Homelessness, negative affect, and coping among veterans with gambling problems who misused substances.

Compared with other populations with addictions, pathological gamblers have higher levels of negative affect and poor coping. A total of 154 formerly homeless veterans who misused substances were assessed six months after treatment to determine whether those with a gambling problem (N = 22) had more negative affect and poorer coping than those without a gambling problem and whether they were more likely to have unstable housing and employment. The veterans with a gambling problem had significantly higher levels of negative affect and poorer coping but did not differ from the other veterans in housing and employment stability.

Evaluating the effectiveness of a residential rehabilitation program for homeless veterans.

OBJECTIVE: This study sought to evaluate the effects of a residential rehabilitation program for homeless mentally ill veterans on several measures of subjects' community adjustment. METHODS: Subjects' housing status, financial and vocational status, psychological stability, utilization of coping resources, and extent of social contacts were measured at entry into the program and at follow-up six months after discharge. Data were available for 58 subjects at follow-up. Outcomes for subjects who successfully completed the program were compared with outcomes for those who did not. RESULTS: As a group, subjects assessed at follow-up showed significant improvement in housing, financial, and vocational status, in severity of several symptoms of psychological and emotional distress, in utilization of some types of coping resources, and in measures of social contacts and satisfaction. However, subjects who completed the program were more likely to have improved their housing, financial, and vocational situations. CONCLUSIONS: Comprehensive residential rehabilitation programs can help homeless veterans improve several aspects of their lives and maintain stability in those areas after discharge.

Videotape reliability of the third revised edition of the K-SADS.

Videotaped interrater reliability was assessed with the K-SADS-III-R on 25 children with a mean age of 10:9. Kappa statistics were computed in syndromes with a frequency rate of at least 20%. The following mean kappas were obtained: major depression = 0.83; overanxious disorder = 0.85; separation anxiety = 0.85; simple phobic disorder = 0.64; oppositional disorder = 0.89; attention deficit disorder = 0.88. The mean kappa for mother derived diagnoses was 0.86; for child derived diagnoses 0.79; and, for all diagnoses combined 0.84. These reliability findings are comparable to reports with similar methodology in the child literature. The improved kappas for the anxiety disorders achieved a primary goal for this revision of the K-SADS. This study has shown that the K-SADS-III-R has sufficient reliability for research purposes.

Depressed mothers as informants in family history research--are they accurate?

A sample of 333 mother-child dyads was used to examine the association between major depression in mothers and children's symptoms. Findings based on children's self-reports were compared to findings based on mothers' reports about the children. Children's data support a depression-specific transmission. In contrast, mothers' data show an increased risk for all psychiatric syndromes covered in the study (including depression, anxiety, oppositionalism, inattention, hyperactivity, impulsivity, and antisocial acts). Results from multivariate analysis support the hypothesis that the discrepancy between mothers and children is in part a function of the tendency of depressed mothers to view their children as more symptomatic. The use of probands as informants may lead to an overestimation of familial aggregation, if the affected probands suffer from major depression or depressive symptoms.

Siblings of disabled children. Effects of chronic stress in the family.

We examined the effects of chronic stress in families of severely disabled children on psychopathology in siblings. We present findings from a five-year follow-up of 192 siblings of disabled children and a geographically based probability sample of 284 children (controls), who were 6 to 18 years old at initial assessment (time 1) and 11 to 23 years old at follow-up (time 2). Data on the Psychiatric Screening Inventory were obtained from mothers at times 1 and 2. Additionally, at time 2 the Diagnostic Interview Schedule for Children was administered to the children themselves. At follow-up, the siblings' picture according to mothers' assessment appears worse than it did initially: In addition to the excess in aggressive symptoms seen at time 1, they manifested an excess in depressive affect and social isolation. The time 2 interviews with the children themselves show that the siblings scored significantly higher than controls on depressive symptoms, although the rate of DSM-III major depression was not significantly different. An excess in depressive symptoms was observed also in mothers of disabled children, who, like the siblings, were not at increased risk for major depression.

Searching for evidence on the validity of generalized anxiety disorder: psychopathology in children of anxious mothers.

The diagnostic validity of generalized anxiety disorder (GAD) is tested by examining the relationship between GAD in mothers and children's overanxious disorder (OAD), separation anxiety (SA), and anxious symptoms in 331 mother-child dyads from a geographically based probability sample. Data on the relationship between mothers' major depressive disorder (MDD) and children's depression are presented for comparison. The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) was used in mothers and the NIMH Diagnostic Interview Schedule for Children (DISC), in children. Children of mothers with GAD were not at increased risk for OAD, SA, or anxious symptoms. In contrast, MDD in mothers conferred a risk for OAD in younger children and of MDD in older children. Additionally, older children of depressed mothers exhibited significantly more depressive symptoms. The presence of diffuse anxiety in children of mothers with MDD may represent a nonspecific response pattern in psychiatrically vulnerable children. Like GAD in adults, these anxiety symptoms in children may constitute a prodromal manifestation of other disorders and transient responses to life stressors.

Iron-deficient anemic infants at play.

The purpose of this study was to determine whether iron-deficient anemic infants show affective and attentional disturbances during play. The behavior of 21 iron-deficient anemic and 21 nonanemic 6- to 24-month-old Guatemalan infants and their mothers was analyzed during a videotaped 8-minute free-play session. There were no statistically significant differences between the two groups in measures of infant irritability, distractibility, or apathy. There were differences, however, in measures of spatial relations. In 71% of the anemic infants, the duration of child-initiated body contact with their mothers was high, compared with a high level of contact in only 26% of the nonanemic babies (p = 0.01). Mothers of anemic infants spent less time at a distance from them, were less likely to break close contact, and were more likely to reestablish close contact if the baby moved away (p less than 0.03). The increase in body contact was interpreted as a reflection of fearfulness, hesitance, or inactivity. The results suggest that the specific behavioral manifestations of iron deficiency anemia in infancy may vary with the context, differing in free play and structured developmental testing.