Children with disrupted attachment histories: Interventions and psychophysiological indices of effects

Diagnosis and treatment of children affected by disruptions of attachment (out of home placement, multiple changes of primary caregiver) is an area of considerable controversy. The possible contribution of psychobiological theories is discussed in three parts. The first part relates the attachment theoretical perspective to major psychobiological theories on the developmental associations of parent-child relationships and emotional response. The second part reviews studies of autonomic reactivity and HPA-axis activity with foster children, showing that foster children show more reactivity within physiological systems facilitating fight or flight behaviours rather than social engagement, especially foster children with atypical attachment behaviour. The third part is focused on treatment of children suffering from the consequences of disrupted attachment, based on a psychotherapy study with psychophysiological outcome measures. Implications are discussed for theory, diagnosis, and intervention

Sensors in the care of persons with visual- or visual-and-intellectual disabilities:Use, needs, practical issues, and ethical concerns

BACKGROUND: Sensor technology may improve the quality of life of persons with visual and/or intellectual disabilities. However, there is no general consensus on its utility and implementation. OBJECTIVE: In this exploratory study the aim was to provide an overview of sensors for persons with disabilities to address priorities and ethical concerns for future research. METHODS: Using a qualitative (Delphi) method, 17 interviews were carried out with 20 representatives in the field of visual- or visual-and-intellectual disabilities (in general: six experts in sensor technology, domotics, and eHealth, specific for persons with a visual or visual-and-intellectual disability: three client representatives; three caregivers; four care team managers; two developmental psychologists; one physician; and one paramedic; age ranges 25-61 years). Atlas.ti software was used to code data and major themes were identified using qualitative analyses. RESULTS: The most used sensors were for surveillance and health and the most desired were for behavior. Different sensors were considered most important for future implementation by the groups of participants, such as sensors for lighting, posture, and entertainment by client experts. Furthermore, the majority of participants agreed that sensors should be easy to use and understand and ethical issues (e.g. privacy, informed consent) should be considered. CONCLUSION: The current applications of sensor technology in clinical practice and future research needs were determined by interviewing experts, caregivers, and client experts

Self-concept and facial appearance of individuals with an intellectual disability:A scoping review

This paper looks at how self-concept is related to facial appearance. Very little information can be found on how persons with intellectual disabilities think and feel about their own facial appearance. In this review 19 articles on subject of self-concept in people with intellectual disabilities were included. Results show that self-concept of individuals with intellectual disabilities is affected by the relationships they have (positively and negatively). The perceptions of caregivers, peers and their awareness of stigma effects self-concept. How facial appearance affects the self-concept of persons with intellectual disabilities remains unclear and should be a focus of research in future. Abstract: Background The mental health and well-being of individuals can be positively affected by improving facial appearance through orthodontic treatment. However, research is limited on the relationship between facial appearance and self-concept of individuals with intellectual disabilities. Materials and methods This scoping review includes 19 articles and is aimed to examine the self-concept of individuals with intellectual disabilities and determine how the self-concept might be impacted by facial appearance. Furthermore, this review is exploratory in the way that an attempt was made to extract constructs that contribute to the self-concept of persons with intellectual disabilities. Results Unfortunately, no articles were found on how individuals with intellectual disabilities think about their own facial appearance. However, the articles on self-concept in persons with intellectual disabilities do mention some interesting facts: social comparisons lead to social stigma that can contribute negatively to the self-concept of individuals with intellectual disabilities. Also, the ability to communicate and express oneself can contribute to one's self-esteem. Furthermore, parents/caregivers often influence the concept of oneself. Moreover, an individual's relationship with their social environment defines their self-concept. Conclusion It is currently unknown how individuals with intellectual disabilities view their own facial appearance and whether their self-concept is influenced by their appearance. Questionnaires which address attitudes on facial appearance could provide a deeper understanding of the self-concept of individuals with intellectual disabilities and possibly make way for orthodontic treatment. However, caution is needed concerning changing the physical appearance of persons with intellectual disabilities. One should also battle stigma by encouraging the social inclusion of persons with intellectual disability

PILOTSTUDIE NAAR DE INZET VAN EEN COMPASSIETRAINING VOOR MENSEN MET EEN VISUELE, LICHAMELIJKE EN LICHTE TOT MATIGE VERSTANDELIJKE BEPERKING

Mensen met een visuele en verstandelijke beperking zijn kwetsbaar voor het ervaren van psychologische lijdensdruk, waarbij een hoge mate van schaamte en zelfkritiek een belangrijke rol kunnen spelen. Op compassie gebaseerde interventies richten zich op het vergroten van het welbevinden door het ontwikkelen van (zelf)compassie. Deze pilotstudie beschrijft de inzet en het effect van een van Mindfulness Based Compassionate Living afgeleide compassietraining bij vier mensen met een visuele en verstandelijke beperking. Op basis van de resultaten lijkt een compassietraining een haalbare en toepasbare interventie te zijn met potentieel positieve uitkomsten (meer zelfcompassie en zelfwaardering), mits goed aangepast aan de voorkeuren en mogelijkheden van deelnemers

The effect of a serious game on empathy and prejudice of psychology students towards persons with disabilities

Background: Much has been done regarding the promotion of equality in rights in terms of legislation, but persons with disabilities remain marginalised in society. Negative attitudes and prejudice contribute towards numerous challenges for persons with disabilities. Objectives: This study investigated the level of empathy and prejudice of students towards persons with disabilities, and the effect of the use of a serious game to enhance empathy and reduce prejudice. Method: A randomised controlled experiment with pre-test, post-test and follow-up test was used. Availability sample (N = 83) of psychology university students (22% males; 78% females) was divided into an experimental group that played the serious game The World of Empa and two control groups. The first control group received texts on case studies and information on reacting in a sensitive and responsive way, and the second control group received no intervention. Results: Participants have average levels of empathy (score: 32 to 52) and strong prejudice (score: 0.08 to −0.87) towards persons with disabilities. The intervention results in a slight short-term effect for prejudice and sub-scale measurements of empathy. A slight improvement was noted in participants’ ability to transpose themselves imaginatively into the experience of disabled characters. Conclusion: The findings contribute to the understanding of empathy as a dynamic component that can be positively influenced by, for example, a serious game. These results have teaching implications on the facilitation of empathy. The short-term effect on empathy and prejudice towards persons with disabilities may contribute to bridge the inequality experienced by persons with disabilities

Comfort provided by parents versus strangers after eliciting stress in children with severe or profound intellectual disabilities: does it make a difference?

The relationships between children with severe or profound intellectual disabilities (ID) and their parents may fulfil attachment functions, such as regulating emotional responses to stress. This study examined the extent to which children with severe or profound ID differentiate between their parents and a stranger as a resource for stress-regulation. A home-based experimental paradigm was conducted and video-recorded in 38 families. Children (1–8 years) were exposed to four naturalistic stressors followed by comfort, randomly provided by the parents or the stranger. Emotional behaviour (arousal and valence) and the skin conductance level were simultaneously recorded. With regard to both emotional behaviour and skin conductance, children significantly differentiated between their parents as attachment figures and the stranger during stress and comfort, despite their impairments on various developmental domains. Behavioural observation and physiology show complementary manifestations of parent-child attachment in this population

Exploration of the effects of an innovative mentalization-based training on patient-centered communication skills of pharmacy staff:A video-observation study

OBJECTIVE: To explore whether a mentalization-based communication training for pharmacy staff impacts their ability to elicit and recognize patients' implicit and explicit medication related needs and concerns.METHODS: A single-arm intervention pilot study was conducted, in which pre-post video-recordings of pharmacy counter-conversations on dispensed-medication (N = 50 and N = 34, respectively; pharmacy staff: N = 22) were coded. Outcome measures included: detecting needs and concerns, and implicitly and explicitly eliciting and recognizing them. Descriptive statistics and a multi-level logistic regression were conducted. Excerpts of videos with needs or concerns were analyzed thematically on mentalizing attitude aspects.RESULTS: Indications show that patients more often express their concerns in an explicit way post-measurement, just as pharmacy staffs' explicit recognition and elicitation of needs and concerns. This was not seen for patients' needs. No statistically significant differences were found for determinants for detecting needs or concerns (i.e., measurement-, professional-type, or interaction). Differences in mentalizing attitude were observed between pre-post-measurements, e.g., more attention for patients.CONCLUSION: This mentalizing training shows the potential of mentalizing to improve pharmacy staff members' explicit elicitation and recognition of patients' medication-related needs and concerns.PRACTICE IMPLICATIONS: The training seems promising for improving patient-oriented communication skills in pharmacy staff. Future studies should confirm this result.</p