Torun Lindholm

Long-term follow-up of prenatally treated children at risk for congenital adrenal hyperplasia : Does dexamethasone cause behavioural problems?

OBJECTIVES To investigate the long-term effects of prenatal treatment of congenital adrenal hyperplasia (CAH) with emphasis on behavioural problems and temperament. DESIGN A population-based long-term follow-up study of Swedish children at risk for virilising CAH, who had received treatment prenatally with dexamethasone (DEX). The questionnaire-based follow-up was performed when the children had reached school age. METHODS Standardised parent-completed questionnaires were used to evaluate adaptive functioning, behavioural/emotional problems and psychopathology, social anxiety and temperament in DEX-exposed school-aged children (n=26) and matched controls (n=35). In addition, the association between parental questionnaires and childrens self-ratings was investigated. RESULTS There were no statistically significant differences between DEX-exposed children and controls in measures of psychopathology, behavioural problems and adaptive functioning. In a questionnaire on temperamental traits, DEX-exposed children were described by their parents as being more sociable than controls (P=0.042). The correlation analysis showed only modest parent-child agreement on social anxiety, i.e. the increased social anxiety in childrens self-ratings was not confirmed by their parents. CONCLUSIONS DEX-treated children showed good overall adjustment. The parent-child agreement with respect to social anxiety was modest, highlighting the importance of multiple information sources and assessment methods. The clinical significance of the observed difference in sociability cannot be determined within the frameworks of this study. Additional studies of larger cohorts are essential to make more decisive conclusions on the safety of the treatment. Until then, it is important that parents are thoroughly informed about the benefits and potential risks and uncertainties of this controversial treatment.

High self-perceived stress and many stressors, but normal diurnal cortisol rhythm, in adults with ADHD (attention-deficit/hyperactivity disorder).

Attention-deficit/hyperactivity disorder (ADHD) in adults is associated with significant impairment in many life activities and may thus increase the risk of chronic stress in everyday life. We compared adults with a DSM-IV ADHD diagnosis (n=28) with healthy controls (n=28) regarding subjective stress and amounts of stressors in everyday life, diurnal salivary cortisol in the everyday environment and salivary cortisol before and after cognitive stress in a laboratory setting. The association between cortisol concentrations and impulsivity was also investigated. Consistent with assumptions, individuals with ADHD reported significantly more self-perceived stress than controls, and subjective stress correlated with the amount of stressors in everyday life. The two groups were comparable with respect to overall diurnal cortisol levels and rhythm, as well as in pre- and post-stress cortisol concentrations. Post-stress cortisol (but not baseline cortisol) concentration was positively correlated with impulsivity. The group with high post-stress cortisol also reported more symptoms of depression and anxiety, as well as self-perceived stress and stressors in every-day life. The diagnosis of ADHD significantly increased the risk of belonging to the group with high post-stress cortisol levels. The results in this study warrant a focus not only on the primary diagnosis of ADHD, but also calls for a broader assessment of stressors and subjective stress in everyday life, as well as support comprising stress management and coping skills.

Women who kill: a comparison of the psychosocial background of female and male perpetrators.

The purpose of this study was to compare the psychosocial background of female and male perpetrators convicted of homicide in Sweden between 1995-2001. All women (n=43) who were convicted for lethal violence during the period and a corresponding number of randomly chosen men (n=43) were examined. In total, information about 86 individuals was collected retrospectively. Areas of interest were psychosocial variables during childhood and at the time of the current crime. Results showed that both female and male perpetrators were psychosocially encumbered already at an early age. Homicidal women had more severe childhood circumstances, but less aggressive childhood behaviour than did their male counterparts. At the time of the crime, women had a more ordered social situation, had more often been exposed to violence and searched for help than had the men. These gender differences suggest that specific actions are needed for preventing womens homicidal behaviour.

Gender role behaviour in prenatally dexamethasone-treated children at risk for congenital adrenal hyperplasia--a pilot study.

Aim:  To investigate the effects of prenatal dexamethasone (DEX) exposure on gender role behaviour.

The fate of traumatic memories in childhood and adulthood

The present article addresses issues concerning the complex relation between memory and trauma in childhood and adult life. Research findings showing how children and adults remember public and personal emotional events are presented, and mechanisms functioning to hold traumatic memories back from awareness are discussed. In the final section, developmental aspects are addressed by considering the interplay between child and adult trauma. Several cases are described that show how childhood trauma may be represented in memory and influence later development and adult memory processes.

Deficient cardiovascular stress reactivity predicts poor executive functions in adults with attention-deficit/hyperactivity disorder

Associations between cardiovascular stress markers, subjective stress reactivity, and executive functions were studied in 60 adults (30 with attention-deficit/hyperactivity disorder, ADHD, and 30 controls) using the Paced Auditory Serial Addition Test (PASAT, a test of executive functions) as a cognitive stressor. Despite higher self-perceived stress, the adults with ADHD showed lower or atypical cardiovascular stress reactivity, which was associated with poorer performance on PASAT. Using cardiovascular stress markers, subjective stress, and results on PASAT as predictors in a logistic regression, 83.3% of the ADHD group and 86.9% of the controls could be classified correctly.

Who are you looking at? The influence of face gender on visual attention and memory for own- and other-race faces

Previous research suggests that the own-race bias (ORB) in memory for faces is a result of other-race faces receiving less visual attention at encoding. As women typically display an own-gender bias in memory for faces and men do not, we investigated whether face gender and sex of viewer influenced visual attention and memory for own- and other-race faces, and if preferential viewing of own-race faces contributed to the ORB in memory. Participants viewed pairs of female or male own- and other-race faces while their viewing time was recorded. Afterwards, they completed a surprise memory test. We found that (1) other-race males received the initial focus of attention, (2) own-race faces were viewed longer than other-race faces over time, although the difference was larger for female faces, and (3) even though longer viewing time increased the probability of remembering a face, it did not explain the magnified ORB in memory for female faces. Importantly, these findings highlight that face gender moderates attentional responses to and memory for own- and other-race faces.

Evidence of gender bias in legal insanity evaluations: A case vignette study of clinicians, judges and students

Forensic psychiatric decision-making plays a key role in the legal process of homicide cases. Research show that women defendants have a higher likelihood of being declared legally insane and being diverted to hospital. This study attempted to explore if this gender difference is explained by biases in the forensic psychiatric assessments. Participants were 45 practicing forensic psychiatric clinicians, 46 chief judges and 80 psychology students. Participants received a written vignette describing a homicide case, with either a female or a male perpetrator. The results suggested strong gender effects on legal insanity judgements. Forensic psychiatric clinicians and psychology students assessed the case information as more indicative of legal insanity if the perpetrator was a woman than a man. Judges assessed offenders of their own gender, as they were more likely to be declared legally insane than a perpetrator of the opposite gender. Implications of and possible ways to minimize such gender biases in forensic psychiatric evaluations need to be thoroughly considered by the legal system.

Gender typing in stereotypes and evaluations of actual managers

Purpose - The pm-pose of this paper is to examine gender-related management stereotypes, perceived gender bias and evaluations of actual managers, and to directly compare stereotypes and ratings of ...

Gender Differences in Diagnoses of Mentally Disordered Offenders

We investigated differences in psychiatric diagnoses and medicolegal insanity decisions between female and male forensic psychiatric patients. Data on all offenders (N = 4396) subjected to a court-ordered forensic psychiatric inpatient evaluation were obtained for the years 1992–2000. A significantly higher proportion of female mentally disordered offenders were given a diagnosis of personality disorder while mentally disordered male offenders more often had a diagnosis of alcohol and/or drug dependence or sexual disorders. There was an increased likelihood that violent women would be declared legally insane even after controlling for a number of potential confounders. This may reflect an underlying difference in the severity of psychiatric morbidity not accounted for diagnostically or that a gender bias exists in the forensic psychiatric evaluation process.