An assessment of autism knowledge in the medical field

Once thought to be rare, pervasive developmental disorders (PDDs) are now recognized as the most common neurological disorders affecting children and one of the most common developmental disabilities (DD) in Canada (Autism Society of Canada, 2006). Recent reports indicate that PDDs currently affect 1 in 150 children (Centre for Disease Control and Prevention, 2007). The purpose of this research was to provide an understanding of medical resident and practicing physicians' basic knowledge regarding PDDs. With a population of children with PDDs who present with varying symptoms, the ability for medical professionals to provide general information, diagnosis, appropriate referrals, and medical care can be quite complex. A basic knowledge of the disorder is only a first step in providing adequate medical care to individuals with autism and their families. An updated version of Stone's (1987) Autism survey was administered to medical residents at four medical schools in Canada and currently practicing physicians at three medical schools and one community health network. As well, a group of professionals specializing in the field ofPDDs, participating in research and clinical practice, were surveyed as an 'expert' group to act as a control measure. Expert responses were consistent with current research in the field. General findings indicated few differences in overall knowledge between residents and physicians, with misconceptions evident in areas such as the nature of the disorder, qualitative characteristics of autism, and effective interventions. Results were also examined by specialty and, while pediatricians demonstrated additional accurate 11 knowledge regarding the nature of the disorder and select qualitative impairments, both residents and practicing physicians demonstrated misconceptions about PDDs. This preliminary study replicated the findings of Stone (1987) and Heidgerken (2005) concerning several misconceptions of PDDs held by residents and practicing physicians. Future research should focus on additional replications with validated measures as well as the gathering of qualitative information, in order to inform the medical profession of the need for education in PDDs at training and professional levels.

Perceived parental monitoring, adolescent disclosure, and adolescent depressive symptoms : a longitudinal examination

Parental monitoring has long been stressed as an important parenting practice in reducing adolescent susceptibility to depression. An extensive review by Stattin and Kerr (2000), however, , revealed that researchers had confounded perceptions of parental monitoring (i.e., parental solicitation and control) with parental knowledge, and neglected to consider the role of adolescent willingness to disclose. In the present study, adolescents (N = 1995; 51.3% female) were surveyed at two time points (grade 10 and 11). To disentangle the role of perceived parenting, three central issues were addressed. First, the present study examined whether parental knowledge, adolescent disclosure, and parental monitoring (i.e., parental solicitation and control) in grade 10 predicted adolescent depression in grade 11. Second, the predictive value of adolescent depression in grade lOon parental knowledge, adolescent disclosure, parental solicitation and parental control in grade 11 was considered. Lastly, associations among parental knowledge, adolescent disclosure, parental solicitation and parental control were examined over time. Findings indicated that higher levels of parental knowledge were associated with subsequent lower levels of depressive symptoms, and that depressive symptoms predicted lower levels of parental knowledge over time. Both adolescent willingness to disclose and parental control predicted higher parental knowledge. These findings underscore the role of adolescent and perceived parent contributions to parental knowledge, and highlight the importance of perceived parental knowledge in predicting reduced adolescent susceptibility to depression.

Posttraumatic stress disorder symptoms might be destroying your intimacy : a test of mediational models in a community sample of couples

The present research focused on the pathways through which the symptoms of posttraumatic stress disorder (PTSD) may negatively impact intimacy. Previous research has confirmed a link between self-reported PTSD symptoms and intimacy; however, a thorough examination of mediating paths, partner effects, and secondary traumatization has not yet been realized. With a sample of 297 heterosexual couples, intraindividual and dyadic models were developed to explain the relationships between PTSD symptoms and intimacy in the context of interdependence theory, attachment theory, and models of selfpreservation (e.g., fight-or-flight). The current study replicated the findings of others and has supported a process in which affective (alexithymia, negative affect, positive affect) and communication (demand-withdraw behaviour, self-concealment, and constructive communication) pathways mediate the intraindividual and dyadic relationships between PTSD symptoms and intimacy. Moreover, it also found that the PTSD symptoms of each partner were significantly related; however, this was only the case for those dyads in which the partners had disclosed most everything about their traumatic experiences. As such, secondary traumatization was supported. Finally, although the overall pattern of results suggest a total negative effect of PTSD symptoms on intimacy, a sex difference was evident such that the direct effect of the woman's PTSD symptoms were positively associated with both her and her partner's intimacy. I t is possible that the Tend-andBefriend model of threat response, wherein women are said to foster social bonds in the face of distress, may account for this sex difference. Overall, however, it is clear that PTSD symptoms were negatively associated with relationship quality and attention to this impact in the development of diagnostic criteria and treatment protocols is necessary.

Health-Enhancing Physical Activity and Well-Being: Is it How Often, How Long, or How Much Effort that Matters? A Test of Basic Psychological Needs Theory

The primary objectives of the present study were 1) to examine the relationship between health-enhancing physical activity (HEPA) and well-being across the previous day and 2) to examine the role of basic psychological need satisfaction as a potential mediator of the HEPA – well-being relationship. Participants (N = 203) were a convenience sample of undergraduate students with data collected cross sectionally. HEPA was generally associated with well-being (r‟s ranged from .18 to .62). Multiple mediation analyses supported psychological need satisfaction as mechanisms underpinning the HEPA – well- being relationship. Subsequent analyses demonstrated that effort put forth in HEPA activities, as opposed to frequency or duration, uniquely predicted well-being. The role of effort was further highlighted in the multiple mediation analyses. As such future research may wish to investigate the utility of a HEPA program that facilitates effortful engagement and fulfillment of basic psychological needs.

The Co-occurrence of Depressive Symptoms and Alcohol Use for Adolescent Boys and Girls: An Investigation of the Role of Self-Regulation and Approach Behavior

While many studies have been conducted on adolescent depressive symptoms and alcohol use, much of the research has examined these behaviors separately rather than examining their co-occurrence within individuals. In the present study, adolescents (N = 4412; 49% female) were surveyed at four time points (grade 9, 10, 11, and 12) and growth mixture modeling was used to identify groups of individuals reporting various patterns of depressive symptoms and alcohol use across the high school years. Four groups were identified, including co-occurrence (higher depressive symptoms and higher alcohol use relative to peers, comprising 6.1 % of boys and 7.1 % of the girls in the sample), pure depressive symptoms (higher depressive symptoms and lower alcohol use; 12.7% of boys and 12.5% of girls), pure alcohol use (higher alcohol use and lower depressive symptoms; 20.9% of boys and 19.9% of girls), and low co-occurrence (lower depressive symptoms and alcohol use, 60.3% of boys and 60.5% of girls). Groups were compared on self-regulatory (i.e., delay of gratification) and approach behaviors. For both boys and girls, delay of gratification was the strongest predictor of group membership, with the co-occurrence group scoring the lowest and the low co-occurrence group the highest. This finding emphasizes the importance of assessing delay of gratification in the identification of high risk youth.

Basic Psychological Needs as mediators: An examination of the relationship between exercise and well-being

Grounded in Basic Psychological Needs Theory (Deci & Ryan, 2002), the present investigation examined whether psychological need satisfaction mediated the relationship between moderate-to-vigorous physical activity (MVPA) and well-being. Adopting a longitudinal design participants (N= 147) completed questionnaires assessing MVPA, well-being and perceived psychological need satisfaction in exercise contexts on three occasions separated by three weeks. A pattern of small-to-moderate correlations were noted between MVPA and indices of well-being (r12's ranged from .16 to .29). Multiple mediation analysis indicated that perceived psychological need satisfaction mediated the relationship between MVPA and well-being with perceived competence emerging as a unique mediator. Serial mediation analyses indicated the importance of ongoing psychological need satisfaction to well-being. Contexts that afford individuals the opportunity to engage in MVPA, as well as supports their need for competence, would be most advantageous for the promotion of psychological well-being.

The Influence of Burnout Symptoms on the Relationship between Work-Life Balance and Self-Rated Health

The effects of stress at work are estimated to cost Canadian employers more than 20 billion dollars annually through absenteeism, sick leave and decreased productivity. Over the past two decades, Canadians have reported higher stress levels, increased work hours and more work performed outside of normal business hours. This work-life imbalance has far-reaching repercussions–affecting an employee’s performance as well as their health. Chronic exposure to these high levels of stress can also lead to burnout. The primary purpose of this study was to determine the magnitude in which burnout symptoms influence the relationship between work-life balance and self-rated health. The secondary purpose of this study was to determine if gender and age interactions exist in the relationship between burnout, work-life balance, and self-rated health. This cross-sectional study involved secondary analysis of 220 managers, workers and human service professionals who completed an Occupational Health Clinics for Ontario Workers’ Mental Injury Toolkit (MIT) survey for the launch of the MIT. The MIT survey is a modified form of the short version of the Copenhagen Psychosocial Questionnaire and includes expanded questioning around burnout, stress, sleep troubles, cognitive, and somatic symptoms. There were no significant differences in self-rated health based on a respondent’s gender or age, indicating that no interaction of gender and age would be required. Respondents with low self-rated health reported significantly higher burnout and work-life imbalance compared to those with high self-rated health. The regression analysis demonstrated that the magnitude in which burnout mediates the relationship between work-life balance and self-rated health was 96%. These findings support previous studies that associate high levels of work-life imbalance or burnout with poor self-rated health or health outcomes. In this study, the shared variance between work-life balance and burnout also supports recent efforts to redefine the context and causes of burnout to include non-work factors. Based on our findings, the potential exists for the development of workplace health promotion strategies that address maintaining a balance between work and home as they may improve employee health and reduce burnout.

Socio-demographic factors, smoking, symptoms, morbidities and pulmonary function and quality of life in individuals with a heavy smoking history

Objective: To determine which socio-demographic, exposure, morbidity and symptom variables are associated with health-related quality of life among former and current heavy smokers. Methods: Cross sectional data from 2537 participants were studied. All participants were at ≥2% risk of developing lung cancer within 6 years. Linear and logistic regression models utilizing a multivariable fractional polynomial selection process identified variables associated with health-related quality of life, measured by the EQ-5D. Results: Upstream and downstream associations between smoking cessation and higher health-related quality of life were evident. Significant upstream associations, such as education level and current working status and were explained by the addition of morbidities and symptoms to regression models. Having arthritis, decreased forced expiratory volume in one second, fatigue, poor appetite or dyspnea were most highly and commonly associated with decreased HRQoL. Discussion: Upstream factors such as educational attainment, employment status and smoking cessation should be targeted to prevent decreased health-related quality of life. Practitioners should focus treatment on downstream factors, especially symptoms, to improve health-related quality of life.