Caregivers' perception of HIV-infected Dominican children's behaviour.

Caregivers (mothers and non-mothers) of HIV children face many challenges related to both physical demands and emotional well-being. The perception of caregivers in the Dominican Republic, a country greatly impacted by HIV/AIDS, in regard to their children's behaviour, has not been investigated to date. To extend understanding of the potential behavioural issues involved in providing care to children without access to antiretroviral therapy, the Child Behaviour Checklist was administered to 52 caregivers of HIV Dominican children (2-8 years old). Both mothers and non-mothers perceived significant pathological internalizing behavioural symptoms in immunosuppressed children, compared to children with less disease progression. Analyses of gender comparisons revealed that older female children were perceived as withdrawn/depressed by their caregivers. These findings suggest that children's disease status may be an important contributor to caregiver perception in mothers, as well as non-mothers and indicate that gender-specific relationships warrant further study.

Behavioural symptoms of children with HIV infection living in the Dominican Republic.

OBJECTIVE: The purpose of this report is to describe behavioural problems encountered in a group of Dominican children living with Human Immunodeficency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in the Dominican Republic. They were not receiving antiretroviral treatment. METHOD: The participants were 43 children with HIV infection (2 to 8 years of age) who were attending an immunology clinic in the largest paediatric hospital in the Dominican Republic. All of the participants were vertically infected with the HIV virus (mother-to-child transmission) and had a very low socio-economic status. The children's caregivers were administered the Child Behavioural Checklist (CBCL) by trained psychologists to determine the caregivers 'perception of the children's behavioural problems. Behavioural findings were examined according to the CBCL age format: younger children (under 5 years of age) and older children (over 6 years of age). RESULTS: Descriptive statistics revealed a high proportion of the children, both younger (approximately 40%) and older (46%) scored in the borderline/clinical ranges for internalizing problems, including anxiety, withdrawn-depressed and somatic complaints. In addition, 46% of the older children were perceived as having externalizing problems (rule breaking and aggressive behaviour). CONCLUSION: These findings suggest that a high incidence of behavioural and mood problems may be prevalent among Dominican children with HIV Thefindings are discussed in terms of future research to examine other risk factors that might contribute to the high rate of maladaptive behaviours observed in the present report, including the contribution of socio-economic status, caregiver illness, caregiver education and parental loss.

Behavioural symptoms of children with HIV infection living in the Dominican Republic / Síntomas de conducta de los niños infectados por vih en la república dominicana

OBJECTIVE: The purpose of this report is to describe behavioural problems encountered in a group of Dominican children living with Human Immunodeficency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in the Dominican Republic. They were not receiving antiretroviral treatment. METHOD: The participants were 43 children with HIV infection (2 to 8 years of age) who were attending an immunology clinic in the largest paediatric hospital in the Dominican Republic. All of the participants were vertically infected with the HIV virus (mother-to-child transmission) and had a very low socio-economic status. The children's caregivers were administered the Child Behavioural Checklist (CBCL) by trained psychologists to determine the caregivers 'perception of the children's behavioural problems. Behavioural findings were examined according to the CBCL age format: younger children (under 5 years of age) and older children (over 6 years of age). RESULTS: Descriptive statistics revealed a high proportion of the children, both younger (approximately 40) and older (46) scored in the borderline/clinical ranges for internalizing problems, including anxiety, withdrawn-depressed and somatic complaints. In addition, 46of the older children were perceived as having externalizing problems (rule breaking and aggressive behaviour). CONCLUSION: These findings suggest that a high incidence of behavioural and mood problems may be prevalent among Dominican children with HIV Thefindings are discussed in terms of future research to examine other risk factors that might contribute to the high rate of maladaptive behaviours observed in the present report, including the contribution of socio-economic status, caregiver illness, caregiver education and parental loss.

Objetivo. El propósito de este reporte es describir los problemas conductuales hallados en un grupo de niños dominicanos que viven con el virus de la inmunodeficiencia humana/síndrome de la inmunodeficiencia humana adquirida (VIH/AIDS) en República Dominicana, sin recibir tratamiento antiretroviral. Método. Los participantes fueron 43 niños (de 2 a 8 años de edad) infectados por el VIH, que asistían a una clínica inmunológica en el mayor hospital pediátrico de la República Dominicana. Todos los participantes estaban verticalmente infectados por el virus del VIH (transmisión de madre a hijo), y tenían un estatus socioeconómico bajo. Con el propósito de determinar la percepción que los encargados del cuidado de los niños tenían de los problemas conductuales de estos, psicólogos profesionales aplicaron a los cuidadores infantiles el instrumento conocido como la Lista de Control de la Conducta del Niño (CBCL). Los hallazgos conductuales fueron examinados de conformidad con el formato de edad de la CBCL: niños menores (por debajo de los 5 años de edad) y niños mayores (más de 6 años de edad) Resultados. Las estadísticas descriptivas revelaron que una alta proporción de niños, tanto menores (aproximadamente 40%) como mayores (46%), alcanzaron puntuaciones en los rangos clínicos/límites de problemas de internalización, incluyendo ansiedad, depresión con retraimiento, y quejas somáticas. Además, del 46% de los niños mayores se tuvo la percepción de que tenían problemas de externalización (rompimiento de las reglas y comportamiento agresivo). Conclusión. Estos hallazgos sugieren que prevalece una alta incidencia de problemas conductuales y anímicos entre los niños dominicanos con VIH. Los hallazgos se discuten en término de una investigación futura a fin de examinar otros factores de riesgo que podrían estar contribuyendo a la alta tasa de comportamientos maladaptativos observados en el reporte presente, incluyendo la contribución del estatus socioeconómico, la enfermedad de los propios cuidadores, la educación de los cuidadores y la pérdida de los padres.

Caregivers' perception of HIV-infected Dominican children's behaviour / La percepción de los encargados del cuidado de la salud en relación con la Conducta de niños dominicanos infestados por vih

Caregivers (mothers and non-mothers) of HIV children face many challenges related to both physical demands and emotional well-being. The perception of caregivers in the Dominican Republic, a country greatly impacted by HIV/AIDS, in regard to their children's behaviour, has not been investigated to date. To extend understanding of the potential behavioural issues involved in providing care to children without access to antiretroviral therapy, the Child Behaviour Checklist was administered to 52 caregivers of HIV Dominican children (2-8 years old). Both mothers and non-mothers perceived significant pathological internalizing behavioural symptoms in immunosuppressed children, compared to children with less disease progression. Analyses of gender comparisons revealed that older female children were perceived as withdrawn/depressed by their caregivers. These findings suggest that children's disease status may be an important contributor to caregiver perception in mothers, as well as non-mothers and indicate that gender-specific relationships warrant further study.

Los encargados del cuidado de la salud (madres y no madres) de niños HIV+ enfrentan muchos retos, tanto en relación con las exigencias físicas cuanto con respecto al estado emocional de los niños. La percepción de los encargados del cuidado de la salud en República Dominicana ­ un país muy impactado por el VIH/SIDA ­ con respecto a la conducta de sus niños, no se ha investigado hasta hoy. A fin de extender la comprensión de los problemas potenciales de comportamiento implícitos en ofrecer cuidado a niños sin acceso a terapia antiretroviral, se administró la Lista de Conductas Infantiles ­ conocida en inglés como Chile Behaviour Checklist ­ a los encargados del cuidado de la salud de los niños dominicanos VIH+ (2 ­ 8 años de edad). Tanto las madres como las no madres percibieron síntomas significativos de conducta de interiorización patológica en los niños inmunodeprimidos, en comparación con los niños con la enfermedad menos avanzada. Los análisis de las comparaciones de género revelaron que las niñas de más edad, pero no los varones, eran percibidas como retraídas/ deprimidas por los encargados del cuidado. Estos hallazgos sugieren que el estatus de la enfermedad de los niños, puede ser un factor que contribuye de forma importante a la percepción de los encargados del cuidado de la salud, ya sean o no madres, e indioan que las relaciones específicas de género merece más estudio

Massage therapy effects on depressed pregnant women.

Eighty-four depressed pregnant women were recruited during the second trimester of pregnancy and randomly assigned to a massage therapy group, a progressive muscle relaxation group or a control group that received standard prenatal care alone. These groups were compared to each other and to a non-depressed group at the end of pregnancy. The massage therapy group participants received two 20 min therapy sessions by their significant others each week for 16 weeks of pregnancy, starting during the second trimester. The relaxation group provided themselves with progressive muscle relaxation sessions on the same time schedule. Immediately after the massage therapy sessions on the first and last days of the 16-week period the women reported lower levels of anxiety and depressed mood and less leg and back pain. By the end of the study the massage group had higher dopamine and serotonin levels and lower levels of cortisol and norepinephrine. These changes may have contributed to the reduced fetal activity and the better neonatal outcome for the massage group (i.e. lesser incidence of prematurity and low birthweight), as well as their better performance on the Brazelton Neonatal Behavior Assessment. The data suggest that depressed pregnant women and their offspring can benefit from massage therapy.

Employment during adolescence is associated with depression, inferior relationships, lower grades, and smoking.

A self-report questionnaire was administered to high school seniors to collect data on the psychological, behavioral, and social aspects of their lives. It was found that employment was associated with (1) greater depression; (2) inferior relationships with parents and best friend, including less time and physical contact with parents; (3) lower grade point average; and (4) smoking.

Childrens' distress during burn treatment is reduced by massage therapy.

Before dressing changes, 24 young children (mean age = 2.5 years) hospitalized for severe burns received standard dressing care or massage therapy in addition to standard dressing care. The massage therapy was conducted to body parts that were not burned. During the dressing change, the children who received massage therapy showed minimal distress behaviors and no increase in movement other than torso movement. In contrast, the children who did not receive massage therapy responded to the dressing change procedure with increased facial grimacing, torso movement, crying, leg movement and reaching out. Nurses also reported greater ease in completing the dressing change procedure for the children in the massage therapy group. These findings suggest that massage therapy attenuates young childrens' distress responses to aversive medical procedures and facilitates dressing changes.

HIV adolescents show improved immune function following massage therapy.

HIV+adolescents (M CD4=466 mm3) recruited from a large urban university hospital's outpatient clinic were randomly assigned to receive massage therapy (n=12) or progressive muscle relaxation (n=12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after treatment the 12 weeks treatment period. Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed, and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number (CD56) and CD56+CD3-. In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number showed an increase for the massage therapy group only.

Lower back pain is reduced and range of motion increased after massage therapy.

STUDY DESIGN: A randomized between-groups design evaluated massage therapy versus relaxation for chronic low back pain. OBJECTIVES: Treatment effects were evaluated for reducing pain, depression, anxiety and stress hormones, and sleeplessness and for improving trunk range of motion associated with chronic low back pain. SUMMARY OF BACKGROUND DATA: Twenty-four adults (M age=39.6 years) with low back pain of nociceptive origin with a duration of at least 6 months participated in the study. The groups did not differ on age, socioeconomic status, ethnicity or gender. METHODS: Twenty-four adults (12 women) with lower back pain were randomly assigned to a massage therapy or a progressive muscle relaxation group. Sessions were 30 minutes long twice a week for five weeks. On the first and last day of the 5-week study participants completed questionnaires, provided a urine sample and were assessed for range of motion. RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and improved sleep. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher. CONCLUSIONS: Massage therapy is effective in reducing pain, stress hormones and symptoms associated with chronic low back pain. PRECIS: Adults (M age=39.6 years) with low back pain with a duration of at least 6 months received two 30-min massage or relaxation therapy sessions per week for 5 weeks. Participants receiving massage therapy reported experiencing less pain, depression, anxiety and their sleep had improved. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher.

CES-D depression scores are correlated with frontal EEG alpha asymmetry.

In order to evaluate the relationship between frontal EEG asymmetry and depressive symptomology, the Center for Epidemiological Studies Depression scale [CES-D; Radloff, 1977] was given to 163 women, and their EEG was recorded from the mid frontal (F3 and F4) and parietal (P3 and P4) regions during a 3 min baseline recording. As expected from previous research on depression, CES-D scores were negatively correlated with frontal EEG alpha asymmetry scores and positively correlated with left frontal EEG alpha power. Analyses of variance further revealed that mothers scoring above the cut-off for depression (CES-D > or = 16) had significantly lower frontal EEG asymmetry scores than mothers with 0-2 and 3-12 CES-D scores but not lower scores than mothers with 13-15 CES-D scores.

Maternal depression and increased fetal activity.

Pregnant women with (n = 45) and without (n = 45) symptoms of depression (CES-D score of 16 or more) were provided ultrasound examinations during the second and third trimesters. An analysis of variance on the cross-sectional data yielded a significant diagnosis by gestational month interaction effect (P < 0.05). The fetuses of depressed mothers spent significantly more time being active during the fifth, sixth and seventh gestational months than fetuses of non-depressed mothers. A stepwise regression analysis revealed that 35% of the variance in time being active could be accounted for by the combined depression and trait anxiety scores of the mothers. These findings suggest that maternal depression correlated with increased fetal activity. These data also highlight the need for research on the potential effects of stress hormones on fetal activity.

Anorexia nervosa symptoms are reduced by massage therapy.

Nineteen women (M age = 26) diagnosed with anorexia nervosa were given standard treatment alone or standard treatment plus massage therapy twice per week for five weeks. The massage group reported lower stress and anxiety levels and had lower cortisol (stress) hormone levels following massage. Over the five-week treatment period, they also reported decreases in body dissatisfaction on the Eating Disorder Inventory and showed increased dopamine and norepinephrine levels. These findings support a previous study on the benefits of massage therapy for eating disorders.

Premenstrual symptoms are relieved by massage therapy.

Twenty-four women meeting Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria for premenstrual dysphoric disorder (PDD) were randomly assigned to a massage therapy or a relaxation therapy group. The massage group showed decreases in anxiety, depressed mood and pain immediately after the first and last massage sessions. The longer term (5 week) effects of massage therapy included a reduction in pain and water retention and overall menstrual distress. However, no long-term changes were observed in the massaged group's activity level or mood. Future studies might examine the effects of a longer massage therapy program on these symptoms. Overall, the findings from this study suggest that massage therapy may be an effective adjunct therapy for treating severe premenstrual symptoms.

Postburn itching, pain, and psychological symptoms are reduced with massage therapy.

Twenty patients with burn injuries were randomly assigned to a massage therapy or a standard treatment control group during the remodeling phase of wound healing. The massage therapy group received a 30-minute massage with cocoa butter to a closed, moderate-sized scar tissue area twice a week for 5 weeks. The massage therapy group reported reduced itching, pain, and anxiety and improved mood immediately after the first and last therapy sessions, and their ratings on these measures improved from the first day to the last day of the study.

Children with cystic fibrosis benefit from massage therapy.

OBJECTIVE: To measure the effects of parents giving massage therapy to their children with cystic fibrosis to reduce anxiety in parents and their children and to improve the children's mood and peak air flow readings. METHODS: Twenty children (5-12 years old) with cystic fibrosis and their parents were randomly assigned to a massage therapy or a reading control group. Parents in the treatment group were instructed and asked to conduct a 20-minute child massage every night at bedtime for one month. Parents in the reading control group were instructed to read for 20 minutes a night with their child for one month. On days 1 and 30, parents and children answered questions relating to present anxiety levels and children answered questions relating to mood, and their peak air flow was measured. RESULTS: Following the first and last massage session, children and parents reported reduced anxiety. Mood and peak air flow readings also improved for children in the massage therapy group. CONCLUSIONS: These findings suggest that parents may reduce anxiety levels by massaging their children with cystic fibrosis and their children may benefit from receiving massage by having less anxiety and improved mood, which in turn may facilitate breathing.

Pregnant women benefit from massage therapy.

Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks. The therapies consisted of 20-min sessions twice a week. Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group and the women had fewer complications during labor and their infants had fewer postnatal complications (e.g., less prematurity).

Smoking cravings are reduced by self-massage.

BACKGROUND: Attempts at smoking cessation have been correlated with severe withdrawal symptoms, including intense cigarette cravings, anxiety, and depressed mood. Massage therapy has been shown to reduce anxiety and stress hormones and improve mood. METHOD: Twenty adult smokers (M age = 32.6) were randomly assigned to a self-massage treatment or a control group. The treatment group was taught to conduct a hand or ear self-massage during three cravings a day for 1 month. RESULTS: Self-reports revealed lower anxiety scores, improved mood, and fewer withdrawal symptoms. In addition, the self-massage group smoked fewer cigarettes per day by the last week of the study. CONCLUSIONS: The present findings suggest that self-massage may be an effective adjunct treatment for adults attempting smoking cessation to alleviate smoking-related anxiety, reduce cravings and withdrawal symptoms, improve mood, and reduce the number of cigarettes smoked.

Intermodal perception of adult and child faces and voices by infants.

This research investigated the ability of 4- and 7-month-old infants to match unfamiliar, dynamic faces and voices on the basis of age or maturity. In Experiment 1, infants received videotaped trials of an adult and a child of the same gender, side by side, speaking a nursery rhyme in synchrony with one another. The voice to one and then the other face was played in synchrony with the movements of both faces in a random order across 12 trials. On one block of 6 trials a man and a boy were presented, and on the other block a woman and a girl. Results indicated significant matching of the faces and voices at both ages, and the infant's prior experience with children appeared to facilitate matching at 7 months. Further, a visual preference for the children's faces was found. Experiment 2 assessed matching to the same events by 7-month-olds, only with the faces inverted. Results indicated no evidence of matching; however, the visual preference for the children's faces was replicated. Together, the findings suggest that infants are able to detect invariant intermodal relations specifying the age or maturity of a person's face and voice. This matching was most likely based on information that was degraded by inverting the faces, including invariant relations between the sound of the voice and configurational aspects of the face, or between temporal aspects of the voice and the relative motion of facial features.

Atopic dermatitis symptoms decreased in children following massage therapy.

Young children with atopic dermatitis were treated with standard topical care and massaged by their parents for 20 minutes daily for a 1 month period. A control group received standard topical care only. The children's affect and activity level significantly improved, and their parent's anxiety decreased immediately after the massage therapy sessions. Over the 1 month period, parents of massaged children reported lower anxiety levels in their children, and the children improved significantly on all clinical measures including redness, scaling, lichenification, excoriation, and pruritus. The control group only improved significantly on the scaling measure. These data suggest that massage therapy may be a cost-effective adjunct treatment for atopic dermatitis, since there is a one-time expense of $30 for the child to receive the massage and the parent to learn the technique.