Bengt Sivberg

Family System and Coping Behaviors: A comparison between parents of children with autistic spectrum disorders and parents with non-autistic children

The study deals with strain on the family system, as well as the level of coping and types of coping behavior of the parents, in families with a child diagnosed as having an autistic spectrum disorder (ASD) as compared to families in a control group. Thirty-seven families and 66 parents were involved in each case, and four psychological tests were used. It was found that lower levels of coping were associated with higher levels of strain on the family system, that the level of strain on the family system was greater in the families with a child with an ASD, and that the two groups differed in their pattern of coping behavior. It is argued that limited contact between the child with an ASD and its parents, claimed earlier to be a cause of autism, can be explained in terms of strain on the family system and the resulting pattern of coping.

Coping strategies and parental attitudes, a comparison of parents with children with autistic spectrum disorders and parents with non-autistic children

This study focused on the coping strategies of parents’ with children with autistic spectrum disorders (ASD) and the relation between these strategies and parenting styles. Coping strategies were measured using the Sense of Coherence Scale (SOC) and the Purpose in Life Test (PIL-R). Parental attitudes toward loving care, stress, worry, and guilt feelings were assessed using the Family Impact Questionnaire. Two groups of participants were included: parents with children with ASD (EG) (n = 66) and a matched control group (CG) (n = 66). Paired Samples t-Test and Pearson’s r correlation were used as methods of analysis. Main results distinguished significant (p < .001 to .003) differences between the EG and CG for almost all variables included. The M level of coping strategy was much higher for the CG than for the EG. SOC showed a stress-reducing effect in both the EG and CG. PIL-R explained 50% of the variance in SOC for the EG and 33% for the CG. The only significant gender difference in the EG was on SOC indicating a higher sense of coherence among the fathers and probably an indicator of a stronger burnout effect of the mothers.

A novel blood-based biomarker for detection of autism spectrum disorders

Autism spectrum disorders (ASD) are classified as neurological developmental disorders. Several studies have been carried out to find a candidate biomarker linked to the development of these disorders, but up to date no reliable biomarker is available. Mass spectrometry techniques have been used for protein profiling of blood plasma of children with such disorders in order to identify proteins/peptides that may be used as biomarkers for detection of the disorders. Three differentially expressed peptides with mass–charge (m/z) values of 2020±1, 1864±1 and 1978±1 Da in the heparin plasma of children with ASD that were significantly changed as compared with the peptide pattern of the non-ASD control group are reported here. This novel set of biomarkers allows for a reliable blood-based diagnostic tool that may be used in diagnosis and potentially, in prognosis of ASD.

Parents’ experience of having a child with autism and learning disabilities living in a group home: A case study

Some children with autism and learning disabilities also have aberrant behaviours that are difficult to regulate and stressful for both the child and family members. This case study concerns experiences of 10 parents from five families before and 2 years after entrusting their 10- to 11-year-old child with autism to a group home. Hermeneutic phenomenological analysis of narrative interviews with the parents before the child’s moving showed them experiencing grief and sorrow, total exhaustion because of inability to regulate their child’s behaviours, social isolation, and negative effects on the child’s siblings, but experiencing themselves as more sympathetic than previously towards other people with problems. Two years later they experienced relief for the family due to the group home arrangement and the child’s improvement, but with an ethical dilemma which made them feel guilty, despite increased hope for the future. Some also felt unhappy with the staff situation at the group home.

Alterations of prolyl endopeptidase activity in the plasma of children with autistic spectrum disorders.

BackgroundProlyl Endopeptidase (PEP, EC 3.4.21.26), a cytosolic endopeptidase, hydrolyses peptide bonds on the carboxyl side of proline residue in proteins with a relatively small molecular weight. It has been shown that altered PEP activity is associated with various psychological diseases such as schizophrenia, mania and depression. Autistic Spectrum Disorders (ASD) are neuropsychiatric and behavioural syndromes affecting social behaviours and communication development. They are classified as developmental disorders. The aim of this study was to examine the hypothesis that PEP activity is also associated with ASDs.MethodsFluorometric assay was used to measure PEP activity in EDTA plasma in children with ASD (n = 18) aged 4–12 years (mean ± SD: 7.9 ± 2.5). These results were then compared to PEP activity in a control group of non-ASD children (n = 15) aged 2–10 years (mean ± SD: 6.4 ± 2.2).ResultsAn alteration in PEP activity was found in the children with ASD compared to the control group. There was much greater variation of PEP activity in the group of ASD children when compared to the controls (SD= 39.9 and SD 9.6, respectively). This variation was significant (p < 0.0005), although the mean level of PEP activity in the group of ASD children was slightly higher than in the control group (124.4 and 134.1, respectively).ConclusionOur preliminary finding suggests a role for PEP enzyme in the pathophysiology of autism but further research should be conducted to establish its role in the aetiology of psychiatric and neurological disorders, including autism and related spectrum disorders.

High Complement Factor I Activity in the Plasma of Children with Autism Spectrum Disorders

Autism spectrum disorders (ASDs) are neurodevelopmental and behavioural syndromes affecting social orientation, behaviour, and communication that can be classified as developmental disorders. ASD is also associated with immune system abnormality. Immune system abnormalities may be caused partly by complement system factor I deficiency. Complement factor I is a serine protease present in human plasma that is involved in the degradation of complement protein C3b, which is a major opsonin of the complement system. Deficiency in factor I activity is associated with an increased incidence of infections in humans. In this paper, we show that the mean level of factor I activity in the ASD group is significantly higher than in the control group of typically developed and healthy children, suggesting that high activity of complement factor I might have an impact on the development of ASD.

The desired competence of the Swedish ambulance nurse according to the professionals - A Delphi study

Nursing is evolving into new fields of health care including ambulance care, where a branch of specialist nursing is growing. Various views exist on the desired competence for the ambulance nurse and valid guidelines are lacking in Sweden. To increase knowledge of the field, professionals were asked to describe what competences an ambulance nurse should possess. The aim of this study was therefore to elucidate the desired professional competence of the specialist ambulance nurse, according to the professionals. A modified Delphi technique was used, where a panel of professional experts expressed their views on the desired competence of the ambulance nurse. This study reports, at a high level of agreement among the panel experts, that the desired competence of the specialist ambulance nurse consist of forty-four separate competences creating ten areas of competences: execute leadership, generic abilities, interpersonal communication, institutional collaboration, pedagogic skills, possession of relevant knowledge, professional judgement, professional skills, research activities, and technical skills. The high level of agreement among the professionals as well as the large number of competences reflects the high demands placed on the ambulance nurse by the professionals themselves.

Self-Image, Self-Values and Interpersonal Values Among Newly Graduated Nurses

This longitudinal study (1994-1996) used the Gordon Personality Inventory to measure nursing students’ self-image (Gordon A), self-values (Gordon B) and interpersonal values (Gordon C). It was performed with students from three colleges of health in the south of Sweden: Jönköping (n = 54), Växjö (n = 24) and Kristianstad (n = 38). The null hypothesis of the study was that the new academic three-year programme did not have the power to change significantly the students’ self-image and professional values. The hypothesis was tested by paired sample Student’s t-test. The result was that, at Jönköping, self-image changed and increased significantly in the dimensions of ‘cautiousness’ and ‘personal relations’, and decreased in ‘sociability’, and increased in the self-value ‘order’. At Växjö the self-image dimensions of ‘original thinking’ and ‘personal relations’ increased, and, at Kristianstad, the students increased their self-image scores in ‘responsibility’.

Self-Perception and Value System as Possible Predictors of Stress

This study was directed towards personality-related, value system and sociodemographic variables of nursing students in a situation of change, using a longitudinal perspective to measure their improvement in principle-based moral judgement (Kohlberg; Rest) as possible predictors of stress. Three subgroups of students were included from the commencement of the first three-year academic nursing programme in 1993. The students came from the colleges of health at Jönköping, Växjö and Kristianstad in the south of Sweden. A principal component factor analysis (varimax) was performed using data obtained from the students in the spring of 1994 (n = 122) and in the spring of 1996 (n = 112). There were 23 variables, of which two were sociodemographic, eight represented self-image, six were self-values, six were interpersonal values, and one was principle-based moral judgement. The analysis of data from students in the first year of a three-year programme demonstrated eight factors that explained 68.8% of the variance. The most important factors were: (1) ascendant decisive disorderly sociability and nonpractical mindedness (18.1% of the variance); (2) original vigour person-related trust (13.3% of the variance); (3) orderly nonvigour achievement (8.9% of the variance) and (4) independent leadership (7.9% of the variance). (The term ‘ascendancy’ refers to self-confidence, and ‘vigour’ denotes responding well to challenges and coping with stress.) The analysis in 1996 demonstrated nine factors, of which the most important were: (1) ascendant original sociability with decisive nonconformist leadership (18.2% of the variance); (2) cautious person-related responsibility (12.6% of the variance); (3) orderly nonvariety achievement (8.4% of the variance); and (4) nonsupportive benevolent conformity (7.2% of the variance). A comparison of the two most prominent factors in 1994 and 1996 showed the process of change to be stronger for 18.2% and weaker for 30% of the variance. Principle-based moral judgement was measured in March 1994 and in May 1996, using the Swedish version of the Defining Issues Test and Index P. The result was that Index P for the students at Jönköping changed significantly (paired samples t-test) between 1994 and 1996 (p = 0.028), but that for the Växjö and Kristianstad students did not. The mean of Index P was 44.3% at Växjö, which was greater than the international average for college students (42.3%); it differed significantly in the spring of 1996 (independent samples t-test), but not in 1994, from the students at Jönköping (p = 0.032) and Kristianstad (p = 0.025). Index P was very heterogeneous for the group of students at Växjö, with the result that the paired samples t-test reached a value close to significance only.

PREDICTING DEVELOPMENTAL DEFICIENCIES AT THE AGE OF FOUR BASED ON DATA FROM THE FIRST SEVEN MONTHS OF LIFE

The study examines very young children with the aim of identifying precursors of developmental problems during the first 7 months of age. Information from screening and observations in the birth clinic, in the first level of health care, and from parents was collected on five different occasions. The information that was included concerning the child and family was defined as either optimal or nonoptimal. At the age of 4 years, a clinical group was identified (11.1% of the total population). Logistic regression analyses were performed to detect risk factors. Twenty-one precursors were used to create a screening questionnaire that provided useful information (sensitivity = 56.1%, specificity = 98.8%) for predicting developmental problems of the children. The contribution of sociodemographic data was significant; medical information was less significant. The highest prediction rate surprisingly was found in the moderate clinical subgroup (62.1%), compared to the group with more severe problems that had a slightly lower rate (46.7%). The conclusion of the study is that it is possible to detect infants in need of early intervention using a continuous process of observation and screening.