Multicenter Study of Long-Term Outcomes and Quality of Life in PHACE Syndrome after Age 10.

OBJECTIVE: To characterize long-term outcomes of PHACE syndrome. STUDY DESIGN: Multicenter study with cross-sectional interviews and chart review of individuals with definite PHACE syndrome ≥10 years of age. Data from charts were collected across multiple PHACE-related topics. Data not available in charts were collected from patients directly. Likert scales were used to assess the impact of specific findings. Patient-Reported Outcomes Measurement Information System (PROMIS) scales were used to assess quality of life domains. RESULTS: A total of 104/153 (68%) individuals contacted participated in the study at a median of 14 years of age (range 10-77 years). There were infantile hemangioma (IH) residua in 94.1%. Approximately one-half had received laser treatment for residual IH, and the majority (89.5%) of participants were satisfied or very satisfied with the appearance. Neurocognitive manifestations were common including headaches/migraines (72.1%), participant-reported learning differences (45.1%), and need for individualized education plans (39.4%). Cerebrovascular arteriopathy was present in 91.3%, with progression identified in 20/68 (29.4%) of those with available follow-up imaging reports. Among these, 6/68 (8.8%) developed moyamoya vasculopathy or progressive stenoocclusion, leading to isolated circulation at or above the level of the circle of Willis. Despite the prevalence of cerebrovascular arteriopathy, the proportion of those with ischemic stroke was low (2/104; 1.9%). PROMIS global health scores were lower than population norms by at least 1 SD. CONCLUSIONS: PHACE syndrome is associated with long-term, mild to severe morbidities including IH residua, headaches, learning differences, and progressive arteriopathy. Primary and specialty follow-up care is critical for PHACE patients into adulthood.

Applied Psychology. The Case of the Baer, Wolf and Risley Prescriptions for Applied Behavior Analysis / Psicologia aplicada. El caso de las prescripciones de Baer, Wolf y Riesley para el análisis aplicado de la conducta

Baer, Wolf and Risley, members of the group that promoted the creation of the Journal of Applied Behavior Analysis, offered in its first issue a detailed series of 'prescriptions' that characterized the way research and research articles would be conceived as adequate to the applied field by the journal editors. Their 'prescriptions' have been largely cited, becoming a sign of authors' identification with the journal policy, and widely influencing the structure and topics of this specialized literature.

El "Journal of Applied of Behavior Analysis" publicó en su primer número, en 1967, unas reglas o prescripciones , elaboradas por tres miembros del grupo editorial (Baer, Wolf y Riesley) , que han servido eficazmente para orientar a los futuros autores acerca del modo como construir los articulos que podrían ser publicados en la revista. Esas prescripciones reunen las principales características propias de la investigación aplicada en el campo del análisis conductual.

Análisis longitudinal de la comorbilidad entre depresión y agresión: Cronicidad y severidad en sujetos de 11 a 13 años / Longitudinal analysis of comorbidity between depression and aggression: Chronicity and severity in individuals 11 to 13 years

La comorbilidad entre depresión y agresión infanto-adolescente ha sido contrastada básicamente a un nivel estadístico. Sin embargo, pocos estudios han comprobado de manera longitudinal otra de las premisas fundamentales que permite establecer la comorbilidad: la sinergia, es decir, la acción conjunta de dos o más trastornos que se traduce en una severidad y cronicidad superior a las generadas por la suma de los efectos individuales. Mediante un diseño longitudinal a lo largo de 3 años se examinó la severidad y cronicidad de un grupo de sujetos comórbidos depresivos - agresivos. Se analizaron los niveles de depresión y agresión, así como el papel del sexo en estas relaciones. La evaluación se realizó a través de autoinformes en una muestra de 525 sujetos de edades comprendidas entre los 11 y 13 años. La muestra fue aleatoriamente seleccionada de diferentes colegios de la Comunidad de Madrid (España). Los resultados muestran que la depresión y agresión se relacionan de manera estadísticamente significativa. Los sujetos comórbidos exhiben una cronicidad de mayor duración en las respuestas agresivas que en las depresivas. La severidad en los sujetos comórbidos es mayor en las respuestas agresivas de tipo total y verbal, así como en las depresivas. El sexo no ejerce ningún efecto significativo. Se concluye que los datos indican la importancia de explorar la comorbilidad con diferentes tipos de agresión, especialmente la verbal, y en diferentes grupos de edad. Se discute la necesidad de atender a los síntomas subyacentes al trastorno principal en afectados de larga duración, ya que a la expresión de uno de los trastornos puede subyacer la cronicidad asociada a la comorbilidad con importantes repercusiones para su diagnóstico y tratamiento.

The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested person's sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.

Análisis longitudinal de la comorbilidad entre depresión y agresión: Cronicidad y severidad en sujetos de 11 a 13 años / Longitudinal analysis of comorbidity between depression and aggression: Chronicity and severity in individuals 11 to 13 years

La comorbilidad entre depresión y agresión infanto-adolescente ha sido contrastada básicamente a un nivel estadístico. Sin embargo, pocos estudios han comprobado de manera longitudinal otra de las premisas fundamentales que permite establecer la comorbilidad: la sinergia, es decir, la acción conjunta de dos o más trastornos que se traduce en una severidad y cronicidad superior a las generadas por la suma de los efectos individuales. Mediante un diseño longitudinal a lo largo de 3 años se examinó la severidad y cronicidad de un grupo de sujetos comórbidos depresivos - agresivos. Se analizaron los niveles de depresión y agresión, así como el papel del sexo en estas relaciones. La evaluación se realizó a través de autoinformes en una muestra de 525 sujetos de edades comprendidas entre los 11 y 13 años. La muestra fue aleatoriamente seleccionada de diferentes colegios de la Comunidad de Madrid (España). Los resultados muestran que la depresión y agresión se relacionan de manera estadísticamente significativa. Los sujetos comórbidos exhiben una cronicidad de mayor duración en las respuestas agresivas que en las depresivas. La severidad en los sujetos comórbidos es mayor en las respuestas agresivas de tipo total y verbal, así como en las depresivas. El sexo no ejerce ningún efecto significativo. Se concluye que los datos indican la importancia de explorar la comorbilidad con diferentes tipos de agresión, especialmente la verbal, y en diferentes grupos de edad. Se discute la necesidad de atender a los síntomas subyacentes al trastorno principal en afectados de larga duración, ya que a la expresión de uno de los trastornos puede subyacer la cronicidad asociada a la comorbilidad con importantes repercusiones para su diagnóstico y tratamiento.(AU)

The comorbidity between depression and aggression in children and adolescents is an issue that has sparked controversy as its existence has important implications for the validity of the classification systems, for the establishment of explanatory models, the design of new treatments as well as in the final outcome which the comorbid person presents in these in comparison with conventional treatments. In addition, the prevalence rates in depressive-aggressive comorbidity are significant, oscillating between 7.97 and 10.91%. Therefore, the study of comorbidity becomes necessary and the lack of studies focusing on the subject comes as a surprise. Perhaps one of the main problems concerning the research of comorbidity lies in the fact that most of the studies do not validate the clinical criteria that focuses on the principle of synergy, as Clark and Watson had established in Tripartite model, since doing so would require longitudinal studies measuring the effects of a commorbid disorder in contrast to those where there is no comorbidity to be found. In addition to clinical judgment, the Tripartite model demands a further statistic indicating the existence of a significant correlation between those synergistic disorders, which is the one on which most studies have been focusing. This type of results, based solely on clinical judgment, mainly through cross-sectional studies, has not allowed to implement another type of results, as suggested by the Tripartite model, that would have helped to establish clinical and diagnostic criteria through dimensional self-assessment tools which are closer to a reality in child and adolescent assessment where comorbidity is rather the rule than the exception. Therefore, that kind of study, using a longitudinal design over a period of three years, will help expand those cross-sectional ones, which will allow for examining whether there is a significant association, as well as a synergy that attests to the existence of an aggressive-depressive comorbidity on both, statistical and clinical level. In order to do so this study examined the severity and chronicity of a group of comorbid depressive-aggressive persons. In addition, the levels of depression and aggression and the role of sex within these relationships were analyzed. The sample, randomly selected from different schools in the Community of Madrid (Spain), comprised 525 individuals ranging from 11 to 13 years old, 58.9% female, the family structure was mostly biparental (92%) and the vast majority belonged to a middle class environment (85%). Depression and aggression were assessed through specific types of self-report questionnaires for children and adolescents, both in their Spanish version. The results support the statistical basis, since depression and aggression exhibit a significant positive and moderate association ranging between .11 and .24, in which the fact that the found association was higher within verbal aggression than in the physical one among all ages with the exception of the group of subjects to testing aged 12 needs to be stressed. With regards to the clinical criteria, the results provide partial support, as comorbid subjects exhibit a longer duration in chronic aggressive symptoms than those other groups affected only by depression or aggression, while they are similar to those of merely depressive subjects in the symptoms indicating a depression. Regarding severity, comorbid subjects show a higher level within the field of totally and verbally aggressive symptoms, as well as in the depressive ones which makes their physical aggression comparable to the one found in the test group of total aggression, hence, the data partially support the clinical standard. The tested persons sex, however, is of no significant meaning for the outcome. In conclusion, the data indicates the importance of exploring the comorbidity of different types of aggression, particularly the verbal one, and within different age groups. The need for addressing the underlying primary disorder symptoms in long-term affected patients is discussed, since chronic comorbidity may underlie the expression of one of the disorders and entail important implications for diagnosis and treatment.(AU)

Adaptacion del cuestionario de crianza parental (PCRI-M) a poblacion española / Adaptation of teh parent-child Relationship Inventory (PCRI) to Spanish population

Se presenta la adaptación española del Cuestionario de Crianza Parental (PCRI; Gerard, 1994), incluyendo sus propiedades psicométricas. El instrumento mide las actitudes de los padres hacia la crianza de los hijos. El PCRI-M consta de 78 ítems distribuidos en 8 escalas: apoyo, satisfacción con la crianza, compromiso, comunicación, disciplina, autonomía, distribución del rol, y deseabilidad social. Después de traducir el instrumento al español y de adaptarlo en una muestra piloto, se aplicó a 547 madres cuyas edades oscilaban entre 26 y 53 años (edad promedio: 36.37). Los resultados indican que las características del cuestionario son adecuadas. Por lo tanto puede utilizarse con este tipo de población