Psychological management of intractable seizures in an adolescent with a learning disability

Psychological interventions aimed at seizure management are described with a 14-year-old buy with a learning disability and intractable epilepsy. Baseline records suggested that a majority of tonic seizures and 'drop attacks' were associated with going off to sleep and by environmental 'startles'. Psychological formulation implicated sudden changes in arousal levels as an underlying mechanism of action. Cognitive-behavioural countermeasures were employed to alter arousal levels and processes in different ways in different 'at-risk' situations. A multiple baseline design was used to control for non-specific effects of interventions on non-targeted seizures. Results suggested significant declines in the number of sleep onset and startle-response seizures were attained by these methods. Gains were maintained at 2-month follow-up. (C) 1999 BEA Trading Ltd.

The Protective Role of Group Identity: Sectarian Antisocial Behavior and Adolescent Emotion Problems

The protective role of strength of group identity was examined for youth in a context of protracted political conflict. Participants included 814 adolescents (M_age = 13.61, SD = 1.99 at Time 1) participating in a longitudinal study in Belfast, Northern Ireland. Utilizing hierarchical linear modeling, the results show that the effect of exposure to sectarian antisocial behaviors has a stronger effect on youth emotion problems for older adolescents. The results also show that youth with higher strength of group identity reported fewer emotion problems in the face of sectarian antisocial behavior but that this buffering effect is stronger for Protestants compared to Catholics. Implications are discussed for understanding the role of social identity in postaccord societies.

The effects of the Omagh bomb on adolescent mental health: a school-based study

Background: The main objective of this study was to assess psychiatric morbidity among adolescentsfollowing the Omagh car bombing in Northern Ireland in 1998.

Methods: Data was collected within schools from adolescents aged between 14 and 18 years via a selfcompletionbooklet comprised of established predictors of PTSD; type of exposure, initialemotional response, long-term adverse physical problems, predictors derived from Ehlers andClark’s (2000) cognitive model, a PTSD symptoms measure (PDS) and the General HealthQuestionnaire (GHQ).

Results:Those with more direct physical exposure were significantly more likely to meet caseness onthe GHQ and the PDS. The combined pre and peri trauma risk factors highlighted in previousmeta-analyses accounted for 20% of the variance in PDS scores but the amount of varianceaccounted for increased to 56% when the variables highlighted in Ehlers and Clark’scognitive model for PTSD were added.

Conclusions: High rates of chronic PTSD were observed in adolescents exposed to the bombing. Whilstincreased exposure was associated with increased psychiatric morbidity, the best predictors ofPTSD were specific aspects of the trauma (‘seeing someone you think is dying’), what youare thinking during the event (‘think you are going to die’) and the cognitive mechanismsemployed after the trauma. As these variables are in principle amenable to treatment theresults have implications for teams planning treatment interventions after future traumas.

Peer effects in UK adolescent substance use: Never mind the classmates?

This article estimates peer influences on the alcohol, tobacco and cannabis use of UK adolescents. We present evidence of large, positive and statistically significant peer effects in all three behaviours when classmates are taken as the reference group. We also find large, positive and statistically significant associations between own substance use and friends' substance use. When both reference groups are considered simultaneously, the influence of classmates either disappears or is much reduced, whereas the association between own and friends' behaviours does not change. The suggestion is that classmate behaviour is primarily relevant only inasmuch as it proxies for friends' behaviour.

Support for the Multidimensional Adolescent Stress Questionnaire in a Sample of Adolescents in the United Kingdom

Adolescence is a time of physical, social and emotional development, and this development can be accompanied by feelings of stress. The Adolescent Stress Questionnaire is a 56-item scale measuring stress in 10 domains. Developed in Australia, the scale has been translated, and its reliability and validity have been tested in a number of countries across Europe, where the 10-factor, 56-item version of the scale has received little support. The present study tested the factor structure, construct validity and reliability in a sample (n=610) of adolescents in the United Kingdom. Support was found for the 10-factor, 56-item version of the scale, and correlations with self-concept measures, sex scores on stress factors and Cronbach's α-values, suggesting that the scale may be a viable assessment tool for adolescent stress. Results for alcohol-specific analyses support the domain-specific nature of the scale. Future work may seek to investigate the stability of age-specific stress domains (e.g. the stress of Emerging Adult Responsibility) in samples that include younger adolescents. 

Adolescent ecstasy use and depression: cause and effect, or two outcomes of home environment?

Background: This study assessed the association between adolescent ecstasy use and depressive symptoms in adolescence. Methods: The Belfast Youth Development Study surveyed a cohort annually from age 11 to 16 years. Gender, Strengths and Difficulties Questionnaire emotional subscale, living arrangements, parental affluence, parent and peer attachment, tobacco, alcohol, cannabis and ecstasy use were investigated as predictors of Short Mood and Feelings Questionnaire (SMFQ) outcome. Results: Of 5371 respondents, 301 (5.6%) had an SMFQ > 15, and 1620 (30.2) had missing data for SMFQ. Around 8% of the cohort had used ecstasy by the end of follow-up. Of the non-drug users, ∼2% showed symptoms of depression, compared with 6% of those who had used alcohol, 6% of cannabis users, 6% of ecstasy users and 7% of frequent ecstasy users. Without adjustment, ecstasy users showed around a 4-fold increased odds of depressive symptoms compared with non-drug users [odds ratio (OR) = 0.26; 95% confidence interval (CI) = 0.10, 0.68]. Further adjustment for living arrangements, peer and parental attachment attenuated the association to under a 3-fold increase (OR = 0.37; 95% CI = 0.15, 0.94). There were no differences by frequency of use. Conclusions: Ecstasy use during adolescence may be associated with poorer mental health; however, this association can be explained by the confounding social influence of family dynamics. These findings could be used to aid effective evidence-based drug policies, which concentrate criminal justice and public health resources on reducing harm.

Political Violence and Adolescent Out-group Attitudes and Prosocial Behaviors: Implications for Positive Inter-group Relations

The negative impact of political violence on adolescent adjustment is well established. Less is known about factors that affect adolescents' positive outcomes in ethnically divided societies, especially influences on prosocial behaviors toward the out-group, which may promote constructive relations. For example, understanding how inter-group experiences and attitudes motivate out-group helping may foster inter-group co-operation and help to consolidate peace. The current study investigated adolescents' overall and out-group prosocial behaviors across two time points in Belfast, Northern Ireland (N = 714 dyads; 49% male; Time 1: M = 14.7, SD = 2.0, years old). Controlling for Time 1 prosocial behaviors, age, and gender, multi-variate structural equation modeling showed that experience with inter-group sectarian threat predicted fewer out-group prosocial behaviors at Time 2 at the trend level. On the other hand, greater experience of intra-group non-sectarian threat at Time 1 predicted more overall and out-group prosocial behaviors at Time 2. Moreover, positive out-group attitudes strengthened the link between intra-group threat and out-group prosocial behaviors one year later. Finally, experience with intra-group non-sectarian threat and out-group prosocial behaviors at Time 1 was related to more positive out-group attitudes at Time 2. The implications for youth development and inter-group relations in post-accord societies are discussed.

How much do you need: a randomised experiment of whether readers can understand the key messages from summaries of Cochrane Reviews, without reading the full review?

Objective: We explored whether readers can understand key messages without having to read the full review, and if there were differences in understanding between various types of summary.
Design: A randomised experiment of review summaries which compared understanding of a key outcome.
Participants: Members of university staff (n = 36).
Setting: Universities on the island of Ireland.
Method: The Cochrane Review chosen examines the health impacts of the use of electric fans during heat waves. Participants were asked their expectation of the effect these would have on mortality. They were then randomly assigned a summary of the review (i.e. abstract, plain language summary, podcast or podcast transcription) and asked to spend a short time reading/listening to the summary. After this they were again asked about the effects of electric fans on mortality and to indicate if they would want to read the full Review.
Main outcome measure: Correct identification of a key review outcome.
Results: Just over half (53%) of the participants identified its key message on mortality after engaging with their summary. The figures were 33% for the abstract group, 50% for both the plain language and transcript groups and 78% for the podcast group.
Conclusions: The differences between the groups were not statistically significant but suggest that the audio summary might improve knowledge transfer compared to written summaries. These findings should be explored further using a larger sample size and with other reviews.

The Relationship Between Cumulative Adversity in Childhood and Adolescent Suicide and Accidental Death

On the whole research has concluded that most young people navigate adolescence with few difficulties, but a minority do find this stage of life challenging, and their ways of coping may have negative consequences for both themselves and others. For some the experience of adversity in earlier childhood, and the cumulative impact of multiple adversities has the potential to compromise a young person’s natural resilience. In some cases this may result in an adolescent feeling overwhelmed, and dying through suicide or other high risk behaviours. This article explores these issues with reference to eight young people who died by suicide in Northern Ireland. The article argues that young people exposed to multiple adversities in childhood require earlier, more sustained and better co-ordinated services from professionals if their psychological and emotional well-being is to be promoted.