Atsurou Yamada

Emotional distress and its correlates among parents of children with pervasive developmental disorders.

Abstract  A number of studies have reported that parents of autistic children face higher levels of stress, but few studies examined the stress associated with the home care of children with pervasive developmental disorders (PDD) other than autistic disorder. The aims of the present study were therefore to (i) evaluate the emotional stress level of parents caring for their children with PDD; and (ii) explore the correlates of their emotional stress. Participants were 147 families (147 mothers and 122 fathers) of 158 children with PDD (42 with autistic disorder, 35 with Aspergers disorder and 81 with PDD not otherwise specified). K6 was used to measure the stress level of the parents. Marital relationships and personality were assessed with the Intimate Bond Measure and the NEO Five‐Factor Inventory, respectively. The parents also rated the characteristics of their children with PDD through the Pervasive Developmental Disorder–Autism Society Japan Rating Scale (PARS). The mean K6 score of the mothers was significantly higher than that of the women in the general population in Japan. Stepwise multiple regression indicated that the emotional stress of the mothers was correlated with the personality traits of Neuroticism and Agreeableness, perceived Control by the husband, and the childrens PARS score. Clinicians can deliver better service by paying appropriate attention to the emotional distress of mothers of children with not only autistic disorder but also other PDD.

Quality of life of parents raising children with pervasive developmental disorders.

BackgroundIt has been reported that parents of children with pervasive developmental disorders (PDDs) face higher levels of stress. The aims of the present study were; (i) to evaluate the quality of life (QOL) of parents caring for their children with PDDs, and (ii) to explore the correlates of their QOL.MethodsA consecutive sample of parents of children with PDDs aged 6 to 15 were approached. The MOS 36-item Short-Form Health Survey (SF-36) was used to measure the QOL of the parents by eight subscales and two summary measures. Parents’ personality and marital relationships were assessed with the NEO Five Factor Inventory and the Intimate Bond Measure, respectively. We characterized the parents’ SF-36 profiles in comparison with the national normative scores and explored variables which correlated with their summary measures.ResultsParticipants were 147 mothers and 122 fathers of 158 children with PDDs. Mothers had significantly lower scores in the areas of Role Physical (RP) Social functioning (SF), General health perceptions (GH), Vitality (VT), Role emotional (RE) and Mental Health (MH) than those among the general female population. The maternal mental component summary (MCS) was also significantly lower, but maternal physical component summary (PCS) and paternal PCS and MCS scores were not lower. Maternal PCS and MCS scores were both significantly associated with the high Care and the low Control scores, but regarding fathers only the paternal PCS scores were significantly associated with the low Control scores. Maternal PCS and MCS and paternal MCS scores were significantly associated with the high Agreeableness scores and the low Neuroticism scores. Multiple regressions have shown that Neuroticism was significantly related to the low MCS scores of mothers and fathers. Next, Care was related to maternal high PCS, and Control was related to maternal low MCS and paternal low PCS.ConclusionsThe mothers of children with PDDs had lower QOL scores than those of the Japanese general population especially in mental domains. Impairment of the maternal QOL is significantly associated with the personality tendency of the parents and relationships with their partners.

TYPUS MELANCHOLICUS IN LIGHT OF THE FIVE-FACTOR MODEL OF PERSONALITY

Abstract The present paper examines Typus melancholicus (TM), which is widely accepted as premorbid personality of depression in Germany and Japan, from the viewpoint of the five-factor model of personality, which has recently been gaining international popularity as the comprehensive model of personality traits. Two measures of TM, von Zerssen’s F-list and Kasahara’s scale, as well as the personality questionnaire for the five-factor model, NEO Five Factor Inventory, were completed for 140 consecutive psychiatric outpatients by their close relatives. It was found that (a) the two measures of TM had good internal consistency reliability, (b) they had reasonable concurrent validity, and (c) TM was characterized by high Conscientiousness, high Agreeableness and, to a lesser degree, high Extraversion. The results were largely in agreement with theoretical prediction and provide further support to the construct validity of the TM measures. Whether combining the three personality traits into one type is meaningful in depicting a particular premorbid personality constellation awaits further empirical examination.

Personality, social support, coping and emotional distress after repeated spontaneous abortions

Systematic investigations on the emotional impacts of repeated spontaneous abortions have been few. We mounted a prospective study of a cohort of couples who had experienced two consecutive first trimester spontaneous abortions and for whom no clearly identifiable causes were found. The present report is based on the first part of the study and examines: (1) emotional distress reported by the miscarrying women at six months (median, range 1-12 months) after two abortions; and (2) psychosocial predictors influencing such distress. The mean score of the women on the Symptom Checklist 90-Revised - one of the most popular self-report scales for psychopathology - was 0.38, whereas that for the general population is reported to be 0.26 (the higher the score, the more psychopathology). Fourteen percent of the cohort scored above the cutoff point for mental disorders screening. Factors examined and found non-influential upon the level of emotional distress include: the maternal age; whether the last pregnancy was planned and wished for or not; and coping styles of the women after the abortions. Control by the husbands over the marital relationship and neurotic personality traits of the women increased the emotional distress, whereas the social support the women perceive decreased it. These findings suggest that marital and social support are important in determining the level of psychiatric morbidity after repeated abortions.

Ictal physiological characteristics of remitters during bilateral electroconvulsive therapy

Ictal heart rate (HR) and postictal suppression in ictal EEG are believed to be predictive of the therapeutic efficacy of eletroconvulsive therapy (ECT) for depression. However, regarding ictal peak HR, previous studies investigated ictal HR on only one or two occasions during the course of ECT. We prospectively examined whether two physiological parameters, ictal peak HR and postictal suppression in ictal EEG, during every session, including those with abortive seizure, predicted ECT efficacy. Ictal peak HR and postictal suppression index were analyzed in 53 consecutive inpatients with depression using generalized estimating equations analysis, which corrects for the repeated nature of the observations. The peak HR and postictal suppression index were associated with therapeutic efficacy in remitters during sessions with adequate seizure. The physiological characteristics of the remitters included lower peak HR, lower stimulus energy, and higher postictal suppression index. However, these results could not be generalized, and are limited to non-atropine conditions and bilateral ECT.

Neural correlates of memory in depression measured by brain perfusion SPECT at rest.

Aim:  Brain metabolism activated studies have indicated associations between memory and the anterior cingulate cortex and hippocampus in patients with depression. The aim of the present study was therefore to investigate memory function, measured as performance on the Wechsler Memory Scale–Revised (WMS‐R), and its relationship to brain perfusion using single‐photon emission computed tomography (SPECT) at rest in patients with depression.

A failure to confirm the effectiveness of a brief group psychoeducational program for mothers of children with high-functioning pervasive developmental disorders: a randomized controlled pilot trial

Objective The purpose of this study was to examine the effectiveness of group psychoeducation to relieve the psychological distress of mothers of children with high-functioning pervasive developmental disorders (HFPDD) and to improve the behaviors of the children. Methods Seventy-two mothers of preschool outpatients with HFPDD were randomly assigned to a four-session brief group psychoeducational program (GP). The sessions were held every second week in addition to the usual treatment (GP + treatment as usual [TAU] group), or to a TAU-alone group. The primary outcome was self-reported symptoms of maternal mental health as assessed using the 28-item General Health Questionnaire (GHQ-28) at 21 weeks post-randomization (week 21). The GHQ-28 at the end of the intervention (week 7), Aberrant Behavior Checklist (ABC) for the behavior of the children, the Zarit Burden Interview (ZBI), and the Medical Outcomes Study 36-item Short Form Health Survey (SF-36) were carried out at weeks 7 and 21. We tested the group effects with the interaction between the intervention and the evaluation points. Results The GHQ-28 score at week 21 was significantly higher in the GP + TAU group as compared to that in the TAU-alone group, indicating a greater improvement in the TAU-alone group. There was no evidence that GP + TAU led to a greater improvement of maternal mental health than TAU-alone at week 7. Similarly, no evidence was obtained to indicate that GP + TAU led to a reduction in the ABC or ZBI scores by week 7 or 21. The adjusted scores for the RF (role emotional) and MH (mental health) subscales of the SF-36 at week 21 were also significantly lower in the GP + TAU group, indicating a similar tendency to that of the change of the GHQ-28 score at week 21. Conclusion The psychoeducational program did not alleviate maternal distress, aberrant behaviors of the children, or caregiver burden.