The role of personality functioning in drug misuse treatment engagement.

BACKGROUND AND AIM: Personality functioning is predictive of drug misuse and relapse, yet little is known about the role of personality in engagement with the treatment process. This study aimed to estimate the extent to which broad- and facet-level characteristic adaptations contribute to or hinder treatment engagement, while controlling for psychosocial indicators. DESIGN: Multi-site cross-sectional survey. SETTING: In-patient treatment units covering 80% of residential treatment entries in Greece. PARTICIPANTS: A total of 338 service users, 287 (84.9%) male, 51 (15.1%) female, average age 33.4 years. MEASUREMENTS: Expressions of personality functioning (characteristic adaptations) were assessed using the Severity Indices of Personality Problems (SIPP-118). Treatment engagement was measured using the Client Evaluation of Self and Treatment, in-patient version (CEST). FINDINGS: Dysfunctional levels of relational capacities predicted counselling rapport [ß = 1.50, 95% confidence interval (CI) = 0.326-2.69, P = 0.013], treatment participation (ß = 2.09, 95% CI = 1.15-3.11, P < 0.001) and treatment satisfaction (ß = 1.65, 95% CI = 0.735-2.57, P < 0.001). Counselling rapport was also predicted by dysfunctional levels in self-control (ß = 1.78, 95% CI = 0.899-2.67, P < 0.001), self-reflective functioning at the facet-level (ß = 2.24, 95% CI = 1.01-3.46, P < 0.001) and aggression regulation (ß = 1.43, 95% CI = 0.438-2.42, P = 0.005). Dysfunctional levels on social concordance (ß = -1.90, 95% CI = -2.87 to -0.941, P = 0.001), emotional regulation (ß = 1.90, 95% CI = 0.87-2.92, P < 0.001) and intimacy (ß = 2.04, 95% CI = 1.31-3.05, P < 0.001) were significant predictors of treatment participation. Treatment readiness and desire for help predicted treatment engagement. CONCLUSIONS: In people attending substance use treatment services, maladaptive interpersonal patterns and relational intimacy, emotional dysregulation and impulse control may be associated with low levels of counselling rapport and treatment participation. Low frustration tolerance and aggressive impulses also appeared to predict low participation.

Premonitory Urges and Their Link With Tic Severity in Children and Adolescents With Tic Disorders.

Tics wax and wane regarding their severity, while their expression is affected by non-motor sensory or cognitive elements that are mostly known as "premonitory urges." Since premonitory urges are often used in non-pharmacological interventions to decrease tic severity, it is of interest in the present study to examine whether premonitory urges can actually predict tic severity. Fifty-two children and adolescents diagnosed with tics and Tourette syndrome (29 children with provisional tic disorder, 16 children with chronic motor tic disorder, and 7 children with Tourette syndrome) were included in the study. Their age ranged between 6 and 15.7 years (mean age 9 years and 2 months). All participants completed the YGTSS (Yale Global Tic Severity Scale) in order to assess tic severity and the Premonitory Urge for Tics Scale (PUTS) to measure premonitory urges (PU). Regression analysis revealed that PU were present at a higher rate in older subjects (>12 years of age) than in younger children and with a higher level of tic severity. Although the presence of PU was associated with tic severity across the entire age range, there was a stronger association between PU and tic severity in older children. A better insight into the pathophysiology of premonitory urges could possibly lead to the identification of new therapeutic modalities targeting the sensory initiators of tics in future research.

Health-Related Quality of Life of Children with Asthma: Self and Parental Perceptions.

PURPOSE: This study aimed to explore whether age, gender, asthma severity, asthma duration, and exposure to parental smoking were associated with levels of asthma-specific health-related quality of life (HRQoL) among Greek children with asthma and to identify any differences between self- and proxy ratings of asthma-specific HRQoL. METHOD: One hundred and seventy-three (173) children with asthma (8-12 years old) and their parents completed the Pediatric Quality of Life Asthma Module self- and proxy measures. RESULTS: Asthma severity, age, and asthma duration explained almost half of the variance in asthma-specific HRQoL scores according to self- and proxy reports. Older male children with more severe asthma who were diagnosed for a longer period of time and had at least one smoking parent reported lower asthma-specific HRQoL according to self- and proxy reports. Although children and their parents seemed to agree in their views of asthma-specific HRQoL, there were significant differences in ratings of specific parameters of asthma-specific HRQoL. CONCLUSION: This study identifies the factors that account for a significant variance in asthma-specific HRQoL scores according to self- and proxy reports and is among the first to record the effect of parental smoking on children's and parents' perceptions of asthma-specific HRQoL.

A cross-cultural study on perceived health-related quality of life in children and adolescents with type 1 diabetes mellitus.

OBJECTIVE: This study investigated whether culture can affect self- and proxy-reports of perceived diabetes-specific health-related quality of life of children and adolescents with type 1 diabetes when taking into account glycemic control, gender and age. METHODS: A total of 416 patients aged between 8 and 18 years--84 (Greece), 135 (Hungary) and 197 (Kuwait)--and their parents completed the Pediatric Quality of Life Inventory 3.0. Diabetes Module. RESULTS: Gender and age did not have any effect on perceived diabetes-specific health-related quality of life. Significant differences were detected among countries in self- and proxy-reports of diabetes-specific health-related quality of life when controlling for glycemic control. More specifically, Greek patients with type 1 diabetes and their parents reported significantly worse disease-specific health-related quality of life than their peers from Kuwait and Hungary. Moreover, culture affected the level of agreement between self- and proxy-reports with parents from Kuwait underestimating their children's diabetes-specific health-related quality of life. CONCLUSION: The impact of culture on self- and proxy-reports of diabetes-specific health-related quality of life warrants further investigation, since it might suggest the need for differential psychosocial treatment.

Parental Perceptions of Health-Related Quality of Life of Albanian Children with Epilepsy.

Epilepsy adversely affects the health-related quality of life (HRQoL) of children living with it. Even though almost 80% of children with epilepsy live in developing countries very little research has been conducted with the specific population. The present study took place in Albania and aimed to investigate parental perceptions of the HRQoL of their children with epilepsy. Considering the well-defined gender roles in the Albanian traditional family it was expected that mothers and fathers reports of their children's HRQoL would differ. Results showed no differences in maternal and paternal reports; instead there was a moderate correspondence between the reports across all dimensions. Parents also reported the highest scores of HRQoL in the interpersonal dimension and the lowest scores in the intrapersonal dimension. The findings have implications in the context of future research and also medical care for children with epilepsy in Albania.

Reported maternal styles and substance use: a cross-sectional study among educated Albanian young adults.

The study explored a predictive model of substance use including perceived maternal parenting style, age and gender. Participants were 347 Albanian young adults (144 males and 203 females) aged 18 to 28 years. They completed the Parental Authority Questionnaire and the Adolescent Alcohol and Drug Involvement Scale. Gender, perceived authoritative maternal style, and age predicted a proportion of substance use involvement. Gender and perceived authoritative maternal style also predicted the proportion of young people at risk for substance use or abuse. Implications of the findings and limitations of the study are discussed.

Autism spectrum disorders: the quest for genetic syndromes.

Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental disabilities with various etiologies, but with a heritability estimate of more than 90%. Although the strong correlation between autism and genetic factors has been long established, the exact genetic background of ASD remains unclear. A number of genetic syndromes manifest ASD at higher than expected frequencies compared to the general population. These syndromes account for more than 10% of all ASD cases and include tuberous sclerosis, fragile X, Down, neurofibromatosis, Angelman, Prader-Willi, Williams, Duchenne, etc. Clinicians are increasingly required to recognize genetic disorders in individuals with ASD, in terms of providing proper care and prognosis to the patient, as well as genetic counseling to the family. Vice versa, it is equally essential to identify ASD in patients with genetic syndromes, in order to ensure correct management and appropriate educational placement. During investigation of genetic syndromes, a number of issues emerge: impact of intellectual disability in ASD diagnoses, identification of autistic subphenotypes and differences from idiopathic autism, validity of assessment tools designed for idiopathic autism, possible mechanisms for the association with ASD, etc. Findings from the study of genetic syndromes are incorporated into the ongoing research on autism etiology and pathogenesis; different syndromes converge upon common biological backgrounds (such as disrupted molecular pathways and brain circuitries), which probably account for their comorbidity with autism. This review paper critically examines the prevalence and characteristics of the main genetic syndromes, as well as the possible mechanisms for their association with ASD.

Young children's attitudes toward peers with intellectual disabilities: effect of the type of school.

BACKGROUND: This study explored typically developing children's attitudes towards peers with intellectual disabilities, with special reference to the type of school they attended. MATERIALS AND METHODS: Two hundred and fifty-six Greek children aged 9-10 (135 in inclusive settings) completed a questionnaire and an adjective list by Gash (European Journal of Special Needs Education 1993; 8, 106) and drew a child with intellectual disabilities, commenting also on their drawings. RESULTS: Typically developing children expressed overall neutral attitudes towards peers with intellectual disabilities. Type of school differentiated their attitudes, with children from inclusive settings being more positive towards peers with intellectual disabilities and choosing less negative adjectives to describe them than children from non-inclusive settings. Girls and students who expressed more positive social, emotional and overall attitudes towards students with intellectual disabilities chose more positive adjectives to describe a child with intellectual disabilities. It was also found that children from inclusive settings drew children with intellectual disabilities as more similar to a child with Down syndrome in comparison with children from non-inclusive settings. CONCLUSIONS: Effective inclusive practices should be promoted to foster social acceptance of students with intellectual disabilities.

Factors associated with behavioral problems in children with idiopathic epilepsy.

The present study examined whether the perceived behavioral problems of children with idiopathic epilepsy differed from those of healthy controls according to parent proxy-reports and which factors are associated with these problems. The parents of 106 children with idiopathic epilepsy and 305 healthy controls aged 6-9 years old completed the Vanderbilt ADHD Diagnostic Parent Rating Scale and the Strengths and Difficulties Questionnaire. The 106 children with idiopathic epilepsy were also interviewed using the K-SADS-PL. The parents of children with idiopathic epilepsy reported more hyperactivity, emotional and conduct problems than the parents of healthy controls, as well as less prosocial behavior. Parents detected no differences in peer problems, inattention, oppositional/defiant disorder, and anxiety/depression. Age of onset of epilepsy (later), the number of administered antiepileptic drugs (polytherapy), and gender (male) predicted behavioral problems in children with idiopathic epilepsy. The frequency of seizures was associated with behavioral problems, while age was not. Finally, children with benign focal epilepsy were rated by their parents as having less behavioral problems than children with generalized epilepsy.

Health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (T1DM): self and parental perceptions.

The aim of the study was to evaluate health-related quality of life (HRQoL) in children and adolescents with type 1 diabetes mellitus (T1DM) in Greece compared with healthy controls and to identify the effect of age, gender, age of onset of disease, and metabolic control on perceptions of HRQoL. A total of 117 children and adolescents with T1DM aged 5-18, their parents, and 128 matched healthy children and adolescents participated. Children and adolescents completed PedsQL™ 4.0 Generic Core Scales. Children and adolescents with T1DM also completed the PedsQL™ 3.0 Diabetes Module, while their parents completed the proxy-reports of both the PedsQL™ 4.0 Generic Core Scales and the PedsQL™ 3.0 Diabetes Module. The results demonstrated that children and adolescents with T1DM had lower general HRQoL compared with healthy matched children and adolescents. Parents of children and adolescents with diabetes reported that the illness has a greater affect on their children's lives than the children themselves. Finally, the results indicated that later age of onset of diabetes, less hyperglycemic episodes, lower glycosylated hemoglobin (HbA1c), older age, and male gender were associated with better general HRQoL and diabetes-specific HRQoL. The findings have implications for designing effective therapeutic interventions aimed at improving the HRQoL of children and adolescents with T1DM.

Multirater congruence on the social skills assessment of children with asperger syndrome: self, mother, father, and teacher ratings.

Children with Asperger Syndrome (AS) who attend mainstream settings face social skills deficits that have not been adequately explored. This study aims to examine social skills through self-reports of children with AS (N = 21) and a matched group of typically developing peers, as well as reports from their mothers, fathers, and teachers. Results showed that children with AS had more social skills deficits according to all raters and that they reported more aggressiveness/antisocial behavior, more conceit/haughtiness, more loneliness/social anxiety, and less assertiveness than controls. The level of agreement between raters varied significantly, suggesting that social skills are best studied with multiple informants.

Comparison of eating attitudes between adolescent girls with and without Asperger syndrome: daughters' and mothers' reports.

Despite the evidence that individuals with Asperger syndrome (AS) have a propensity for being underweight or having comorbid eating disorders, no previous research has compared the eating attitudes of adolescent girls with AS to typically developing peers. This study compared reports of eating problems provided by the adolescent girls themselves (56 with and 56 without AS) and their mothers on the EAT-26. Results indicated that adolescent girls with AS are at a higher risk for eating problems than their typically developing peers according to their reports and the reports of their mothers. Moreover, it was found that although the agreement between mothers' and daughter's reports is very satisfactory, mothers of girls with AS report statistically less eating-disordered behaviors than their daughters.

Can social stories enhance the interpersonal conflict resolution skills of children with LD?

Since many children with learning disabilities (LD) face interpersonal conflict resolution problems, this study examines the efficacy of social stories in helping them choose more appropriate interpersonal conflict resolution strategies. A social story was recorded and played to the 31 children with LD in the experimental group twice a week for a period of 1 month, while the 32 children with LD in the control group did not receive any intervention. The effects of the intervention were systematically examined by means of an interview with the participants, while teachers completed the T-MESSY (Matson, J. L. (1990). Matson Evaluation of Social Skills With Youngsters: Manual. Worthington, OR: International Diagnostic Systems). All children chose mainly avoidance and hostile strategies before the intervention, but children in the experimental group chose predominantly positive strategies both after the intervention and at follow-up in comparison to control children. Furthermore, children with LD who received the intervention were rated by their teachers as engaging in significantly less inappropriate social behaviors after the intervention and at follow-up in comparison to control children. The recorded changes in the choice of interpersonal conflict resolution strategies and the more positive teacher ratings for the experimental group indicate that social stories constitute a powerful intervention for the enhancement of the social competence of children with LD.

Nonverbal social interaction skills of children with learning disabilities.

Many children with learning disabilities (LD) face problems in their nonverbal communication, which constitutes an important component of their social skills. This study explores the frequency of nonverbal initiations and responses of 36 children with LD and 36 children without LD matched for age and gender, who were observed for 40 min during the break. Younger and older children with and without LD did not differ significantly in their nonverbal responses, but there was a statistically significant difference in terms of younger children's nonverbal initiations. Younger children with LD exhibited significantly fewer nonverbal initiations than younger children without LD. Findings are discussed and suggestions are made for further research.