Pediatric Psychology Research Papers - Academia.edu (original) (raw)

Acceptance and Commitment Therapy (ACT) is an empirically supported treatment for chronic pain in adults. There is also a small but growing evidence base of ACT for pediatric chronic pain. However, because of limited access to... more

Acceptance and Commitment Therapy (ACT) is an empirically supported treatment for chronic pain in adults. There is also a small but growing evidence base of ACT for pediatric chronic pain. However, because of limited access to psychological treatment for pain, and geographical distances from pain facilities, many patients will not receive such treatment. The aim of the study was to evaluate the feasibility and preliminary effects of an internet-delivered ACT for adolescents with chronic pain, and their parents. In this nonrandomized pilot study 28 self-recruited adolescents, aged 13–17 years, received 8 weeks of internet-delivered ACT, while outcomes were assessed at pre-, posttreatment, and at follow-up (17–25 weeks). Parents of the adolescents received an 8-week internet-delivered parental program, and their outcomes were assessed at the same timepoints. Both treatments were guided by a therapist experienced in ACT and chronic pain. Some threats to feasibility were identified such as slow recruitment rate, low compliance and a delay in completion of follow-up assessments. Preliminary outcome evaluation showed that adolescents showed a large significant improvement on their main outcome (pain interference, d = 1.09), and parents a medium improvement on their main outcome, pain reactivity (d = 0.70). Improvements were also seen in adolescents' depressive symptoms and insomnia severity. The preliminary results of internet-delivered ACT are promising with regards to improvements in adolescent and parent outcome. Measures to improve feasibility are needed prior to conducting a larger randomized trial.

To describe empirically the risky sexual behavior of an at-risk sample of adolescent girls, to assess psychosocial correlates of risky behavior, and to examine the utility of applying a risk and protective model to predicting teens'... more

To describe empirically the risky sexual behavior of an at-risk sample of adolescent girls, to assess psychosocial correlates of risky behavior, and to examine the utility of applying a risk and protective model to predicting teens' risky sexual behavior. Participants included 158 African American girls, ages 12 to 19, who were receiving medical care in an adolescent primary care clinic. Teens completed measures of depression, conduct problems, substance use, peer norms, social support, HIV knowledge, sexual self-efficacy, and sexual behavior. Teens in this sample reported high rates of risky sexual behaviors, including early sexual debuts and frequent unprotected sexual encounters with multiple partners. African American girls who reported high rates of substance use and who reported that their peers engaged in risky behaviors also reported engaging in high rates of risky sexual behaviors. Little support was obtained for protective factors (HIV knowledge, social support, sexual...

This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP) medication adherence in a multisite cohort of pediatric patients diagnosed with cancer (N = 139).... more

This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP) medication adherence in a multisite cohort of pediatric patients diagnosed with cancer (N = 139). Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. To our knowledge, this was the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric...

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection... more

Acquired Immuno Deficiency Syndrome has been remained one of the most health issue concerns till recently. HIV infection can be transmitted through unprotected sexual intercourse with an infected partner, unprotected oral sex, injection or transfusion of contaminated blood or blood products, sharing unsterilized injection equipment that was previously used by an infected person and maternal-fetal transmission during pregnancy, at birth or through breastfeeding. Transmission of HIV from an infected patient to a health-care worker has been documented after parenteral or mucous membrane exposure to blood. Oral manifestations are one of the earliest clinical indicators of HIV infection which is independent of CD4 status has a prognostic value. By the way, screening of the AIDS associated manifestations in the oral cavity is a noninvasive and feasible approach, these oral lesions should be used to help diagnose, prevent and intervene in the progression of HIV infection to AIDS. This review includes studies that investigate the impact of HIV infection on personal life and importance of oral lesion in early diagnosis of HIV infection in children. Articles were identified through searches of PubMed MEDLINE from 1970 to 2015, using the MESH based key words.

In addition to repeated reexperiencing of the event, the delayed effects of severe psychological trauma, i.e., post traumatic stress disorder (PTSD), present a paradoxical mix of symptoms. There is enhancement of the self-preservative... more

In addition to repeated reexperiencing of the event, the delayed effects of severe psychological trauma, i.e., post traumatic stress disorder (PTSD), present a paradoxical mix of symptoms. There is enhancement of the self-preservative catecholamine states; anger and fear with a contrasting sense of meaninglessness and a blunting of the emotional responses of the attachment behavior so critical for species preservation. Hormonally, there is a striking separation of the catecholamine response, which stays elevated and that of the hypothalamo-pituitary-adrenal (HPA) axis, which may remain at normal levels. Pathophysiologically, the reexperiencing of the trauma and the arousal may be associated with dysfunction of the locus coeruleus, amygdala and hippocampal systems. This article explores the consequences of an additional dysfunction: a dissociation of the hemispheres that appears to be responsible for the alexithymic avoidance and failure of the cortisol response that so often follow severe psychological trauma. There is neurophysiological evidence that the left and right hemispheres subserve different emotional sets that correspond to “control” and “appraisal,” i.e., very approximately to the self and species preservative behavioral complexes, respectively. Several studies point to physiological dissociation of hemispheric functions during alexithymia. This raises the question: What has been lost if in this condition the right side no longer fully contributes to integrated cerebral function? Right hemispheric damaged children lose critical social skills and in adults the related sense of familiarity critical for bonding is lost. Such losses of social sensibilities may account for the lack of empathy and difficulties with bonding found in sociopathy and borderline personality: conditions now believed to result from repeated psychological trauma during development. On the other hand, systems that promote right hemispheric contributions provide solacing access to a “Higher Power.” They also appear to protect against socially disordered behavior, substance abuse, the failure of the HPA axis and some aspects of the pathophysiology of chronic disease.

The prevalence of Autism is on the rise worldwide with studies presenting the worldwide prevalence rates as 1 in 68 children. This is rising alarmingly every year and the combined presentation of Autism with ADHD in the same child is also... more

The prevalence of Autism is on the rise worldwide with studies presenting the worldwide prevalence rates as 1 in 68 children. This is rising alarmingly every year and the combined presentation of Autism with ADHD in the same child is also increasing. In this scenario it is shocking to note that many medical professionals in general and paediatricians in particular are unaware of the availability of an Autism Cure that is already being accessed by parents with children with autism from all over the world and these children are thriving completely free from their limiting symptoms. This article seeks to enlighten medical professionals about this Autism Cure and emphasizes the urgent necessity for them to update themselves about the same so that more children with Autism and ADHD (and their parents) need not suffer unnecessarily due to this " autism cure awareness gap " that is currently prevailing among medical professionals and paediatricians worldwide. Read More ... #Autism #AutismCure #AutismTreatment

Discontinuation is a problem in fertility clinics. Many couples discontinue assisted reproductive technologies (ART) without achieving a live birth for reasons other than poor prognosis or the cost of treatment. Discontinuation has been... more

Discontinuation is a problem in fertility clinics. Many couples discontinue
assisted reproductive technologies (ART) without achieving a live birth for
reasons other than poor prognosis or the cost of treatment. Discontinuation has
been attributed to the burden of treatment. The causes of burden can be broadly
classified according to whether they originate in the patient, clinic or
treatment. Interventions to alleviate these burdens include provision of
comprehensive educational material, screening to identify highly distressed
patients, provision of tailored coping tools and improvements in the clinic
environment and medical interventions. Practical interventions to reduce the
different causes of burden in ART exist, but further development and evaluation
of the efficacy of these interventions requires more precise definition of terms
and theory. In this paper, we propose a general integrated approach to cover
different perspectives in dealing with burden in ART clinics. We firstly describe
the integrated approach and present common sources of burden. We then describe
interventions that could help reduce the burden in ART. Our paper is aimed at
fertility clinic staff because of their day-to-day involvement with patients.
However, this discussion should also be relevant to companies that develop
treatments and to psychosocial experts. Reducing the burden of treatment should
lead to improved outcomes, namely better quality of life during treatment and
lower discontinuation rates.

The aim of this study was to investigate how individuals;who had been victims of school bullying;perceived their bullying experiences and how these had affected them;and to generate a grounded theory of being a victim of bullying at... more

The aim of this study was to investigate how individuals;who had been victims of school bullying;perceived their bullying experiences and how these had affected them;and to generate a grounded theory of being a victim of bullying at school. Twenty-one individuals;who all had prior experiences of being bullied in school for more than one year;were interviewed. Qualitative analysis of data was performed by methods from grounded theory. The research identified a basic process of victimising in school bullying;which consisted of four phases: (a) initial attacks;(b) double victimising;(c) bullying exit and (d) after-effects of bullying. Double victimising refers to a process in which there was an interplay between external victimising and internal victimising. Acts of harassment were repeatedly directed at the victims from their social environment at school – a social process that constructed and repeatedly confirmed their victim role in the class or the group. This external victimising affected the victims and initiated an internal victimising;which meant that they internalised the socially constructed victim-image and acted upon this image;which in turn often supported the bullies’ agenda and confirmed the socially constructed victim-image. The findings also indicate the possible positive effect of changing the social environment.

Aims - Highlight the impact that diagnosis communication to an ill child and his siblings can have on the understanding and the experience of the disease, on the child’s compliance and on the communication within the family about the... more

Aims - Highlight the impact that diagnosis communication to an ill child and his siblings can have on the understanding and the experience of the disease, on the child’s compliance and on the communication within the family about the experience of illness. Methods - Through a qualitative approach, a study case has been conducted by observing doctor-child diagnosis communication and by interviewing parents. The materials have been studied by content analysis.
Results - Diagnosis communication to children helps their participation and understanding of the illness and supports parents to communicate with ill children and with their siblings. The latter often look isolated, suffering, sometimes forgotten and with many problematic behaviors.
Conclusions - Diagnosis communication is really precious to promote children participation; however, it needs to be continuously renewed at home and in the hospital, and requires the constant promotion of an educational alliance with parents.

The overall aim of the study was to investigate the applicability of Objectification Theory to the mental health of early adolescent girls, in particular, their dieting behaviors and depressive symptoms. Both predictors and consequences... more

The overall aim of the study was to investigate the applicability of Objectification Theory to the mental health of early adolescent girls, in particular, their dieting behaviors and depressive symptoms. Both predictors and consequences of self-objectification were examined. A sample of 204 girls with a mean age of 11.6 years completed questionnaire measures of media consumption, time spent on sports and hobbies, appearance conversations, self-objectification, body shame, dieting, and depressive symptoms. RESULTS: Structural equation modeling showed that magazine and Internet exposure and appearance conversations with friends predicted self-objectification. Self-objectification itself predicted body shame, which in turn predicted both dieting and depressive symptoms, in accord with the pathways postulated by Objectification Theory. CONCLUSIONS: The results confirm that, as is the case with adult women, self-objectification plays a significant role in the mental health of early...

To study identified rates of long-term behavior problems in children with traumatic brain injury (TBI) compared to children with only orthopedic injuries and risk factors and correlates for new behavior problems following TBI. Sample... more

To study identified rates of long-term behavior problems in children with traumatic brain injury (TBI) compared to children with only orthopedic injuries and risk factors and correlates for new behavior problems following TBI. Sample included children with severe TBI (n = 42), moderate TBI (n = 41), and orthopedic injuries only (ORTHO;n = 50). The baseline assessment measured child behavior, adaptation, and neuropsychological, academic, and family functioning. Follow-ups were conducted at 6 and 12 months and at an extended follow-up a mean of 4 years after injury. The prevalence of caseness, defined as elevated behavior problem ratings, was higher in one or both TBI groups than in the ORTHO group at each follow-up (e.g., 36% of severe TBI group, 22% of moderate TBI group, and 10% of ORTHO group at extended follow-up). Most instances of postinjury-onset caseness at the extended follow-up were evident within the first year after TBI. Predictors were severe TBI, socioeconomic disadvant...

Foster children often experience compromising situations such as neglect, physical abuse, or sexual abuse before out-of-home placement. This article aims to give a literature review related to the development and mental health of foster... more

Foster children often experience compromising situations such as neglect, physical abuse, or sexual abuse before out-of-home placement. This article aims to give a literature review related to the development and mental health of foster children with special consideration of trauma history. A computer-based literature search was conducted in the databases Medline, PsycINFO, PSYNDEXplus, and SCOPUS. We determined a time frame from 1998 to 2009. The literature search resulted in 32 articles reporting empirical data about development and mental health in foster children. Very high rates of exposure to maltreatment, developmental delays and mental disorders were found. A broad spectrum of externalizing as well as internalizing symptoms and a high prevalence of comorbid mental disorders were found. Foster children exhibit a broad pattern of developmental problems and psychopathology. The etiology of these disorders is discussed in the context of multiple risk factors, especially that of persistent maltreatment.

According to Brian Morris (2013), “Science supports infant circumcision” and “so should skeptics.” It would be more accurate to say that ‘Brian Morris supports infant circumcision,’ and that skeptics can think for themselves. In this... more

According to Brian Morris (2013), “Science supports infant circumcision” and “so should skeptics.” It would be more accurate to say that ‘Brian Morris supports infant circumcision,’ and that skeptics can think for themselves. In this paper, we critically assess the arguments and evidence presented by Morris in his recent article, and draw some general lessons for the ongoing debate about the science and ethics of infant male circumcision.

Hypospadias is a relatively common genital condition in which the urethral opening forms on the underside of the penis, as opposed to at the tip of the glans. Patients with hypospadias are typically referred for surgery during infancy or... more

Hypospadias is a relatively common genital condition in which the urethral opening forms on the underside of the penis, as opposed to at the tip of the glans. Patients with hypospadias are typically referred for surgery during infancy or early childhood. Recent evidence, however, indicates that many individuals with hypospadias do not experience the functional or psychosocial difficulties that are commonly attributed to the condition, and that surgical intervention for hypospadias carries substantial risk of adverse outcomes. In this article, we review published outcomes data and conduct an in-depth analysis of the typical rationales for hypospadias surgery, taking into consideration both the potential benefits and harms of the procedure, as well as the existence of non-surgical alternatives. We argue, firstly, that most childhood surgeries for hypospadias are performed for anticipated future problems concerning function and cosmesis, rather than extant problems that serve to undermine the child’s well-being. Secondly, we contend that the surgery can be safely performed after an age of consent without increasing the absolute risk of surgical complications to an ethically meaningful degree. We conclude that surgery for hypospadias should typically be performed only if requested by the affected individual, under conditions of informed consent.

What are the effects of circumcision on sexual function and experience? And what does sex—in the sense related to gender—have to do with the ethics of circumcision? Jacobs and Arora (2015) give short shrift to the first of these... more

What are the effects of circumcision on sexual function and experience? And what does sex—in the sense related to gender—have to do with the ethics of circumcision? Jacobs and Arora (2015) give short shrift to the first of these questions; and they do not seem to have considered the second. In this commentary, I explore the relationship between sex (in both senses) and infant male circumcision, and draw some conclusions about the ongoing debate regarding this controversial practice.

Critics of non-therapeutic male and female childhood genital cutting claim that such cutting is harmful. It is therefore puzzling that ‘circumcised’ women and men do not typically regard themselves as having been harmed by the cutting,... more

Critics of non-therapeutic male and female childhood genital cutting claim that such cutting is harmful. It is therefore puzzling that ‘circumcised’ women and men do not typically regard themselves as having been harmed by the cutting, notwithstanding the loss of sensitive, prima facie valuable tissue. For female genital cutting (FGC), a commonly proposed solution to this puzzle is that women who had part(s) of their vulvae removed before sexual debut ‘do not know what they are missing’ and may ‘justify’ their genitally altered state by adopting false beliefs about the benefits of FGC, while simultaneously stigmatising unmodified genitalia as unattractive or unclean. Might a similar phenomenon apply to neonatally circumcised men? In this survey of 999 US American men, we find that greater endorsement of false beliefs concerning circumcision and penile anatomy predicts greater satisfaction with being circumcised, while among genitally intact men, a trend in the opposite direction occurs: greater endorsement of false beliefs predicts less satisfaction with being genitally intact. These findings provide tentative support for the hypothesis that the lack of harm reported by many circumcised men, like the lack of harm reported by their female counterparts in societies that practice FGC, may be related to holding inaccurate beliefs concerning unaltered genitalia and the consequences of childhood genital modification.

In December of 2014, an anonymous working group under the United States’ Centers for Disease Control and Prevention (CDC) issued a draft of the first-ever federal recommendations regarding male circumcision. In accordance with the... more

In December of 2014, an anonymous working group under the United States’ Centers for Disease Control and Prevention (CDC) issued a draft of the first-ever federal recommendations regarding male circumcision. In accordance with the American Academy of Pediatrics’ circumcision policy from 2012 – but in contrast to the more recent 2015 policy from the Canadian Paediatric Society as well as prior policies (still in force) from medical associations in Europe and Australasia – the CDC suggested that the benefits of the surgery outweigh the risks. In this article, we provide a brief scientific and conceptual analysis of the CDC’s assessment of benefit versus risk, and argue that it deserves a closer look. Although we set aside the burgeoning bioethical debate surrounding the moral permissibility of performing non-therapeutic circumcisions on healthy minors, we argue that, from a scientific and medical perspective, current evidence suggests that such circumcision is not an appropriate public health measure for developed countries such as the United States.