[Characteristics associated with depression and post-traumatic stress disorder among childhood sexual abuse women]. / Caractéristiques associées à la dépression et aux symptômes de stress post-traumatique chez les femmes victimes d'agression sexuelle durant l'enfance.

BACKGROUND: A significant proportion of childhood sexual abuse victims suffer from psychological sequelae in adulthood. Factors that provide a better understanding for the reasons why some victims develop these sequelae remain under-explored. In this context, the main objective is to examine the specific contribution of the contextual characteristics of childhood sexual abuse, multitype childhood maltreatment and adolescent suicide attempts on the development of depression and post-traumatic stress disorder in adulthood among sexually abused women as children. A secondary objective aimed to establish the prevalence of various forms of childhood maltreatment, adult onset post-traumatic stress disorder and depression among those women. METHODS: The sample included 479 women victims of childhood sexual abuse who participated in two separate surveys taken by women in the province of Quebec. RESULTS: More than half of these women reported at least one other form of childhood maltreatment, 30% of them presented post-traumatic disorder and 40% suffered from depression in adulthood. Regression analysis indicates that post-traumatic stress disorder was associated with early onset childhood sexual abuse and intergenerational continuity of sexual victimization, as well as childhood physical maltreatment and negligence. Depression was associated with childhood psychological maltreatment and negligence, a non-supportive response following child sexual abuse related disclosure and suicide attempt in adolescence. CONCLUSION: These results confirm the need to consider the cumulative effects of various childhood adversity factors in the psychosocial assessment of sexually abused women in early life, thus helping to better understand and treat their psychological sequelae.

The potential role of benefit and burden finding in school engagement of young leukaemia survivors: an exploratory study.

BACKGROUND: Childhood cancer may radically change the daily lives of young survivors, particularly in school. Depending on the sense they derive from the experience of illness, survivors may go through profound transformations in the way they approach life. METHODS: This exploratory study reports on school engagement of cancer survivors by examining their perceptions of benefits and burdens in relation to their illness. Forty-nine young Quebecers, previously diagnosed and treated for leukaemia, completed a questionnaire measuring their school engagement and participated in an interview focusing on the impact of cancer on their lives. Perceptions with regard to the presence and types of benefits and burdens were described and examined in light of participants' characteristics. An analysis of variance explored whether the presence/absence of benefits and burdens were associated with participants' scores regarding school engagement. RESULTS: Most participants mentioned benefits from having had cancer, and in particular benefits at an interpersonal level. Half of the participants mentioned burdens, mainly of a physical and psychological nature. Significant correlations indicated that (i) the older the survivors were, the more likely they were to report benefits in terms of qualities and strengths of character; (ii) the more time had elapsed since their diagnosis, the more survivors were likely to report psychological types of burdens; and (iii) children from single-parent families reported more frequently having appreciated social or recreational activities compared with children from two-parent families. One main effect indicated that school engagement was greater for survivors who perceived the presence of benefits. An interaction effect revealed that the perception of both benefits and burdens predicts the highest scores of school engagement. CONCLUSIONS: While the results reveal the promising potential that an optimistic yet realistic disposition has in regard to school engagement, more research is necessary to further our understanding of such a disposition.

[Psychological and health sequelae of childhood sexual, physical and psychological abuse]. / Les conséquences à long terme de la violence sexuelle, physique et psychologique vécue pendant l'enfance.

BACKGROUND: The co-occurrence of child victimization experiences is not a rare phenomenon. However, few studies have explored the long-term consequences of such experiences. Empirical studies present important methodological limitations, namely the fact that few studies have documented more than two forms of victimization, that they rely on non representative samples and have not used multivariate analyses. The present study aims to evaluate the specific contribution of each form of child victimization (sexual, physical and psychological) on the outcomes in adulthood. Moreover, the study explores the role of co-occurrence on these symptoms. METHODS: A phone survey was conducted with a representative sample of 804 adults from the province of Quebec. Households were randomly selected among those having a telephone. Sociodemographic variables, child victimization experiences (sexual, physical and psychological) and partner violence were evaluated to explore their links with psychological distress, post-traumatic stress symptoms and physical health of participants. RESULTS: Higher psychological distress in men is associated with younger age, lower education level and having experienced sexual and physical violence in childhood. For women, psychological distress is linked to younger age, having experienced partner violence, childhood physical and psychological violence. Only experiencing partner violence and childhood sexual and psychological victimization are linked to greater post-traumatic stress symptoms in men and women. Finally, lower education level and childhood sexual and physical victimization increase physical health problems for men, while for women, only lower education level contributes to the prediction. CONCLUSION: The results of this study show that experiencing more than one form of childhood victimization increases the negative outcomes in adulthood, underlying the relevance of considering the phenomenon of co-occurring victimization in the elaboration and dissemination of intervention programs.

Canadian Incidence Study of Reported Child Abuse and Neglect: methodology.

This article describes the methodology of the first Canada-wide study of the incidence and characteristics of reported child abuse and neglect. Child welfare investigators from a random sample of 51 child welfare service areas completed a three-page survey form describing the results of 7,672 child maltreatment reports received during the months of October to December 1998. The study documented a 90% participation rate and a 95% item completion rate. An estimated 135,571 child maltreatment investigations were completed, a rate of 21.52 investigated children per 1,000 children in Canada in 1998. The Canadian Incidence Study of Reported Child Abuse and Neglect is a rich database that will provide researchers with important contextual information on reported child maltreatment in Canada and a comprehensive source of information on factors associated with key service decisions made by child welfare investigators.

Attenuation of apoptosis underlies B lymphocyte stimulator enhancement of humoral immune response.

B lymphocyte stimulator (BLyS) is a newly identified monocyte-specific TNF family cytokine. It has been implicated in the development of autoimmunity, and functions as a potent costimulator with antiimmunoglobulin M in B cell proliferation in vitro. Here we demonstrate that BLyS prominently enhances the humoral responses to both T cell-independent and T cell-dependent antigens, primarily by attenuation of apoptosis as evidenced by the prolonged survival of antigen-activated B cells in vivo and in vitro. BLyS acts on primary splenic B cells autonomously, and directly cooperates with CD40 ligand (CD40L) in B cell activation in vitro by protecting replicating B cells from apoptosis. Moreover, although BLyS alone cannot activate the cell cycle, it is sufficient to prolong the survival of naive resting B cells in vitro. Attenuation of apoptosis by BLyS correlates with changes in the ratios between Bcl-2 family proteins in favor of cell survival, predominantly by reducing the proapoptotic Bak and increasing its prosurvival partners, Bcl-2 and Bcl-xL. In either resting or CD40L-activated B cells, the NF-kappaB transcription factors RelB and p50 are specifically activated, suggesting that they may mediate BLyS signals for B cell survival. Together, these results provide direct evidence for BLyS enhancement of both T cell-independent and T cell-dependent humoral immune responses, and imply a role for BLyS in the conservation of the B cell repertoire. The ability of BLyS to increase B cell survival indiscriminately, at either a resting or activated state, and to cooperate with CD40L, further suggests that attenuation of apoptosis underlies BLyS enhancement of polyclonal autoimmunity as well as the physiologic humoral immune response.

Precursor thymocyte proliferation and differentiation are controlled by signals unrelated to the pre-TCR.

In-frame rearrangement of the TCR-beta locus and expression of the pre-TCR are compulsory for the production of CD4+8+ thymocytes from CD4-8- precursors. Signals delivered via the pre-TCR are thought to induce the differentiation process as well as the extensive proliferation that accompanies this transition. However, it is equally possible that pre-TCR expression is required for the success of this transition, but does not play a direct role in the inductive process. In the present manuscript we examine this possibility using a variety of normal and genetically modified mouse models. Our evidence shows that differentiation and mitogenesis can both occur independently of pre-TCR expression. However, these processes are absolutely dependent on the presence of normal thymic architecture and cellular composition. These findings are consistent with a checkpoint role for the pre-TCR in regulating the divergence of survival and cell death fates at the CD4-8- to CD4+8+ transition. Further, our data suggest that precursor thymocyte differentiation is induced by other, probably ubiquitous, mechanisms that require the presence of normal thymic cellularity, composition, and architecture.

Characterization of TCR gene rearrangements during adult murine T cell development.

Development of the alphabeta and gammadelta T cell lineages is dependent upon the rearrangement and expression of the TCRalpha and beta or gamma and delta genes, respectively. Although the timing and sequence of rearrangements of the TCRalpha and TCRbeta loci in adult murine thymic precursors has been characterized, no similar information is available for the TCRgamma and TCRdelta loci. In this report, we show that approximately half of the total TCRdelta alleles initiate rearrangements at the CD44highCD25+ stage, whereas the TCRbeta locus is mainly in germline configuration. In the subsequent CD44lowCD25+ stage, most TCRdelta alleles are fully recombined, whereas TCRbeta rearrangements are only complete on 10-30% of alleles. These results indicate that rearrangement at the TCRdelta locus can precede that of TCRbeta locus recombination by one developmental stage. In addition, we find a bias toward productive rearrangements of both TCRdelta and TCRgamma genes among CD44highCD25+ thymocytes, suggesting that functional gammadelta TCR complexes can be formed before the rearrangement of TCRbeta. These data support a model of lineage commitment in which sequential TCR gene rearrangements may influence alphabeta/gammadelta lineage decisions. Further, because TCR gene rearrangements are generally limited to T lineage cells, these analyses provide molecular evidence that irreversible commitment to the T lineage can occur as early as the CD44highCD25+ stage of development.

[Efficacy of a treatment program for sexually abused children]. / Efficacité d'un programme de traitement pour enfants abusés sexuellement.

OBJECTIVE: An evaluation study was conducted in order to evaluate the impact of the treatment program for sexually abused children. METHOD: Forty-one (41) children (aged 6-17 years), victims of a sexual abuse by a family member, were assessed at pre- and post-treatment (16 months following the pre-test). The evolution of children's psychological well-being was measured by the Children's Depression Inventory (CDI), the Picturial Scale of Perceived Competence and Acceptance for Young Children (PSPCA), the Children's Nowicki-Strickland Internal-External control scale (CNS-IE), the Children's Action Tendency Scale (CATS), the Revised Children's Manifest Anxiety Scale (RCMAS), and the Pediatric Behavior Scale (PBS). A hierarchical multiple regression analysis was used to assess the strength of the relationship between the level of participation in both individual (including dyadic and family therapy) and group therapy and the evolution of Ss' psychological well-being. RESULTS: Results indicate that the child's mental health was generally positively related to the level of participation in individual therapy but not related or negatively related with the level of participation in group sessions except for the PBS. CONCLUSIONS: These results indicate the need: (a) to consider the adoption of a dose measurement in the appreciation of the therapeutic impact; (b) to have a better grasp of the nature and the effects of specific therapeutic activities included in a program; (c) to have a better understanding of the disparities observed between parents' and children's evaluation of the psychological status of the child.

T cell receptor (TCR)-beta gene recombination: dissociation from cell cycle regulation and developmental progression during T cell ontogeny.

T cell lymphopoiesis involves extensive cell division and differentiation; these must be balanced by export and programmed cell death to maintain thymic homeostasis. Details regarding the nature of these processes, as well as their relationships to each other and to the definitive process of T cell receptor (TCR) gene recombination, are presently emerging. Two widely held concepts are that cell cycle status is inherently and inversely linked to gene recombination and that the outcomes of gene recombination regulate developmental progression. In this study, we analyze TCR-beta recombination and cell cycle status with respect to differentiation during early T cell ontogeny. We find that although differentiation, cell cycle fluctuations, and gene recombination are coincident during normal T cell development, differentiation and cell cycle status are not inherently linked to the recombination process or its products. Rather, recombination appears to occur in parallel with these events as part of a genetically patterned program of development. We propose that the outcome of gene recombination (i.e., TCR expression) may not influence developmental progression per se, but instead serves to perpetuate those developing cells that have been successful in recombination. The potential consequences of this model for the regulation of thymic lymphopoiesis and programmed cell death are discussed.

Developmental changes in alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate receptor properties and expression in the rat hippocampal formation.

The developmental changes in alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA) receptor properties in rat hippocampus were evaluated with quantitative autoradiography of ligand binding and in situ hybridization performed in adjacent sections with antisense oligonucleotides for AMPA receptor subunits (GluR1-3, flip and flop splice variants). Specific 3H-AMPA binding in different hippocampal subfields increased between postnatal day 7 and 15 and was higher in CA3 during the postnatal period when compared to adult levels. This effect was mostly due to high levels of high affinity binding sites in cell body layers during the developmental period. By contrast, autoradiograms of 3H-AMPA binding predominantly to the low affinity binding sites indicated an absence of these sites in cell body layers and the overall levels of binding exhibited little overshoot compared to adult levels during the developmental period. The changes in binding of the antagonist of the AMPA receptor, 6-nitro-7-cyanoquinoxaline-2,3-dione were markedly different from those for the high affinity AMPA binding sites but quite similar to those for the low affinity sites. The binding was extremely low at postnatal day 7 and increased rapidly between postnatal day 7 and 15 and slowly between postnatal day 15 and adult. Low levels of binding were observed in the cell body layer at every postnatal age. The changes in expression of messenger RNAs for the different subunits of the AMPA receptors were well correlated with the modifications in high affinity AMPA binding sites measured in the cell body layers also exhibiting an increased expression of the receptors at the transcriptional level during the developmental period as compared to adult levels. The relative expression of the GluR2 subunits decreased during the postnatal period and the time course for this reduction paralleled that for the increased vulnerability of hippocampal pyramidal neurons to a variety of insults. The results indicate that both the messenger RNAs for the subunits and the AMPA receptors exhibit increased levels of expression during the postnatal period compared to adult levels. They also suggest that nascent receptors might bind AMPA with high affinity before their insertion in membranes into functional receptors that have low affinity for agonists and high affinity for antagonists. The changes in subunit composition of the receptors during the postnatal period may have important implications for mechanisms of plasticity as well as of neuropathology.

[Incidence and characteristics in identification of abused children: cross-cultural comparison]. / Incidence et caractéristiques des signalements d'enfants maltraités: comparaison interculturelle.

This study compared the incidence and characteristics of reported child abuse cases in two different ethnic groups. Incidence was calculated based on the total number of cases (N = 2,854) reported to child protection authorities between July 17, 1988 and March 31, 1989. In a sample of 953 reports, the following were examined: the source of the reporting, type of abuse, substantiation and age of the child. The incidence was found to be slightly higher among Haitian group compared to French-Canadian group. In the former case, reporting tended to originate with public authorities such as the police or school personnel. Cases tended to consist mainly of physical abuse, with very few cases of sexual abuse. Most involved adolescents. These results suggest that child-rearing practices of Haitian families are in conflict with the values of the host community, and that there exist similar value-based conflicts between Haitian parents and their children.

Familiarity, group exposure, and risk-taking behavior in gambling.

This research studied the effect of familiarity and individual versus group participation on risk-taking behavior in gambling (American roulette). Thirty-eight subjects (21 men and 17 women) were randomly selected and assigned to two experimental groups that gambled either individually or in groups. Results revealed that players bet more heavily as they became more familiar with the game, whether playing alone or in groups.

Abnormal alanine aminotransferase level in blood units from donors in Montreal does not indicate high risk of transmitting hepatitis.

We undertook a prospective study to estimate the risk in Montreal of developing hepatitis following transfusion of blood with an elevated alanine aminotransferase (ALT) level. Two thousand consecutive donor units were screened for ALT activity; 133 (6.7%) had values greater than or equal to 51 IU 1(-1). Twenty-four patients received one or more units with elevated ALT levels and completed follow-up; two (8%) developed hepatitis (one of these was type B hepatitis). One of the 10 'control' patients who received only units with normal ALT levels also developed hepatitis. In this study, the risk of transfusion-transmitted hepatitis was the same in recipients of blood units with abnormal ALT levels as in those who received only blood with normal ALT, and very similar to the risk reported in other studies for recipients of volunteer donor blood with normal ALT. These findings require confirmation by a larger study, but suggest that the hepatitis risk associated with transfusion of high-ALT blood may be lower in Montreal than has been reported in several centers in the U.S.