Longitudinal development of antisocial behaviors in young and early adolescent Puerto Rican children at two sites.

OBJECTIVE: This report provides descriptive longitudinal findings over three waves of a study designed to assess the development of antisocial behaviors in young and early adolescent Puerto Rican children at two sites. METHOD: Through the use of standard assessment measures, representative samples of Puerto Rican children of both genders 5 to 13 years of age and their adult caretakers were interviewed at two sites: the South Bronx in New York City (n = 1,138) and the Standard Metropolitan Areas in Puerto Rico (n = 1,353; N = 2,491). RESULTS: Although no differences in prevalence between the two sites were apparent at baseline, analyses of the longitudinal data show that site differences emerge over time, with a decrease in risk of antisocial behavior over time in the Standard Metropolitan Areas relative to the Bronx. CONCLUSIONS: The decreased risk of these disorders in the Standard Metropolitan Areas corroborates the low rates in Puerto Rico reported in previous research. Future analyses of these data are needed to identify the risk and protective factors associated with this difference.

A study of disruptive behavior disorders in Puerto Rican youth: II. Baseline prevalence, comorbidity, and correlates in two sites.

OBJECTIVE: This is the second of two associated articles. The prevalence, correlates, and comorbidities of disruptive behavior disorders (DBDs) in two populations are reported. METHOD: Probability community samples of Puerto Rican boys and girls ages 5-13 years in San Juan, and the south Bronx in New York City are included (n = 2,491). The Diagnostic Interview Schedule for Children-IV and measures of correlates were employed to look at the association between DBDs and potential correlates, taking comorbidity into account. Data presented in this report were collected primarily between 2002 and 2003 but spanned a 3-year period from August 2000 to August 2003. RESULTS: There were no significant age or site differences among males in rates of DBDs, but rates among females increased with age in the south Bronx and decreased with age in Puerto Rico. The salient comorbidity of DBDs was with attention-deficit/hyperactivity disorder. Multiple regression showed lack of parental warmth and approval, poor peer relationships, and parental report of aggressive behavior during the toddler years to be the most significant correlates of DBDs in this population. CONCLUSIONS: Cultural factors, such as level of acculturation, were not associated with DBDs. The results suggest that clinical and preventive efforts need to emphasize interpersonal factors such as parent-child relationships and peer interactions.

Maternal smoking and drinking during pregnancy and the risk for child and adolescent psychiatric disorders.

OBJECTIVE: To examine the relative importance of prenatal exposure to cigarettes and alcohol and familial/genetic susceptibility for alcohol dependence in the etiology of childhood psychopathology. METHOD: A longitudinal prospective study of 150 children/adolescents (51.3% male), who were at either high or low risk for developing alcohol dependence because of their familial loading for alcoholism, provided multiple diagnostic assessments (N = 318) of these subjects. High-risk families were identified through the presence of two adult alcoholic sisters; low-risk control families were selected from the community. Annual assessments of offspring from these families included an in-depth psychiatric interview of each child and his/her parent to determine the presence or absence of childhood disorders. Mothers were interviewed concerning their prenatal use of substances, and information was gathered concerning their personal and familial loading for psychiatric disorders. RESULTS: Using conventional logistic regression analyses, internalizing and externalizing disorders were found to be associated with familial loading for alcoholism and prenatal exposure to cigarettes and alcohol. In addition, a specialized statistical analysis, a multivariate confounder score approach, was conducted using familial risk status and the child's exposure to maternal prenatal use of alcohol and cigarettes. This analysis demonstrated that only one relationship between a single variable and a childhood disorder was significant while controlling for the other two variables: Oppositional disorder remained significant in association with familial risk status. Three additional analyses were performed to evaluate the effects of familial risk status, prenatal alcohol exposure and prenatal cigarette exposure on childhood psychopathology while controlling for two known risk factors (SES and parental ASPD) for externalizing disorders. Results of these analyses revealed that the only childhood disorder that was elevated was ADHD, and that this was the result of the familial risk variable only. CONCLUSIONS: Familial loading for alcohol dependence is an important risk factor for the development of childhood psychopathology and may account for the previously reported associations between prenatal exposure to nicotine and alcohol. Studies of substance abuse/dependence etiology and childhood psychopathology need to include consideration of both prenatal exposures and familial loading for alcohol dependence and other psychiatric disorders.

An in-service education program as a means to improve nurses' knowledge and attitude about AIDS and to increase their willingness to care for AIDS patients.

This study evaluates changes in nurses' knowledge and attitudes about AIDS and changes in their willingness to care for AIDS patients following a 2 hour educational program. The nursing staff of Kaohsiung Medical College Hospital was divided into two groups: an experimental group (n = 280) and a control group (n = 119). Scores were obtained from a pre-test and from a post-test. The questionnaire that was given to both groups. The results were analyzed by 2-way ANOVA with repeated measures. The experimental group's overall pre-test score on their knowledge of AIDS was 25.9 +/- 4.5 (66.4% of the maximal score of 39) and the post-test score showed an improvement to 28.7 +/- 4.2 (73.6% of the maximal score). The difference between the pre-test and post-test scores of the experimental group was statistically significant (P < 0.01). The difference in the post-test scores between the experimental group and the control group (26.0 +/- 4.0) was also statistically significant (P < 0.01). Pertaining to attitudes towards AIDS, the experimental group had a pre-test score of 47.2 +/- 5.2 and a post-test score of 47.3 +/- 5.5, and there was neither a significant difference between the pre-test score and the post-test score of the experimental group nor in the post-test scores between the experimental group and the control group (47.6 +/- 4.3). The post-test score of willingness to care for AIDS patients was slightly higher than the pre-test score in both groups, but the difference was not significant. Nurses who originally were willing to care for AIDS patients had a more positive attitude toward AIDS than did nurses who had originally refused to care for AIDS patients in the pre-test and post-test (p < 0.01). In conclusion, the in-service education apparently enhanced the knowledge of AIDS, however, no statistical difference was established for changes in nurses' attitudes or in their willingness to care for AIDS patients. In order to provide better nursing care, we believe, AIDS knowledge needs to be further promoted.