Investigating and quantifying obsessive-compulsive and related disorders among childhood cancer survivors: a brief report.

OBJECTIVE: Long-term psychological impacts are well--documented among childhood cancer survivors. To our knowledge, however, no research has been conducted to investigate obsessive--compulsive and related disorders (OCRD) among childhood -cancer survivors (CCS). METHODS: Using a large electronic medical record database, relative risk were calculated to examine associations between demographic characteristics and childhood cancer type and OCRDs among childhood cancer survivors. RESULTS: Among 121 survivors of childhood cancer diagnosed with OCRD, 57% were female. The most common childhood cancer diagnoses were leukemia/lymphoma (41%) and central nervous system (CNS) malignancies (38%), and OCRD diagnoses most frequently observed were obsessive-compulsive disorder (OCD; 76%) and excoriation disorder (13%). Female sex (RR= 1.39, 95% confidence interval (CI) 1.17-1.61), White race (RR= 1.28, 95% CI 1.15-1.36) and history of CNS malignancies (RR= 1.36, 95% CI 1.18, 1.92) were associated with OCD. CONCLUSIONS: Numerous factors, including sex, race, and cancer type, were seen as contributors to risk variance for OCRDs, particularly OCD, among CCS, compared to CCS with no OCRD diagnosis. This provides an enhanced understanding of risk factors for OCRD development and may help improve early identification and care for at-risk survivors.

Scripted attachment representations of current romantic relationships: measurement and validation.

This report describes the development and validation of a new coding system for the Current Relationship Interview (CRI) that assesses individual differences in secure base script knowledge with respect to adult romantic partners. Drawing on data from the Minnesota Longitudinal Study of Risk and Adaptation (N = 116) a coding system was developed to parallel the secure base script coding system for the Adult Attachment Interview. Specifically, CRIs conducted in adulthood were re-coded for the extent to which the interviews reflected script-like expectations that romantic partners are available and provide effective support in times of distress (CRIsbs). CRIsbs was moderately associated with the traditional coding system for the CRI and showed concurrent and/or predictive validity in relation to observed and self-reported romantic relationship quality as well as interview ratings of the effectiveness with which adults engaged in romantic relationships. Theoretical and practical benefits of the CRIsbs coding system are discussed.

Health Equity Considerations for Children With Type 1 Diabetes Who Utilize Insulin Cost-Sharing Cap Programs.

The cost associated with type 1 diabetes care is considerable and the rising price of insulin has further amplified this financial burden. To curb insulin costs, numerous policies have been enacted in the past five years, both by pharmaceutical companies and their intermediaries, as well as federal and state legislatures. The most notable example is implementation of insulin cost-sharing cap laws, which place limits on out-of-pocket expenses for insulin, and in some cases, diabetes technology. Although insulin cost-sharing cap laws have the potential to mitigate the financial burden associated with routine diabetes care, these policies have largely benefitted adults living with type 1 diabetes, while children, especially those from racial and ethnic underrepresented groups, appear to have derived limited advantage. We describe the current state of insulin cost-sharing cap laws and utilization among children and adolescents with type 1 diabetes, with a focus on the limitations of current insulin laws, the importance of measuring health outcomes for children who utilize such programs, and the impact on health equity. We provide a call to action for policymakers and provide recommendations for future research in this area.