Association of fake-good MMPI-2 profiles with low Beck Depression Inventory scores.

Seventy-nine adolescent mothers (mean age = 18.1 years) were administered the Beck Depression Inventory (BDI) and three validity scales (L, F, and K) of the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). The aim was to determine whether low-BDI mothers were "faking good," or denying their depression. The adolescent mothers were assigned to a low-BDI group (scores = 0, 1, 2), a nondepressed group (scores = 3-9), or a depressed group (scores > or = 13). The depressed group had higher F (Symptom) scale scores than did the nondepressed group, which in turn had higher scores than did the low-BDI group. The low-BDI group, in contrast, had more fake-good profiles than did the two other groups. Discriminant analyses indicated that 90% of the fake-good profiles could be classified correctly based on BDI and K (Defensiveness) scale scores. These data suggest the need for further assessment when individuals have extremely low BDI scores.

Correlations between the BDI and CES-D in a sample of adolescent mothers.

Adolescent mothers were administered the Beck Depression Inventory (BDI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Diagnostic Interview Schedule for Children (DISC). They also were asked if they preferred the BDI or CES-D. The findings indicated that BDI and CES-D scores were significantly correlated, and that more adolescent mothers preferred the CES-D. Both the BDI and CES-D were correlated with the DISC; however, the BDI was more highly correlated with the Major Depression subscale, and the CES-D with the Dysthymia subscale.

PIP: This study investigates the correlation between the Beck Depression Inventory (BDI) and the Center for Epidemiologic Studies Depression Scale (CES-D) among adolescent mothers. It further analyzed how well the BDI and CES-D correlated with a clinical measure of depression, the Diagnostic Interview Schedule for Children (DISC). The BDI, CES-D and DISC were administered to African American and Hispanic adolescent mothers between the ages 13-21 years. They were also asked if they preferred the BDI or CES-D. The findings suggested that BDI and CES-D scores were significantly correlated. More adolescent mothers preferred the CES-D, stating that it was quick and simple while several commented that the BDI was depressing. Both the BID and CES-D were correlated with the DISC. However, the BDI was more highly correlated with the Major Depression subscale, and the CES-D with the Dysthymia subscale.

Polydrug-using adolescent mothers and their infants receiving early intervention.

This study investigated the effects of an intervention for polydrug-using adolescent mothers. The program included educational, vocational, and parenting classes; social and drug rehab; and day care for their infants while they attended school half-day. The drug-exposed infants were similar to the nonexposed infants on traditional birth measures, although they had inferior Brazelton Neonatal Behavioral Assessment Scale scores, including habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity. The drug-exposed infants also spent less time in quiet sleep and more time crying and showing stress behaviors. Both the mothers and the infants in the drug groups demonstrated inferior interactions, and their dopamine and serotonin levels were significantly higher. As early as 3 months (following 3 months of intervention), the drug rehab mothers and their infants looked more like the nondrug group in their interactions; by 6 months, they looked similar on virtually every measure. At 12 months, the infants of drug rehab mothers (versus the drug control group) had superior Early Social Communication Scale scores and Bayley Mental scale scores, as well as significantly greater head circumference and fewer pediatric complications. The drug rehab mothers also improved on several lifestyle variables. They demonstrated a lower incidence of continued drug use and repeat pregnancy, and a greater number continued school, received a high school or general equivalency diploma, or were placed in a job. Thus, a relatively cost-effective high school based intervention had positive effects on both adolescent mothers who had used drugs and their infants.

PIP: The impact of an early childhood intervention program on polydrug-abusing US adolescent mothers and their infants was evaluated. The program, which was located in a vocational school attended by the mothers, included drug rehabilitation, social skills training, parenting classes, job training, and relaxation therapy. Outcomes in 126 drug-exposed mothers 16-21 years of age who participated in the program were compared to those recorded among non-drug-using adolescent mothers who participated in the program and drug-using control mothers who did not participate. All three groups were similar in terms of age, education, socioeconomic status, and ethnicity, but drug-abusing mothers had higher rates of depression and stress. At baseline, drug-exposed infants had lower scores on the measures of habituation, orientation, abnormal reflexes, general irritability, and regulatory capacity on the Neonatal Behavioral Assessment Scale. Drug-exposed infants spent less time sleeping and more time crying and showing stress behaviors. The drug groups also had lower Optimal Interaction Rating Scale scores for both mothers and infants. Their dopamine and serotonin levels were higher than those recorded among non-drug-using mothers and their cortisol levels were lower. However, after 6 months of participation in the intervention program, the drug-using mothers had Beck Depression Inventory scores and interaction ratings that approached those of non-drug-using mothers and exceeded those among drug-using controls. Similar trends were observed for infants' head circumference and scores on the Early Social Communication Scale and the Bayley Mental Status Scale. Moreover, drug-using adolescent mothers who participated in the program demonstrated a lower incidence of repeat pregnancy and continued drug use than those who were not enrolled in the program; moreover, they were more likely to receive their high school diploma and be placed in jobs. Interventions such as this have the potential to attenuate the developmental delays of infants of drug-exposed adolescents.

Psychosocial stressors of drug-abusing disadvantaged adolescent mothers.

The Problem Oriented Screening Instrument for Teenagers (POSIT) and the Beck Depression Inventory (BDI) were administered to 55 disadvantaged adolescent mothers who abused drugs during pregnancy and 49 nondrug-abusing disadvantaged adolescent mothers. Results suggested that the drug-abusing mothers were depressed (BDI = 14) while the nondrug-abusing mothers were nondepressed (BDI = 6). In addition, the drug-abusing mothers reported more mental and physical health problems, more problematic family and peer relationships, poorer social skills, more aggressive behavior, less constructive use of leisure time, and a lower educational and vocational status than did nondrug-abusing adolescent mothers. A multiple regression analysis of POSIT scales indicated that the best predictors of drug abuse during pregnancy were mental health status, leisure and recreational activities, and peer relationships. These results highlight the utility of administering the POSIT to identify stressors that place pregnant adolescents at risk for drug abuse.

PIP: A comparative study of 55 low-income adolescents who abused drugs or alcohol during pregnancy and 49 non-drug-abusing adolescent mothers of similar socioeconomic status revealed significantly more psychosocial stressors in the drug users. All study participants received obstetric care at an inner-city US teaching hospital. Inclusion criteria for the drug-abusing group included 15 or more alcoholic drinks, any marijuana use, or any cocaine use during pregnancy. Within 24 hours after delivery, respondents were administered a social history, the Beck Depression Inventory, the Paranoid-Borderline Features Scale, and the Problem Oriented Screening Instrument for Teenagers (POSIT). Drug-abusing mothers were significantly more depressed (p 0.001) than their non-drug-abusing counterparts and had less optimal scores on each component of the POSIT (substance use, physical health, mental health, family relations, peer relations, educational status, vocational status, social skills, leisure and recreation, and aggressive behavior). 40% of the variance in drug use was explained by three of these variables: mental health (30%), leisure and recreation (6%), and peer relationships (5%). It is unclear whether these stressors lead to, maintain, or are a consequence of drug abuse. The POSIT scales correctly classified 75% of the drug-abusing and 84% of the non-drug-abusing teen mothers, suggesting its potential use as a screening instrument for identifying at-risk pregnant adolescents.

Brief report: HIV-exposed newborns show inferior orienting and abnormal reflexes on the Brazelton Scale.

Assessed 48 infants of HIV-positive and HIV-negative mothers on the Brazelton Neonatal Behavioral Assessment Scale. Infants exposed to HIV-positive mothers were disadvantaged from birth due to their mothers having obstetric complications and to the infants having orienting problems and abnormal reflexes on the Brazelton Newborn Scale. These problems may be early precursors of the later visual-spatial delays and hypertonicity noted in these infants.

Adolescent psychiatric patients' interactions with their mothers.

Thirty-eight adolescent psychiatric patients and their mothers engaged in two dyadic interactions. The participants rated themselves and each other on four behavioral dimensions (calmness, friendliness, involvement, and bossiness) during a videotaped playback. An independent observer rated the dyads on the same dimensions. Analyses were conducted based on classification of adolescents as internalizers/externalizers, depressed/nondepressed, and socially anxious/nonanxious. Internalizing adolescent dyads were significantly calmer, friendlier, and more involved than were externalizing adolescent dyads. The dyads in which the adolescents scored lower on the depression scale were calmer, friendlier, and more involved than were the dyads with adolescents who had higher depression scores. No differences were noted between high and low socially anxious dyads. The findings indicated that the videotaping procedure could help familiarize clinical staff with the dynamics of parent-adolescent interactions.

Massage therapy improves behavior in neonates born to HIV-positive mothers.

Assigned randomly 28 neonates born to HIV-positive mothers to a massage therapy or control group. The treatment infants were given three 15-minute massages daily for 10 days. The massaged group showed superior performance on almost every Brazelton newborn cluster score and had a greater daily weight gain at the end of the treatment period unlike the control group who showed declining performance.

Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations.

Twenty-six adults were given a chair massage and 24 control group adults were asked to relax in the massage chair for 15 minutes, two times per week for five weeks. On the first and last days of the study they were monitored for EEG, before, during and after the sessions. In addition, before and after the sessions they performed math computations, they completed POMS Depression and State Anxiety Scales and they provided a saliva sample for cortisol. At the beginning of the sessions they completed Life Events, Job Stress and Chronic POMS Depression Scales. Group by repeated measures and post hoc analyses revealed the following: 1) frontal delta power increased for both groups, suggesting relaxation; 2) the massage group showed decreased frontal alpha and beta power (suggesting enhanced alertness); while the control group showed increased alpha and beta power; 3) the massage group showed increased speed and accuracy on math computations while the control group did not change; 4) anxiety levels were lower following the massage but not the control sessions, although mood state was less depressed following both the massage and control sessions; 5) salivary cortisol levels were lower following the massage but not the control sessions but only on the first day; and 6) at the end of the 5 week period depression scores were lower for both groups but job stress score were lower only for the massage group.

Cocaine-exposed preterm neonates show behavioral and hormonal differences.

OBJECTIVE: Prematurity has been associated with prenatal cocaine exposure, but most studies on the behavioral effects of prenatal cocaine exposure have been restricted to full-term infant samples. The current study focused on behavioral and hormonal responses in preterm cocaine-exposed infants compared with a cohort of non-cocaine-exposed infants of similar gestational age. METHODOLOGY: A comparison between 30 cocaine-exposed and 30 non-cocaine-exposed preterm neonates suggested that the cocaine-exposed neonates were born to mothers who had higher parity and more obstetric complications. In addition, mothers of cocaine-exposed preterm neonates visited, touched, held, and fed their infants less frequently than mothers of nonexposed infants. RESULTS: The cocaine-exposed infants had smaller head circumferences at birth, spent more time in the neonatal intensive care unit, and had a greater incidence of periventricular-intraventricular hemorrhages. They also had inferior Brazelton cluster scores, including lower state regulation and range-of-state scores, and greater depression. During sleep-wake behavior observations, they showed difficulty maintaining alert states and self-regulating their behavior, and they spent more time in indeterminate sleep and had decreased periods of quiet sleep and increased levels of agitated behavior, including tremulousness, mouthing, multiple limb movements, and clenched fists. Finally, higher urinary norepinephrine, dopamine, and cortisol levels and lower plasma insulin levels were noted in the cocaine-exposed preterm neonates. CONCLUSIONS: These findings highlight the need for follow-up assessments and early intervention.

Massage therapy is associated with enhancement of the immune system's cytotoxic capacity.

Twenty-nine gay men (20 HIV+, 9 HIV-) received daily massages for one month. A subset of 11 of the HIV+ subjects served as a within subject control group (one month with and without massages). Major immune findings for the effects of the month of massage included a significant increase in Natural Killer Cell number, Natural Killer Cell Cytotoxicity, soluble CD8, and the cytotoxic subset of CD8 cells. There were no changes in HIV disease progression markers (CD4, CD4/CD8 ratio, Beta-2 microglobulin, neopterin). Major neuroendocrine findings, measured via 24 hour urines included a significant decrease in cortisol, and nonsignificant trends toward decrease of catecholamines. There were also significant decreases in anxiety and increases in relaxation which were significantly correlated with increases in NK cell number. Thus, there appears to be an increase in cytotoxic capacity associated with massage. Implications for HIV+ men as those with other illnesses, particularly cancer, are discussed.

Massage and relaxation therapies' effects on depressed adolescent mothers.

Thirty-two depressed adolescent mothers received ten 30-minute sessions of massage therapy or relaxation therapy over a five-week period. Subjects were randomly assigned to each group. Although both groups reported lower anxiety following their first and last therapy sessions, only the massage therapy group showed behavioral and stress hormone changes including a decrease in anxious behavior, pulse, and salivary cortisol levels. A decrease in urine cortisol levels suggested lower stress following the five-week period for the massage therapy group.

Psychosocial stressors among depressed adolescent mothers.

This study sought to determine whether depressed adolescent mothers experience more psychosocial stressors than do nondepressed mothers and which stressors best predict maternal depression. Subjects consisted of 154 adolescent mothers 14 to 21 years of age who were recruited 1 to 3 days postpartum. The Beck Depression Inventory was used to assess severity of depression, and the Problem Oriented Screening Instrument for Teenagers was administered to assess mothers' level of psychosocial functioning. Depressed mothers consistently reported more problems in most areas of psychosocial functioning. Additionally, the best predictors of maternal depression were mental health status, family relations, and social skills.

Massage effects on cocaine-exposed preterm neonates.

Thirty preterm cocaine-exposed preterm neonates (mean gestational age 30 wks, mean birth weight = 1212 g, mean intensive care unit duration = 18 days) were randomly assigned to a massage therapy or a control group as soon as they were considered medically stable. Group assignment was based on a random stratification of gestational age, birth weight, intensive care unit duration, and entry weight into the study. The treatment group (N = 15) received massages for three 15-minute periods 3 consecutive hours for a 10-day period. Findings suggested that the massaged infants (1) averaged 28% greater weight gain per day (33 vs 26 g) although the groups did not differ in intake (calories or volume), (2) showed significantly fewer postnatal complications and stress behaviors than did control infants, and (3) demonstrated more mature motor behaviors on the Brazelton examination at the end of the 10-day study period.

Factors that predict which preterm infants benefit most from massage therapy.

Ninety-three preterm infants (M gestational age = 30 wks; M birth weight = 1204 g; M ICU duration = 15 days) were randomly assigned to a massage therapy group or a control group once they were considered medically stable. The treatment group (N = 50) received three daily 15-minute massages for 10 days. The massage therapy infants gained significantly more weight per day (32 vs 29 g) than did the control infants. Treatment and control groups were divided into high and low weight gainers based on the average weight gain for the control group. Seventy percent of the massage therapy infants were classified as high weight gainers whereas only 40% of the control infants were classified as high weight gainers. Discriminant function analyses determining the characteristics that distinguished the high from the low weight gainers suggested that the control infants who, before the study, consumed more calories and spent less time in Intermediate care gained more weight. In contrast, for the massage therapy group, the pattern of greater caloric intake and more days in Intermediate care before the study period along with more obstetric complications differentiated the high from the low weight gainers, suggesting that the infants who had experienced more complications before the study benefitted more from the massage therapy. These variables accurately predicted 78% of the infants who benefitted significantly from the massage therapy. Thus, these variables can be used to suggest infants who would benefit most from future massage therapy programs.

Tactile-kinesthetic stimulation effects on sympathetic and adrenocortical function in preterm infants.

The purpose of our study was to investigate the neuroendocrine response in preterm infants to a pattern of tactile-kinesthetic stimulation that facilitates their growth and development. Preterm infants (mean gestational age 30 weeks, mean birth weight 1176 gm) received normal nursery care or tactile-kinesthetic stimulation for three 15-minute periods at the start of three consecutive hours each day for 10 days. On day 1 and day 10 of the study, a 24-hour urine sample was collected for norepinephrine, epinephrine, dopamine, cortisol, and creatinine assay and a blood sample was taken by heel stick for cortisol and growth hormone assay. Urine norepinephrine and epinephrine values increased significantly only in the stimulated babies. Urine dopamine and cortisol values increased in both groups, and serum growth hormone decreased in both groups. Individual differences in urine norepinephrine, epinephrine, dopamine, and cortisol values were highly stable across the 10 days despite a 10-fold range of values among the infants. The results of this study suggest that tactile-kinesthetic stimulation of preterm infants has fairly specific effects on maturation and/or activity of the sympathetic nervous system. In addition, this study has defined catecholamine and cortisol secretion across gestational age in normal preterm infants. Finally, these data suggest that highly stable individual levels of catecholamine and cortisol secretion are established by birth in humans.

Transcutaneous oxygen tension in preterm neonates during neonatal behavioral assessments and heelsticks.

This study evaluates the effects of neonatal behavioral assessments and heelsticks on transcutaneous oxygen tension (TcPO2) in 37 preterm neonates from a neonatal intensive care unit. Two behavioral assessments were evaluated, the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) and the Neurobehavioral Assessment for Preterm Infants (NAPI). TcPO2 during heelsticks was used as a comparison because reliable decreases have typically been noted during heelsticks. Although the heelsticks resulted in significant declines in TcPO2, the behavioral assessments led to only negligible changes in TcPO2. Observed changes during the behavioral assessments occurred in a small number of infants, primarily during the few test procedures administered to the infants outside of their isolettes. Accordingly, it is suggested that time outside the isolette and associated temperature changes may be more critical variables than the assessments per se.

Tactile/kinesthetic stimulation effects on preterm neonates.

Tactile/kinesthetic stimulation was given to 20 preterm neonates (mean gestational age, 31 weeks; mean birth weight, 1,280 g; mean time in neonatal intensive care unit, 20 days) during transitional ("grower") nursery care, and their growth, sleep-wake behavior, and Brazelton scale performance was compared with a group of 20 control neonates. The tactile/kinesthetic stimulation consisted of body stroking and passive movements of the limbs for three, 15-minute periods per day for a 10 days. The stimulated neonates averaged a 47% greater weight gain per day (mean 25 g v 17 g), were more active and alert during sleep/wake behavior observations, and showed more mature habituation, orientation, motor, and range of state behavior on the Brazelton scale than control infants. Finally, their hospital stay was 6 days shorter, yielding a cost savings of approximately $3,000 per infant. These data suggest that tactile/kinesthetic stimulation may be a cost effective way of facilitating growth and behavioral organization even in very small preterm neonates.