The impact of disablism on the psycho-emotional well-being of families with a child with impairment

According to Carol Thomas, individuals with impairment are subjected to disablism. They are disadvantaged in material areas of life and also in the non-material domain of psycho-emotional well-being, by the impact of negative ideas, images and stereotypes about impairment and disability. Families with children with impairment have also been described as disadvantaged. Whether this disadvantage is the result of disablism is unknown. This study explored how disadvantage affects families with a child with impairment using Thomas' iteration of the social model of disability. Twelve mothers were interviewed to understand their everyday routines and the influence of impairment in their family life. Family members did encounter prejudice associated with impairment, however, the mothers were able to ‘stand aside’ from this such that their psycho-emotional well-being was not harmed as Thomas describes for individuals with impairment. These families are nevertheless disadvantaged in that they do not enter social interactions on an equal footing with others. This paper describes the ways in which the mothers resisted prejudice. It also suggests that Thomas' model may benefit from considering the harms of disablism from this perspective

The Influence of Predictability and Controllability on Stress Responses to the Aversive Component of a Virtual Fence

To ensure animal welfare is not compromised, virtual fencing must be predictable and controllable, and this is achieved through associative learning. To assess the influence of predictability and controllability on physiological and behavioral responses to the aversive component of a virtual fence, two methods of training animals were compared. In the first method, positive punishment training involved sheep learning that after an audio stimulus, an electrical stimulus would follow only when they did not respond by stopping or turning at the virtual fence (predictable controllability). In the second method, classical conditioning was used to associate an audio stimulus with an electrical stimulus on all occasions (predictable uncontrollability). Eighty Merino ewes received one of the following treatments: control (no training and no stimuli in testing); positive punishment training with an audio stimulus in testing (PP); classical conditioning training with only an audio stimulus in testing (CC1); and classical conditioning training with an audio stimulus followed by electrical stimulus in testing (CC2). The stimuli were applied manually with an electronic collar. Training occurred on 4 consecutive days with one session per sheep per day. Sheep were then assessed for stress responses to the cues by measuring plasma cortisol, body temperature and behaviors. Predictable controllability (PP) sheep showed no differences in behavioral and physiological responses compared with the control treatment (P P

Positive and Negative Reinforcement Underlying Risk Behavior in Early Adolescents

This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s11121-010-0172-7The goal of the current study was to examine the combined influence of positive reinforcement processes using a behavioral task measuring risk taking propensity (RTP) and negative reinforcement processes using a behavioral task measuring deficits in distress tolerance (DT) on a range of risk taking behaviors among early adolescents. Participants included a community sample of 230 early adolescents (aged 9–13) who completed two behavioral tasks assessing reinforcement processes as well as reported on past year risk behavior involvement as assessed by items from the Youth Risk Behavior Surveillance System at a baseline and a 1-year follow-up assessment. Data indicated that at the Wave 2 assessment, RTP was positively related to number of risk-taking behaviors in the past year but only for those with low DT, with this finding persisting after controlling for the significant influence of male gender and higher sensation seeking. Results of the present study highlight the importance of considering both positive and negative reinforcement processes in combination when investigating vulnerability factors for early risk behavior engagement in youth.https://doi.org/10.1007/s11121-010-0172-

Del DSM-IV-TR al DSM-5: análisis de algunos cambios

La publicación de la quinta edición del DSM ha avivado un debate iniciado tiempo atrás, desde el anuncio de los cambios en los criterios de diagnóstico propuestos por la APA. En este artículo se analizan algunas de estas modificaciones. Se plantean aspectos interesantes y acertados, como la inclusión de la dimensionalidad tanto en las clases diagnósticas como en algunos trastornos, la incorporación de un espectro obsesivo-compulsivo o la desaparición de los subtipos de esquizofrenia. También se analizan otros aspectos más controvertidos como la consideración del síndrome de psicosis atenuada, la descripción de un trastorno depresivo persistente, la reordenación en trastornos de síntomas somáticos los clásicos trastornos somatoformes, o el mantenimiento de los tres grandes grupos de trastornos de la personalidad,siempre insatisfactorios, junto con un planteamiento anunciado, pero marginal, de la perspec-tiva dimensional de las alteraciones de la personalidad. La nueva clasificación del DSM-5 abrenumerosos interrogantes acerca de la validez que se pretende mejorar en el diagnóstico, enesta ocasión, asumiendo un planteamiento más cercano a la neurología y la genética que a lapsicopatología clínica.The publication of the fifth edition of the DSM has intensified a debate begun some time agowith the announcement of the changes in diagnostic criteria proposed by the APA. This article analyzes some of these modifications. Some interesting points where it is right, such as the inclusion of dimensionality in both diagnostic classes and in some disorders, the inclusion of an obsessive-compulsive spectrum, and the disappearance of subtypes of schizophrenia. It also analyzes other more controversial points, such as the consideration of the attenuated psychosis syndrome, the description of a persistent depressive disorder, reorganization of the classic somatoform disorders as somatic symptom disorders, or maintenance of three large clusters of personality disorders, always unsatisfactory, along with an announced, but marginal, suggestion of the dimensional perspective of personality impairments. The new DSM-5 classification opens many questions about the diagnostic validity which it attempts to improve, this time taking an approach nearer to neurology and genetics than to clinical psychology

S.11.1 Influence of digital ulcer healing on disability and daily activity limitations in SSc

Objective. We previously showed that DU significantly increased global and hand disability with a significant impact on activities of daily living (ADLs) and work disability. This study aims to evaluate the impact of digital ulcer (DU) healing on disability and daily activity limitations in SSc. Methods. From January 2008 and June 2009, we prospectively evaluated 189 SSc patients for DU history, disability, employment and occupational status during meetings of the French SSc Patient Association (n = 86, 45.5%) or during hospitalization (n = 103, 54.5%)1. Among the 60 patients with at least one active DU at baseline (M0), 40 patients were followed longitudinally over 6 (3) months. These patients were evaluated for DU history, global and hand disability, health-related quality of life (HRQoL), daily activity limitation and employment status. Results. The median (IQR) age was 57.5 (43.5-68) years and the median (IQR) disease duration was 8.3 (3-16.5) years. Twenty-two (55%) patients had diffuse SSc and 34 (85%) were females. At baseline, a mean of 2.9 (2.8) DU per patient was reported. Thirty-three (82.5%) patients had ischaemic DU, 7 (17.5%) patients had >1 DU associated with calcinosis and 13 (32.5%) patients had mechanical DU. Thirteen (32.5%) patients had >4 DU at baseline. Among the 40 patients, 16 (40%) patients showed complete ulcer healing. In these patients with DU, the presence of calcinosis was associated with a lower probability of healing (P = 0.03). Comparison between healed and no-healed DU patients showed an improvement of hand disability provided by an improvement of the Cochin Hand Function score (P = 0.05)) and a trend towards HAQ domain dressing and grooming (P = 0.06) between M0 and M6 (3) visit in healed patients but not in no-healed patients. Concerning HRQoL, there were no difference for Mental and Physical component Scores of SF-36 but significant improvement of Bodily Pain score (P = 0.04) and Physical Role score (P = 0.05) between M0 and M6 (3) visit in patients with healed DU. The absence of healing was associated with significantly decreased work productivity (P = 0.05), whereas the performance in ADL was not significantly decreased (P = 0.15). Patients who were on sick-leave and who received some help for household tasks at the time of active DU were more likely to heal. Conclusion. For the first time, we provide prospective data with evidence that DU healing is associated with an improvement in hand function. Sick leave was associated with better healing of D

Using a genetically informative design to examine the relationship between breastfeeding and childhood conduct problems

A number of public health interventions aimed at increasing the uptake of breastfeeding are in place in the United States and other Western countries. While the physical health and nutritional benefits of breastfeeding for the mother and child are relatively well established, the evidence for psychological effects is less clear. This study aimed to examine whether there is an association between breastfeeding and later conduct problems in children. It also considered the extent to which any relationship is attributable to maternally-provided inherited characteristics that influence both likelihood of breastfeeding and child conduct problems. A prenatal cross-fostering design with a sample of 870 families with a child aged 4–11 years was used. Mothers were genetically related or unrelated to their child as a result of assisted reproductive technologies. The relationship between breastfeeding and conduct problems was assessed while controlling for theorised measured confounders by multivariate regression (e.g. maternal smoking, education, and antisocial behaviour), and for unmeasured inherited factors by testing associations separately for related and unrelated mother-child pairs. Breastfeeding was associated with lower levels of conduct disorder symptoms in offspring in middle childhood. Breastfeeding was associated with lower levels of conduct problems even after controlling for observed confounders in the genetically related group, but not in the genetically unrelated group. In contrast, maternal antisocial behaviour showed robust associations with child conduct problems after controlling for measured and inherited confounders. These findings highlight the importance of using genetically sensitive designs in order to test causal environmental influences

Subgrouping the autism "spectrum": reflections on DSM-5

DSM-5 has moved autism from the level of subgroups ("apples and oranges") to the prototypical level ("fruit"). But making progress in research, and ultimately improving clinical practice, will require identifying subgroups within the autism spectrum

The design and user-testing of a question prompt list for attention-deficit/hyperactivity disorder

Objectives: This study involved the development of a question prompt list (QPL) booklet designed to facilitate communication and shared decision-making between parents/carers of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) and their clinicians; and user-testing of the QPL to assess its usability. Design: Best practice in information writing and design was used to format the QPL content into a 16-page booklet. We then applied user-testing, which uses mixed methods to assess document performance with small cohorts of participants and then improves it in an iterative process. Individual interviews assessed the ability of QPL users to locate and understand key points of information, followed by a semistructured questionnaire, to ascertain their general views about the booklet. Setting and participants: Testing was undertaken with two cohorts of 10 parents/carers of children with ADHD (n=20); matched on age, gender and educational attainment. Tested documents: In round 1, we tested 15 key points of information related to the QPL. Participant responses and feedback from round 1 informed a revised version of the booklet, tested in a subsequent round. Primary outcome measure: The target was for 8/10 of the participants to be able to find and demonstrate an understanding of all key information points, in accordance with European guidelines for medicine leaflet testing. Results: After round 1, problems related to 4/15 information points were identified (booklet purpose; preparing for appointments; asking about a second medical opinion; selecting which questions to ask). Participants also made suggestions regarding the booklet's layout and design. After round 2, all information points were located and understood by at least 8/10 participants. Conclusions: This is the first study to have developed a usable ADHD-specific QPL for use by parents/carers of children with ADHD during clinical consultations, and the first demonstration of the utility of user-testing methods in ensuring QPL usability