Effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder. A randomized clinical trial

The effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder in Denmark is not known. A total of 328 patients were randomly assigned to integrated treatment (167 patients) or standard treatment (161 patients). Integrated treatment consisted of assertive community treatment, psycho-educational multi-family groups, and social skills training. Data on coercion were extracted from the register from the National Board of Health, and data on continuity from medical records. Even though the level of continuity seemed higher in integrated treatment, this did not reduce the use of coercive measures compared to the use in standard treatment.     

Dealing with cryopreserved embryos upon divorce: a contractual approach aimed at preserving party expectations

The development of assisted reproductive technologies, including cryopreservation, or freezing, of embryos created through in vitro fertilization, has given rise to complex legal questions. Because cryopreservation permits indefinite storage of embryos, if couples fail to specify disposition directions, they may disagree regarding embryo treatment upon the occurrence of contingencies such as divorce. Few courts have resolved such disputes, and those that have appear to uphold the rights of the party seeking to prevent implantation in the absence of a written agreement specifying otherwise. In this Comment, Sara Petersen proposes that courts should draw upon contract law principles in determining whether the parties to such conflicts actually reached agreements regarding embryo disposition in the event of divorce. After analyzing existing precedent, the author assesses proposed approaches for deciding which party's interests should prevail and concludes that these methods are inherently ineffective. She then argues that, in an effort to preserve party expectations and to provide fair results, courts instead should examine whether the parties executed binding contracts or achieved mutual assent. Furthermore, she suggests that couples undergoing cryopreservation will be more likely to contemplate and to provide for various outcomes if they know that courts will look at evidence of their conversations and thought processes prior to cryopreserving their excess embryos.     

Assisted reproductive technologies: professional and legal restrictions in Australian clinics

The professional and legal regulation of assisted reproductive technologies (ART) in Australia is a vast maze of intersecting laws and guidelines which place restrictions on the provision of services such as infertility treatment, surrogacy, sex selection for social reasons, donor insemination, pre-implantation diagnosis and human embryo research. This study investigated the application of these restrictions on clinical practice in New South Wales, a relatively unregulated State, and Victoria, a relatively highly regulated State. The results of the survey indicate that the range of ART services in Victorian clinics was far more limited than in New South Wales clinics. The Victorian clinics uniformly restricted access of single and lesbian women and did not offer social sex selection procedures. The New South Wales clinics adopted different polices regarding these services. It was found that restrictive laws governing "social" issues have a significant impact on the availability of ART services and some respondents seemed unclear about the nature of restrictions and laws relevant to their work. It was also found that "reproductive tourism" is prevalent and restrictions were circumnavigated by patients with assistance from clinics. It was concluded that more evidence is required to evaluate regulation in this field of medicine.     

Gender Differential Influences of Early Adolescent Risk Factors for the Development of Depressive Affect

Based on a model by Cyranowski, J., et al. (2000), Arch. Gen. Psychiatry 57: 21–27, adolescents at-risk for the development of depressive symptoms were identified. Adolescents were considered at-risk if they had 2 or more of the following early adolescent risk factors: (1) insecure parental attachment, (2) anxious/inhibited temperament, (3) low instrumental coping skills, and (4) early pubertal maturation. Nonrisk adolescents had zero or just one risk factor. Using data from a 10-year longitudinal study on the development of adolescents’ health, with 5 points of data assessment (i.e., 6th, 7th, 8th, 12th, and 12 + 4 follow-up), the impact of the four early adolescent risk factors on the development of emotional tone was investigated. Emotional tone was measured by the Emotional Tone Scale of the SIQYA (Petersen, A. C., et al. (1984), J. Youth Adolesc. 13: 93–111), an indicator for positive emotional tone and low depressed affect. Growth curve modeling was applied to reveal significant gender differences in level and slope for the development of emotional tone over the adolescent years. Latent Growth Curve Models can be seen as a combination consisting of repeated measures analysis of variance and autoregressive analyses to evaluate the latent change of the variables under investigation (Rovine, M. J., and Molenaar, P. C. M. (2000), Multivar. Behav. Res. 35(1): 51–88). At-risk girls revealed poorer levels of emotional tone which stayed almost at the same low level up to young adulthood (i.e., 12 + 4), indicating a long lasting impact of the specified risk factors. In contrast, at-risk boys showed poorer emotional tone in early adolescence, but at the end of adolescence boys at-risk had the same level of emotional tone as nonrisk boys. At-risk girls showed significantly higher levels of depressive symptoms at grade 12 and at 12 + 4.Assistant Professor at the Department of Psychology, University of Erlangen-Nuremberg. He received his master’s degree from the Technical University Berlin in 1989 and his PhD from the Pennsylvania State University in 1993. His research interests encompass developmental psychology and methodology.Senior Vice President for Programs at the W. K. Kellogg Foundation, Battle Creek, Michigan. She received her PhD from the University of Chicago.