Tattoos and antisocial personality disorder

Objective  The relationship of tattoos to the diagnosis of antisocial personality disorder (ASPD) was explored in a forensic psychiatric inpatient hospital setting. It was hypothesized that a greater proportion of forensic inpatients that possessed tattoos had ASPD than patients who did not possess tattoos. Method  Forensic male psychiatric inpatients (N = 36) were administered a semi-structured interview to determine the presence of a tattoo. ASPD was determined by criteria on a Diagnostic and Statistical Manual of Mental Disorders-IV ASPD checklist. Demographic and background characteristics of the patients were collected, and details about each tattoo were obtained including a calculation of the surface area of each tattoo. Results  Significantly more forensic psychiatric inpatients with tattoos had a diagnosis of ASPD compared to patients without tattoos. Patients with ASPD also had a significantly greater number of tattoos, a trend toward having a greater percentage of their total body surface area tattooed, and were more likely to have a history of substance abuse than patients without ASPD. Tattooed subjects, with or without ASPD, were significantly more likely to have histories of substance abuse, sexual abuse and suicide attempts than non-tattooed patients. Conclusions  Forensic psychiatric inpatients with tattoos should be assessed carefully for the presence of ASPD as well as for substance abuse, sexual abuse and suicide attempts, factors having potentially significant influence on the assessment and treatment of such patients. Copyright © 2008 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60449/1/43_ftp.pd

Community- delivered infant- parent psychotherapy improves maternal sensitive caregiving: Evaluation of the Michigan model of infant mental health home visiting

The current study evaluated the effectiveness of a home- based psychotherapeutic Infant Mental Health Home Visiting (IMH- HV) intervention for enhancing parenting sensitivity; a secondary aim was to evaluate whether the use of video feedback was associated with greater treatment response. Participants were N = 78 mothers and their children (age at entry ranged from prebirth to 24- month old (M = 9.8, SD = 8.4), who were initiating IMH- HV services with community mental health- based therapists (N = 51). Dyads were assessed during extended home visits via standardized interviews and observational and questionnaire methods within the first month of treatment (baseline), and again 6 and 12 months thereafter. Following each of these extended home visits, study evaluators completed a standard Q- sort to capture observations of maternal sensitivity during the visit. Therapists completed fidelity checklists used to derive the total number of IMH- HV sessions received (i.e., dosage) and frequency with which therapists provided video feedback. Results indicated a dose- response relationship between number of sessions and maternal sensitivity, and that video review with parents independently contributed to improved maternal sensitivity. Discussion focuses on the effectiveness of this community- based psychotherapeutic home visiting model for enhancing parenting, as well as the value of video feedback as a specific therapeutic strategy.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154891/1/imhj21840_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154891/2/imhj21840.pd

Parenting mediates associations between intimate partner violence at different life stages and toddler social–emotional problems

Background: Researchers have linked parent experiences of intimate partner violence (IPV) to engagement in more negative and less positive parenting behaviors with their own children. This parenting behavior is associated with more negative child social-emotional outcomes. There is little research examining the impact of exposure to IPV during childhood on subsequent parenting and child outcomes in the next generation. This study aimed to better understand the complex relationship between IPV, parenting, and child social-emotional development among mothers of toddler-aged children, using both mothers’ self-reported and observed parenting. Method: This study utilized longitudinal data from an economically disadvantaged, racially diverse sample of 120 women who participated in data collection across the perinatal period, until children were 2 years of age. Measures included self-reported and observed parenting, mother-reported IPV history, and mother-report of toddler social-emotional difficulties. Results: Childhood exposure to IPV predicted observed parenting problems, which in turn predicted greater toddler social-emotional problems. Conversely, adult experiences of IPV predicted self-reported parenting difficulties, which predicted greater toddler social-emotional problems. Summary: Findings suggest that exposure to IPV at different time points may influence parenting in different ways, representing unique pathways between maternal IPV experiences and child social-emotional difficultie

Introduction to the Special Issue on Adverse Childhood Experiences (ACEs): Prevention, Intervention, and Access to Care

Exposure to adverse childhood experiences (ACEs) is an international public health problem [...

Establishing Trauma-Informed Primary Care: Qualitative Guidance from Patients and Staff in an Urban Healthcare Clinic

Patients present to primary care clinics with a variety of experiences, including exposure to adverse childhood experiences (ACEs) and other social determinants of health. The pervasive impact of early adversity on later healthcare outcomes has resulted in the development of trauma-informed care principles that can be applied to healthcare settings. The primary aim of this study is to improve understanding of patient and staff experiences within a trauma-informed urban healthcare setting to guide considerations and recommendations when implementing such a model. A phenomenologic approach was taken using an interpretivist paradigm to collect qualitative data by conducting patient and staff focus groups. The following themes were identified: the communal experience of significant trauma, lack of continuity of care and time for each appointment, the importance of a sense of community and standardization and normalization of asking about trauma, development of social support networks, and creating a safe and non-judgmental healthcare space. Based on findings, considerations for implementing a trauma-informed healthcare model are provided

Effects of intimate partner violence and home environment on child language development in the first 3 years of life

Objective: Intimate partner violence (IPV) can adversely affect children\u27s cognitive development, but links between IPV exposure and language development in the earliest years of life remain unknown. The present study examined the effects of IPV and the quality of the home environment on children\u27s language development at age 3 years. Methods: In a prospective, 5-panel, longitudinal study of 79 mother-child dyads assessed prenatally to age 3 years, we examined standardized measures of receptive and expressive language development at age 3 years. Predictors and covariates included measures of IPV, characteristics of the home environment, maternal education, and maternal depression. Results: Regression analyses indicated a significant main effect of the home environment and maternal education on receptive language, with more supportive homes and more educated mothers at age 1 year linked to better child receptive language at age 3 years. Higher maternal education also significantly predicted better child expressive language at age 3 years. Early exposure to IPV had a direct adverse effect on children\u27s expressive language development; however, interaction analyses indicated that this association was moderated by the quality of the home environment. Specifically, IPV adversely affected expressive language even when home quality was high, indicating that a supportive and stimulating home environment did not buffer effects of IPV on expressive language development. Conclusions: Intimate partner violence may adversely affect expressive language, even in positive home environments. Early language skill is an important predictor of later academic readiness and psychological development; therefore, children from at-risk home environments should be screened and monitored early for intervention

Profiles of Early Childhood Adversity in an Urban Pediatric Clinic: Implications for Pediatric Primary Care

Pediatricians are well-positioned to screen for early childhood adversities, but effective responses to positive screens require an understanding of which adversities typically co-occur, and to what extent they are associated with other risk or protective factors. Among children seen at an urban academic pediatric practice, this study aimed to (1) examine the prevalence of different types of early adversity and protective experiences reported by primary caregivers, and (2) define latent classes of co-occurring adversities. Of 1434 children whose parents completed the Safe Environment for Every Kid (SEEK) at well-child visits during November 2019–January 2021, three classes of adverse experiences emerged, including those reporting low adversity (L; 73%), caregiver stress (CS; 17%), and both caregiver stress and depression (CSD; 10%). Among those who also completed the Adverse Childhood Experiences Questionnaire (ACE-Q, n = 1373) and the Protective and Compensatory Experiences Scale (PACES, n = 1377), belonging to the L class was associated with lower ACE-Q and higher PACES scores. For parent-respondents only, ACE-Q scores were significantly greater for the CSD class compared to the CS and L classes. Pediatricians should attend to the needs of caregivers reporting both stress and depression, as these families may face especially high levels of adversity and low levels of protective factors

Cumulative risk, infant sleep, and infant social-emotional development

The effect of cumulative biological, psychosocial, and demographic risk and infant sleep on infant social-emotional functioning in 12-month-old infants (46% female) was examined in data from racially (30% Black, 60% White, 10% multiracial/other) and socioeconomically (41% below median income) diverse caregivers (N = 468, M = 30.42 years old, SD = 5.65) recruited from two midwestern states in 2019–2020. Due to the major changes in sleep patterns during infancy and the reported association between sleep and social-emotional functioning, this study also examined whether sleep moderates the association between risk and infant social-emotional functioning and potentially promotes healthy social-emotional functioning despite risk. Greater cumulative risk was associated with poorer sleep efficiency and more social-emotional problems, but was not associated with the general acquisition of social-emotional milestones. Results also suggested that poorer sleep efficiency was associated with more social-emotional problems and poorer social-emotional milestone acquisition. No significant interaction effects were found between cumulative risk and infant sleep. Risk and sleep appear to have unique associations with infant social-emotional problems and development; thus both could be targeted in early intervention to promote social-emotional functioning during infancy and early childhood

Longitudinal changes in term and preterm infant night wakings: The role of caregiver anxious‐depression

Changes in infant night waking during the first year of life are associated with individual (e.g., prematurity) and family (e.g., caregiver psychopathology) factors. This study examined the association between infant night waking and caregiver anxious-depressive symptoms during the first year of life in preterm and term infants. We considered between-person differences and within-person changes in caregiver anxious-depressive symptoms in relation to changes in infant night waking from 2- to 9-months. Racially (30.0% Black, 60.4% White, 9.5% multiracial/other) and socioeconomically (40.0% below median household income) diverse caregivers (N = 445) of full term (n = 258) and preterm (n = 187) infants were recruited from hospitals and clinics in two midwestern states. Caregivers completed measures of anxious-depression and their infant’s night waking at four sampling periods (2-, 4-, 6-, and 9-months). Infant night wakings declined from 2- to 9-months. Between-person differences were observed, such that caregivers with higher average anxious-depressive symptoms or infants born full term reported more night wakings. Within-person effects of caregiver anxious-depressive symptoms were not significant. Caregiver anxious-depression is closely associated with infant night wakings. By considering a caregiver’s average severity of anxious-depression, healthcare providers can more effectively plan infant sleep interventions. If caregiver anxious-depressive symptoms are ameliorated, night wakings may also decrease.ResumenLos cambios en el despertar nocturno del infante durante el primer año de vida se asocian con factores individuales (v.g. nacimiento prematuro) y familiares (v.g. sicopatología de quien presta el cuidado). Este estudio examinó la asociación entre el despertar nocturno del infante y los síntomas de depresión por ansiedad de quien presta el cuidado durante el primer año de vida de infantes nacidos prematuramente y de ciclo completo. Tomamos en cuenta las diferencias entre las personas y los cambios dentro de las personas en los síntomas de depresión por ansiedad de quien presta el cuidado con relación a los cambios en el despertar nocturno del infante de los 2 a los 9 meses. Se reclutaron en hospitales y clínicas de dos estados del medio oeste cuidadores (N = 445) racial (30.0% de raza negra, 60.4% blancos, 9.5% multirraciales o de otra raza) y socioeconómicamente (40.0% por debajo del promedio de ingresos caseros) diversos, de infantes de ciclo completo (n = 258) y prematuros (n = 187). Los cuidadores completaron medidas de depresión por ansiedad y el despertar nocturno de sus infantes en cuatro períodos muestra (a los 2, 4, 6 y 9 meses). El despertar nocturno del infante declinó de los 2 a los 9 meses. Se observaron las diferencias entre personas, de tal manera que los cuidadores con un promedio mayor de síntomas de depresión por ansiedad o infantes nacidos en el ciclo completo reportaron más despertar nocturno. Los efectos de dentro de las personas de los síntomas de depresión por ansiedad del cuidador no fueron significativos. La depresión por ansiedad del cuidador se asocia cercanamente con el despertar nocturno del infante. Por medio de considerar el promedio de la severidad de la depresión por ansiedad del cuidador, quienes ofrecen el cuidado de salud pueden planear más eficazmente las intervenciones en cuanto al sueño del infante. Si se mejoran los síntomas de depresión por ansiedad de quien presta el cuidado, el despertar nocturno también podría disminuir.RésuméLes changements dans le réveil nocturne du bébé pendant la première année sont liés à des facteurs individuels (par exemple la prématurité) et familiaux (par exemple la psychopathologie de la personne prenant soin de l’enfant). Cette étude a examiné le lien entre le réveil nocturne du bébé et les symptômes anxieux-dépressifs de la personne prenant soin de l’enfant durant la première année de vie de bébés prématurés et à terme. Nous avons considéré les différences entre les personnes et les changements au sein de la personne dans les symptômes anxieux-dépressifs de la personne prenant soin de l’enfant, en lien aux changements dans le réveil nocturne du bébé de 2 à 9 mois. Des personnes (N = 445) prenant soin d’un bébé à plein terme (n = 258) et prématuré (n = 187), divers du point de vue de leur race (30,0% noirs, 60,4% blancs, 9,5% multiracial/autre) et de leur statut socioéconomique (40,0% en dessous du revenu moyen d’une famille) ont été recrutés dans des hôpitaux et des cliniques des états au centre nord des Etats-Unis. Les personnes prenant soin du bébé ont rempli des mesures de dépression anxiété et de la nuit de leur bébé à quatre périodes de prélèvement des renseignements (2-, 4-, 6-, et 9- mois). Les réveils nocturnes du bébé ont décliné de 2- à 9- mois. Des différences entre les personnes ont été observées, au point que les personnes prenant soin du bébé avec la moyenne de symptômes anxieux-dépressifs la plus élevée ou des bébé nés à terme ont fait état de plus de réveils nocturnes. Les effets au sein de la personne des personnes prenant soin du bébé avec des symptômes anxieux-dépressifs n’étaient pas importants. La personne prenant du bébé avec une dépression anxieuse est fortement liée aux réveils nocturnes du bébé. En considérant la sévérité moyenne de la dépression anxieuse de la personne prenant soin du bébé, les prestataires de santé peuvent planifier les interventions concernant le sommeil du bébé de manière plus efficace. Si les symptômes anxieux-dépressifs de la personne prenant soin du bébé sont améliorer, alors les réveils nocturnes pourraient aussi diminuer.ZusammenfassungLängsschnittliche Veränderungen beim nächtlichen Aufwachen von Frühchen und reifgeborenen Kindern: Die Rolle von Angst und Depression bei der BetreuungspersonVeränderungen des nächtlichen Aufwachens bei Säuglingen im ersten Lebensjahr sind mit individuellen und familiären Faktoren assoziiert, wie z. B. einer Frühgeburt oder der Psychopathologie der Betreuungsperson. In dieser Studie wurde der Zusammenhang zwischen nächtlichem Aufwachen von Säuglingen während des ersten Lebensjahres (Frühchen sowie reifgeborenen Kinder) und ängstlich-depressiven Symptomen der Betreuungspersonen untersucht. In Bezug auf ängstlich-depressive Symptome der Betreuungsperson untersuchten wir sowohl between-subject Unterschiede als auch within-subject Veränderungen im Zusammenhang mit Veränderungen des nächtlichen Aufwachens von Säuglingen im Zeitraum von 2 bis 9 Monaten. Aus Krankenhäusern und Kliniken in zwei Staaten des Mittleren Westens wurden ethnisch (30,0 % Schwarze, 60,4 % Weiße, 9,5 % gemischt/andere) und sozioökonomisch (40,0 % unter dem mittleren Haushaltseinkommen) diverse Betreuungspersonen (N = 445) von reifgeborenen Kindern (n = 258) und Frühchen (n = 187) rekrutiert. Die Betreuungspersonen füllten in vier Stichprobenzeiträumen (2-, 4-, 6- und 9-Monate) Maße für Angst/Depression und das nächtliche Aufwachen ihres Kindes aus. Das nächtliche Aufwachen von Säuglingen nahm zwischen dem zweiten und dem neunten Monat ab. Bezüglich der between-subject Unterschiede wurde beobachtet, dass Betreuungspersonen mit höheren durchschnittlichen ängstlich-depressiven Symptomen oder reifgeborenen Säuglingen mehr nächtliches Aufwachen berichteten. Die within-subject Effekte der ängstlich-depressiven Symptome der Betreuungspersonen waren nicht signifikant. Angst und Depressionen der Betreuungspersonen stehen in engem Zusammenhang mit nächtlichem Aufwachen von Säuglingen. Durch die Berücksichtigung des durchschnittlichen Schweregrads von Angst und Depression bei einer Betreuungsperson könnten Gesundheitsdienstleister auf wirksamere Art und Weise Interventionen für den Säuglingsschlaf planen. Wenn sich ängstlich-depressiven Symptome bei der Betreuungsperson bessern, könnte auch das nächtliche Aufwachen abnehmen.抄録生後1年間の乳児の夜間覚醒の変化は、個人 (例:未熟性) および家族 (例:養育者の精神病理学) 因子と関連する。本研究では、早産児と正期産児の生後1年間の乳児の夜間覚醒と養育者の不安抑うつ症状との関連を検討した。2カ月から9カ月までの乳児の夜間覚醒の変化と養育者の不安抑うつ症状の個人間差および個人内変化を検討した。満期産児 (258人) および早産児 (187人) の養育者で、人種的 (30％が黒色人種、60.4％が白色人種、9.5％が多民族/その他) ならびに社会経済学的 (40.0％は平均以下の世帯収入) に多様な養育者 (N = 445人) を、中西部2州の病院および診療所から募集した。4つのサンプリング期間 (2ヶ月、4ヶ月、6ヶ月、9ヶ月) に、養育者は自分の不安抑うつとわが子の夜間覚醒の測定に取り組んだ。乳児の夜間覚醒は生後2カ月から9カ月にかけて減少した。個人間差異が観察され、平均的な不安抑うつ症状がより高い養育者、または満期産の乳児により多くの夜間覚醒が報告された。養育者の不安抑うつ症状の個人内効果は有意ではなかった。養育者の不安抑うつ症状は、乳児の夜間覚醒と密接に関連している。養育者の不安抑うつ状態の平均的な重症度を考慮することで、医療従事者はより効果的に乳児の睡眠介入を計画することができる。養育者の不安抑うつ症状が改善されれば、夜間覚醒も減少する可能性がある。摘要婴儿出生后第一年的夜醒变化与个体 (如早产) 和家庭 (如看护者精神病理) 等因素相关。本研究调查了早产儿和足月儿在出生后的第一年内, 婴儿夜醒与看护者焦虑抑郁症状之间的关系。我们关注了看护者焦虑抑郁症状的人与人之间的差异以及个体内部的变化, 与2至9个月婴儿夜醒变化之间的关系。从中西部两个州的医院和诊所招募了种族 (30.0%黑人, 60.4%白人, 9.5%多种族/其他) 和社会经济条件 (40.0%低于家庭收入中位数) 不同的足月婴儿 (n = 258) 和早产婴儿 (n = 187) 的看护者 (N = 445) 。看护者在四个采样期 (2个月、4个月、6个月和9个月) 完成了焦虑抑郁和婴儿夜醒情况的测量。婴儿夜醒的次数从2个月到9个月递减。我们观察到了人与人之间的差异, 即平均焦虑抑郁症状较高的看护者或足月出生的婴儿报告了更多的夜醒活动。看护者焦虑抑郁症状对个体内部的影响不显著。看护者焦虑抑郁与婴儿夜醒密切相关。通过考虑看护者焦虑抑郁的平均严重程度, 医疗保健提供者可以更有效地规划婴儿睡眠干预措施。如果看护者的焦虑抑郁症状得到改善, 婴儿夜醒次数也可能减少。ملخصترتبط التغييرات في الاستيقاظ الليلي للرضع خلال السنة الأولى من الحياة بعوامل فردية (على سبيل المثال ، الخداج) والعائلة (على سبيل المثال ، التشخيصات النفسية لمقدم الرعاية). تناولت هذه الدراسة العلاقة بين الاستيقاظ الليلي للرضع وأعراض القلق والاكتئاب لدى مقدم الرعاية خلال السنة الأولى من العمر عند الخدج والرضع الناضجين. أخذنا في الاعتبار الاختلافات بين الأشخاص والتغيرات داخل الشخص في أعراض القلق والاكتئاب لدى مقدم الرعاية فيما يتعلق بالتغيرات في استيقاظ الرضيع ليلاً من شهرين إلى تسعة أشهر. اشترك في الدراسة مجموعة متنوعة من مقدمي الرعاية (N = 445) عرقيًا (30.0٪ أسود ، 60.4٪ أبيض ، 9.5٪ متعدد الأعراق) واجتماعيًا واقتصاديًا (40.0٪ أقل من متوسط دخل الأسرة) للرضع كاملي المدة (العدد = 258) والخدج (العدد = 187) حيث تم إشراكهم من خلال المستشفيات والعيادات في ولايتين في الغرب الأوسط. أكمل مقدمو الرعاية مقاييس القلق والاكتئاب واستيقاظ رضيعهم ليلاً في أربع فترات أخذ عينات (2 و 4 و 6 و 9 أشهر). انخفض معدل الاستيقاظ في الليل عند الرضع من شهرين إلى تسعة أشهر. لوحظت الفروق بين الأشخاص ، مثل أن مقدمي الرعاية الذين يعانون من أعراض القلق والاكتئاب المرتفعة أو الأطفال المولودين لفترة كاملة أبلغوا عن استيقاظهم ليلا أكثر. لم تكن التأثيرات الداخلية لأعراض القلق والاكتئاب لدى مقدم الرعاية مهمة. يرتبط القلق والاكتئاب لدى مقدم الرعاية ارتباطًا وثيقًا بالاستيقاظ الليلي للرضع. من خلال النظر في متوسط شدة القلق والاكتئاب لدى مقدم الرعاية ، يمكن لمقدمي الرعاية الصحية التخطيط بشكل أكثر فاعلية لتدخلات نوم الرضع. إذا تم تخفيف أعراض القلق والاكتئاب لدى مقدم الرعاية ، فقد ينخفض أيضًا الاستيقاظ ليلاً.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/175740/1/imhj22024_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/175740/2/imhj22024.pd