Dental parameters in the long-term survivors of childhood cancer compared with siblings

There have been a number of reports on the dental health of long-term survivors (LTS) of childhood malignancy as compared with normal controls. However, it is usually difficult to identify a meaningful control population as most of these patients are from widely differing geographical areas and socio-economic status. The aim of this investigation was, therefore, to study the dental health of LTS compared with siblings. 46 LTS who had siblings of a similar age were identified for the study. Both groups were examined for dental caries, gingivitis and enamel defects. There was no statistically significant difference in the mean DMFS of the test and control groups. However, the LTS had a significantly (P = 0.006) higher number of decayed surfaces (1.50 +/- 0.30) as compared with their siblings (0.50 +/- 0.20). The LTS also had a significantly higher prevalence of severe gingivitis (1.11 +/- 0.33) compared with controls (0.02 +/- 0.02). There was a significantly higher prevalence of all types of enamel defects in the LTS and fewer teeth with no enamel defect as compared with their siblings, with the mean values being 15.7 +/- 0.9 and 25.3 +/- 0.3, respectively. It was concluded that there was a higher prevalence of untreated dental disease and developmental defects in long-term survivors.     

Repressive adaptation in children with cancer.

The constructs of repressive adaptive style and avoidant coping (blunting) were assessed as possible explanatory factors for previously reported findings of lower self-reported depression in children with cancer. Pediatric oncology patients 7–16 years old (n?=?107) and healthy control participants (n?=?442) completed measures of depressive symptoms, trait anxiety, defensiveness, and approach and avoidant coping. Oncology patients scored significantly lower on measures of depression and trait anxiety, and higher on defensiveness. Applying the adaptive style paradigm, the oncology group showed a significant excess of repressors. Depressive symptoms differed as a function of adaptive style, with repressors demonstrating the lowest levels of self-reported depression. Children with cancer also reported greater use of blunting, but this difference was small and appeared unrelated to depression scores. Within the cancer group, repressive adaptation was unrelated to time elapsed since diagnosis. These findings are discussed with reference to the ongoing controversy regarding cancer–personality style associations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sibling Adaptation to Childhood Cancer Collaborative Study: the association of sibling adaptation with maternal well-being, physical health, and resource use

OBJECTIVE: To assess the role of heredity in the development of keratoconus. DESIGN: Prospective study. SETTING: Eye clinic providing secondary and tertiary ophthalmic care in Toronto. PATIENTS: Thirty-nine patients with keratoconus (57 eyes) and 48 relatives of 11 patients with keratoconus. The corneal topography of the family members was compared with that of a group of 68 volunteer control subjects (136 eyes) without clinical evidence or a family history of keratoconus. OUTCOME MEASURES: Three quantitative measures derived from computerized videokeratography: the relative steepness of the inferior cornea versus the superior cornea, central corneal power and the difference in central corneal power between the two eyes. All the data were statistically analysed with the use of nonparametric discriminant analysis. RESULTS: Fifteen family members who were believed to be clinically normal on the basis of refraction, keratometry and slit-lamp examination has statistically significant topographic abnormalities suggestive of early or mild keratoconus. CONCLUSIONS: The presence of these findings in family members of patients with keratoconus may represent the incomplete expression of a gene contributing to the development of the condition. Pedigree analysis suggested an autosomal dominant inheritance pattern in 9 of the 11 families. Our results underline the value of videokeratography for accurate family pedigree analysis and the diagnosis of keratoconus.     

A controlled study of siblings of hyperactive children

A controlled study of siblings of hyperactive boys resulted in the following findings. The hyperactive child syndrome is more common among brothers of hyperactive children than among brothers of controls (26 per cent vs. 9 per cent). Both probands and their brothers presented with more symptoms of depression-anxiety than controls. The probands, but not their sibs, presented with more antisocial symptoms than controls. Although differences in intelligence and achievement scores were found between probands, their sibs, and controls, both intelligence level and academic achievement were within normal limits in all groups.     

Repressive adaptation in children with cancer: A replication and extension.

Prior research has shown a high incidence of a repressive adaptive style in children with cancer. To explore whether repressive adaptation in this population is premorbid or reactive, adaptive style was assessed longitudinally in children with cancer at the time of diagnosis and at 6 months and 1 year after diagnosis. Comparison groups included healthy children and children with other serious but nonmalignant chronic illnesses. At diagnosis, children with cancer showed a higher incidence of a repressive adaptive style than healthy children, and the incidence of repressive adaptation remained stable over time. Children with other chronic illnesses also showed levels of repressive adaptive style comparable to the cancer group. These findings suggest a shift toward repressiveness in response to the diagnosis of cancer that is then maintained over time, and demonstrate the necessity of further examination of the health consequences of adaptive style in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sibling relationships in early/middle childhood: links with individual adjustment.

The overarching goal of the study was to identify links between sibling relationship quality in early/middle childhood with children's adjustment, having accounted for the effects of parent-child relationship quality. The sample consisted of 101 working and middle-class 2-parent English families with 2 children ages 4-8 years. Parents provided reports of sibling relationship quality, the parent-child relationship, and the children's prosocial and problematic behaviors. The children also provided reports of their familial relationships with a puppet interview. Results indicated that sibling relationship quality was associated with the older siblings' adjustment, controlling for the children's relationships with parents. In addition, the pattern of findings suggested that positivity within the sibling relationship was more strongly linked with child adjustment than was sibling conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sibling influences on gender development in middle childhood and early adolescence: A longitudinal study.

The development of gender role qualities (attitudes, personality, leisure activities) from middle childhood to early adolescence was studied to determine whether siblings' gender role qualities predicted those of their sisters and brothers. Participants were 198 firstborn and second-born siblings (Ms?=?10 years 9 months and 8 years 3 months, respectively, in Year 1) and their parents. Families were interviewed annually for 3 years. Firstborn siblings' qualities in Year 1 predicted second-born children's qualities in Year 3 when both parent and child qualities in Year 1 were controlled, a pattern consistent with a social learning model of sibling influence. Parental influence was more evident and sibling influence less evident in predicting firstborns' qualities; for firstborns, sibling influences suggested a de-identification process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral inhibition: Stability and associations with adaptation from childhood to early adulthood.

The stability of individual differences in behavioral inhibition and their association with peer relations, emotional distress, and life-course timing were examined in a longitudinal study of 205 individuals from childhood (ages 8–12) to early adulthood (ages 17–24). Behavioral inhibition was conceptualized as stranger wariness and measured through ratings made by interviewers following individual interview or testing sessions. Individual differences in behavioral inhibition were consistent from childhood to early adulthood (r?=?.57). In early adulthood, higher behavioral inhibition was associated with a less positive, less active social life for both sexes and, for men, with greater emotional distress and negative emotionality. For both genders, participants who were inhibited as children were less likely to have moved away from their family of origin by the early adulthood assessment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Sibling outcomes and disparate parenting and stepparenting after divorce: Report from a 10-year longitudinal study.

This is a first longitudinal study of parenting and stepparenting of siblings in divorced and remarried families over the postdivorce decade. Disparate parenting of siblings was evident in one half of the families. This was seriously and lastingly detrimental to the marginalized youngsters. The unexpectedly powerful influence of the stepparent on the parenting of the biological parents is reported along with the psychological role of children in reflecting the relationships and projections of parents and stepparents. The study raises clinical and theoretical questions regarding the roots of instability in parenting following disrupted and new adult partnering. The findings also call attention to the distinctive developmental pathways of children in divorced and remarried families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of dependent-care activities for well siblings of children with cystic fibrosis and well siblings in families without children with chronic illness

School-based health clinics (SBCs) have been promoted as an innovative approach to providing adolescent health care. The present study examined the effect of a SBC on academic success. We studied the effect of clinic registration and use on students' absence, suspension, withdrawal, and graduation or promotion rates in an alternative high school for students who were not able to succeed in traditional educational programs. On average, these 322 high-risk students attended school only 56% of the time; 24% were suspended; and only 26% graduated or were promoted. The 189 (59%) students who were registered to use the clinic and the 159 (49%) who actually used the clinic were as likely to be absent or to be suspended as non-registered students. However, students who used the clinic were significantly more likely to stay in school, and to graduate or be promoted than students who were not registered for the clinic. This relationship was strongest for black males; those who used the clinic were nearly three times [odds ratio = 0.35; 95% confidence interval (CI) = (0.16-0.78)] more likely to stay in school than those who did not use the clinic. In multiple linear regression models predicting school performance, only clinic use and percent of enrolled days absent were significantly associated with graduation/promotion, and these two variables predicted 23% of the variance in promotion status.     

Competence and adjustment of siblings of children with mental retardation

Adjustment and competence of siblings who had a brother or sister with mental retardation were compared to those of control siblings who had brothers or sisters with no disabilities. Results indicated no overall differences for internalizing disorders, externalizing disorders, or for self-esteem and competence based on group membership, gender, or gender match. However, boys with a brother or sister with mental retardation had difficulty in school functioning. In addition, a greater number of girls with brothers and sisters with mental retardation expressed their distress through internalization.     

Sibling relationships of children with disabled and nondisabled brothers and sisters.

Goals were to compare children with and without mentally retarded (MR) siblings in terms of their sibling relations and adjustment and to examine the links between these constructs. Ss were 62 children (M age?=?12 years), half with and half without a younger MR sibling. Children and mothers evaluated children's adjustment and sibling relations in home interviews and in 7 telephone calls described the child's sibling activities, household tasks, and negative maternal and sibling interactions that day. Children with MR siblings reported more caregiving, more maternal negativity, and poorer adjustment. Caregiving, sibling and maternal negativity, and child's satisfaction with parents' differential treatment of self compared with sibling were associated with adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health outcomes of children receiving EPSDT checkups: a pilot study

This pilot study used medical records to examine the health outcomes of children receiving care in Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program. Medical records from 76 children seen for EPSDT visits during a 6-month period were reviewed to assess whether health problems were identified and whether treatment, follow-up, or referral care was provided. Health problems were identified for 43% of the children; 22% received treatment, and 18% were referred for specialty care. Checkups uncovered fewer problems than would be expected in a poor, largely minority population. Almost one third of the children referred for specialty care apparently did not receive such care. The study verified the need for further research and provides direction for future study.     

The health status of adult survivors of cancer in childhood

Based on an extensive cost-effectiveness analysis, the Dutch nation-wide breast cancer screening programme started in 1990, providing a biennial screen examination to women aged 50 to 69 years. The programme is monitored by the National Evaluation Team, which annually collects tabulated regional evaluation data to determine performance indicators. This study presents (trends in) the outcomes of initial and subsequent screening rounds, 1990-1995, and compares them to the predictions of the cost-effectiveness-analysis. Up to 1996, 88% of the target population was covered by the programme and more than 2.4 x 10(6) women were invited. The overall attendance rate was 77.5% with little differences between screening rounds and age groups; the highest rate was found in non-urbanised areas (82.4%). Of 1,000 initially (and 2 years thereafter) screened women, 13.4 (6.6) were referred for further investigation, 9.7 (4.4) were biopsied and 6.4 (3.4) had breast cancer. The positive predictive values of screen test and biopsy were 47% (51%) and 66% (78%), respectively. DCIS was diagnosed in 0.9 (0.5) and invasive cancers < or = 10 mm in 1.5 (1.0) per 1,000 screens. Lymph node metastases were found in 28% (24%) of the invasive cancers. Except the increasing attendance, which was much higher than expected, the results were fairly constant over the years. Contrary to initial screens, the results of subsequent screens did not fulfil expectations with regard to breast cancer detection and tumour size distribution. We conclude that the nation-wide screening programme is being implemented successfully. Given the results, the programme should contribute to a substantial breast cancer mortality reduction in the future. The discrepancy between observed and expected results in subsequent screens has to be watched carefully.     

Anger expression and adaptation to childhood sexual abuse: The role of disclosure.

Previous research on anger and childhood sexual abuse (CSA) is largely cross-sectional and retrospective. In this study, we prospectively examined the consequences of expressing anger among sexually abused women in contexts of either voluntarily disclosing or not disclosing a previous abuse episode (n = 94). All CSA survivors in the study had documented histories of CSA. These participants and a matched, nonabused sample were asked to describe their most distressing experience while being videotaped to allow coding of anger expression. Approximately two thirds of the CSA survivors voluntarily disclosed a previous abuse experience. Participants completed measures of internalizing symptoms and externalizing symptoms at the time of disclosure and again two years later. The expression of anger was associated with better long-term adjustment (decreased internalizing and externalizing symptoms), but only among CSA survivors who had expressed anger while not disclosing an abuse experience. For CSA survivors who disclosed an abuse experience and for nonabused women, anger expression was unrelated to long-term outcome. These findings suggest that the benefits of anger expression for CSA survivors may be context specific. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Controlled prospective longitudinal study of women with cancer: II. Psychological outcomes.

The incidence and etiology of major life difficulties for women with survivable cancer were studied. Women with early stage cancer (n?=?65) were assessed after diagnosis but prior to treatment and reassessed at 4, 8, and 12 mo posttreatment. Two matched comparison groups, women diagnosed and treated for benign disease (n?=?22) and healthy women (n?=?60), were also assessed longitudinally. Results for 4 life areas are reported: (a) Emotional response to the life-threatening diagnosis and anticipation of treatment was characterized by depressed, anxious, and confused moods, whereas the response for women with benign disease was anxious only; these responses were transitory. (b) There was no evidence for a higher incidence of relationship dissolution or poorer marital adjustment; however, 30% of the women treated for disease reported that their partners may have had some sexual difficulty. (c) There was no evidence for impaired social adjustment. (d) Women treated for cancer retained their employment; however, their involvement was significantly reduced during recovery. Data suggest "islands" of significant life disruption following cancer, which do not appear to portend global adjustment vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health status and satisfaction with health care: Results from the medical outcomes study.

Relations between self-assessed health status and satisfaction with health care were examined using 2 waves of data obtained from participants in the Medical Outcomes Study. Using a multisample covariance modeling framework, separate models were examined for patients with significant symptoms of depression (n?=?417 ) and patients with chronic physical health conditions (n?=?535 ). The pattern of findings was essentially identical for both patient subgroups. General satisfaction with care was cross-sectionally associated with mental?but not physical--health status. In addition, significant cross-lagged effects were found linking baseline satisfaction with care to subsequent mental health and baseline mental health to subsequent satisfaction with care. By contrast, no crosslagged directional effects linking satisfaction with care and physical health status were identified. Finally, no evidence was found that satisfaction with specific aspects of health care contributed independently to either mental or physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent outcomes for hyperactive children: Perspectives on general and specific patterns of childhood risk for adolescent educational, social, and mental health problems.

Examined significant differences, if any, among adolescent outcomes for hyperactive children and examined early life contributions of biological and psychological characteristics, family environments, social relationships, cognitive and academic status, and school behavior, along with hyperactivity, in explaining each of several outcomes. The Ss were classified on the basis of social system definitions of hyperactivity as well as on the basis of pervasive attention deficit disorder with hyperactivity (ADDH) based on parent and teacher ratings. Outcome measures at ages 17 and 18 included data on educational status, conduct problems, mental health disorders, and substance use. Regardless of the definition used, hyperactive children had significantly poorer educational outcomes and a greater extent of conduct disorders than their age peer controls. Regression analyses supported the inference that early biological factors, as well as the child's early health and temperament, predispose for adolescent mental health outcomes of depression, aggressive and nonaggressive conduct disorders, and hospitalization for psychological treatment. Familial, social, and cognitive factors had greater contributory potential in explaining educational outcomes, substance use, and conduct problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment feedback with parents and preadolescent children: A collaborative approach.

Psychologists routinely provide feedback to parents (and sometimes children) after conducting psychological assessments of children. The authors review the literature on sharing feedback from child assessments. They then present a rationale, grounded in the theory and principles of collaborative assessment, for why it is useful to discuss assessment results with parents and children. Citing available research evidence, they propose a conceptual framework for understanding the potential therapeutic impact of feedback. Next, they present detailed guidelines--illustrated with case examples from a research project and an independent assessment practice--for how to prepare for and give oral and written feedback to parents and children. The authors encourage assessment professionals to consider the insights and techniques derived from collaborative assessment when providing feedback. (PsycINFO Database Record (c) 2010 APA, all rights reserved)