Treatment decision-making capacity in children and adolescents hospitalized for an acute mental disorder: The role of cognitive functioning and psychiatric symptoms

OBJECTIVE: This study was conducted to assess treatment decision-making capacity (TDMC) in a child and adolescent psychiatric sample and to verify possible associations between TDMC, psychiatric symptom severity, and cognitive functioning. METHODS: Twenty-two consecutively recruited patients hospitalized for an acute mental disorder, aged 11-18 years, underwent measurement of TDMC by the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). The MacCAT-T interview focused on patients' current treatment, which comprised second-generation antipsychotics (45.5%), first-generation antipsychotics (13.6%), antiepileptic drugs used as mood stabilizers or lithium carbonate (45.5%), selective serotonin reuptake inhibitors (32%), and benzodiazepines (18%). We moreover measured cognitive functioning (Wechsler Intelligence Scale for Children III) and psychiatric symptom severity (Brief Psychiatric Rating Scale v 4.0). RESULTS: Patients' TDMC varied within the sample, but MacCAT-T scores were good in the sample overall, suggesting that children and adolescents with severe mental disorders could be competent to consent to treatment. The TDMC proved independent of psychiatric diagnosis while being positively associated with cognitive functioning and negatively with excitement. CONCLUSION: The MacCAT-T proved feasible for measuring TDMC in a child and adolescent psychiatric sample. TDMC in minors with severe mental disorders was not necessarily impaired. These results deserve reconsidering the interplay between minors and surrogate decision-makers as concerning treatment decisions

Psychological Predictors of Homophobic Bullying Among Adolescents and Young Adults: The Role of Parental Psychological Control and Sensation Seeking

AbstractWe aimed to investigate the relationship between homophobic bullying, parental psychological control and sensation seeking among adolescents and young adults and to examine the mediating role of sensation seeking. The participants included 394 adolescents and young adults aged 15 to 20 years attending the 3rd, 4th and 5th years of two public high schools in Italian cities. Participants completed the Homophobic Bullying Scale, the Dependency—oriented and Achievement—oriented Parental Psychological Control, and the Sensation—Seeking Scale. The results showed that parental psychological control predicted bullying toward gay and lesbian people. However, the two dimensions of sensation seeking (thrill and adventure seeking, and disinhibition) represented two mediators in the relationship between parental psychological control, both achievement and dependency—oriented, and homophobic bullying

The Effects of Leader Self-Sacrifice in Virtual Teams on Prosocial Behavior: The Mediational Role of Team Identification and Self-Efficacy

Leadership is one of the most studied features of virtual teams. Among the various characteristics analyzed by recent literature, leadership self-sacrifice is one of the most important, as it represents a predictor of many positive characteristics of teams' functioning. In this study, we (a) analyze the relationship between leader self-sacrifice and the prosocial behavior of followers in a work team and (b) observe the effects of leader self-sacrifice in virtual teams. A sample of 197 university students enrolled in a psychology course took part in a group electronic task of writing a detailed research plan for a scientific investigation. Participants collaborated in groups of five, led by a senior student for 30 days. Results showed the presence of an effect of e-leadership self-sacrifice on followers' prosocial behavior. Another effect of e-leadership self-sacrifice was found via team identification and perceived self-efficacy. Findings are discussed on the basis of Social Identity Theory, showing the importance of self-sacrifice e-leaders to promote reciprocal prosocial behavior of the followers

Gambling Disorders Among Young Women Regular Gamblers:The Unique and Common Contribution of Executive Thinking Style and Mindfulness

The aim of this study is to investigate the role played by mindfulness in the relationship between cognitive styles and gambling disorders in a sample of female young adults. Participants in this study (125 women; M-age = 18.64 years; SD = 1.7) were recruited in betting or bingo halls. They completed the South Oaks Gambling Screen, the Child and Adolescent Mindfulness Measure, and Sternberg's questionnaire on thinking styles. The results from the mediation analyses revealed that the executive thinking style increases gambling and that the deficit in mindfulness ability mediates this relationship. Theoretical and clinical implications are discussed

Practicing psychologists’ accounts of demand avoidance and extreme demand avoidance in children and adolescents

The construct of pathological or extreme demand avoidance (EDA) is used to describe the experience of avoiding demands and having an extreme need for control. However, the EDA construct is contested by researchers and educational psychology practitioners. To investigate the utility and validity of the construct of EDA, this qualitative study explored psychologists’ experience and conceptualisation of demand avoidance and extreme demand avoidance, and their approach to working with children and adolescents who avoid demands. Online semi-structured interviews were conducted with 12 psychologists (female = 9) working in private, education and disability services. Thematic analysis yielded six themes: (i) reason for the psychologists’ involvement, (ii) psychologists understanding of child’s presentation, (iii) psychologists’ focus in supporting the child, (iv) challenges for psychologists, (v) enablers for psychologists and (vi) success for psychologists. Results indicated that psychologists do not view the construct of EDA as necessary for their work and achieve success with children who avoid demands by drawing on range of approaches focusing on the underlying needs of those children

Evaluation of Tumor Response after Short-Course Radiotherapy and Delayed Surgery for Rectal Cancer.

PURPOSE: Neoadjuvant therapy is able to reduce local recurrence in rectal cancer. Immediate surgery after short course radiotherapy allows only for minimal downstaging. We investigated the effect of delayed surgery after short-course radiotherapy at different time intervals before surgery, in patients affected by rectal cancer. METHODS: From January 2003 to December 2013 sixty-seven patients with the following characteristics have been selected: clinical (c) stage T3N0 ≤ 12 cm from the anal verge and with circumferential resection margin > 5 mm (by magnetic resonance imaging); cT2, any N, < 5 cm from anal verge; and patients facing tumors with enlarged nodes and/or CRM+ve who resulted unfit for chemo-radiation, were also included. Patients underwent preoperative short-course radiotherapy with different interval to surgery were divided in three groups: A (within 6 weeks), B (between 6 and 8 weeks) and C (after more than 8 weeks). Hystopatolgical response to radiotherapy was measured by Mandard's modified tumor regression grade (TRG). RESULTS: All patients completed the scheduled treatment. Sixty-six patients underwent surgery. Fifty-three of which (80.3%) received a sphincter saving procedure. Downstaging occurred in 41 cases (62.1%). The analysis of subgroups showed an increasing prevalence of TRG 1-2 prolonging the interval to surgery (group A-16.7%, group B-36.8% and 54.3% in group C; p value 0.023). CONCLUSIONS: Preoperative short-course radiotherapy is able to downstage rectal cancer if surgery is delayed. A higher rate of TRG 1-2 can be obtained if interval to surgery is prolonged to more than 8 weeks

does a mediterranean model of family functioning in the perception of italian and spanish adolescents exist a cross national study

The current study explored the influence of belonging to a different areas, South of Italy and Spain, on perception of parenting and family functioning adolescents in order to highlight the similarities and differences among two samples and verify if Mediterranean model of family exists". Empirical evidence of the existence of a Mediterranean family model has been conducted to verify which common and differentiating features exist in the perception of family ties among adolescents. Data highlighted that adolescents belonging to these areas report similar levels in different component of familial ties that can be defined as "Links and Roles": On the contrary, important differences were underlined on the perception of levels of rigidity and enmeshment within family: on the base of Marcia's model of identity status, we called this dimension "Foreclosure status". DOI: 10.5901/mjss.2014.v5n1p37