The pathological response to DNA damage does not contribute to p53-mediated tumour suppression.

The p53 protein has a highly evolutionarily conserved role in metazoans as 'guardian of the genome', mediating cell-cycle arrest and apoptosis in response to genotoxic injury. In large, long-lived animals with substantial somatic regenerative capacity, such as vertebrates, p53 is an important tumour suppressor--an attribute thought to stem directly from its induction of death or arrest in mutant cells with damaged or unstable genomes. Chemotherapy and radiation exposure both induce widespread p53-dependent DNA damage. This triggers potentially lethal pathologies that are generally deemed an unfortunate but unavoidable consequence of the role p53 has in tumour suppression. Here we show, using a mouse model in which p53 status can be reversibly switched in vivo between functional and inactive states, that the p53-mediated pathological response to whole-body irradiation, a prototypical genotoxic carcinogen, is irrelevant for suppression of radiation-induced lymphoma. In contrast, delaying the restoration of p53 function until the acute radiation response has subsided abrogates all of the radiation-induced pathology yet preserves much of the protection from lymphoma. Such protection is absolutely dependent on p19(ARF)--a tumour suppressor induced not by DNA damage, but by oncogenic disruption of the cell cycle.

Anxiety and depression in children and adolescents: negative affectivity and the utility of self-reports.

Self-reported depression and anxiety were examined in 233 inpatient children diagnosed with either an anxiety disorder or a depressive disorder. Depressed children reported more problems related to a loss of interest and low motivation, and they had a more negative view of themselves. Anxious children reported more worry about the future, their well-being, and the reactions of others. The groups did not differ in the degree of depressed affect reported in terms of being sad, lethargic, bothered by things, or feeling alone and isolated. These findings suggest that a general negative affectivity component is common to both anxiety and depression disorders and measures. The results demonstrate that anxiety and depression in children have distinguishing features that can be measured by common self-report instruments, and the findings indicate that 1 factor that may distinguish between anxiety and depression in children is positive affectivity.

Characteristics of children selecting low-fat foods in an elementary school lunch program.

OBJECTIVE: To describe the demographic characteristics of children that were associated with the selection of low-fat entrees available in a school lunch program. DESIGN: For 5 consecutive months, we recorded student entree selections on the 46 days in which one of the two available lunch entrees was low fat (< or = 30% of calories from fat). Entree selections were tracked using a computerized meal-card system. The lunch menus did not indicate that one of the two entrees was low fat. Demographic and family characteristics were obtained from the school district's registration database and, in one school, from a household telephone survey. SETTING: A school lunch program in two public elementary schools in Bellevue, Wash. PARTICIPANTS: Students who regularly eat school lunches (N = 471). Sixty-five percent were from families with incomes less than 185% of the federal poverty level, and 49% were nonwhite. INTERVENTION: None. MAIN OUTCOME MEASURE: The proportion of days that each student selected the low-fat entree. RESULTS: Girls selected the low-fat entree more often than boys (33% of days vs 27% of days; P < .001), and the proportion of students selecting the low-fat entree increased with grade level (P = .003). Children were more likely to select low-fat entrees if a household member was known to have an elevated blood cholesterol level (P = .004). The proportion of students selecting the low-fat entree increased with maternal education level (P = .007), but children receiving free or reduced-price lunches (< 185% of the federal poverty level) chose the low-fat entree as often as those receiving full-price lunches (30% of days vs 29% of days; P = .14). There were no significant differences in entree selection among races. CONCLUSIONS: Given a choice of low-fat school lunch entrees, girls, older children, and those who had family members with elevated cholesterol levels were most likely to select these entrees. While parental education level was directly related to the selection of low-fat entrees, race and family income had little association with entree selection.

Randomized intervention to increase children's selection of low-fat foods in school lunches.

OBJECTIVE: The purpose of this study was to determine whether children would increase their selection of low-fat foods in school lunches if these foods were labeled on the menu and parents were notified of their availability. METHODS: The 16 elementary schools in the Bellevue (Washington) School District were randomly assigned to intervention and control groups. Participants were the students eating the school lunch--an average of 2445 students per day, of whom one third received free or reduced-price lunches. In all schools, one of the two daily lunch entrees was low in fat (< or = 30% of calories from fat). After a 5-month baseline period, eight schools received a 4-month intervention. The monthly menus carried home by students began to indicate the low-fat entree and to compare the fat content of both entrees. In the first month, parents in the intervention schools (2329 households) received a mailing with a copy of the menu, an informational pamphlet on dietary fat, and a letter that described the menu changes and asked the parents to encourage their children to select low-fat entrees. A follow-up telephone survey was performed in one school 1 month after the intervention mailing to assess the recall and impact of the intervention. The main outcome, based on 249,861 student meal selections, was the proportion of students who selected the low-fat entree, and the unit of analysis was the school. RESULTS: At baseline, there was little difference between intervention and control schools in the percentage of children choosing the low-fat entree (31.5% vs 30.8%). During the intervention, there was an increase in low-fat entree selection in the intervention schools compared with the control schools (35.5% vs 32.2%; p = 0.03). Of 221 parents surveyed, 71% recalled the mailing, 53% remembered that there were now low-fat entrees on the menu, and 10% reported that, after the mailing, they asked their child to choose a low-fat entree.

Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles.

OBJECTIVE: To determine the range and severity of post-traumatic stress disorder (PTSD) symptoms exhibited by children after exposure to a natural disaster. METHOD: Three months after Hurricane Hugo struck Berkeley County, South Carolina, 5,687 school-aged children were surveyed about their experiences and reactions related to the storm. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index. RESULTS: Significant variation in the prevalence of PTSD symptoms was found across race, gender, and age groups. Self-reported symptoms were used to derive a post-traumatic stress syndrome classification according to DSM-III-R guidelines for the diagnosis of PTSD. More than 5% of the sample reported sufficient symptoms to be classified as exhibiting this post-traumatic stress syndrome. Females and younger children were more likely to receive this classification. At the symptom level, females reported more symptoms associated with emotional processing and emotional reaction to the trauma. Males were more likely to report symptoms related to cognitive and behavioral factors. Younger children were more likely to report symptoms overall. CONCLUSIONS: Children exposed to a high magnitude natural disaster report sufficient symptoms to establish a DSM-III-R derived classification of a PTSD syndrome. Differences between gender, age, and race groups appear to be related to differential risk of exposure, reporting biases, as well as a differential risk for developing post-traumatic symptoms.

Children exposed to disaster: II. Risk factors for the development of post-traumatic symptomatology.

OBJECTIVE: To examine the influence of subject and exposure variables on the development of post-traumatic stress disorder (PTSD) symptoms and syndrome in children exposed to disaster. METHOD: Three months after Hurricane Hugo, 5,687 school-aged children were surveyed about their experiences and reactions to the hurricane. Self-reports of PTSD symptoms were obtained by use of a PTSD Reaction Index. RESULTS: The presence of PTSD symptoms was strongly related to children's reported severity of the hurricane, degree of home damage sustained, and continued displacement; however, children's level of trait anxiety and their reported emotional reactivity during the hurricane were more strongly related to the presence of PTSD symptoms than were the exposure factors. Different sets of risk factors appeared to differentially influence the development of the three DSM-III-R PTSD symptom clusters. Little evidence for a differential effect of the risk factors between females and males and younger and older children was found. CONCLUSIONS: Level of trait anxiety appears to be the single strongest risk for the development of severe post-traumatic reactions. The higher rate of post-traumatic symptoms in females and younger children in combination with the absence of differential reaction to the risk factors suggests that females and younger children are more likely to develop posttraumatic reactions following a disaster.

School lunch: a comparison of the fat and cholesterol content with dietary guidelines.

OBJECTIVE: To compare the fat and cholesterol content of the foods offered and selected in an elementary school lunch program with current dietary guidelines. DESIGN: For 105 school days we recorded the food items selected by elementary school students in an entire school district (262,851 meals) who were given a choice between two entrees. The nutrient content of foods was assessed with a computerized nutrient data base supplemented by the food manufacturers' data. SETTING: Sixteen elementary schools in the Bellevue (Washington) School District. PARTICIPANTS: The number of students eating school lunch averaged 2500 per day, of whom 25% were from households with incomes less than 185% of poverty. INTERVENTION: None. MAIN OUTCOME MEASURES: We determined the nutritional content of the average meal selected; the proportion of days when one of the two offered entrees met fat and cholesterol guidelines; and the proportion of children selecting the entrees that met the guidelines. RESULTS: The average lunch selected had 35.9% of calories from total fat and 12.6% from saturated fat, exceeding the guidelines of 30% and 10%, respectively. Lunch contained an average of 57 mg cholesterol (106 mg/1000 kcal) and met guidelines. One of the two daily entree choices met guidelines for both total fat and saturated fat on 20% of days, and met both fat and cholesterol guidelines on 14% of days. When available, entrees meeting the fat guidelines were chosen by 37% of students, and entrees meeting both fat and cholesterol guidelines were chosen by 34% of students. CONCLUSIONS: In this school district the average lunch selected did not meet the current guidelines for dietary fat; when given the choice, more than one third of students selected the entrees that met these guidelines.

An environmental intervention to reduce dietary fat in school lunches.

OBJECTIVE: To determine whether making a low-fat entree available as one of two choices in an elementary school lunch program would reduce the fat content of meals selected by children. DESIGN: In this before-after trial, students had a daily choice between two entrees, one of which was sometimes low-fat. For 93% of school days during 14 consecutive school months, daily entree choices were recorded for 619,976 student meals. The fat content of entrees was assessed with a computerized nutrient database supplemented by food manufacturer's data. SETTING: Sixteen elementary schools in the Bellevue (Washington) School District. PARTICIPANTS: The number of students eating school lunch averaged 2440 per day, of whom 25% were less than 185% of poverty. INTERVENTION: After a baseline period of 6 months, the intervention increased the number of days per month when one of the two entrees had 30% or fewer calories from fat. MAIN OUTCOME MEASURES: Data for the entire district were combined to estimate for each month the percent of students who selected low-fat entrees and the percent of calories from fat in the average meal selected by students. RESULTS: During the 6 months before the intervention, a low-fat entree was available on 23% of days; it was selected by 39% of students; and the average meal selected by students had 36% of calories from fat. By the end of the 8-month intervention, a low-fat option was available on 71% of days; it was selected by 29% of students; and the fat content of the average meal dropped from 36% to 30% of calories from fat (P = .02). CONCLUSIONS: In this school district, many students, given the choice, selected low-fat entrees. Recommendations for dietary fat were met simply by the environmental intervention of increasing the availability of low-fat foods.

Children's coping styles and report of depressive symptoms following a natural disaster.

The present study examined the relationship between children's coping styles (Spirito, Stark, & Williams, 1988) and self-reported levels of depressive symptoms (Kovacs, 1983) following a major stressor. 257 third- to fifth-grade children consented to participate in the study, 5 months following a hurricane. The number of coping strategies employed was positively related to depression scores, whereas coping efficacy was negatively related to depression scores. Social withdrawal, self-blaming, and emotional regulation were associated with more severe depressive symptoms. Lower levels of symptomatology were found among children who sought social support and engaged in cognitive restructuring. The overall symptom level in the sample did not exceed that of normative samples. Results are discussed in terms of competing theories of childhood depression.

Relations among self-reported depressive symptoms in clinic-referred children versus adolescents.

Although there is consensus regarding the existence of childhood depression, disagreement remains as to whether symptoms are developmentally isomorphic. Previous studies focused on developmental differences in symptom levels; analyses of relations among symptoms may be more appropriate, however. Here both approaches were used to compare the Children's Depression Inventory responses from 1,030 clinic-referred children and adolescents. Four of nine symptom categories showed significant developmental differences in their correlations with total score. Externalizing behavior and guilt were more strongly related to depression in children than adolescents; affective symptoms and concerns about the future showed the reverse pattern. Results illustrate the importance of considering relations among symptoms as well as differences in symptom levels when evaluating theoretical claims about developmental differences in the nature of clinical syndromes.

Human figure drawings: validity in assessing intellectual level and academic achievement.

In a sample of 216 child and adolescent psychiatric inpatients, significant but low correlations were found between Goodenough-Harris (GH) drawing scores and both Full Scale IQs and academic achievement. The percentage of subjects correctly classified in appropriate IQ categories ranged from 35 to 44%; the percentage of misclassified subjects ranged from 56 to 65%. Consideration of visual-motor integration, using the Bender-Gestalt, did not improve the accuracy of G-H scores in predicting IQ scores in this sample. These results indicate that human figure drawings should not be substituted for other well-established intelligence and achievement tests nor used as an additional measure of these constructs when one is evaluating psychiatric patients.

Children's coping styles and report of depressive symptoms following a natural disaster

The present study examined the relationship between children's coping styles (Spirito, Stark, and Williams, 1988) and self report levels of depressive symptoms (kovacs, 1983) following a major stressor. 257 thrit - to fifth - grade children consented to participate in the study, 5 months following a hurricane. The number of coping strategies employed was positively related to depression scores, whereas coping efficacy was negatively related to depression scores. Social withdrawal, self - blaming, and emotional regulation were associated with more severe depressive symptoms. Lower levels of symptomatology were found among children who sought social support and engaged in cognitive restructuring. The overall symptom level in the sample did not exceed that of normative samples. Results are discussed in terms of competing theories of childhood depression (AU)

Relation between differential emotions and depression in emotionally disturbed children and adolescents.

Differential emotions theory (Izard, 1972) provides a conceptual framework for the role of emotions in affective disorders. The present study investigated the relation of emotions to depression in a sample of child and adolescent psychiatric inpatients (N = 145). Findings indicate that shyness, anger, enjoyment, and shame explained 51.4% of the variance in depression scores. Furthermore, profiles of emotions experienced by youths with a depressive disorder differed significantly from emotion profiles of nondepressed youths on the following emotions: enjoyment, surprise, sadness, anger, shame, shyness, guilt, and self-directed hostility. Differential emotions also correctly classified 80.0% of depressed and nondepressed subjects into their respective groups.

Assessment of short-term visual memory in child and adolescent psychiatric inpatients.

This study provides normative data on 270 child and adolescent psychiatric inpatients using the Bender Recall technique as a measure of short-term visual memory. In addition, the authors present normative data on another immediate recall technique using the Coding section of the WISC-R. These findings are examined in light of age differences and IQ scores. Detailed instructions for administering the Coding Recall technique are presented.

Personality factors, family structure, and sex of drawn figure on the Draw-A-Person Test.

One hundred seventy-four youthful psychiatric inpatients were given the Draw-A-Person Test (DAP) as part of an assessment battery. Sex of person drawn was compared to subject's sex, Achenbach aggression and delinquency scores, and scores on Children's Inventory of Anger and Nowicki-Strickland Locus of Control Scale. The sex of the person drawn was also compared to family composition, specifically whether or not the child came from an intact family with both a male and female parent or role model. Results support drawing of a same-sexed individual as normative, regardless of age or sex. Adolescent girls and young boys were the only groups that differed significantly from this norm. Personality measures and family composition were not significantly related to the tendency to draw same versus opposite sex.

Brief Rorschach records with children and adolescents.

In order to determine the frequency with which children and adolescents give brief Rorschach (R less than 14) records and to test the hypothesis that brief records represent a resistance to testing, the psychological evaluations of 439 admissions to an inpatient unit were reviewed. Of the records reviewed, 16.6% were found to contain less than 14 responses. When the complete test protocol of those subjects who provided brief records were compared with those of a matched group, it was found that the group with brief records failed to complete the other parts of the evaluation significantly more often than did those subjects who did not give brief records. There was no significant difference between the two groups on IQ scores or on self-report scores of depression, anxiety, and social desirability. Result are interpreted as supporting Exner's (1988) hypothesis that brief records represent a form of resistance to being tested.

Helping the child with cancer: what school personnel want to know.

As more children with cancer survive, the importance of facilitating school reintegration as a part of maximizing the quality of life has become evident. Workshops have been presented to school personnel to acquaint them with the issues facing cancer patients and their families, but there are gaps in our knowledge of what school personnel really need or want to know. In this study, 18 teachers of children with cancer and 15 teachers with no prior contact with students with cancer completed a questionnaire designed to assess needs, beliefs, and priorities with regard to working with cancer patients in the classroom. Significant findings included: (a) a consensus that a certain core of information about medical/psychological issues would be useful, and presentation of such information by psychologists and medical personnel working with such families would be optimal; (b) teachers having cancer patients as students were less likely to see the adaptation of siblings as an important issue; (c) teachers associated working with a student with cancer with less stress and demands on their time than predictable from previous studies; and (d) cancer patients as a whole were rated as having fewer behavioral, emotional, and learning problems than randomly selected students without a major illness, suggesting a "halo effect" or contradiction of some literature. Preliminary findings are detailed and implications are discussed for those attempting to help teachers facilitate students' adjustment to school following diagnosis and treatment of cancer.

The Bender-Gestalt as a method of personality assessment with adolescents.

Normative data are presented for two Bender-Gestalt scoring systems with a sample of "normal" controls (n = 150), emotionally disturbed (n = 140), and mentally retarded/neurologically impaired (MR/NI) adolescents (n = 47), aged 12 to 17 years. The results failed to support the use of Hutt's (1985) Psychopathology Scale and Adolescent Configuration in differentiating the "normal" and emotionally disturbed groups, but did support their use in differentiating the MR/NI group from the other two. The Hutt scores also were found to be related inversely to age and IQ. By contrast, the Koppitz scores differentiated the three groups from each other and were not related significantly to IQ. The results supported limited use of Koppitz's (1975) Emotional Indicators as a "sign" approach to brief screening for emotional disturbance in adolescents.

Rorschach Egocentricity Index and self-concept in children and adolescents.

In a sample of 65 child and adolescent psychiatric inpatients, the hypothesized relation between the Egocentricity Index from the Rorschach and standard self-report measures of self-concept was not supported. Although the sample as a group had a markedly low mean Egocentricity Index, self-reported self-concept was at a normative level. The validity of the Egocentricity Index and self-report measures of self-concept is discussed, and guidelines for their interpretation are presented.

Assessment of depression in adolescents: objective and projective measures.

This study is a multimethod assessment of depressive features in a sample of 60 adolescent inpatients. The purpose of the study was to examine the relationship between self-report measures of depression and Rorschach variables commonly associated with depression. Patients represented a variety of diagnostic categories in order to determine whether information gathered through assessment instruments was related to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III], American Psychiatric Association, 1980) diagnoses of depression. Findings indicated that this sample of adolescents was highly defensive and emotionally constricted. There were several significant relationships between self-report measures and Rorschach indicators of depression. However, in general, the Rorschach variables were not strongly related to depression. The self-report measures were more accurate than Rorschach variables in discriminating between depressed and nondepressed subjects.