-residential children randomly selected from special schools for educable (IQ 60 to 80) and trainable (IQ 30 to 60) children without severe additional physical or sensory impairments, and compared them to 1,855 children randomly selected from the general population (both ages 6 to 18). Parents completed the Child Behavior Checklist (CBCL), and teachers the Teacher's Report Form (TRF). RESULTS: Controlling for sex, age, and socioeconomic status, we found that both educable and trainable children had significantly higher mean scores on all CBCL and TRF scales than children without ID, except for trainable children on the scales Anxious/Depressed and Somatic Complaints. Almost 50% of children with ID had a Total Problem score in the deviant range compared to about 18% in children without ID. Compared to children without ID, the most prominent problem behaviors of educable children were Social Problems, Attention Problems, and Aggressive Behavior, and trainable children had an increased risk for Social Problems, Attention Problems, Withdrawn and Thought Problems. CONCLUSIONS: Elevated scale scores reflected differences between children with and without ID over a broad range of items, and not solely on items more likely to be related to developmental delay. Therefore, problem areas covered by the items in these scales deserve special attention in the mental health care of children with ID.

Adolescent↗
PubMed2004

[Functional ability and social-care problems of the elderly in the Cáceres health area].

OBJECTIVE: To describe the social environment and to identify the health problems and the functional and mental ability of the elderly in the community. DESIGN: Cross-sectional, observational study by means of a questionnaire. PATIENTS: 228 people over 71 and not living in an institution. SETTING: Cáceres Health Area. MAIN MEASUREMENTS: Questionnaire on social and demographic details, main pathologies, social assessment (Gijón scale), functional assessment (Barthel and Lawton-Brody scales), mental assessment (Pfeiffer test), geriatric problems and visits from health professionals. RESULTS: 67% of the 228 people in the sample were women, with an average age of 79. Comorbidity, present in over 70% of the elderly, was significantly related to multi-medication, falls, hospital admission, depression and insomnia. The most common social and family situation was of a person living with his/her partner (38.3%; CI, 6.31) or children, in a dwelling with architectural barriers (43.0%; CI, 6.43), with a good relationship to his/her social surroundings (61.0%; CI, 6.33). The Barthel test showed a significant relationship with all the geriatric problems declared. The Pfeiffer test showed a relationship with falls (t=3.10; P=.00214), with hearing problems (t=1.98; P=.048), with incontinence (t=3.59; P=.0040) and constipation (t=2.64; P=.0086). The Lawton-Brody test was related, in women, with falls (t=4.27; P=.00034), admissions (t=2.02; P=.044), constipation and sight and hearing problems; and in men, with depression and incontinence. CONCLUSIONS: Elderly people in the Cáceres Health Area showed good functional ability in their basic daily tasks, less ability in instrumental activities and high comorbidity.

Activities of Daily Living↗