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PubMed2001

Children with disabilities: a longitudinal study of child development and parent well-being.

This Monograph presents the results of the Early Intervention Collaborative Study, a longitudinal investigation of the cognitive and adaptive behavior development of children with developmental disabilities and the adaptation of their parents, extending from infancy through middle childhood. The study was designed to generate and test conceptual models of child and family development and contribute to the knowledge base that informs social policy and practice. The sample for the investigation reported here consists of 183 children with Down syndrome, motor impairment, developmental delay and their families who were recruited at the time of their enrollment in an early intervention program in Massachusetts or New Hampshire. Data were collected at five time points between entry to early intervention and the child's 10th birthday. Home visits were conducted at each time point and included child assessments, maternal interview, and questionnaires completed independently by both parents. Trajectories in children's development and parental well-being were analyzed using hierarchical linear modeling. Predictor variables were measured at age 3 years when children were exiting early intervention programs. Children's type of disability predicted trajectories of development in cognition, social skills, and daily living skills. Children's type of disability also predicted changes in maternal (but not paternal) child-related and parent-related stress. Beyond type of disability, child self-regulatory processes (notably behavior problems and mastery motivation) and one aspect of the family climate (notably mother-child interaction) were key predictors of change in both child outcomes and parent well-being. A different aspect of the family climate--family relations--also predicted change in child social skills. Parent assets, measured as social support and problem-focused coping, predicted change in maternal and paternal parent-related stress respectively. The implications of these findings for both the science of child development and the policies and practices of developmental intervention are discussed.

Adaptation, Psychological↗
PubMed2004

Emotional and behavioral problems of children living with drug-abusing fathers: comparisons with children living with alcohol-abusing and non-substance-abusing fathers.

Although the effects of paternal alcoholism on the psychosocial adjustment of children are well documented, the impact of fathers' illicit drug abuse on their children is poorly understood. The purpose of this study was to compare the adjustment of children living in families with drug-abusing fathers (n = 40) with that of children with fathers who abused alcohol (n = 40) and children with non-substance-abusing fathers (n = 40). Children with drug-abusing fathers experienced more internalizing and externalizing symptoms than children with alcoholic or non-substance-abusing fathers. Interparental conflict and parenting behavior mediated the relationship between family type and children's adjustment. Interventions to improve fathers' parenting behavior and reduce partner conflict may lead to better adjustment among custodial children of drug-abusing fathers.

Adult↗
PubMed1995

Dental fear and behavior management problems in children. A study of measurement, prevalence, concomitant factors, and clinical effects.

A Swedish parental version of the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS) was administered twice to the parents of 52 children aged 4-14 yr, and CFSS-DS was compared with child behavior during treatment. CFSS-DS reached high values for validity and reliability, and scores of 38 or more were found to be related to dental fear. The prevalences, concomitant factors, and clinical effects of dental fear and behavior management problems (BMP) were studied in a representative study population of 4,505 children aged 4-6 and 9-11 yr. Parents of 3,204 of the children (71%) answered a questionnaire containing CFSS-DS, a Short Form of Children's Fear Survey Schedule (CFSS-SF) measuring general emotional status, Corah Dental Anxiety Scale (DAS) to measure maternal and paternal dental fear. The dental records were retrieved from the Public Dental Service, and 4,061 complete dental records provided information regarding behavior management problems, caries, fillings, dental treatments and number of missed appointments. The study population had a mean score of 23.1 on CFSS-DS (sd 8.1; range 15-71). Dental fear (CFSS-DS scores > or = 38) was found in 6.7%, and BMP in 10.5% of the children. Both dental fear and BMP decreased with age. Age, general emotional status, and maternal dental anxiety were identified as concomitant factors in the development of dental fear. Experiences of pain during dental treatment increased the risk of developing dental fear and BMP. Dental fear and BMP were associated with missing of dental appointments and deterioration of dental health. A new method using projective techniques to measure child dental fear, the Children's Dental Fear Picture test (CDFP), was developed. Data regarding reliability and validity of CDFP was established in a group of 146 children selected from the questionnaire survey. The testings with CDFP were performed by two trained dentists. CDFP proved to have high interexaminer reliability (88.9%), and to be a valid test. Sensitivity was calculated to 98.5%.

Adolescent↗
PubMed1994

Acute alcohol exposure markedly influences male fertility and fetal outcome in the male rat.

Although it is recognized that drugs ingested by pregnant females produce marked cognitive and physiological deficits in their offspring, the possibility that paternal exposure to drugs prior to mating may have adverse effects on fertility and fetal outcome has not received much attention. The purpose of the present studies was to examine whether a single, acute exposure to alcohol influences the subsequent ability of adult male rats to mate and produce healthy and viable litters. Our results showed that a relatively large dose of alcohol 24 hours prior to breeding had little effect on the mating behavior of male rats, but there were markedly fewer pregnancies in females mated with alcohol-exposed male rats than in controls. Of equal importance, we found that, even when conception occurred and live births were produced, there were striking differences in fetal outcome. Alcohol-treated males sired many fewer pups than control males and there was a markedly enhanced mortality rate in their offspring. Collectively, these data suggest that acute paternal alcohol administration 24 hours prior to breeding does not affect mating behavior, but results in a greatly diminished fertility rate and fewer and less viable offspring. These studies suggest that paternal alcohol use may be as important as maternal alcohol abuse as a negative variable in pregnancy and fetal outcome.

Animals↗
PubMed1997

Behavioral teratogenesis: an extension to the teratogenesis of functions.

Major malformations correspond to pathology during the first 2 months of gestation. Thereafter, histological and biochemical abnormalities can result from different negative maternal incidents and, without obvious malformations, change the phenotype of the conceptus. These abnormalities lead to essentially functional disorders often compatible with life and to more or less serious handicaps. All systems, when they arrive at such a stage of development, can be theoretically involved. The central nervous system (CNS) offers a very clear example of such weaknesses because its maturation is particularly long and susceptible to changes even after birth. The steps of this maturation overlap and form a continuum reflected in the pathology. Mental retardation occurring in children born of mothers who were subjected to atomic radiation, or ingested methylmercury from industrial waste, or who suffered the effects of lead, alcohol or tobacco constitutes a clear clinical example. Animal experiments confirm these data, adding pathogenic explanations. These experiments also explore the possible consequences that some medical techniques such as modern reproductive technology, for example embro freezing, can have on the development of the conceptus. Toxic substances or drugs can also be responsible for such abnormalities through a genetic attack on spermatogenesis. Behavioral teratogenesis also opens a larger perspective related to the optimal quality of the conceptus and the determining factors, from stress or dietary factors during apparently normal pregnancy to paternal age at the moment of conception. Finally, given that other systems than the CNS can be involved in histological or biochemical abnormalities, such as the reproductive system, we must ask what other types of functional pathology can be induced by interventions on gametes, the embryo and the fetus. Thus, behavioral teratogenesis leads to the teratogenesis of functions.

Abnormalities, Drug-Induced↗
PubMed1991

Confidentiality for whom?

Confidentiality has been argued to be a cornerstone both of medical and social research encounters, particularly because of the protection it offers for patients and informants. In practice the idea of confidentiality is fractured. Professional interests in the organisation of medical work, and concerns for the collective interest amongst social researchers may lead to individual confidentiality being undermined. In addition discrepancies in the ethical positions and practices of social researchers and those in biomedicine may produce further problems for the maintenance of confidentiality.

Behavioral Research↗
PubMed2002

A novel song parameter correlates with extra-pair paternity and reflects male longevity.

Although elaborate bird song provides one of the prime examples of a trait that evolved under sexual selection, it is still unclear whether females judge the quality of males by attributes of their song and whether these song features honestly signal a male's genetic quality. We measured the ability of male dusky warblers Phylloscopus fuscatus to maintain a high sound amplitude during singing, which probably reflects an individual's physiological limitations. This new measure of singing performance was correlated with male longevity and with extra-pair paternity, indicating that females who copulated with better singers obtained 'good genes' for their offspring. Our findings are consistent with the idea that females assess male quality by subtle differences in their performance during the production of notes, rather than by the quantity or versatility of song. In addition, observations on territorial conflicts indicate that attractive males invest less in competition over territories because they can reproduce via extra-pair paternity.

Animals↗
PubMed2004

Why people follow the leader: the power of transference.

We all admire leaders. In trying to understand how leadership works, however, we often lose sight of the fact that followers are a crucial part of the equation. Regrettably, they get short shrift in the management literature, where they are described as merely responding to their leaders' charisma or caring attitudes. What most analyses seem to ignore is that followers have their own motivations and are as powerfully driven to follow as leaders are to lead. In this article, psychoanalyst, anthropologist, and management consultant Michael Maccoby delves into the unconscious recesses of followers' minds. He looks closely at the often irrational tendency to relate to a leader as some important person from the past--a parent, a sibling, a close friend, or even a nanny. Sigmund Freud discovered this dynamic when working with his patients and called it"transference." But as important as it is, the concept remains little understood outside the realm of clinical psychoanalysis. This is unfortunate, because a solid understanding of transference can yield great insight into organizational behavior and endow you with the wisdom and compassion to be a tremendous leader. The author explains the most common types of transference--paternal, maternal, and sibling--and shows how they play out in the workplace. He notes that they have evolved as our family structures have changed. Whether followers perceive a leader as an all-knowing father figure, as an authoritative yet unconditionally loving mother figure, or as a brother or sister who isn't necessarily a model of good behavior, the leader can manage transferential ties by bringing unconscious projections to light. Then debilitating resentment and animosity can give way to mutual understanding and productivity--and a limping organization can start to thrive.

Administrative Personnel↗
PubMed2005

Temperamental emotionality in preschoolers and parental mood disorders.

A number of models developed in the adult psychopathology literature (i.e., L. A. Clark & D. Watson, 1991) have asserted that low levels of positive emotionality (PE) are predisposing factors or precursors for depression and represent a form of temperamental risk for depression. Further support for this claim would derive from evidence linking low PE to known indicators of risk for depression. The authors examined the association between temperamental emotionality in young children and parental mood disorders. One hundred unselected preschool-aged children completed a battery of emotion-eliciting tasks tapping aspects of PE, negative emotionality (NE), and behavioral inhibition (BI). Parental psychopathology was assessed with semistructured diagnostic interviews. Low PE in children was associated with maternal, but not paternal, mood disorder. The low PE-maternal depression link was relatively specific, as there were few associations between low PE and other forms of parental psychopathology or between NE and BI and parental mood disorders.

Affect↗
PubMed2005

In defense of paternalism.

This paper argues that we have wrongly and not for the patient's benefit made a form of stark autonomy our highest value which allows physicians to slip out from under their basic duty which has always been to pursue a particular patient's good. In general - I shall argue - it is the patient's right to select his or her own goals and the physician's duty to inform the patient of the feasibility of that goal and of the means needed to attain it. If the goal is not one that is possible, the patient, with the physician and family, must select a feasible goal and then discuss the costs/benefits of various approaches. The physician should take a leading role in helping the patient select the goal. I argue that to simply present a laundry list of means and insist that patients choose for themselves is not only abandoning patients to their autonomy but is, in fact, a crass form of violating the patient's autonomy. Freely choosing not to choose is a choice a patient with decisional capacity is entitled to make and one that needs to be respected.

Beneficence↗
PubMed2001

On risk and decisional capacity.

Limits to paternalism are, in the liberal democracies, partially defined by the concepts of decision-making capacity/incapacity (mental competence/incompetence). The paper is a response to Ian Wilks's (1997) recent attempt to defend the idea that the standards for decisional capacity ought to vary with the degree of risk incurred by certain choices. Wilks's defense is based on a direct appeal to the logical features of examples and analogies, thus attempting to by-pass earlier criticisms (e.g., Culver & Gert, 1990) of risk-based standards. Wilks's argument is found wanting on the grounds that he misconstrues the logic of such capacity, especially in accounting for conceptual and pragmatic ties with issues of decisional authority. A diagnosis is offered as to the source of Wilks's error (the assumption that mental competence is a species of wider genus of "competence"), and an alternative way of accounting for risk within the predominant contemporary legal framework is sketched.

Choice Behavior↗
PubMed1985

The ageing gamete in relation to birth control failures and Down syndrome.

Some indirect relationships between contraception failures and offspring with a pathological condition are reviewed, and a causal connection between them is suggested. This hypothesis is supported by the decreasing incidence of Down syndrome (DS) in general in recent years, and the increase among the younger maternal age categories as well as the effect of birth order. A more than doubled incidence of DS children among young Catholic mothers and the fact that conceptions of children with DS are preceded by unusually long periods of abstinence are emphasised and discussed. These data offer circumstantial evidence that the conceptions that occur despite application of the so called "natural" family planning methods in particular are at high risk. The impact of reproductive biological failures ("nature") and of reproductive behaviour ("nurture") on the human gametes can be disentangled by thorough studies of the epidemiology of major and minor congenital anomalies.

Adult↗
PubMed1985

Adolescent pregnancy: contributing factors, consequences, treatment, and plausible solutions.

Adolescence, although not always necessarily a period of extreme stress, is a time of profound physical changes which increase the adolescent's awareness of and interest in sexual behavior. This issue of sexuality, which begins in early adolescence, creates new challenges to personal and gender identity formation as the person matures. Sexual maturation is a three-fold process, requiring growth in understanding of oneself as a sexual being, in the ability to handle interpersonal relationships effectively, and in the capacity to plan behavior in view of future outcomes and present problems. A current concern is that today's adolescents, including early adolescents, may be making important life choices such as parenthood before they are developmentally ready for such roles (Chilman, 1980). This paper deals with pregnancy in adolescents and modes of responding to this phenomenon by those in the counseling and other helping professions.

Adolescent↗
PubMed2026

Prader-Willi syndrome as a neurogenetic model for psychosis and obsessive-compulsive disorder: A review of clinical, behavioral, and biological insights.

Prader-Willi syndrome (PWS) is a complex neurodevelopmental disorder classically defined by hyperphagia and obesity. However, its profound psychiatric phenotype offers a unique genetic framework for understanding major mental illnesses. This review positions PWS as a potentially informative biological model for psychosis and obsessive-compulsive disorder (OCD), bridging the gap between 15q11-q13 imprinting defects and neural circuit dysfunction. We synthesize evidence demonstrating that psychosis in PWS is not a uniform trait but is disproportionately linked to the maternal uniparental disomy (mUPD) subtype. This genotype-phenotype correlation suggests that overexpression of maternally imprinted genes and loss of paternal expression disrupt cortical excitatory-inhibitory balance, resembling the "schizophrenia-bipolar" genomic architecture. Furthermore, synthesized evidence characterizes the repetitive, ritualistic behaviors in PWS not merely as behavioral challenges, but as a developmentally arrested OCD-spectrum phenotype driven by distinct serotonergic-oxytocinergic imbalances and hypothalamic-limbic dysconnectivity. Mechanistic insights from preclinical models of MAGEL2, SNORD116, and NDN deficiency are integrated with clinical findings to highlight shared neurobiological substrates. Finally, we outline a roadmap for precision psychiatry in PWS, emphasizing the necessity of pharmacogenomics in antipsychotic management and the potential of targeted circuit-based therapeutics. By deconstructing the psychiatric comorbidities of PWS, we provide a framework for translating genomic architecture into mechanistic understanding and targeted treatment for complex neuropsychiatric disorders.

15q11-q13↗
PubMed2001

Reconstitution of enhancer function in paternal pronuclei of one-cell mouse embryos.

How chromatin-mediated transcription regulates the beginning of mammalian development is currently unknown. Factors responsible for promoter repression and enhancer-mediated relief of this repression are not present in the paternal pronuclei of one-cell mouse embryos but are present in the zygotic nuclei of two-cell embryos. Here we show that coinjection of purified histones and a plasmid-encoded reporter gene into the paternal pronuclei of one-cell embryos at a specific histone-DNA concentration could recreate the behavior observed in two-cell embryos: acquisition of promoter repression and subsequent relief of this repression either by functional enhancers or by histone deacetylase inhibitors. Furthermore, the extent of enhancer-mediated stimulation in one-cell embryos depended on the acetylation status of the injected histones, on the treatment of embryos with a histone deacetylase inhibitor, and on the developmentally regulated appearance of enhancer-specific coactivator activity. The coinjected plasmids in one-cell embryos also exhibited chromatin assembly, as determined by a supercoiling assay. Thus, injection of histones into one-cell embryos faithfully reproduced the chromatin-mediated transcription observed in two-cell embryos. These results suggest that the need for enhancers to stimulate promoters through relief of chromatin-mediated repression occurs once the parental genomes are organized into chromatin. Furthermore, we present a model mammalian system in which the role of individual histones, and particular domains within the histones that are targeted in enhancer function, can be examined using purified mutant histones.

Animals↗