Julie Malphurs

A statewide case-control study of spousal homicide-suicide in older persons

OBJECTIVE Homicide-suicides are rare relative to suicides and homicides, but these lethal events are an emerging public health concern. They have a mortality count similar to meningitis, pulmonary tuberculosis, influenza, and viral hepatitis, and the rate may be increasing in the United States, especially among older persons. The goal of this case-control study was to identify factors that differentiate older married men who commit homicide-suicide from those who commit suicide only. METHODS A total of 20 spousal homicide-suicides involving persons age 55 years and older were ascertained in Florida between January 1, 1998 and December 31, 1999 from medical examiner records. Two suicide controls were matched to each homicide-suicide perpetrator by age, race, marital status, method of death, and medical examiner district. Perpetrator groups were compared on sociodemographic characteristics, medical variables, and autopsy findings. RESULTS Homicide-suicide perpetrators displayed significantly more domestic violence or were caregivers for their wives, in contrast to suicide perpetrators, who had health problems and were receiving care from their spouses. Both groups of perpetrators had reported depressed mood, and there were no differences in sociodemographic factors. CONCLUSIONS Depression plays a significant role in both homicide-suicide and suicide, but the associated factors are different: we see caregiving strain in perpetrators of homicide-suicide, and living with physical health disorders as a care-recipient in men who commit suicide. Marital conflict is a significant factor in some spousal homicide-suicides.

Infants of intrusive and withdrawn mothers

Two styles of mother-infant interactions have been observed in depressed mothers, including an intrusive style (overstimulating behavior) and a withdrawn style (understimulating behavior). To examine how these styles affect infants, we assessed 87 infants and their mothers, who had been assigned to “intrusive” or “withdrawn” profiles, based on their face-to-face interactive behaviors with their 3-month-old infants. Behavioral assessments were made at 3, 6, and 12 months. The results indicated that infants of withdrawn mothers showed less optimal interactive behavior, greater relative right frontal EEG asymmetry (due to decreased left frontal EEG activation and increased right frontal EEG activation), and lower Bayley Mental Scale scores at 1 year. Infants of intrusive mothers had higher catecholamine and dopamine levels, and their EEG patterns showed greater relative left frontal EEG asymmetry (due to increased left frontal EEG activation and decreased right frontal EEG activation).

Infants' preference for touch stimulation in face-to-face interactions

Abstract Infant preference for social stimulation that included touch during a face-to-face situation with an adult was investigated. Ten 1.5- to 3.5-month-old infants (M = 2.6, SD = .6) participated in a within-subjects repeated-measures design. Two treatment conditions were compared in an alternated, counterbalanced order with each infant. Under the touch treatment, the infant eye-contact responses were followed by continuous contingent adult smiling, cooing, and rubbing of the legs and feet. Under the no-touch treatment, the infant eye-contact responses were followed by contingent adult smiling and cooing, but not by touching. The results showed that, during the touch condition, infants emitted more eye contact and more smiles and vocalizations, and they spent less time crying and protesting compared with the no-touch condition. The results demonstrated that a social stimulus compound that included touching the infants functioned as a more effective reinforcer for infant eye-contact behavior than a stimulus compound that did not include touch.

Depressed mothers' and their infants' interactions with nondepressed partners

Twenty depressed adolescent mothers were videotaped interacting with their own infant and with the infant of a nondepressed mother. In addition. nondepressed mothers were videotaped with their own infant as well as with the infant of a depressed mother. Depressed mothers showed less facial expressivity than nondepressed mothers and received less optimal interaction rating scale scores (a sum- mary score for state, physical activity, head orientation, gaze, silence during gaze aversion, facial expres- sions, vocalizations, infantized behavior, contingent responsivity, and gameplaying). This occurred in- dependent of whether they were interacting with their own infant versus an infant of a nondepressed mother, suggesting that depressed mothers display less optimal behaviors to infants in general. The infants of both depressed and nondepressed mothers received better head orientation and summary ratings when they were interacting with another mother, perhaps because the other mother was more novel. Infants of nondepressed mothers, in particular, had better summary ratings (state, physical activity, head onenta- tion, gaze, facial expressions, fussiness, and vocalizations) than the infants of depressed mothers when interacting with depressed mothers. Thus, it may be thathfants of nondepressed mothers are generally better interaction partners than infants of depressed mothers. Another related possibility is that they per- sist longer in trying to elicit a response from mothers less responsive than their own, given that they have learned to expect a response to their behavior.

Vitamin E and memantine in Alzheimer's disease: Clinical trial methods and baseline data

Alzheimers disease (AD) has been associated with both oxidative stress and excessive glutamate activity. A clinical trial was designed to compare the effectiveness of (i) alpha‐tocopherol, a vitamin E antioxidant; (ii) memantine (Namenda), an N‐methyl‐D‐aspartate antagonist; (iii) their combination; and (iv) placebo in delaying clinical progression in AD.

Care coordination assisted by technology for multiethnic caregivers of persons with dementia: a pilot clinical demonstration project on caregiver burden and depression

We evaluated a care-coordination project assisted by a screen-phone to support and educate caregivers. A total of 113 caregivers of home-dwelling veterans with dementia were recruited to the study: 72 were white, 32 were African American and nine were Hispanic. Caregivers were assessed for burden, depression, coping, quality of life, knowledge and satisfaction. None of the outcome measures changed significantly after 12 months. Forty care-recipient and caregiver dyads responded to the 12-month telephone satisfaction survey. The respondents were more satisfied with the care-coordination (90%) aspect of the programme than the education (77%) or the monitoring (50%). The pilot project suggests that care coordination aided by screen-phones may be a useful model for caregiver support in a managed-care setting. A systematic study is now required.

Legal Interviewers Use Children's Affect and Eye Contact Cues to Assess Credibility of Their Testimony.

Based on interviews with 120 children ranging from age 3 to 12, legal interviewers rated the grade school and middle school age children as competent and as understanding the meaning of lying. The interviewers rated the grade school children as more credible ‘witnesses in court’ than either the preschool or the middle school age children. The cues they reported using most frequently were affect and eye contact.

Psychiatric disorders and diabetes mellitus

1. Overview of diabetes mellitus. 2. Diabetes mellitus and schizophrenia. 3. Diabetes mellitus and depression. 4. Diabetes mellitus and cognitive impairment. 5. Diabetes mellitus and sexual dysfunction. 6. Diabetic peripheral neuropathic pain: an inevitable consequence of diabetes mellitus? 7. HIV-1 infection, diabetes mellitus, and psychiatric disorders. 8. Nutritional interventions for individuals with mental illness and diabetes mellitus. 9. Impact of exercise on psychiatric disorders and diabetes mellitus. 10. Psychopharmacologic treatment of psychiatric disorders in patients with diabetes mellitus: clinical considerations and options. 11. Treatment options for diabetic peripheral neuropathic pain. 12. Psychosocial therapies for psychiatric disorders and diabetes mellitus. 13. Collaborative care to improve treatment of co-occurring diabetes mellitus and psychiatric disorders.

Carrying position influences infant behavior

Three‐month‐old infants were carried by their mothers in a soft infant carrier designed for infants being faced inward or faced outward. A within subjects comparison of these two positions revealed...

Development of a Curriculum for Long-Term Care Nurses to Improve Recognition of Depression in Dementia

There is increasing recognition of the severe consequences of depression in long-term care residents with dementia. Most health care providers are unprepared to recognize and to manage the complexity of depression in dementia. Targeted educational initiatives in nursing homes are needed to address this growing problem. This paper describes the development of competencies, learning objectives, and learning outcomes for a curriculum on depression in dementia for nurses working in nursing home settings. This work provides the foundation for a curriculum to improve learning for nurses and, ultimately, to advance health care outcomes for residents with cooccurring depression and dementia.