Behavioral Treatment of CPR Anxiety: A Case Study

Abstract: A 23-year-old mother with a previously documented psychiatric history experienced extreme anxiety regarding the potential need to resuscitate her infant from recurrent life-threatening apnea. Before discharge on a home monitor, the mother was treated with systematic desensitization and response prevention techniques for cardiopulmonary resuscitation (CPR) anxiety Following 4 days of therapy, the mother successfully completed the CPR training course. At 4-month follow-up, the mother reported that she was able to use CPR successfully and could respond to apnea alarms within 10 seconds Implications of this technique for other health care concerns are discussed. Article: The infant with interrupted apnea of unknown etiology, often labeled interrupted infantile apnea (11A) or idiopathic apnea, presents a complicated medical and psychological problem for the health care team. The infant is typically found limp, pale and/or cyanotic, and not breathing. Initial attempts to revive the infant are often made by auditory or manual stimulation, followed by rushing the infant to a hospital emergency room where a description of the apneic event is obtained by an emergency room physician. Infantile apnea has been linked to a multitude of causes including prematurity, infection, hypoglycemia, metabolic imbalance, drug toxicity, seizure disorder, gastroesophageal reflux, congenital anomalies, and upper airway obstruction. Because of this varied etiology, a comprehensive medical evaluation is necessary to search for treatable disorders. At the University of Oklahoma Health Sciences Center, the work-up typically includes a medical and family history, physical examination, blood gases, serum electrolytes, glucose, cultures, toxicological analysis, electroencephalogram (EEG), electrocardiogram, and radiographic examinations of the lower and upper respiratory tract. Since these tests are usually negative, an overnight sleep study is then performed. The sleep study includes a 12-hour continuous polygraphic recording of sleep state, nasal airflow, and chest wall movement Simultaneous continuous esophageal pH monitoring and ventilatory response to carbon dioxide inhalation are performed to identify gastroesophageal reflux and aberrant chemoreceptor function, respectively

Prevalence of obesity and autism spectrum disorder.

Childhood obesity is a growing public health concern and is increasingly prevalent in recent years. There are a variety of risk factors for obesity in children with autism spectrum disorder (ASD). To estimate the prevalence of obesity in children with ASD, a secondary data analysis was conducted on the nationally representative National Survey of Children's Health (NSCH; 2011-2012) archival database. Variables specific to ASD as well as body mass index were analyzed using a cross-tabulation analysis to compare a sample of children with ASD with a random control sample. The prevalence of obesity in children with ASD was 12.6% compared with 7.2% of children without ASD. Additionally, 9.3% of children with ASD met criteria for being overweight compared to 7.5% of those without ASD. These findings suggest that children with ASD could benefit from applied behavioral interventions to reduce risk factors for obesity. Specific recommendations for behavior-analytic treatment are discussed as well as recommendations for future research to better understand these risk factors

Decisional Capacity Among Minors With HIV: A Model for Balancing Autonomy Rights With the Need for Protection

The purpose of this article is threefold: (a) to describe the relevant ethical and legal issues associated with decisional capacity among minors and to discuss the importance of these concepts for children and adolescents living with HIV, (b) to provide a framework for assessing the decisional capacity of children and adolescents with HIV, and (c) to present a model for thinking about how to use this assessment data to guide action along the protection-autonomy continuum

Rejection Sensitivity and Marital Adjustment among Military Spouses during Deployments

This research examined the relationship between rejection sensitivity and marital adjustment. The Adult Rejection Sensitivity Questionnaire (ARSQ) and the Revised Dyadic Adjustment Scale (RDAS) were given to address this question among a sample of 129 spouses of individuals currently deployed on mili-tary missions in Iraq or Afghanistan. Other potentially confounding variables were examined including gender, age, education, number of times married, number of children in the household, number of previ-ous deployments, and number of months separated during the current combat deployment. Rejection sen-sitivity and number of deployments contributed to 34 % of the variance on relationship adjustment

Children's Effects on Parenting Stress in a Low Income, Minority Population

Relationships between parenting stress as measured by the Parenting Stress Index and other maternal and child characteristics were investigated in a sample of 66 low income mothers and their 5- to 8-year-old children who are at risk for educational disabilities. The data provide concurrent and construct validity support for the Parenting Stress Index. In addition, child characteristics (self-esteem, behavior conduct, and spelling achievement) and maternal characteristics (self-esteem and crowding stress) related to parenting stress in this sample. That these variables combined to explain approximately half of the variance on the Parenting Stress Index suggests that they represent important sources of parenting stress, at least during the early grade school years. Because the children's behavior and academic achievement constituted significant sources of parent stress, supportive counseling services may be needed that are often required for children of low income, less well-educated parents

COVID-19 Lockdown Worries About the Virus and Finances

Worries about getting the virus and worrying about finances have been associated with negative mood states including anxiety and depression during COVID-19 lockdowns. In this Survey Monkey study conducted during a COVID-19 lockdown (N= 260 respondents), 88% reported worrying about getting the virus and 72% worrying about their finances. Correlation analyses suggested that worries about the virus and about finances were related to each other and were, in turn, positively related to scores on scales measuring COVID-related stress, negative mood states including anxiety and depression, fatigue, sleep disturbances, and posttraumatic stress symptoms. These problems were common to both types of worries as was the lack of health activities including exercise, self-care, and touching partners and children. Some findings were unique to each of the worries. Worrying about the virus was related to being active on social media, connecting with friends, and housekeeping and paperwork. Worrying about finances was correlated with caregiving, unemployment, less schooling, and alcohol use. The results of this survey are limited by the self-reported data from a non-representative sample that is cross-sectional. Nonetheless, they highlight the negative effects of worries about the virus and about finances during a COVID-19 lockdown

It\u27s Not Always Binary: Connecting the Continuum of Caregiver Depression With Child Adjustment in Children Who Are High Risk for Maltreatment

BACKGROUND: Young children living with a depressed parent are at risk for developing social, behavioral, and emotional problems. The purpose of this study was to evaluate whether an increase in subclinical caregiver depression scores was associated with increases in internalizing and externalizing behavior in children who are at high risk for maltreatment. METHODS: The 1019 U.S.-based dyads consisted of predominantly single (45.53%) and Black/African American (53.29%) caregivers and high-risk 4-year-olds from the LONGSCAN study. Multivariate regression analyzes were used to evaluate the relationship between caregiver Center for Epidemiological Studies-Depression (CES-D) scores, above and below the at-risk for depression CES-D score, and preschooler internalizing, externalizing, and total problem behaviors, measured with the Child Behavior Checklist (CBCL). RESULTS: Caregiver CES-D score increases, above and below the at-risk for depression score, were significantly associated (p \u3c 0.05) with increased child internalizing, externalizing, and total problem behaviors. After adjusting for covariates, among dyads whose caregivers had subclinical (CES-D \u3c 16) scores, a one-unit score increase was significantly associated with a 0.43 increase (p = 0.00) in children\u27s CBCL internalizing score. LIMITATIONS: These findings are restricted to preschool children who are at risk for maltreatment, limiting generalizability. CONCLUSIONS: Low and moderate levels of caregiver depressive symptomatology were associated with a negative influence on preschoolers\u27 adjustment. Practitioners should consider that the link between caregiver depression and child wellbeing may lie on a continuum. With consideration of the full continuum of symptoms, early intervention and anticipatory guidance may decrease the impact of depression on the caregiver, child, and system

Fathers massaging and relaxing their pregnant wives lowered anxiety and facilitated marital adjustment

This study examined the effects of fathers massaging their pregnant wives and practicing relaxation with them. Participants were married American fathers who completed the Dyadic Adjustment Scale (DAS), the State-Trait Anxiety Inventory (STAI), and the Paternal Fetal Attachment Scale. The fathers learned to massage their pregnant wives, learned relaxation techniques with their wives, or received no intervention. Massage therapy lowered the fathers’ self-reported anxiety levels on the STAI and improved marital adjustment on the DAS