The paradox of prematurity: the behavioral vulnerability of late preterm infants and the cognitive susceptibility of very preterm infants at 36 months post-term.

We explored associations among preterm status (very preterm infant (VPI: <30 weeks), moderate preterm (MPI: 30-33(6/7) weeks), late preterm (LPI: 34-36(6/7) weeks), parenting, and 3-year cognitive and behavioral outcomes. We hypothesized that LPIs would demonstrate better health and neurobehavioral outcomes compared with more premature infants, and that preterm status would moderate the association between parenting quality and 3-year outcomes. Sample included 123 preterm infants (gestation <37 weeks) and their mothers from a larger study of high-risk infants with measures of neonatal and socioeconomic risks at hospital discharge; maternal vocabulary at 9-months, child IQ and behavior at 36 months, and maternal depressive symptoms and parenting at all timepoints. Group differences were explored using MANOVAs while predictors of child outcomes were explored using hierarchical regression analyses. MANOVAs indicated that LPIs had more optimal neonatal health during the hospital stay, yet more externalizing (p=.043), aggressive (p=.006) and oppositional behaviors (p=.008) at 3 years compared with VPIs. There were no IQ differences between VPIs, MPIs and LPIs. However, preterm infants who experienced less negative parenting had higher IQs at 36 months (ß=-3.245, p=.017), with the greatest effects seen in VPIs (ß=0.406, p=.01) compared with LPIs (ß=0.148, p=.381). LPIs manifested similar IQ, but more externalizing, oppositional and aggressive behavior symptoms compared to VPIs. VPIs appeared to be differentially susceptible to parenting effects, with VPIs demonstrating the highest cognitive scores in the context of more positive parenting.

Congenital adrenal hyperplasia: classification of studies employing psychological endpoints.

Psychological outcomes in persons with congenital adrenal hyperplasia (CAH) have received substantial attention. The objectives of this paper were to (1) catalog psychological endpoints assessed in CAH outcome studies and (2) classify the conceptual/theoretical model shaping the research design and interpretation of CAH-related psychological effects. A total of 98 original research studies, published between 1955 and 2009, were categorized based on psychological endpoints examined as well as the research design and conceptual model guiding analysis and interpretation of data. The majority of studies (68%) investigated endpoints related to psychosexual differentiation. The preponderance of studies (76%) examined a direct relationship (i.e., inferring causality) between prenatal androgen exposure and psychological outcomes. Findings are discussed in relation to the observed imbalance between theoretical interest in the role of prenatal androgens in shaping psychosexual differentiation and a broader conceptual model that examines the role of other potential factors in mediating or moderating the influence of CAH pathophysiology on psychological outcomes in both affected females and males. The latter approach offers to identify factors amenable to clinical intervention that enhance both health and quality of life outcomes in CAH as well as other disorders of sex development.

The Cultural Genogram: experiences from within a marriage and family therapy training program.

The purpose of this article is to illustrate and demonstrate the use of the Cultural Genogram (CG) in a graduate-level course in gender and culture for family therapists-in-training at a large Midwestern university's accredited program in family therapy. Although the importance of the CG as a training tool is delineated by Hardy and Laszloffy, very little information exists about the actual implementation and usefulness of this tool within a training program for family therapists. In this article, we present a qualitative research study of the lived experiences of a class of women from diverse cultures as they constructed and presented their CGs. We discuss the basic curriculum and structure of the course in which the CG was used, the process the class members developed to create and present their CGs, the effects of presenting the CGs, and a set of recommendations and ideas for further exploration.