Assessing preschoolers interactive behaviour: A validation study of the "Coding System for Mother-Child Interaction".

BACKGROUND: The preschool years are a period of great developmental achievements, which impact critically on a child's interactive skills. Having valid and reliable measures to assess interactive behaviour at this stage is therefore crucial. The aim of this study was to describe the adaptation and validation of the child coding of the Coding System for Mother-Child Interactions and discuss its applications and implications in future research and practice. METHODS: Two hundred twenty Portuguese preschoolers and their mothers were videotaped during a structured task. Child and mother interactive behaviours were coded based on the task. Maternal reports on the child's temperament and emotional and behaviour problems were also collected, along with family psychosocial information. RESULTS: Interrater agreement was confirmed. The use of child Cooperation, Enthusiasm, and Negativity as subscales was supported by their correlations across tasks. Moreover, these subscales were correlated with each other, which supports the use of a global child interactive behaviour score. Convergent validity with a measure of emotional and behavioural problems (Child Behaviour Checklist 1 ½-5) was established, as well as divergent validity with a measure of temperament (Children's Behaviour Questionnaire-Short Form). Regarding associations with family variables, child interactive behaviour was only associated with maternal behaviour. CONCLUSIONS: Findings suggest that this coding system is a valid and reliable measure for assessing child interactive behaviour in preschool age children. It therefore represents an important alternative to this area of research and practice, with reduced costs and with more flexible training requirements. Attention should be given in future research to expanding this work to clinical populations and different age groups.

Psychophysiological Reactivity in Couples During a Marital Interaction Task.

The ability to regulate our own physiological arousal when dealing with the emotional expression of our partner is crucial for satisfactory and stable intimate relationships. In previous physiological studies of marital interactions, researchers have found greater levels of psychophysiological arousal for members of the couple in conflictual interactions in comparison with positive interactions. Past researchers have established that intense and prolonged autonomic and neuroendocrine arousal during marital conflict can have negative consequences for mental and physical health. In this study we examined the physiological reactivity, as measured by skin conductance level, heart rate and cortisol levels, from both partners during a couple's interaction task consisting of a structured conversation about positive and negative aspects of their relationship. Participants were thirty-two heterosexual couples (N = 64) in a committed monogamous relationship with a minimum duration of one year. We found higher heart rate and cortisol levels during negative interaction condition when compared with the positive condition. Skin conductance was higher in the positive interaction condition, when compared with the negative interaction condition. In addition, we found a significant negative association between heart rate variability and autonomic arousal evoked by the interaction task. The implications of these findings for the effects of marital strain on health as well as for the design of risk-reducing interventions, namely biofeedback are discussed.

Lithium blocks stress-induced changes in depressive-like behavior and hippocampal cell fate: the role of glycogen-synthase-kinase-3beta.

Mood disorders are the most common psychiatric disorders. Although the mechanisms implicated in the genesis of mood disorders are still unclear, stress is known to predispose to depression, and recently, studies have related hippocampal neurogenesis and apoptosis to depression. In the present study we first examined the balance between cell birth-death in the hippocampus and subventricular zone (SVZ) of pre-pubertal and adult rats subjected to chronic-mild-stress (CMS). CMS led to increased corticosterone secretion and induced depressive-like symptoms (assessed in the forced-swimming test); these endocrine and behavioral effects were paralleled by decreased hippocampal, but not SVZ, cell proliferation/differentiation and by increased apoptotic rate. In order to determine if lithium, a known mood stabilizer with antidepressant properties, could prevent the stress-induced events, we analyzed the same parameters in a group of rats treated with lithium during the stress exposure period (CMS+Li) and observed that the hormonal, behavioral and cell turnover effects of CMS were abrogated in these animals. Subsequently, to search for possible pathways through which CMS and lithium influence behavior, cell fate and synaptic plasticity, we analyzed the expression of glycogen-synthase-kinase-3beta (GSK-3beta), as well as some of its downstream targets (B-cell-CLL/lymphoma2-associated athanonege (BAG-1) and synapsin-I). CMS increased GSK-3beta and decreased synapsin-I and BAG-1 expression in the hippocampus. Interestingly, co-administration of lithium precluded the CMS-induced effects in GSK-3beta, synapsin-I and BAG-1 expression. Our observation that specific inhibition of this kinase with AR-A014418 blocked the effects of CMS in depressive-like behavior and in BAG-1 and synapsin-I expression confirmed the involvement of the GSK-3beta pathway in stress-induced effects. In summary, these results reveal that lithium, by regulating the activity of GSK-3beta, prevents the deleterious effects of stress on behavior and cellular functions.

Neurodevelopment milestone abnormalities in rats exposed to stress in early life.

Manipulation of the corticosteroid milieu by interfering with the mother-newborn relationship has received much attention because of its potential bearing on psychopathology later in life. In the present study, infant rats that were deprived of maternal contact between the 2nd and the 15th postnatal days (MS2-15) for 6 h/day were subjected to a systematic assessment of neurodevelopmental milestones between postnatal days 2 and 21. The analyses included measurements of physical growth and maturation and evaluation of neurological reflexes. Although some somatic milestones (e.g. eye opening) were anticipated, MS2-15 animals showed retardation in the acquisition of postural reflex, air righting and surface righting reflexes, and in the wire suspension test; the latter two abnormalities were only found in males. A gender effect was also observed in negative geotaxis, with retardation being observed in females but not males. To better understand the delay of neurological maturation in MS2-15 rats, we determined the levels of various monoamines in different regions of the brain stem, including the vestibular area, the substantia nigra, ventral tegmental area and dorsal raphe nuclei. In the vestibular region of MS2-15 rats the levels of 5-HT were reduced, while 5-HT turnover was increased. There was also a significant increase of the 5-HT turnover in MS2-15 animals in the raphe nuclei, mainly due to increased 5-hydroxyindoleacetic acid (5-HIAA) levels, and an increase of 3,4-dihydroxyphenylacetic acid (DOPAC) levels in the ventral tegmental area (VTA) of stressed females. No significant differences were found in the immunohistochemical sections for tyrosine and tryptophan hydroxylase in these regions of the brain stem. In conclusion, the present results show that postnatal stress induces signs of neurological pathology that may contribute to the genesis of behavioral abnormalities later in life.

Institutionalization and indiscriminate social behavior: Differential-susceptibility versus diathesis-stress models for the 5-HTTLPR and BDNF genotypes.

Institutionalization adversely impacts children's emotional functioning, proving related to attachment disorders, perhaps most notably that involving indiscriminate behavior, the subject of this report. In seeking to extend work in this area, this research on gene X environment (GXE) interplay investigated whether the serotonin transporter (5-HTTLPR) and val66met Brain-Derived Neurotrophic Factor (BDNF) polymorphisms moderated the effect of institutional care on indiscriminate behavior in preschoolers. Eighty-five institutionalized and 135 home-reared Portuguese children were assessed using Disturbances of Attachment Interview (DAI). GXE results indicated that s/s homozygotes of the 5-HTTLPR gene displayed significantly higher levels of indiscriminate behavior than all other children if institutionalized, something not true of such children when family reared. These findings proved consistent with the diathesis-stress rather than differential-susceptibility model of person×environment interaction. BDNF proved unrelated to indiscriminate behavior. Results are discussed in relation to previous work on this subject of indiscriminate behavior, institutionalization and GXE interaction.

Febrile convulsions in developing rats induce a hyperanxious phenotype later in life.

Exposure of rodent pups to hyperthermia constitutes one of the best known models of febrile seizures. Studies designed to evaluate the behavioral impact of heat-induced convulsions (HCs) have focused mainly on hippocampus-dependent tasks and produced rather conflicting results. In this study, we assessed, in detail, developmental milestones, emotional behavior, and cognitive performance in animals submitted to HCs on Postnatal Day 10. There was no alteration in the acquisition of neurological reflexes, but there was an anticipation of eye opening in animals exposed to hyperthermia. As adults, the locomotor and exploratory behavior of these rats was unaffected. Interestingly, animals exposed to hyperthermia displayed signs of increased anxiety in the elevated-plus maze, although these signs were not associated with increased susceptibility to depression-like behavior. Additionally, we failed to observe impairments in spatial and working memory tasks. In conclusion, HCs at a particular period of neurodevelopment determine a hyperanxious phenotype later in life.

Efeito de um programa de manejo farmacoterapêutico em um grupo de idosos com hipertensão em Aracaju-Sergipe / Effect of a drug therapy management program in a group of elderly patients with hypertension in Aracaju (Sergipe, Brazil).

O presente estudo visou avaliar o efeito de um programa de manejo farmacoterapêutico no atendimento de idosos com hipertensão arterial sistêmica assistidos em unidade básica de saúde no município de Aracaju-Sergipe. Foram selecionados 30 idosos portadores de hipertensão, entre 60 e 75 anos de ambos os gêneros. Foi realizado um estudo de intervenção. Ao longo do estudo foram avaliadas as mudanças referentes ao manejo da farmacoterapia, de janeiro de 2007 a agosto de 2008. As variáveis analisadas foram: perfil sócio-demográfico e farmacoterapêutico e freqüência de comorbidades. A média de idade foi 69 ± 4 anos, com prevalência do gênero feminino. Os dados obtidos mostraram freqüência das comorbidades, especialmente nos sistema cardiovascular (100%) e músculo-esquelético (90%). Com relação ao perfil farmacoterapêutico foram identificados 76 diferentes tipos de especialidades farmacêuticas. Os medicamentos mais consumidos foram a hidroclorotiazida (53,3%) e o captopril (30%). Além disso, as intervenções reduziram o uso de AINEs (25,3% para 10%) e de polifarmácia (de nove para seis pacientes). O levantamento do perfil farmacoterapêutico forneceu elementos relevantes para compreender o uso de medicamentos em uma unidade de saúde, bem como, para eleger prioridades no cuidado aos idosos com hipertensão e elaborar estratégias em que o farmacêutico possa intervir de modo a reduzir e prevenir problemas farmacoterapêuticos.

This study was designed to assess the effect of a drug therapy management program on the treatment of elderly patients with systemic arterial hypertension who were attended at a primary health care unit (PCHU) in the city of Aracaju (SE). An intervention study was carried out at the PCHU, for which a sample of 30 elderly patients (60 - 75 years old) with hypertension, of both genders, was selected. During the study, changes in drug therapy management, from January 2007 up to August 2008, were assessed. The variables analyzed were socio-demographic and drug therapy profiles, as well as the frequency of comorbidity. The mean age was 69 ± 4 years, with a preponderance of women. The data showed a high frequency of comorbidity, especially in cardiovascular (100%) and musculoskeletal (90%) systems. Regarding the drug therapy profile, 76 different drugs were found. Those consumed most were hydrochlorothiazide (53.3%) and captopril (30%). The interventions reduced the prescription of NSAIDs (25.3% to 10%) and the practice of polypharmacy (nine to six patients). The drug therapy profile obtained from the survey provided details that could be employed to understand the use of drugs in a PCHU; for instance, to select priorities in caring for the elderly with hypertension and develop strategies in which the pharmacist can intervene to reduce and prevent drug therapy problems.