Author Index of Volume 14

Authors Index

Author Index of Volume 14     

Parenting,Marital Conflict and Adjustment From Early- to Mid-Adolescence: Mediated by Adolescent Attachment Style?

Contributions of 3 dimensions of parenting (psychological control, warmth, and behavioural control), marital conflict, and attachment style (anxiety and avoidance) to adjustment from early to middle adolescence were assessed. Mediation of marital conflict effects by parenting, and of parenting effects by attachment were examined. Adolescents (n = 175) initially age 13 years reported parenting practices, attachment styles, school grades, self-esteem, and internalizing and externalizing problems twice (T1, T2) 2 years apart. T1 marital conflict was associated with lower self-esteem, more externalizing symptoms, and lower academic achievement at T2, all but the latter mediated by parental warmth. T1 parental psychological control was associated with increases in internalizing symptoms over time, an effect not mediated by attachment insecurity, which contributed independently. T1 parental warmth was associated with decreases in externalizing symptoms and increases in self-esteem over time, the latter mediated by attachment security.Professor of Psychology, Concordia University, Montreal, QC, Canada, H4B 1R6. Received PhD in Developmental Psychology from Stanford University. Research interests include parenting, attachment, and adjustment in adolescence.Professor of Psychology and Applied Human Sciences, Concordia University, Montreal, QC, Canada, H3G 1M8. Received PhD in Social Psychology from Ohio State University. Research interests include close personal relationships and adjustment.     

Unexpected perinatal death and sudden infant death syndrome (SIDS): anatomopathologic and legal aspects

This work intends to be a review of the recent histopathological findings elicited by research into sudden and unexpected perinatal death and sudden infant death syndrome (SIDS) that have dictated a novel approach to the inherent problems by pathologists, especially those entrusted with forensic medical authority. The new approach stems from the recent advances made in the understanding of neuro- and/or cardiac-conduction-system diseases present in unexpected perinatal death and SIDS. These demand that an accurate morphologic examination be performed of these structures, which modulate respiratory, cardiovascular, digestive, and arousal activities, in all victims of sudden death. A histopathologic study of an ample register of cases of victims of sudden death, either perinatally or in early infancy, has demonstrated frequent alterations both of the autonomic nervous system (especially hypoplasia of the arcuate nucleus) and of the cardiac conduction system (accessory atrioventricular pathways). The present research provides an in-depth study of the many still-controversial aspects underlying perinatal unexpected death and SIDS and is recommended for professionals working in the forensic field, whose greater insight into this problem will allow more complete medicolegal documentation.     

Perianal and vulvar Crohn's disease presenting as suspected abuse

Misdiagnosis of sexual abuse may arise in cases of vulvar and/or perianal diseases such as lichen sclerosus et atrophicus, Behcet's syndrome, bullous diseases, contact dermatitis, or neoplastic lesions. We present the case of a 7-year-old girl who was referred by her general paediatrician to the local hospital for perianal fissures and swelling of the labia majora. A report to the judicial authorities was made, for suspected sexual abuse, and the patient was transferred to the department of paediatric surgery. Here, histopathologic examination of vulvar and rectal biopsies revealed multiple non-caseating and non-confluent epithelioid-gigantocellular granulomas, consistent with a diagnosis of Crohn's disease, with cutaneous involvement of the genitalia. In cases of suspected sexual abuse, examination of children should be performed by a specialist in legal medicine in collaboration with a gynaecologist or paediatric surgeon. If the patient is hospitalised and the question of protection does not arise, physicians should exclude dermatological diseases before reporting to the judicial authorities.     

Recidivism is related to psychopathy (PCL-R) in a group of men convicted of homicide

It is well known that psychopaths are a group with high risk for criminality. Despite that, researchers and clinicians have not yet agreed on a general cause of psychopathy. However Raine [Raine, A. (2002). Biosocial studies of antisocial and violent behavior in children and adults: A review. Journal of Abnormal Child Psychology, 30, 311-326.] advocated a biosocial model of violent behaviour where the greatest risk for criminal behaviour occurred when both heredity and environmental risk factors (e.g., social class, childhood history) were present. In this follow-up study, 35 men convicted of homicide were assessed retrospectively for psychopathy according to the Psychopathy Checklist-Revised (PCL-R). Information on personal history, as well as from legal documents and records of offences committed by the subjects was also obtained. Fourteen of the 35 men were classified as psychopaths. Two men, both rated as psychopaths, had criminal parents. Twenty-seven of the men had a social relationship with their victim, and eleven out of these were rated as psychopaths. There was no difference in PCL-R scores between those who had a social relationship with their victim and those who did not. The psychopaths relapsed more frequently than the nonpsychopaths into criminality after their prison term. This result confirms previous research indicating that psychopathy is a risk factor for recidivism. It is, therefore, very important that psychopaths get the best possible treatment, aftercare, and supervision.     

Fatal intoxications in a Swedish forensic autopsy material during 1992-2002

Compilations of substances detected in fatal intoxications are important in order to observe changes in intoxication patterns, to monitor effects of preventive work and to discover new trends in drug usage. The aim of the present study was to describe the current pattern of substances detected in fatal intoxications in Sweden. Fatal intoxications investigated at the Department of Forensic Chemistry, Link?ping, Sweden, during 1992-2002, were analysed. All suicides, uncertain cases and accidents where the cause of death were fatal intoxications (ICD-9: E950, E980 and E859) were included and substances detected in more than 50 fatal intoxications (in femoral blood) were listed. For each substance, a cut off value was set, above which concentrations were considered toxic. Fatal intoxications were detected by forensic-chemical analyses in 12% (6998/60,314) of the forensic autopsies during the study period. Among the suicides, an average of 3.8 substances were detected per case, the corresponding figure for uncertain cases and accidents were 3.5 and 4.1 substances, respectively. Ethanol was by far the most frequently detected substance, detected in 43% (3039) of the fatal intoxications, of which 32% (960) had toxic concentrations, followed by propoxyphene, detected in 27% (1863) of the fatal intoxications of which 74% (1370) had toxic concentrations. The number of cases where ethanol and propoxyphene were detected decreased during the study period. Moreover, other CNS-active drugs such as antidepressants, analgesics and anxiolytics were also frequently detected. The drugs with high proportions of cases with toxic concentrations detected were propoxyphene, amitriptyline, zolpidem, carisoprodol, alprazolam, thioridazine, methadone and ketobemidone. Selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants (TCA) were detected in 12% (833) and 10% (665), respectively. A significantly (P <0.001) higher proportion of cases where TCA were detected had toxic concentrations when compared with cases where SSRI were detected (64% versus 31%).     

Developmental Differences in Adolescents’ and Young Adults’ Use of Mothers, Fathers, Best Friends, and Romantic Partners to Fulfill Attachment Needs

Adolescents and young adults (three age groups: 12–15, 16–19, and 20–28 years) reported their use of parents, and peers to fulfill attachment functions (proximity-seeking, safe haven, and secure base.) The use of each target figure varied with age and attachment function. Mothers were an important source of security across this age range. They were used as secure base consistently more than fathers or peers for all age groups, and regardless of whether or not participants had romantic partners; but were used less for proximity and safe haven by the two older groups. Best friends were used most and more than others as a safe haven; but were used less by young adults (vs. early adolescents) and by older adolescents with romantic partners. Romantic partners were used most and more than others for proximity; but were used less by early adolescents than by older participants. Fathers were selected less than other targets for all attachment functions. Those with romantic partners turned to them more than to others, and young adults selected their romantic partners as much as friends for safe haven. Those insecurely attached to mother turned to her less and to romantic partners more than did those securely attached. Implications for developmental changes in adolescent attachments are discussed. Professor of Psychology and Applied Human Sciences, Concordia University. Received PhD in social psychology from Ohio State University. Research interests include close interpersonal relationships and adjustment. Received MA in social/developmental psychology from Wilfrid Laurier University. Research interests include attachment and well-being in adolescence Received PhD in developmental psychology from Stanford University. Research interests include parenting, attachment, and adjustment in adolescence Received BA in Psychology (Honors) from Concordia University. Research interests include romantic relationships in adolescence     

Monitoring deliberate self-harm presentations to general hospitals

Monitoring of deliberate self-harm (DSH) presentations to hospitals (and in other settings) is receiving increased attention in many countries. This is due to greater recognition of the size of the problem and awareness of its relevance to suicide prevention policy initiatives, because of the strong association between DSH and suicide. A system for monitoring all DSH presentations has been in place in the general hospital in Oxford for 30 years. Based on our experience, in this paper we describe procedures for monitoring, including case definition and identification, linkage of persons and episodes in order to investigate repetition of DSH and other outcomes (including deaths), and data protection and ethical issues. We also provide details of how to carry out monitoring, including different models of data collection, and what data to collect. Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives.