Well-being, self-esteem and body satisfaction in new mothers.

BACKGROUND: How mother's recall their experience of childbirth, their concerns about body image, their sense of competence in parenting, and their combined sense of self-esteem are all factors with the potential to impact on mental well-being. METHOD: A total of 234 women, who had given birth within the past 3 years, completed a survey comprised of the Birth Memories and Recall Questionnaire, the Parenting Sense of Competence Scale, the Warwick-Edinburgh Mental Well-being Scale, the Rosenberg Self-Esteem Questionnaire and the Body Shape Questionnaire. RESULTS: Mothers who have higher body dissatisfaction show significantly lower well-being, self-esteem and perceived parenting competence. Mothers who experienced higher levels of mental well-being were found to have higher levels of perceived parenting competence and self-esteem, and those who experienced higher levels of self-esteem were also found to have higher levels of perceived parenting competence. CONCLUSION: Memories of the birth experience, perceived postpartum body image, parenting sense of competence and self-esteem have a combined and complex relationship with mental well-being. Health care professionals should inform mothers about the body changes which may occur throughout the postpartum period, to encourage mothers not to be deceived by media images and to stress the importance of realistic expectations following giving birth.

Consensus report on impulsive aggression as a symptom across diagnostic categories in child psychiatry: implications for medication studies.

OBJECTIVE: To determine whether impulsive aggression (IA) is a meaningful clinical construct and to ascertain whether it is sufficiently similar across diagnostic categories, such that parallel studies across disorders might constitute appropriate evidence for pursuing indications. If so, how should IA be assessed, pharmacological studies designed, and ethical issues addressed? METHOD: Experts from key stakeholder communities, including academic clinicians, researchers, practicing clinicians, U.S. Food and Drug Administration, National Institute of Mental Health, industry sponsors, and patient and family advocates, met for a 2-day consensus conference on November 4 and 5, 2004. After evaluating summary presentations on current research evidence, participants were assigned to three workgroups, examined core issues, and generated consensus guidelines in their areas. Workgroup recommendations were discussed by the whole group to reach consensus, and then further iterated and condensed into this report postconference by the authors. RESULTS: Conference participants agreed that IA is a substantial public health and clinical concern, constitutes a key therapeutic target across multiple disorders, and can be measured with sufficient precision that pharmacological studies are warranted. Additional areas of consensus concerned types of measures, optimal study designs, and ethical imperatives. CONCLUSION: Derived from scientific evidence and clinical experience, these consensus-driven recommendations can guide the design of future studies.

Juvenile maladaptive aggression: a review of prevention, treatment, and service configuration and a proposed research agenda.

OBJECTIVE: To review prevention programs, psychosocial and psychopharmacologic treatments, and service delivery configurations for children and adolescents with maladaptive aggression. To propose a research agenda for disorders of aggression in child and adolescent psychiatry. DATA SOURCES: Recent empirical studies were reviewed using searches of MEDLINE and PsycINFO (text terms: aggression, antisocial, violence, conduct, oppositional, psychosocial treatment, psychopharmacology, and prevention), relevant books, review articles, and bibliographies. DATA EXTRACTION: Articles met the following criteria: published in an English-language, peer-reviewed journal between 1980 and 2005, included a focus on individuals < 18 years old, and included an outcome measure of relevant significance. STUDY SELECTION: Results of 154 randomized, controlled psychosocial treatment trials, 20 controlled psychopharmacology studies, 4 open-label medication studies, and 2 psychopharmacology meta-analyses were reviewed. RESULTS: Prevention programs show promise for reducing future aggression in at-risk populations. Empirical support is available for the effectiveness of multifocused psychosocial treatments in reducing aggression in children and adolescents. Atypical antipsychotics, lithium, divalproex sodium, and stimulants for conduct problems associated with attention-deficit/hyperactivity disorder have empirical support for reducing aggression in selected patient populations. CONCLUSIONS: Therapeutic nihilism in the treatment of aggressive children and adolescents with conduct problems is no longer warranted. Multifocused psychosocial interventions given early in life to at-risk children have the most support for effectiveness. However, treatments for children who routinely present to the child psychiatrist with already well-established disorders of aggression are neither robust nor well-established. Further research into maladaptive aggression in referred children and adolescents within and across psychiatric diagnoses is important for the field of child and adolescent psychiatry.

Family resemblance for anthropometric and blood pressure measurements in Black Caribs and Creoles from St. Vincent Island

This paper examines family resemblance for five anthropometric measurements (height, weight, triceps skinfold, upper arm circumference relaxed [UACR] and flexed [UACF] and for systolic and diastolic blood pressure in a group of adult Caribbean islanders of primarily African ancestry. Six hypotheses about family resemblance are tested by using path analysis and likelihood ratios. Significant intergenerational transmission is found only for height and UACR. For weight, UACF, and diastolic blood pressure, non-transmissionible sibling resemblance is the primary component of family resemblance, although significant marital resemblance exists for diastolic blood pressure. Triceps skinfold and systolic blood pressure show no evidence of any family resemblance. Although results for highly inheritable traits such as height are comparable to reports from other populations, measurements with a large contribution from common family environment or residual environment effects, such as triceps skinfold or blood pressure, have much lower family resemblance in this population than in other populations. We hypothesize that this difference is due to the fact that adult children and their parents do not share a common household in this culture and to the presence of major nonfamilial environmental factors contributing to obesity and hypertension in this population.(AU)

Association between stress and blood pressure variation in a Caribbean population

Based on the work of Selye (The Stress of Life, New York: McGraw Hill, 1976) it is hypothesized that stress can produce physiological abnormalities, i.e. elevated blood pressure, and that social variables can be used as indicators or risk factors for diseases. It is theorized that deviations from acceptable social patterns or traditional life-styles can produce stressful conditions that are associated with disease and that these situations can be demonstrated by examination of certain social characteristics. This association is examined among the Black Caribs of St. Vincent, West Indies. The social variables included in this analysis are marital status (single, married, widowed, or separated), frequency of church attendance (frequently, sometimes, seldom, or never), years of education, and number of children (for women only). The findings show that single individuals have higher pressures than married subjects and that males who never attended church have higher pressures than men who frequently attend church; a relationship was not demonstrated for females. Among males, as the years of education was increased, blood pressure also increased, but for females, increased education was associated with lower pressures. Family size was not associated with systolic or diastolic pressure. The analysis of these selected social variables suggest that these variables influence male systolic and diastolic pressures, but only female diastolic pressure. (AU)

A biocultural analysis of blood pressure variation among the Black Caribs and creoles of St. Vincent, West Indies

This present study is a biochemical examination of blood pressure variation among the Black Caribs and Creoles of St. Vincent, West Indies. In particular, it investigates the etiology of essential (primary) hypertension by examining both cultural and biological contributory components. Four asspects of Caribbean culture are examined: Marital status, family size