Adolescent-parent disagreement on health-related quality of life of food-allergic adolescents:who makes the difference?

Background: Food-allergic adolescents are at highest risk for food allergy fatalities, which may be partly due to compromised self-management behavior. Such behavior may be negatively influenced by conflictual situations caused by adolescent–parent disagreement on the adolescent’s health-related quality of life (HRQL). Comparisons of adolescent-self-reported and parent-proxy-reported HRQL of food-allergic adolescents have never extensively been studied. The aims of this study were to investigate disagreement in adolescent-self-reports and parent-proxy-reports on the HRQL of food-allergic adolescents and to investigate the factors influencing adolescent–parent disagreement. Methods: Teenager Form (TF) and Parent Form (PFA) of the Food Allergy Quality of Life Questionnaire (FAQLQ), Food Allergy Independent Measure (FAIM), and Brief-Illness Perception Questionnaire (Brief-IPQ) were sent to food-allergic Dutch adolescents (13–17 years) and their parents. ICCs, t-tests, and Bland–Altman plots were used to investigate adolescent–parent disagreement. Participant characteristics, illness expectations, and illness perceptions influencing adolescent–parent disagreement were studied using regression analysis. Results: Seventy adolescent–parent pairs were included. There were a moderate correlation (ICC = 0.61, P < 0.001) and no significant difference (3.78 vs 3.56, P = 0.103) between adolescent-self-reported and parent-proxy-reported HRQL at group level. However, Bland–Altman plots showed relevant differences (exceeding the minimal important difference) for 63% of all adolescent–parent pairs. Adolescent’s age (>15 years), poorer adolescent-reported illness comprehension (Brief-IPQ-TF, coherence), and higher adolescent-reported perceived disease severity (Food Allergy Independent Measure-Teenager Form & -Parent Form) were associated with adolescent–parent disagreement. Conclusions: Adolescent–parent disagreement on the adolescent’s HRQL was mainly associated with adolescents’ rather than parents’ perceptions and characteristics. Illness comprehension of the adolescent may be an important target for intervention aimed at reducing adolescent–parent disagreement.

Dissociable brain structural changes associated with predisposition, resilience, and disease expression in bipolar disorder

Genetic factors are important in the etiology of bipolar disorder (BD). However, first-degree relatives of BD patients are at risk for a number of psychiatric conditions, most commonly major depressive disorder (MDD), although the majority remain well. The purpose of the present study was to identify potential brain structural correlates for risk and resilience to mood disorders in patients with BD, type I (BD-I) and their relatives. Structural magnetic resonance imaging scans were acquired from 30 patients with BD-I, 50 of their firstdegree relatives (28 had no Axis I disorder, while 14 had MDD) and 52 controls. We used voxel-based morphometry, implemented in SPM5 to identify group differences in regional gray matter volume. From the identified clusters, potential differences were further examined based on diagnostic status (BD-I patients, MDD relatives, healthy relatives, controls). Whole-brain voxel-based analysis identified group differences in the left hemisphere in the insula, cerebellum, and substantia nigra. Increased left insula volume was associated with genetic preposition to BD-I independent of clinical phenotype. In contrast, increased left substantia nigra volume was observed in those with the clinical phenotype of BD-I. Changes uniquely associated with the absence of a clinical diagnosis in BD relatives were observed in the left cerebellum. Our data suggest that in BD, genetic and phenotype-related influences on brain structure are dissociable; if replicated, these findings may help with early identification of high-risk individuals who are more likely to transition to syndromal states. Copyright © 2009 Society for Neuroscience.

On the periphery of Europe:an investigation of the construction of Turkish-Cypriot adolescent identities

This research study investigates the identities of a group of adolescent Turkish Cypriot (TC) students in their final year of secondary education in northern Cyprus, which it is argued, lies on the periphery of Europe. The main aim is to explore the linguistic construction of TC youth identities within school contexts but primarily the classroom in a political context in which the uniquely ambiguous status of Turkish Cypriots within the European Union (EU) continues, and where Turkish Cypriots are considered to be Europeans as individuals but not as a separate political entity. A secondary focus is upon the students’ investment in learning the English language. Identity is defined as a lifelong process of 'the social positioning of self and the other' (Bucholtz and Hall, 2005:586) which is endlessly re-created (Tabouret-Keller, 1997) and the distinction between the terms 'identity' and 'identities' is discussed. The study explores the social construction of TC students' identities using an ethnomethodological case study. By using Conversation Analysis of selected extracts from the data collected through observations of classroom interactions, focus group discussions and interviews, the thesis shows that TC students perceive and enact 'in-betweener identities' in terms of their ethnicity, societal values, age, religion, languages and Europeanness. Being on the periphery of the EU, it is argued that the Turkish Cypriots of northern Cyprus are the ‘peripheral members of the EU, remaining present yet absent. They are personally EU citizens but not as a society and cannot be represented within EU institutions. But will they ever acquire full membership, as any peripheral member would aspire to have or will they remain in between occident and orient? The possible answers to this question and the resulting ideological associations will shape how and to what extent these TC students perceive and enact their identities.