Adoption predicts psychiatric treatment resistances in hospitalized adolescents.
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Adolescent↗
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Results for “Personality Development”
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The professional development portfolio process: setting goals for credentialing.
Professional Development Portfolio (PDP), the new credentialing system for dietetics professionals, places the responsibility for learning, professional development, and career direction on the individual practitioner. This study used questionnaires and focus group interviews to determine whether dietitians engage in reflection, self-assessment, and goal setting, the critical components of PDP recertification. Volunteers (n = 132) participated in 16 focus groups held during 8 state dietetic association meetings. Content analysis was conducted. Some subjects reflected using an informal non-structured process (42 text units), almost half (41%) performed annual self-assessments, and 25% set goals. Job availability, new practice areas, family obligations, and employer needs were key factors in goal formulation. Opportunities for self-direction, independent decision-making, and application of technical expertise were also considered in career choices and goal setting. Although few participants were currently performing PDP critical components, we conclude dietetic practitioners can gain the necessary skills for professional development with the newly available PDP Guide to support the portfolio process. We recommend that dietitians (a) allow sufficient time for the reflection process, including the use of additional tools; (b) develop personal mission statements to drive the goal-setting process; and (c) use effectiveness criteria to critique their goals.
Career Mobility↗
Acute multifocal placoid pigment epitheliopathy-like lesion as an early presentation of subacute sclerosing panencephalitis.
PURPOSE: To report a case of acute multifocal placoid pigment epitheliopathy (AMPPE)-like lesion as an early presentation of subacute sclerosing panencephalitis (SSPE). DESIGN: Observational case report. METHODS: A 21-year-old woman presented with a profound loss of vision in the left eye. The initial clinical picture was characterized by a whitish infiltration of the macular area and papillary edema in the left eye. Six days later multiple chorioretinal infiltrations were present in the peripheral fundus of the left eye, which led to the diagnosis of AMPPE. RESULTS: During the following year, a gradual change in her personality developed. The diagnosis of SSPE was made by cerebrospinal fluid examination. Her clinical condition deteriorated rapidly, and she died. CONCLUSIONS: AMPPE can be accompanied by central nervous system involvement. We wish to emphasize the importance of considering the diagnosis of SSPE in cases of AMPPE.
Adult↗
Social phobia and avoidant personality disorder as related to parental history of social anxiety: a general population study.
Using a validated and DSM-IV compatible questionnaire, the present study related family history of excessive social anxiety to social phobia and avoidant personality disorder (APD) in epidemiologically identified probands in the general population. Probands met diagnostic criteria for social phobia with or without APD and APD with or without social phobia. A two- to three-fold increased relative risk of social anxiety was observed for all diagnostic groups. Increasing severity in probands by varying diagnostic criteria did not affect the relative risk. Because familial aggregation of social anxiety was not modulated by Axis I or II diagnosis or diagnostic cut-off levels, data imply that social phobia and APD may represent a dimension of social anxiety rather than separate disorders. Thus, having an affected family member is associated with a two- to three-fold risk increase for both social phobia and APD.
Adolescent↗
Worry in children is related to perceived parental rearing and attachment.
In a sample of 159 primary school children, the relationship between perceived parental rearing behaviours and self-reported attachment style, on the one hand, and worry, on the other hand, was investigated. Children completed (a) the EMBU, a questionnaire measuring perceptions of parental rearing behaviours, (b) a single-item measure of attachment style, and (c) the Penn State Worry Questionnaire for Children (PSWQ-C), an index of severity of worrying. Results showed that parental rearing behaviours, in particular rejection and anxious rearing, were positively associated with worry. Thus, children who perceived their parents as more rejective and anxious reported higher levels of worry. Furthermore, self-reported attachment style appeared to be related to worry. More specifically, children who classified themselves as avoidantly or ambivalently attached displayed higher levels of worry than did children who classified themselves as securely attached. These findings are consistent with the notion that family environment factors such as parental rearing and attachment style contribute to the severity of anxiety symptoms in children.
Adolescent↗
Dissociative symptoms are related to endorsement of vague trauma items.
In current psychiatric literature, the received view is that dissociative symptoms originate from aversive childhood events. To a large extent, this view is based on cross-sectional studies that do not rule out a scenario in which dissociative tendencies contribute to self-reports of childhood trauma. In two studies, we tested one particular implication of this scenario, namely, that dissociative symptoms are related to endorsement of vague rather than specific items about childhood trauma. In study 1 (N = 43) and study 2 (N = 127), nonclinical participants completed standard measures of dissociation, childhood trauma, and fantasy proneness. We performed correlational and regression analyses on the data. Fantasy proneness and responses to broad trauma items, but not responses to factual trauma items predicted dissociation levels. This pattern of findings shows that the link between trauma and dissociation is considerably more complex than is often assumed. As well, it suggests that at least in nonclinical samples, dissociative symptoms may breed endorsement of vague trauma items.
Adolescent↗
A developmental perspective on character pathology.
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Humans↗
Is early separation anxiety a risk factor for adult panic disorder?: a critical review.
Heightened levels of early separation anxiety (SA) have long been linked to the risk of adult panic disorder (PD), suggesting that the two types of anxiety arise from a common diathesis--a proposition that has considerably influenced the classification of the anxiety disorders. However, the SA-PD link remains contentious, with some recent studies failing to confirm that putative association. All published research studies investigating the relationship of early SA to PD and/or other anxiety disorders were reviewed. Taken as a whole, the evidence provides support for the SA-PD hypothesis, although the specificity of that relationship needs further clarification. Problems of sample selection, retrospective measurement of early SA and comorbid diagnoses limit the certainty with which inferences can be drawn from existing data. Nevertheless, a recent community-based study provides additional support for the SA-PD hypothesis. Possible developmental pathways linking SA to PD are considered. One possibility that has not received adequate research attention is that early SA disorder (SAD) may persist into adulthood, rendering the sufferer vulnerable to panic and other anxiety symptoms when confronted with salient life stressors. We conclude that it is premature to reject the SA hypothesis of PD. Only well-designed longitudinal studies can map the complex developmental pathways linking early and later manifestations of morbid anxiety.
Adolescent↗
The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation.
The overall purpose of the present study was to further our understanding of the mechanisms of self-mutilative behavior in a sample of female inpatients. The study found that self-mutilators (n = 103) displayed a greater degree of dissociative symptoms and alexithymia and a greater number of self-injurious behaviors, as well as higher rates of childhood sexual abuse, than nonmutilators (n = 45). In addition, the study found that among these variables, the number of self-injurious behaviors had the strongest relationship to self-mutilation. However, both dissociative symptoms and alexithymia were independently associated with self-mutilative behavior. Implications of our findings for clinicians and researchers are discussed.
Adult↗
Separation anxiety in adulthood: a phenomenological investigation.
Separation anxiety disorder is well recognized as a juvenile psychiatric disorder, but it appears to be rarely diagnosed in adulthood. Drawing on our clinical impressions and a review of the relevant literature, we sought to investigate whether separation anxiety symptoms could be identified in adulthood. Forty-four subjects recruited by a media campaign were administered a semistructured interview and a self-report checklist for adult separation anxiety (ASA) symptoms, as well as the Separation Anxiety Symptom Inventory (SASI), a retrospective measure of early separation anxiety symptoms. Diagnoses of major depressive disorder (MDD), panic disorder (PD), agoraphobia (Ag), and dependent personality disorder were made using the SCID-P and SCID-II. Thirty-six subjects met criteria for a putative diagnosis of ASA based on a global clinical rating and/or endorsement of DSM-IV-derived criteria. Although most subjects dated the separation anxiety symptoms to their juvenile years, it was notable that one third reported the first onset of separation anxiety symptoms in adulthood. Although comorbid lifetime anxiety or depressive disorders were common, the majority of subjects reported that the separation anxiety symptoms predated other axis I disorders. Only six subjects (17%) were diagnosed with dependent personality disorder. Although limited by the method of sampling, this preliminary study suggests the need to examine more systematically whether a form of separation anxiety disorder may occur in adulthood.
Adult↗
A developmental perspective on family risk factors in somatization.
It is widely believed that the family plays an etiologically significant role in somatization. Although research indicates many high symptom reporters come from dysfunctional homes, very little is known about the more specific aspects of daily family functioning that may heighten the risk of physical symptomatology at different developmental levels. Accordingly, we report findings on the relationship between ten dimensions of family-of-origin environment and physical health complaints in 933 children, adolescents, and young adults in junior high, high, and undergraduate school (grades 6-16). Results indicated that certain aspects of family life may combine to heighten the risk of somatic complaints for youth at different developmental levels. The implications of these findings are discussed and directions for future research are noted.
Adolescent↗
Behavioral aspects of trauma in children and youth.
Trauma is prevalent in the lives of children. It derives from many sources, and, depending on its characteristics, can produce transient or enduring and devastating consequences. Early trauma, if left untreated, can set the stage for chronic deficits in the behavioral repertoires of affected children, and thus shape personality development. Additionally, when trauma is repetitive and chronic, the developing brain may be affected in ways that impede otherwise effective intervention. Yet diagnosing traumatic stress in children requires a departure from exclusively adult-like considerations and attention must be devoted to the ongoing developmental processes. Trauma-associated clinical features in children are sharply distinct from those that are associated with adult traumatization and must be taken into account from screening and diagnosis through treatment and outcome evaluation. We suggest that a learning foundation for symptom development will best assist the identification and selection of efficacious treatments. Pediatricians should make use of validated screening procedures that effectively identify affected children to facilitate timely referral and ongoing monitoring of treatment outcomes for their patients. A representative list of such instruments can be found in Table 1. With respect to hospital-based trauma work, we suggest the following recommendations: Professionals must be alert to the presence of acute stress symptoms in any child or parent after all injury incidents. These symptoms may occur in any injured child regardless of age, gender, injury severity, mechanism of injury, or length of time since injury. Certain mechanisms of injury, (ie, pedestrian versus motor vehicle collision), place the parent at higher risk for symptomatology. All family members, including parents and siblings, must be considered at risk for acute and long-term functional abnormalities. It is important to educate patients and family members that acute stress symptoms are common after an injury incident and are likely to resolve as the patient's injuries heal. Yet despite this, before discharge from the hospital, parents must be taught to evaluate their traumatized child's behavior, as well as their own, for any evidence of posttraumatic stress disorder. Health care providers must anticipate potential strain upon family relationships and financial resources. Parent's posttraumatic stress symptoms may result in deterioration of their own ability to support their injured child. And finally, reassessment of patient and family members should occur within the first days, at 1 to 2 weeks, 6 months, and 1 year following injury to ensure proper recovery and optimization of psychosocial function.
Adaptation, Psychological↗
The structure of developmental theory.
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Child↗
Questions a satisfying developmental theory would answer: the scope of a complete explanation of development phenomena.
The good theory of human development is a complete theory, a theory that addresses the 10 points cited above. While the good theory cannot be about a set of a priori and objective facts, it is nevertheless about a set of facts that control the degree to which theory and interpretation correspond to them and are also consistent with other propositions in the theory and with other theories. Correspondence and consistency are compatible attributes of the good theory and are achieved through a dialectical exchange between a community of investigators that demands, in the end, that some theories and accounts be discarded because they fail to conform to the facts, as they were established in the theory, or because they lead to a reductio absurdum with regard to other established propositions. They fail, in other words, because they fail to sustain a sentiment of rationality.
Child↗
Obesity: food intake.
This article discusses some of the changes in our food environment that have encouraged overeating and some research that underlies successful weight loss and maintenance of weight loss. The discussion of these topics will help in the guidance of patients to develop personalized eating plans and reduce energy intake, in part by recognizing the contributions of fat, concentrated carbohydrates, and large portion sizes.
Diet, Reducing↗
Predicting intraindividual self-concept trajectories during adolescence.
The level and stability of both global and domain-specific self-concepts was examined in a study of 253 adolescents, aged 11-20. Intraindividual self-concept trajectories were calculated through growth curve modeling. Six of the self-concept domains were stable over time. In the remaining three domains, there was a significant increase in perceived competency. Growth curve modeling highlighted individual differences in both level and change in self-concept for each of the domains. These differences were partially accounted for by the adolescents' age and gender, suggesting that these variables are important determinants of adolescent self-concept.
Adolescent↗
Adolescent age trends in primary personality factors measured in T-data: a contribution to use of standardized measures in practice.
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Adolescent↗
Identity status and personal construct systems.
The relationship between identity status and the structural features of an individual's personal construct system or self-theory was investigated. Personal constructs relevant to 10 contemporaneous roles (myself as a friend, student, son/daughter, and so on) were elicited from 75 late adolescents who also completed an identity-status measure. Correlational analyses between identity-status scores and structural features of the self-system revealed a theoretically interpretable pattern of interrelationships. The implications of these findings for future research is considered.
Adolescent↗