Abstract
Background
Both the latest edition of the DSM-5 as well as the new ICD-11 have established a new focus in the diagnosis of personality disorders: the assessment of personality functioning. ...This recent shift in focus converges with long-standing psychodynamic conceptualizations of personality pathology, particularly Kernberg’s object relations model. Although a significant amount of research supports these models in adults, much less is known about the validity of these frameworks in youth. Considering the paucity of brief measures of personality functioning in adolescents, the current study aimed to develop and investigate the validity of the Inventory of Personality Organization for Adolescents—Short Form, a theoretically-informed measure assessing severity and core domains of functioning in adolescents.
Methods
A total sample of
N
= 525 adolescents aged 13 to 19 years were recruited through a community University-Health Psychology Clinic as current patients (
n
= 94) or who responded to an online research call (
n
= 431).
Results
Results indicate that a bifactor model provided the best fit to the data and consisted of a general factor reflecting core self-other functioning and three specific factors, representing additional dimensions of personality organization.
Conclusions
A brief 15-item version of the IPO-A was successfully derived for time-efficient screening of personality pathology in youth. Similarities with the ICD-11 framework are discussed.
Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient ...experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues.
We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients' experience of emotional support throughout their care trajectory.
This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.
In Fonagy and Target's (1996, 2000) developmental model of mentalization, play is theorized as a precursor of later mentalization and reflective function (RF); however, the relationship between play ...and later mentalization and RF has yet to be empirically tested. These processes are particularly important in the context of trauma, but an empirical model of the relationships among mentalization, play, and trauma is currently lacking. The aim of this longitudinal study was to examine whether children's capacity to engage in pretend play, to symbolize, and to make play narratives was associated with later RF in those children. Thirty-nine sexually abused children and 21 nonabused children (aged 3 to 8) participated in the study. The Children's Play Therapy Instrument was used to assess children's free play. Three years after the play assessment, children's RF was assessed using the Child Attachment Interview, coded with the Child and Adolescent Reflective Functioning Scale. Pretend play completion was associated with later other-understanding. Play was also found to mediate the relationship between sexual abuse and children's later mentalization regarding others. These findings are consistent with Fonagy and Target's emphasis on the role of pretend play in the development of a nuanced sense of the qualities of the mind and reality. In sum, the findings lend support to Fonagy and Target's account of playing with reality, and the development of mentalization suggests that it may be more than "fiction." Furthermore, these results suggest that children's ability to create meaningful and coherent play sequences after sexual abuse is associated with the development of a better understanding of their relationships with others. Clinical implications and future directions are discussed.
The aim of this longitudinal study was to examine the course of sexualized behavior problems (SBP) over 2 years in a sample comprised of 104 children aged 2–12, including 62 children with histories ...of child sexual abuse (CSA). Parents completed questionnaires assessing SBP, internalizing and externalizing difficulties at baseline, as well as 2 years later. In more than half (56.7%) of children with clinically significant SBP at baseline, sexualized behaviors persisted and remained at a clinically significant level over time. In children with CSA, 48.4% presented persistent SBP, 27.4% presented transitory SBP, while 19.4% did not present clinically significant SBP at either time. CSA increased the relative risk of persistent SBP 3.29 times, and for each one-unit increase in scores of externalizing difficulties, the odds of persistent SBP increased by 21%. The findings suggest that SBP consequent to CSA, especially when it co-occurs with externalizing difficulties, is likely to remain at levels warranting clinical intervention.
Background & Aims: Manganese (Mn) deposition could be responsible for the T
1-weighted magnetic resonance signal hyperintensities observed in cirrhotic patients. These experiments were designed to ...assess the regional specificity of the Mn increases as well as their relationship to portal-systemic shunting or hepatobiliary dysfunction.
Methods: Mn concentrations were measured in (1) brain samples from basal ganglia structures (pallidum, putamen, caudate nucleus) and cerebral cortical structures (frontal, occipital cortex) obtained at autopsy from 12 cirrhotic patients who died in hepatic coma and from 12 matched controls; and from (2) brain samples (caudate/putamen, globus pallidus, frontal cortex) from groups (n = 8) of rats either with end-to-side portacaval anastomosis, with biliary cirrhosis, or with fulminant hepatic failure as well as from sham-operated and normal rats.
Results: Mn content was significantly increased in frontal cortex (by 38%), occipital cortex (by 55%), pallidum (by 186%), putamen (by 66%), and caudate (by 54%) of cirrhotic patients compared with controls. Brain Mn content did not correlate with patient age, etiology of cirrhosis, or history of chronic hepatic encephalopathy. In cirrhotic and portacaval-shunted rats, Mn content was increased in pallidum (by 27% and 57%, respectively) and in caudate/putamen (by 57% and 67%, respectively) compared with control groups. Mn concentration in pallidum was significantly higher in portacaval-shunted rats than in cirrhotic rats. No significant changes in brain Mn concentrations were observed in rats with acute liver failure.
Conclusions: These findings suggest that brain Mn deposition results both from portal-systemic shunting and from liver dysfunction.
GASTROENTEROLOGY 1999;117:640-644
The central nervous system is an important target for manganese (Mn) intoxication in humans; it may cause neurological symptoms similar to Parkinson’s disease. Manganese compounds emitted from the ...tailpipe of vehicles using methylcyclopentadienyl manganese tricarbonyl (MMT) are primarily Mn phosphate, Mn sulfate, and Mn phosphate/sulfate mixture. The purpose of this study is to compare the patterns of Mn distribution in various brain regions (olfactory bulb, frontal parietal cortex, globus pallidus, striatum and cerebellum) and other tissues (lung, liver, kidney, testis) and the neurobehavioral damage following inhalation exposure of rats to three Mn species. Rats (
n=15
rats per Mn species) were exposed 6
h per day, 5 days per week for 13 consecutive weeks to metallic Mn, Mn phosphate or Mn phosphate/sulfate mixture at about 3000
μg
m
−3 and compared to controls. At the end of the exposure period, spontaneous motor activity was measured for 36
h using a computerized autotrack system. Mn in tissues was determined by instrumental neutron activation analysis (INAA). The Mn concentrations in the brain were significantly higher in rats exposed to Mn phosphate and Mn phosphate/sulfate mixture than in control rats or rats exposed to metallic Mn. Exposure to Mn phosphate/sulfate mixture caused a decrease in the total ambulatory count related to locomotor activity. Our results confirm that Mn species and solubility have an influence on the brain distribution of Mn in rats.
The primary goal of this study is to determine the effects of Mn exposure via inhalation. The bioaccumulation of Mn in different organs and tissues, the alteration of biochemical parameters, and the ...locomotor activity were assessed. A group of 26 male Sprague-Dawley rats (E) were exposed to 3750 µg/m3 of Mn dust for 6 h/day, 5 days/wk for 13 consecutive weeks and compared to a control group of 12 rats (C) exposed to 4 µg/m3. After exposure, neurological evaluation was carried out for 36 h (a night-day-night cycle) using a computerized autotrack system. Rats were then sacrificed by exsanguination, and Mn content in organs and tissues was determined by neutron activation analysis. Mn concentrations in lung, putamen, and cerebellum were significantly higher in E than in C (0.30 vs. 0.17, 0.89 vs. 0.44, 0.63 vs. 0.48 ppm; p < .01), as well as in the kidney, frontal cortex, and globus pallidus (1.15 vs. 0.96, 0.84 vs. 0.47, 1.28 vs. 0.55 ppm; p < .05). Potassium concentration was significantly lower in E than in C (5.11 vs. 5.79 mmol/L; p < .05), as was alkaline phosphatase (106.9 vs. 129.6 U/L; p < .01). Locomotor activity indicated higher distance covered in the first 12-h period for E (45 383 vs. 36 098 cm; p < .05) and lower resting time in the last 12-h period for E (36 326 vs. 37 393 s; p < .05). This study is the first of several ongoing studies in our laboratory that address health concerns associated with inhalation exposure to different Mn species and to different levels of exposure.
Methylcyclopentadienyl manganese tricarbonyl (MMT) is an organic manganese (Mn) compound currently added to unleaded gasoline in Canada. It has been suggested that the combustion of MMT containing Mn ...could cause various deleterious health effects in animals and humans at very high concentrations. This study evaluates the potential of dandelions (
Taraxacum officinale) as bioindicators of Mn environmental comtamination. Samples were picked at three different distances from a highway: a highly exposed site (E
++), a lightly exposed site (E
+) and a control site (E), located respectively at 10, 50 and 100 m. The total Mn, Mg, Ca, Al, Fe and Zn concentrations were measured in the soils and in the plants (flower, stem, leaves and root) by neutron activation analysis. Exchangeable Mn was measured in soils by atomic absorption spectrophotometry. Mn concentrations of the different parts of the plant and exchangeable Mn in soils were not correlated with distance from the roadway and, thus, do not seem to be a sensitive indicator of Mn contamination. Soil Mn concentrations were correlated with distance from the roadway. This suggests the hypothesis that the environmental fate of Mn from MMT sources could be associated with an increased total Mn in soil but does not lead to an increase in exchangeable Mn.
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