A Mindful Way to Staying Mentally Healthy at UniversityBarry Tse
A deck prepared for an online talk given to the University of Liverpool students and staff in Feb 2022 Feel Good Month. The talk touched on common psychological issues identified in a recent study in the UK and explained some of the problems that plagued our modern lifestyle. Secular mindfulness is then introduced as a tool to regain control of our declining ability to focus and our stress response that has constantly been put on hyperdrive due to our evolution, neurological wiring, and psychological processes needed for our survival.
A Mindful Way to Staying Mentally Healthy at UniversityBarry Tse
A deck prepared for an online talk given to the University of Liverpool students and staff in Feb 2022 Feel Good Month. The talk touched on common psychological issues identified in a recent study in the UK and explained some of the problems that plagued our modern lifestyle. Secular mindfulness is then introduced as a tool to regain control of our declining ability to focus and our stress response that has constantly been put on hyperdrive due to our evolution, neurological wiring, and psychological processes needed for our survival.
Dr. Michael H. Bloch - Simposio Internacional 'La enfermedad de la duda: el TOC'Fundación Ramón Areces
El 14 de noviembre de 2013, la Fundación Ramón Areces organizó y acogió en su sede un Simposio Internacional sobre 'La enfermedad de la duda: el TOC'. El Trastorno Obsesivo-Compulsivo (TOC) es un problema de salud pública, poco conocido, que afecta a un porcentaje de la población en torno a un 1-2% y que la Organización Mundial de la Salud ha situado entre las diez entidades que producen más discapacidad.
Dr. Michael H. Bloch - Simposio Internacional 'La enfermedad de la duda: el TOC'Fundación Ramón Areces
El 14 de noviembre de 2013, la Fundación Ramón Areces organizó y acogió en su sede un Simposio Internacional sobre 'La enfermedad de la duda: el TOC'. El Trastorno Obsesivo-Compulsivo (TOC) es un problema de salud pública, poco conocido, que afecta a un porcentaje de la población en torno a un 1-2% y que la Organización Mundial de la Salud ha situado entre las diez entidades que producen más discapacidad.
Descriptive Assessment of Depression and Anxiety Symptoms in an Outpatient Ob...ErikaAGoyer
NATIONAL PERINATAL ASSOCIATION 2014 CONFERENCE
Descriptive Assessment of Depression and
Anxiety Symptoms in an Outpatient Obstetric Clinic
Sample: Screening for Symptoms in the Context of
Substance Use Histories: The participant will be able
to: Describe psychiatric disorders during
pregnancy/postpartum, comorbidities, frequent
symptoms of depression and anxiety, a plan of care for
women with past and/or current issues with chemical
dependency and formulate recommendations for
improving mental health screening during routine
obstetric visits.
ISPCAN Jamaica 2018 (CIHRTeamSV) - Improving Health and Behavioral Outcomes a...Christine Wekerle
Improving Health and Behavioral Outcomes among Sexually Victimized Male Youth: A Qualitative Investigation Among Trauma Treatment Providers
Ashwini Tiwari, Christine Wekerle, Andrea Gonzalez (CIHRTeamSV)
ISPCAN Jamaica 2018 - Personality-targeted Interventions for Building Resilie...Christine Wekerle
Personality-targeted Interventions for Building Resilience against Substance Use and Mental Health Problems among Adolescents Involved in Child Welfare System
Hanie Edalati, Patricia Conrod
Presentation by Daniel Flannery, Ph.D. given at the 2010 RWJF LFP Annual Meeting in St. Paul, MN
This presentation will present recent research on the links between brain development and neurochemistry, mental health and violence. We will compare traditional treatment programs that focus separately on perpetrators, victims and witnesses with examples of specific, innovative, multi-systemic treatment models that providers have employed in an attempt to break the cycle of violence. Our discussion will revolve around several video vignettes and principles of Trauma-Informed care.
Participants will address the challenges of pilot-tested, “evidence-based practice” versus the “practice-based evidence” of community programs. Treatment challenges related to co-morbid functioning of high-risk individuals will be discussed including substance use, offending, mental health, family functioning and academic achievement. Examples of specific innovative treatment models and local and national data on multi-system involved youth and intervention outcomes will be provided. We will also consider the difficulties and benefits of working in collaborative, community-based coalitions to effect change and how this movement has been affected by policy, resources, and increased demands for accountability.
Director del Centro de Excelencia para rl Desarrollo de la Primera Infancia de la Univerisdad de Montreal, Canadá en el Seminario Internacional “El Impacto de la Educación Inicial”, organizado por JUNJI, Unicef y el Ministerio de Hacienda.
Risk Reduction Through Family Therapy (RRFT)BASPCAN
An integrative approach to treating substance use problems and PTSD among maltreated youth.
Carla Kmett Danielson PhD
Medical University of South Caolina
Wekerle-Ron Joyce Centre Grand Rounds-Boy's and men's health: Child sexual ab...Christine Wekerle
Defines sexual violence and gives info. on prevalence rates, examines emotion dysregulation in at-risk youth, child sexual abuse research findings, and introduces a developing resilience-based app for at-risk youth.
Wekerle CIHR Team - Child Sexual Abuse & Adolescent Development: Moving from ...Christine Wekerle
Child Sexual Abuse & Adolescent Development: Moving from Trauma To Resilience - Findings from The Maltreatment and Adolescent Pathways (MAP) Research Study
INDIGENOUS YOUTHS’ RELATIONSHIPS WITH WATER: TRAUMA, ADVOCACY & RESILIENCEChristine Wekerle
Indigenous communities often experience disproportionate access to clean, safe drinking water. For youth water insecurity may lead to adverse mental health effects, referred to as 'water anxiety'. However, water resilience actions such as advocacy and youths' responsibilities to water, may have the potential to mitigate potential mental health effects associated with 'water anxiety'.
Positive psychology evolved from a recognition that the clinical encounter is often over-focused on concerns and problems, and that positive actions may not have a central role in the treatment plan. With youth, many issues - treatment compliance, help-seeking, impulsive self-harm, high risk-taking - may be ameliorated with a plan of positive actions. The technology that are youths' worlds may deliver some of these therapeutics. Resilience may be galvanized when inner resources interacts with external resources. This talk will introduce the evidence-based components of a resilience in youth App, JoyPop, and open discuss for research use in clinical populations.
ISPCAN Jamaica 2018 (CIHRTeamSV) - Investigating the Path from Child Maltreat...Christine Wekerle
Investigating the Path from Child Maltreatment to Alcohol Problems in a Sample of Child Welfare-Involved Youth
Sherry Stewart, Tristan Park, Kara Thompson, Mohammed Al-Hamdani, Amanda Hudson, Christine Wekerle, Savanah Smith (CIHRTeamSV)
ISPCAN Jamaica 2018 - The Impact of Domestic Violence on Children's Functioni...Christine Wekerle
The Impact of Domestic Violence on Children's Functioning: Care Planning Approaches to Foster Trauma-Informed Care
Shannon Stewart, Yasmin Garad, Natalia Lapshini
Adolescence is a key period for intervention among at-risk populations of youth, as this is when risk-taking behaviors tend to emerge. The Sustainable Development Goals for achieving 2030 youth health targets outline two issues central to reduce risks of gendered violence, sexual violence (SV) and adolescent sexual risk taking: (1) gender equity and (2) mental health promotion education. Only half of women reported having the autonomy to make their own decisions regarding sexual relations, usage of contraception and access to health care services. In developing countries women and children are extremely vulnerable to sexual violence which thereby places them at increased risk for contracting STIs from the perpetrator, as well as pregnancy as a result of SV. Undocumented minors; unaccompanied minors; refugees; child soldiers; youth post natural disasters; orphans; street-involved youth; and youth without parental care or financial means who are exposed to dangerous people or places are most vulnerable to sexual violence. UNICEF states that ending cases of new HIV infections by 2030 is unlikely, due to large concentrations of new infections occurring in areas where transactional sex, child sexual exploitation, drug use, street involved youth and SV are prevalent. Adverse Childhood Experiences (ACEs), which include forms of childhood maltreatment, increase the risk of contracting STIs. In particular, sexual abuse is linked with increased likelihood for risky sexual behavior, making victims vulnerable to poor sexual health outcomes.7 Protecting youth from exposure to SV and providing adolescents with sexual and mental health education are central to promoting resilience in youth.
Resilience Knowledge Mobilization and the ResilienceInYouth AppChristine Wekerle
This presentation outlines an exploratory knowledge mobilization study where research-based and evidence-based posts were shared on instagram (@resilienceinyouth) to see if instagram was a feasible outlet for resilience knowledge mobilization. Research conducted by researchers in the CIHRTeamSV grant was shared on instagram via links to ResearchGate. The development of a resilience-based app for youth is described and an overview of its features is given.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pharma Pcd Franchise in Jharkhand - Yodley Lifesciences
Posttraumatic Stress Disorder (PTSD) Symptomatology as a Mediator Between Childhood Maltreatment & Substance Use
1. Posttraumatic Stress Disorder
(PTSD) Symptomatology as a
Mediator Between Childhood
Maltreatment & Substance Use
Christine Wekerle, Ph.D.
Associate Professor, Education,
Psychology, Psychiatry
The University of Western Ontario
cwekerle@uwo.ca
2. Christine Wekerle, Ph.D., PI (cwekerle@uwo.ca)
Anne-Marie Wall, Ph.D.,Co-PI
Harriet MacMillan, MD., Co-Investigator
Nico Trocme, Ph.D., Co-Investigator
Michael Boyle, Ph.D., Co-Investigator
Eman Leung, M.A., Co-Investigator
Funded by: CIHR/CAHR, Public Health Agency of Canada
Project Manager: Randy Waechter, M.A.
In Collaboration With:
Children’s Aid Society of Toronto (Deb Goodman)
Advisory Board: Dan Cadman, Rob Ferguson, Phil Howe,Heidi
Kiang/David Firang, Nancy MacLaren/Joanne Filippilli Franz Noritz/Lori
Bell, Rhona Delisle/Barry McKendry
Catholic Children’s Aid Society (Bruce Leslie)
Advisory Board: Jim Langstaff, Sean Wyers, Coreen Van Es, Mario
Giancola, Tara Nassar
Maltreatment and Adolescent
Pathways (MAP) Longitudinal Project
3. What is the MAP Research
Project?
• Random sampling of 14 to 17 year-old youth from
active caseload in child-welfare population
• Youth report on childhood maltreatment, mental
health, substance use, risky sexual practices,
violence (dating, bullying, delinquency)
• Youth anonymity protected with self-generated ID
methodology
• Multiple data points every 6 months over 2 years
• Participatory Action Research Model - Partnership
• Funding by CIHR, CHEO Centre of Excellence in
Child & Youth Mental Health, Public Health Agency
of Canada
4. MAP Feasibility Study: Research Process
• Mean Age of tested youth: 15.5 years (SD=1.23)
• Ineligibility Rate: Overall 31% (Case closed, AWOL, Discharged, mental
health issues, developmental delay, In custody, Not identified client)
• Refusal Rate: Overall 30% (Community: 55%, In-care: 17%; Males: 39%;
Females: 19%)
• Reasons given for Refusal: “Just not interested”/ no reason: 65%
(Parental Refusal: 14%; “Too busy”: 8%;“Not comfortable sharing”:
5%;Other: 8%)
• Recruitment Rate: Overall 70% (Community: 45%; In-care: 83%;Males:
61%; Females: 81%)
• Reasons given for participation: Money: 59%;“No reason given”: 32%;
Other: 9%
• Retention Rate: Overall 90%
• Average testing time: 2.8 hrs (Range = 2.0 to 4.5 hrs)
• Avg. Cost/Ss/Testing: $133.11 – Youth paid ON minimum wage/4hrs
(>80% youth selected testing at residence)
5. MAP Youth Pre-Post Experience
Not at all So-So A lot
0 1 2 3 4 5 6
How relaxed do you feel?* (3.8)
How happy do you feel? * (3.5)
How clear is this study to you(5.0)
How distressed do you feel? (2.4)
How interested..in this study?(4.7)
How important..this study is? (4.9)
How high..your energy level? (3.7)
How easy..to express yourself?(4.1)
6. Value of MAP Participation?
Not at all So-So A lot
0 1 2 3 4 5 6
• I gained something from filling out this
questionnaire (3.6)
• Had I known in advance what
completing this questionnaire would
be like for me, I still would have
agreed (4.8)
7. Descriptives of the MAP
Preliminary Analysis Sample
• N Initial Testing: 122 (52% female)
• CAS status:
– Crown Ward: 46 (40%)
– Society Ward: 27 (23%)
– Community Family/Temporary Care:
10(8.6%)
– Voluntary Care: 2 (1.7%)
8. Youth Differences Between MAP
Participating Vs. Refusing, p<.05
Subset Analyses on 85 Ss (n=59 participants, n=26
refusers)
• Males > refuse (OR=3.06)
• Society Wards > participate (OR=3.33) while community
youth < likely to participate (OR=2.96)
No significant differences on caseworker rated:
• Risk, Experience, Severity Physical, Sexual, Emotional
Abuse & Neglect
• School Status (in/out; past year average grades
obtained; special needs class status; learning disability)
• Substance abuse; mental health problems; psychiatric
diagnoses; risky sexual behavior; dating violence
• Overall level of impairment (youth’s psychological, social,
and occupational functioning; DSM-IV: 0-24 serious
impairment, 25-49 moderate, 50-74 mild, 75-99 absent of
symptom, 100 superior)
9. Childhood Maltreatment
Measurement
Childhood Trauma Questionnaire–Short Form (CTQ)
Reference: Bernstein et al. (2003), commercial measure
Stem: “When I was growing up”
No. of Items: 28 (5-point Likert scale “never true to very often
true”)
Sample Item: “People in my family hit me so hard that it left me
with bruises or marks”
5 subscales: Emotional abuse, physical abuse, sexual abuse,
emotional neglect, physical neglect
Berstein’s adolescent sample: Chronbach’s Alpha: EA:.89, PA:.86,
SA:.95, EN:.89, PN:.78
• With increasing N, all MAP sample Chronbach Alpha computed
for all measures
10. Childhood Maltreatment
Measurement
Childhood Experiences of Victimization Questionnaire
(CEVQ; under review measure)
Reference: Walsh et al. (2002)
Stem: “Things that may have happened to you…”
No. of Items: 18 major questions, with follow-up queries
(Frequency categories: Never; 1-2 times; 3-5 times; 6-10 times;
>10 times)
Sample Item: “How many times has an adult thrown something at
you to hurt you?”
5 subscales: physical, sexual, emotional abuse; bullying;
witnessing domestic violence
Author-reported Intraclass correlation: severe physical and sexual
abuse were .85 and .92 respectively
• MAP collecting agency record of # investigations, investigation
outcomes, primary substantiated type to compare CEVQ & CTQ
11. PTSD Measurement
Trauma Symptom Checklist for Children (TSCC)
Reference: Briere (1996), commercial measure
Stem: “The items that follow describe things that youth
sometimes think, feel, or do”
No. of Items: 54 (Likert Scale “never to “almost all of the time”)
Sample Item: “Feeling like I’m not in my body”
5 subscales: Anxiety, depression, posttraumatic stress,
sexual concerns, dissociation, and anger
Briere child/teen sample: Chronbach’s Alpha: sexual
concerns: .65 –.75, other subscales: mid to high .80
12. Substance Abuse Problems
Measurement
Youth Risk Behavior Surveillance Survey
Reference: Centre for Disease Control, Youth Risk Behavior
Surveillance System (2003)
Stem/Timeframe: last 30 days, days of use
No. of Items: 2 (Frequency categories: Don’t use; 0; 1-2; 3-
7;8-12; 13+; >Once a day)
Sample Item: “In the last 30 days, how many days did you
consume alcoholic drinks?” “…use cannabis?”
No. of Problem Items: 10
2 subscales: alcohol-related problems, drug-related problems
Sample Item: “Have you every had any medical problems as
a result of your alcohol/drug use?”
• MAP have OSDUS questions @ 1 and 2 year data points to
compare to Ontario youth population
13. Self-report Measure Validity and
Reliability (initial & 6 mo.)
• CTQ (initial) – CEVQ (initial): r=.69, p<.01
• CTQ (initial –6-month): r=.77, p<.01
• CEVQ (initial –6-month): r=.64, p<.01
• Reasonable correspondence between total maltreatment
scores at two MAP timepoints
• TSCC (initial) – TSCC (6-month): r=.65, p<.01
• Alcohol use past month (initial – 6-month): r=.71, p<.01
• Cannabis use past month (initial – 6-month): r=.73, p<.01
• Alcohol-related problems (initial – 6-month): r=.42, p<.01
• Drug-related problems (initial – 6-month): r=.52, p<.01
• Reasonable correspondence between health outcomes at two
MAP testing timepoints
14. DSM-IV PTSD Criteria
• Specifier: (1) Acute (< 3 months); (2) Chronic (> 3
months); (3) Delayed Onset (6 months past
traumatic stressor)
• Issues: Intensity, proximity, chronicity of stressor,
age of child, relationship to perpetrator, presence
of supportive and protective caretaker
• Criterion A: Both must be present
(1) traumatic event w/ actual/threatened death or
serious injury to threat to physical integrity to
self/others
(2) response involved intense fear, helplessness,
horror, disorganized or agitated behaviour
15. DSM-IV PTSD Symptomatology
DSM- IV Symptom Classes:
(1) Re-experiencing:
• recurrent, intrusive thoughts; bad dreams*; sense of re-
living*; physiological reactivity and psychological
distress* at cue exposure
(2) Avoidance/Numbing*
• avoid thoughts, feelings, places, people, activities related
to trauma*; gaps in recall; feeling detached; feeling
problems; pessimism about future
(3) Arousal
• sleeping, anger, irritability, startle*, hypervigilance,
concentration difficulty
* Higher among chronic, abused youth (Fletcher, 2003)
16. Developmental Traumatology Tenets
(DeBellis, 2001)
• The biological stress system response varies with
individual’s genetics, nature of the stressor, and
whether the system can maintain homeostasis or
whether it permanently changes due to stressor
• PTSD symptoms are normal responses, but when
chronic can lead to adverse brain development
• PTSD symptoms represents pathway to more
impairment; intergenerational maltreatment follows
PTSD mediation
• Chronic mobilization of the fight/flight response, is
the key cause of persistent negative neurological
effects and neurobiological changes
• PTSD key causal factor underlying broad range of
academic and mental health impairments
17. Why Childhood Maltreatment,
PTSD, Substance Use Related?
Cognitive models:
• Perceived current threat supports chronic PTSD
• Greater (negative) emotional reactivity to stimuli
• Greater secondary traumatization potential
• Preferential processing of maltreatment-related and
danger cues (e.g., unresolved anger)
• Self-medication via substance use to decrease negative
affect (e.g., tension reduction)
• Substance use as maladaptive coping
• Altered self-schema may support self-destructive
behaviors
• Substance use as self-harming behavior
• Future MAP direction: experimental task will be
administered to study alternative mechanisms: biases
perceptual/interpretational errors or selective attention?
18. Mediator:
PTSD Symptomatology
Adolescent
Substance Abuse,
Substance Use-related
Problems
Severity of Childhood
Maltreatment
Mediators:
Causal Factors Preceding Target Change
• Mediator = a variable the accounts for the effect of
maltreatment on substance abuse
• The identification of mediator provides target for cost-
effective intervention and ground for evidence-based
policy decision.
19. Emotional Abuse is Common
• CEVQ
– 70% Witness verbal abuse by parents
• 63% occurred before grade 6
– 43% Witness physical abuse by parents
• 55% occurred before grade 6
– 74% Victim of verbal abuse by parents
• 59% occurred before grade 6
• CTQ (While growing up as a child … )
– 72% Family said hurtful or insulting things
– 72% Being called “stupid,” “lazy,” or “ugly” by family
– 61% “I believe that I was emotionally abused”
– 88.9% Females; 85.4% Males endorsed 1 or > items
20. Physical Abuse is Common
• CEVQ
– 65% Being pushed, grabbed or shoved as a way to
hurt
• 61% before grade 6, 81% parental perpetration
– 43% Being kicked, bit or punched as a way to hurt
• 56% before grade 6, 78% parental perpetration
• CTQ (While growing up as a child …)
– 62% Being hit so hard it left marks:
– 57% Being punished with belt, cord, hard objects
– 54% “I believe that I was physically abused”
• 83.9% of Females; 91.3% of Males endorsed 1
or > severe physical abuse items
21. Neglect is Difficult to Define
• CTQ (growing up as a child …)
– 40% Not having enough to eat
– 22% Parent too drunk or high to take
care of the family
– 25% Had to wear dirty cloth
– 54% “ I believe that I was neglected”
– 98.2% Females; 97.7% Males 1> items
22. Sexual Abuse maybe more
common than we think …
• CEVQ
– 32% Being touched or forced to touch other’s private
part
• 54% before grade 6;
– 26% Being coerced into having sex
• 43% before grade 6 & 30% high school
– 33% perpetration by a male Other Adult (non-relative)
• CTQ (growing up as a child … )
– 20% Being forced to do or watch sexual things
– 20% Being molested
– 21% “I believe I was sexually abused”
• 62.7% female and 16% males endorsed 1 or >
contact sexual abuse items
23. Posttraumatic Stress Disorder
Symptomatology
Trauma Symptom Checklist for Children (TSCC)
Most frequently endorsed items:
– 75% Feeling afraid something bad might happen
– 74% Remembering things that happened that didn’t like
– 63% Bad dreams or nightmare
MEAN TSCC Male T Score= 37.34 (SD=29.06)
Female T Score= 36.96 (SD=33.16)
% in Clinical Range (T=or>70)=19.0% Female,19.6% Male
Future MAP work examine factor structure of PTSD
symptoms for males and females; child welfare vs. non-
child welfare youth with other datasets
24. Substance Use is Early & More?
• Alcohol Use
– 36% Drinking Before Age 13 (US 28%)
– 49% Binge Drinking Past Year (US 28%)
– 47 % Past Month Drinking (US 45%)
– 23% Past Month Binge Drinking (US 28%)
– Mean Days Past Month Use=3-7 days (15.9% Female and 32.3%
male drank >= 3 days in the past month)
• Cannabis Use
– 36% Use Before Age 13 (US 10%)
– 84% Past Year
– 62% Past Month (US 22%)
– Mean Days Cannabis Use Past Days =1-2 days (54.5% Female
and 90.6% male ever used Cannabis in the past month)
• Talk to School Counselor
– 3% alcohol related problem
– 3% drug related problem
• Arrested by Police
– 6% alcohol related problem
– 6% drug related problem
25. Mediators:
Causal Factors Preceding Target Change
• Sobel = βaβb/Sβaβb
(β=unstandardized regression coefficient, S=standard error)
Where Sβaβb = (βa
2
Sb
2
+ βb
2
Sa
2
- Sa
2
Sb
2
)0.5
Mediator:
PTSD Symptomatology
Adolescent
Substance Abuse,
Substance Use-related
Problems
Severity of Childhood
Maltreatment
Direct effect of maltreatment on substance abuse
Direct effect of maltreatment on substance use-related problem
βa (Sa) βb (Sb)
26. PTSD
Symptoms
no. of days
used Alcohol
no. of days
used Cannabis
Maltreatment
Experience
Female .55** .31* .38*
Male .09 .13 -.13
Initial Testing: Direct Effect
Maltreatment, Past Month Number of days using Alcohol/Drug, number of
Alcohol/Drug Use-related Problem
PTSD
Symptoms
# of Alcohol
Related
Problem
# of Cannabis
Related
Problem
Maltreatment
Experience
Female .56** .41** 33*
Male .09 .03 .06
* p<.05, ** p<.01
* p<.05, ** p<.01
N.B. Recent publication (Preacher & Hayes, 2004) suggested that significant direct
effect is not a necessary precondition for mediation, as per Baron and Kenny (1986)
27. Maltreatment
Experience
no. of days
used Alcohol
no. of days
used Cannabis
PTSD
Symptoms
Female .55** .48** .48**
Male .09 .18 .16
* p<.05, ** p<.01
Childhood
Maltreatment
*p<.05; **p<.01
Childhood
Maltreatment
*p<.05; **p<.01
PTSD
Symptomatology
no. of days used
Alcohol last month
6.47 (1.67)** .01 (.003)*
PTSD
Symptomatology
no. of days used
Cannabis last month
6.47 (1.67)** .03 (.008)*
Sobel=2.68** (Female only)
Sobel=2.87** (Female only)
Initial Testing: Maltreatment, PTSD, and the Past Month Number of days
using Alcohol/Drug
28. Maltreatment
Experience
# of Alcohol
Related
Problem
# of Cannabis
Related
Problem
PTSD
Symptoms
Female .56** .31* 34*
Male .09 .04 -.03
* p<.05, ** P<.01
PTSD
Symptomatology
Childhood
Maltreatment
no. of Alcohol
Related Problems
6.47 (1.67)** 0.02 (0.01)*
*p<.05; **p<.01
PTSD
Symptomatology
Childhood
Maltreatment
no. of Cannabis #
Related Problems
6.47 (1.67)** 0.03 (0.01)*
*p<.05; **p<.01
Sobel=2.07* (Female only)
Sobel=1.94* (Female only)
Initial Testing: Maltreatment, PTSD, and the number of Alcohol/Drug
Related Problem
29. Why PTSD may be > relevant for
females than males?
• These preliminary analyses indicated that PTSD, as currently measured,
may be a more relevant process for females than males
• MAP initial analyses based on simultaneously obtained measurement
• However, gender-based hypotheses is suggested as over-emphasized:
• Meta-analyses review support gender similarities hypothesis in normative
samples (Hyde, 2005)
– Moderate, stable effect (d=.4-.6) across studies, males > physical, verbal
aggression
– Small/moderate effects (d=.2 to .4) for female > males in spelling, language,
affiliative communication
– Small effect for females > males in depressive symptoms in midadolescence
(13-16 yrs.) (d=.16)
– Small/moderate effects for males > females in self-esteem increasing over 7 yr
to 18 yr period (d=.16-.33)
But in clinical samples, females > males in PTSD, MD diagnoses
Question: Presence of gender-specific clinical pathways or gender-specific
pathways?
Future work subgroup analyses
30. Conclusion
• Child welfare youth readily report on their
maltreatment history and well-being
• Child welfare youth indicate low distress from
answering sensitive questions
• Child welfare youth report substantial amount and
types of victimization
• Sexual protection may be one are of strength
• Child welfare youth are one sub-population where
mental health, substance abuse coincide
• PTSD mediational model supported for females
only
• PTSD mediational model points to targeting
PTSD symptomatology to reduce/prevent
substance use and problems associated with
substance use as potentially promising
Editor's Notes
Mediators for what? May be different mediators predicting problem behavior initiation than maintenance of problem behaviors
e.g., Trudeau, L, Lillehoj, C, Spoth, R, & Redmond, C. (2003). The role of assertiveness and decision making in early adolescent substance initiation: Mediating Processes. J or R on Adolescence, 13, 301-328
PTSD symptoms for teens @ 40% or above, but based on studies with small n sizes
Mediators for what? May be different mediators predicting problem behavior initiation than maintenance of problem behaviors
e.g., Trudeau, L, Lillehoj, C, Spoth, R, & Redmond, C. (2003). The role of assertiveness and decision making in early adolescent substance initiation: Mediating Processes. J or R on Adolescence, 13, 301-328
PTSD symptoms for teens @ 40% or above, but based on studies with small n sizes