Another way of thinking about ADHD: the predictive role of early attachment deprivation in adolescents' level of symptoms.

PURPOSE: Attention deficit and hyperactivity disorder (ADHD) is one of the most frequent disorders in childhood and adolescence. Both neurocognitive and environmental factors have been related to ADHD. The current study contributes to the documentation of the predictive relation between early attachment deprivation and ADHD. METHOD: Data were collected from 641 adopted adolescents (53.2% girls) aged 11-16 years in five countries, using the DSM oriented scale for ADHD of the Child Behavior Checklist (CBCL) (Achenbach and Rescorla, Manual for the ASEBA school-age forms and profiles. University of Vermont, Research Center for Children, Youth and Families, Burlington, 2001). The influence of attachment deprivation on ADHD symptoms was initially tested taking into consideration several key variables that have been reported as influencing ADHD at the adoptee level (age, gender, length of time in the adoptive family, parents' educational level and marital status), and at the level of the country of origin and country of adoption (poverty, quality of health services and values). The analyses were computed using the multilevel modeling technique. RESULTS: The results showed that an increase in the level of ADHD symptoms was predicted by the duration of exposure to early attachment deprivation, estimated from the age of adoption, after controlling for the influence of adoptee and country variables. The effect of the age of adoption was also demonstrated to be specific to the level of ADHD symptoms in comparison to both the externalizing and internalizing behavior scales of the CBCL. CONCLUSION: Deprivation of stable and sensitive care in infancy may have long-lasting consequences for children's development.

[Traumatic events and stress responses: the role of oxytocin and attachment]. / Evénements traumatiques et réponses de stress: le rôle de l'ocytocine et de l'attachement.

Being repeatedly confronted to very difficult situations since childhood influences the way indivuals will later respond to even mildly stressful events. The hypothalamic-pituitary-adrenal axis (HPA) is a complex system implicated in regulating neuroendocrine responses to stress. Its activation produces among others the <

Parental post-traumatic reactions after premature birth: implications for sleeping and eating problems in the infant.

BACKGROUND: Progress in perinatal medicine has made it possible to increase the survival of very or extremely low birthweight infants. Developmental outcomes of surviving preterm infants have been analysed at the paediatric, neurological, cognitive, and behavioural levels, and a series of perinatal and environmental risk factors have been identified. The threat to the child's survival and invasive medical procedures can be very traumatic for the parents. Few empirical reports have considered post-traumatic stress reactions of the parents as a possible variable affecting a child's outcome. Some studies have described sleeping and eating problems as related to prematurity; these problems are especially critical for the parents. OBJECTIVE: To examine the effects of post-traumatic reactions of the parents on sleeping and eating problems of the children. DESIGN: Fifty families with a premature infant (25-33 gestation weeks) and a control group of 25 families with a full term infant participated in the study. Perinatal risks were evaluated during the hospital stay. Mothers and fathers were interviewed when their children were 18 months old about the child's problems and filled in a perinatal post-traumatic stress disorder questionnaire (PPQ). RESULTS: The severity of the perinatal risks only partly predicts a child's problems. Independently of the perinatal risks, the intensity of the post-traumatic reactions of the parents is an important predictor of these problems. CONCLUSIONS: These findings suggest that the parental response to premature birth mediates the risks of later adverse outcomes. Preventive intervention should be promoted.

[Reality approach in senile dementia. Fundamental methodologies of occupational therapy in psychogeriatrics]. / L'approche du réel chez le dement senile. Fondements méthodologiques de l'ergothérapie en psychogériatrie

Occupational therapy in psychogeriatrics has always been practiced empirically, aimed mainly at merely occupying patients. In the light of recent findings from the old age psychological research, a specific method should cope with certain forms of lost intellectual capacities. The purpose of this work is to define as accurately as possible the field of occupational therapy in psychogeriatrics. Three main concepts towards a systematic approach can be proposed: a) Those related to a careful observation of spontaneous activities dealing with the relationship between the patient and the world around him, and which lead to a classification of these activities. b) Concepts related to the most elementary level of intervention in occupational therapy termed as "objective relationship", in other words the construction of the external objective world as opposed to the world of phantasms or magical thought. c) Concepts, at a more sophisticated level, related to the instrumental aspects of traditional occupational therapy. An important distinction should thus be made between local and inclusive constituent parts of an activity.

Adaptación y validación preliminar argentina del cuestionario de evaluación del apego (CaMir) / Adaptació i validació preliminar argentina del qüestionari d'avaluació de l’aferrament (CaMir) / Preliminary Argentinean adaptation and validation of the bonding assessment questionnaire (CaMir)

El propósitode este estudio fue adaptar lingüísticamente y evaluar validez y fiabilidad del instrumento de evaluación demodelos individuales de relación del estilo de apego, CaMir (Cartes: Modèles Individuels de Relation), en unamuestra argentina de adolescentes y adultos. Se trabajó con una muestra de 549 sujetos de ambos sexos deentre 14 y 80 años. El análisis factorial exploratorio develó una estructura de cuatro factores y el análisis fac-torial confirmatorio corroboró la misma, así como los índices de fiabilidad de los factores. Se confirma que esun instrumento válido y confiable para evaluar los modelos individuales de relación en adolescentes y adultosargentinos. Finalmente, se señalan limitaciones y contribuciones.(AU)

The pur-pose of this study was to linguistically adapt and evaluate the validity and reliability of the individual modelsof attachment style relationship assessment instrument, CaMir (Cartes: Modèles Individuels de Relation), in anArgentinean sample of adolescents and adults. A sample of 549 subjects of both sexes aged between 14 and80 years was used. The exploratory factor analysis revealed a four-factor structure and the confirmatory factoranalysis corroborated it, as well as the reliability indices of the factors. It is confirmed that it is a valid and reliableinstrument to assess individual relationship patterns in Argentinean adolescents and adults. Finally, limitations andcontributions are pointed out.(AU)

El propòsitd'aquest estudi va ser adaptar lingüísticament i avaluar la validesa i la fiabilitat de l'instrument d'avaluació demodels individuals de relació de l'estil d'aferrament, CaMir (Cartes: Modèles Individuels de Relation), en una mos-tra argentina d'adolescents i adults. Es va treballar amb una mostra de 549 subjectes d'ambdós sexes d'entre14 i 80 anys. L'anàlisi factorial exploratòria va desvetllar una estructura de quatre factors i l'anàlisi factorial con-firmatori la va corroborar, així com els índexs de fiabilitat dels factors. Es confirma que és un instrument vàlidi fiable per avaluar els models individuals de relació en adolescents i adults argentins. Finalment, s'assenyalenlimitacions i contribucions.(AU)

Oxytocin response to an experimental psychosocial challenge in adults exposed to traumatic experiences during childhood or adolescence.

Long-term implications of the exposure to traumatizing experiences during childhood or adolescence, such as sexual abuse, or cancer, have been documented, namely the subjects' response to an acute stress in adulthood. Several indicators of the stress response have been considered (e.g. cortisol, heart rate). Oxytocin (OT) response to an acute stress of individuals exposed to trauma has not been documented. Eighty subjects (n=26 women who had experienced episodes of child abuse, n=25 men and women healthy survivors of cancer in childhood or adolescence, and 29 controls) have been submitted to a laboratory session involving an experimental stress challenge, the Trier social stress test. Overall, there was a clear OT response to the psychosocial challenge. Subjects having experienced a childhood/adolescence life-threatening illness had higher mean levels of OT than both abused and control subjects. There was a moderate negative relationship between OT and salivary cortisol. It is suggested that an acute stress stimulates OT secretion, and that the exposure to enduring life-threatening experiences in childhood/adolescence has long-lasting consequences regarding the stress system and connected functions, namely the activation of OT secretion. Better knowledge of such long-term implications is important so that to prevent dysregulations of the stress responses, which have been shown to be associated to the individual's mental health.

[Activity and rehabilitation of senile dementia. Methodological suggestions for an ergotherapy in psychogeriatrics]. / Activité et réhabilitation dans les démences de la vieilesse. Propositions méthodologiques pour une ergothérapie en psychogériatrie.

The aim of this study is to make clear the conditions of an ergotherapy particularly fit for the aged suffering from senile dementia. It should keep the intellectual instruments in working condition and, eventually, postpone their impairment. The general frame in which theory and experiment are inscribed is the Piaget's theory. Especially the part that concerns the different stages of childhood development of which, one thinks, can be observed the deterioration "in reverse" during the senile dementia impairment processes. Some special hypothesis concern:--the different parts of reality in which relations between patient and society are disturbed --the activities that are connected in a network of relations between the conceptual instruments required to realize these activities --the fact that the steadiness of a particular activity should help to recover another one, thought to be close in the way by which its realization puts into action the same cognitive processes. Thus, we have been able to fix the way of directing a first examination for the taking in charge in ergotherapy; examination that should point out the fields in which the patient can be mobilized (as well from the level where he is as from the investment one can expect in regard to the pleasure or the interest that he shows for a work rather than another). Besides, we tried to represent the channels of activities and their relations, starting from the most elementary one to reach the most complicated one, that is to say the ones that allow us to work on reality. It is in the network of these channels that the proposed activities should find their place in the ergotherapy workshop and their application should permit the readaptation to everyday actions in a progressive way.