Autopsy confirmation of severe pulmonary interstitial fibrosis secondary to Munchausen syndrome presenting as cystic fibrosis

Chronic factitious disorder with physical symptoms, or Munchausen syndrome, is a well-recognized but uncommonly diagnosed psychiatric condition characterized by the deliberate production of signs and symptoms of disease in order to receive medical attention. Clinical suspicion of this disease is rarely confirmed by autopsy, as the patients usually do not die as a consequence of feigning illness. Here we report the autopsy confirmation of a case of a suspected Munchausen syndrome patient who presented with a history of cystic fibrosis. Examination of the lungs demonstrated extensive severe interstitial fibrosis, and polariscopic examination revealed a large quantity of crystalline material throughout the tissue; X-ray diffraction identified the material as talc. Synopses of published cases of Munchausen syndrome presenting as cystic fibrosis, and cases of Munchausen syndrome with pulmonary talcosis are presented as part of the discussion.     

The Impact of School Mental Health Services on Out-of-School Suspension Rates

The current study investigated whether the presence of school-based mental health clinicians in an urban school district was associated with reduced out-of-school suspension rates. Forty one elementary schools with expanded school mental health (ESMH) programs were compared to 41 schools without ESMH programs. Correlational analyses revealed associations between suspension outcomes and several school-level demographic variables including school attendance rate, percent of students in poverty, and percent of nonwhite students in the school. After controlling for these variables, however, results of stepwise linear regressions demonstrated no significant differences between ESMH and non-ESMH schools on suspension outcomes. Results of the current study suggest that the presence of ESMH clinicians will not necessarily impact suspension rates in an elementary school. Targeted and well-implemented approaches to address behaviors that lead to suspension, or school- and system-level policies to provide alternatives to suspensions, will likely be a better route to achieving this outcome.     

Informing Juvenile Justice Policy: Directions for Behavioral Science Research

Recent policy initiatives threaten to reduce the rehabilitative mission of the juvenile court or eliminate the court entirely. This article lays out a framework for an empirical assessment of these developments. It first evaluates the available and potential empirical support for three hypotheses about juveniles that might justify maintaining a separate, rehabilitation-oriented juvenile justice system: the hypotheses that, compared to adults, juveniles are more treatable, less culpable, and less deterrable. On the assumption that the continued existence of a rehabilitation-oriented juvenile court can be justified, it then provides suggestions as to how existing intervention strategies for juveniles could benefit from research attention to several substantive and methodological issues. These include refining outcome criteria and sampling strategies, matching offender and program characteristics, reexamining intervention efficacy, and focusing on decision makers and resource allocations.     

Community Influence on Adolescent Obesity: Race/Ethnic Differences

Using a sample of 20,000 adolescents (Add Health data), this study examined the influences of community poverty and race/ethnicity on adolescent obesity. Multilevel analyses revealed strong evidence for the unique influences of community poverty and race/ethnicity on adolescent obesity net of family characteristics. The prevalence of obesity is significantly higher in poor communities than in affluent communities; and it is higher among African Americans, Hispanics and Native Americans than among Whites. The interaction between race/ethnicity and community poverty indicates that race/ethnicity moderates the influence of community poverty on the prevalence of obesity. Although the prevalence of obesity is higher among minorities than among Whites, the influence of community poverty is stronger for Whites than for minorities, suggesting that unlike Whites, most minority groups may not accrue benefits of structural community advantages. The state of being overweight as the outcome variable provided essentially the same findings. The practical implications are discussed.     

A Prospective Study of Extreme Weight Change Behaviors Among Adolescent Boys and Girls

This study examined changes in extreme weight change attitudes and behaviors (exercise dependence, food supplements, drive for thinness, bulimia) among adolescent boys and girls over a 16 month period. It also investigated the impact of body mass index, puberty, body image, depression and positive affect on these attitudes and behaviors 16 months later. The participants were 847 young adolescents (411 boys, 436 girls). Participants completed questionnaires evaluating the above variables on three occasions, eight months apart. Girls obtained higher scores on exercise dependence, drive for thinness and bulimia. Changes in depression and body image importance were the strongest predictors of changes in these extreme attitudes and behaviors among boys; changes in depression, body dissatisfaction and body image importance were the strongest predictors for girls. The need for gender specific educational and intervention programs for adolescents are discussed.Marita McCabe PhD, Professor in Psychology in the School of Psychology, Deakin University, Melbourne, Australia. She has completed her PhD in 1981 on adolescent development, and has been completing research on various aspects of adolescent adjustment for 30 years. To whom correspondence should be addressed at 221 Burwood Highway, Burwood, Victoria 3125, Australia;Senior Lecturer in the School of Psychology, Deakin University, Melbourne Australia. She completed her PhD in 1990 on Childrens Language Development. In the last 10 years she has been researching body image concerns in adolescents and children     

Validation of the Propensity for Abusiveness Scale in Diverse Male Populations

The Propensity for Abusiveness Scale (PAS; Dutton, 1995) was designed as a self-report perpetrator profile for intimate abusiveness. It was empirically validated through reports of abuse by intimate partners. The original PAS (Dutton, 1995) was given to 144 men in treatment for partner abuse and 44 demographically matched controls. It correlated significantly with partner reports of abusiveness and correctly classified men 82.2% of the time, as one standard deviation above or below the mean partners' report score for abusiveness. In the present study, the PAS was given to clinical outpatients, gay males, male college students, and a group of spousal assaulters. A criterion measure for abusiveness (the Psychological Maltreatment of Women Inventory; Tolman 1989, or the Psychological Maltreatment Inventory; Kasian & Painter, 1992) was collected from intimate partners. In all groups, the PAS correlated significantly with partners' reports of both physical and psychological abusiveness on subscales of the criterion measures: Dominance/Isolation and Emotional Abuse. For the college students and wife-assault groups, a new criterion measure was used: the Severity of Violence Against Women Scale. The PAS correlated significantly with partners' reports of threats and violence measured by this scale. The PAS appears to provide a nonreactive assessment instrument that is a strong predictor of intimate abusiveness across a variety of populations.     

Industry–University Research Centers: A Multivariate Analysis of Member Retention

Although a growing literature documents the benefits of industry–university research centers, most centers experience a significant amount of turnover among their industrial members. In order to gain a better understanding of this phenomenon, the current study attempts to identify factors that predict member renewal (DV). Questionnaire data were collected from industrial respondents (N=249) participating in 39 centers funded by the NSF IUCRC program. Structural, member benefits and administrative process variables were used to predict the dependent variable. Logistic regression analyses identified three significant predictors: professional networking benefits, research relevance and administrative operations. Implications of these findings for public policy, cooperative research management and future research are discussed.     

AMPFlSTR Identifiler STR allele frequencies in Tanzania, Africa

POPULATION:  Identifiler—Employees and students of Muhimibili University College of Health Sciences in Dar es Salaam representing 19 widely distributed administrative districts and 42 tribes within the country.