High Levels Of Psychosocial Stress Research Articles

Neurobiología del maltrato infantil: el ‘ciclo de la violencia’

A high level of stress at an early age, like that produced in the case of child abuse, can have crucial consequences for the development of the human brain. This study aims to review and go over the main points of the results obtained by different clinical research works carried out on the structural and functional consequences of child abuse on the central nervous system. At the same it also seeks to integrate and relate them with those described in the case of violent adults. Firstly, we establish the relationship between post-natal development of the brain and child abuse. Then, the most important changes in the brain, both in structural and functional terms, are reviewed and the main modulating variables are highlighted. Lastly, the neurobiological changes are related with the so-called 'cycle of violence'. In addition to the individual differences and the diverse environmental, social and genetic factors that exert an influence on the consequences of abuse, there are neurobiological changes that affect their development both in the short and the long term. Some of the more significant structural changes are those affecting the hippocampus, the amygdala, the cerebellar structures, the corpus callosum and the cerebral cortex. Functional changes include cognitive sequelae, high levels of psychosocial stress, behavioural disorders and social problems, which are associated with a range of psycho-pathologies. These disorders are modulated by a series of different variables, such as the kind of abuse and the child's sex, and may be related to the changes observed in aggressive adults, which could contribute to perpetuate human violence.

Severe psychosocial stress and heavy cigarette smoking during pregnancy: an examination of the pre- and perinatal risk factors associated with ADHD and Tourette syndrome

Attention-deficit/hyperactivity disorder (ADHD) is frequently diagnosed in children with Tourette syndrome (TS). The basis for this co-occurrence is uncertain. This study aimed to determine if specific pre- and perinatal risk factors, including heavy maternal smoking and severe psychosocial stress during pregnancy, were associated with one or both disorders, or neither. We compared maternal report data on pre- and perinatal risk factors on 222 children between the ages of 7 and 18 years including 45 individuals with TS alone, 52 individuals with ADHD alone, 60 individuals with condition of comorbid TS + ADHD, and 65 unaffected control children. Pre- and perinatal histories as well as psychiatric assessments were performed using standardized questionnaires and semi-structured interviews with the mothers and children. Logistic regression was used to determine the odds ratio for each variable of interest. Compared to the mothers of unaffected control children, the mothers of children with ADHD alone reported higher rates of heavy smoking (>10 cigarettes per day) during pregnancy and higher levels of severe psychosocial stress during pregnancy (OR = 13.5, p < 0.01 and OR = 6.8, p < 0.002, respectively). The TS + ADHD and the TS alone patients also had higher rates heavy maternal smoking and high levels of psychosocial stress compared to the control children, but these differences failed to reach statistical significance (heavy smoking: OR = 8.5, p < 0.052, OR = 4.6, p < 0.19, respectively; severe psychosocial stress: OR = 3.1, p < 0.07, OR = 2.6, p < 0.11, respectively). Heavy maternal smoking and severe levels psychosocial stress during pregnancy were independently associated with a diagnosis of ADHD. TS patients also had higher rates of these risk factors, but the ORs failed to reach statistical significance. Efforts are needed to reduce the frequency of these risk factors in high-risk populations. Future studies, using genetically sensitive designs, are also needed to sort out the causal pathways.

Preterm labour and clinical hypnosis

AbstractHypnosis may play an important role in reducing preterm labour for patients who have higher levels of psychosocial stress. This study examines the rate of late‐preterm birth in a hypnosis group (directed to all women) and a historical control group. From July 2007 all women (n = 64), who were in their 28th to 34th weeks' gestation, were offered self‐hypnosis training using the hypnoreflexogenous protocol after Hüsken‐Janßen and Schauble. Expectant mothers with uncertain anticipated days of delivery were excluded. All women who delivered after 31 weeks' gestation served as a control group (n = 2135) from January 2006 till June 2007. In the hypnosis group there were three preterm deliveries (4.7%) (before 37 + 0 weeks' gestation) whereas in the control group there were 220 preterm deliveries (10.3%) (p = 0.01). Average cigarette usage during the current pregnancy was lower in the hypnosis group (p = 0.02). Higher work‐educated employments (p = 0.01), higher age of the mother (p &lt; 0.001) and fewer previous pregnancies (p &lt; 0.03) were found in the hypnosis group. Preterm birth correlated with the number of previous pregnancies (−0.38; p &lt; 0.001) but not with smoking. Hypnosis was shown to be effective therapy without side‐effects, which can reduce preterm delivery. This clinical study showed a significant prevention of preterm delivery. Prospective randomized controlled studies are required to evaluate fully the preventive value of clinical hypnosis. Copyright © 2009 British Society of Experimental &amp; Clinical Hypnosis. Published by John Wiley &amp; Sons, Ltd.

Psychosocial Stress and 13‐year BMI Change Among Blacks: The Pitt County Study

Adverse psychosocial exposures may partially drive the high rates of obesity among blacks. The objective of this study was to prospectively examine the relationship between perceived psychosocial stress and percent change in BMI among adult black men and women. We used data from 756 women and 416 men who were participants in the Pitt County Study, a community-based, prospective cohort study of blacks in eastern North Carolina. Participants were aged 25-50 years of age on entry into the study in 1988 and follow-up was obtained in 2001. Using multivariable linear regression, we calculated the adjusted mean percentage change in BMI over the follow-up period for each tertile of baseline measures of the Perceived Stress Scale (low, medium, and high), adjusted for potential confounders. For black women, higher levels of psychosocial stress at baseline predicted higher adjusted percentage increase in BMI over the 13-year follow-up: low stress 12.0% (95% CI 9.6-14.4), medium stress 16.3% (95% CI 13.7-18.9), and high stress 15.5% (95% CI 13.1-17.8). For black men, perceived stress was not associated with percent BMI change. These data suggest that interventions targeting obesity in black women should consider the potential impact of emotional stress on weight change.

Reducing Psychosocial Stress: A Novel Mechanism of Improving Survival from Exercise Training

Background Exercise training reduces mortality in patients with coronary artery disease. Behavioral characteristics, including depression, hostility, and overall psychosocial stress, have been shown to be independent risk factors for recurrent myocardial infarction and death in these patients. Exercise training can reduce these high-risk behaviors, but it remains uncertain as to what extent the health benefits of exercise training can be attributed to improving these behaviors. Methods We evaluated the impact of exercise training during cardiac rehabilitation on mortality in 53 patients with coronary artery disease with high levels of psychosocial stress and in 469 patients with coronary artery disease with low levels of psychosocial stress and compared them with 27 control patients with high psychosocial stress who did not undergo formal cardiac rehabilitation and exercise training. Results Mortality was approximately 4-fold greater in patients with high psychosocial stress than in those with low psychosocial stress (22% vs 5%; P = .003). Exercise training decreased the prevalence of psychosocial stress from 10% to 4% ( P < .0001) and similarly improved peak oxygen uptake in patients with high and low psychosocial stress. Mortality in patients who improved exercise capacity by ≥ 10% (high exercise change) was 60% lower than in patients who had < 10% improvement in exercise capacity (low exercise change) ( P = .009). Mortality was lower in patients with high psychosocial stress with high exercise change compared with patients with high psychosocial stress with low exercise change (0% vs 19%; P = .009). In contrast, there was no significant improvement in mortality in patients with high versus low exercise change with low psychosocial stress (4% vs 8%; P = .14). Conclusion Psychosocial stress is an independent risk factor for mortality in patients with coronary artery disease, and exercise training can effectively reduce its prevalence. Exercise training reduces mortality in patients with coronary artery disease, and this effect seems to be mediated in part because of the salutary effects of exercise on psychosocial stress.

Pregnancy Intentions and Folic Acid Supplementation Exemplars: Findings from the Central Pennsylvania Women's Health Study

One Healthy People 2010 objective is that 80% of women in the United States start a pregnancy with optimal levels of folic acid. This often requires women to use folic acid supplements preconceptionally to get adequate levels. Efforts to achieve the objective have resulted in a suboptimal floor effect at less than 50% of women. We advance a framework based on exemplification theory, identifying supplementation as an additive action in which two role models exemplify folic acid supplementation among women of reproductive age able to become pregnant (n = 1,258). The women were participants in Phase I of the Central Pennsylvania Women's Health Study (CePAWHS). One exemplar identified represents the positive habits aligned with supplementers considering a pregnancy sometime in their future, while the other resides in the exemplification of positive habits aligned with supplementers not considering a pregnancy sometime in their future but still able to become pregnant. Among women not considering a future pregnancy, daily green salad consumption, weekly fish consumption, having had a health care visit in the past year, and having had any ob/gyn visit in the past 2 years resulted in increased odds of folic acid supplement use in a multivariable model. In the same model, an increase in age resulted in increased odds of folic acid supplement use. Among women considering a future pregnancy, not smoking cigarettes, having higher levels of psychosocial stress, and having higher levels of interaction social support resulted in increased odds of folic acid supplement use in a multivariable model. In the same model, those who have had a health care visit in the past year, as well as those who have received pregnancy planning counseling, were also more likely to use a folic acid supplement. Implications for strategic communication are considered.

Estrés psicosocial laboral en embarazadas del sector de la salud de Cuba, 2005-2006.

Objectives. Evaluate the level of psychosocial stress at work according to the models of demand-control of the work tension and imbalance effort recompense; and to determine associations between the psychosocial stress at work and pregnancy complications. Material and methods. We performed a prospective cohort study with 78 pregnant health workers from the municipality of the Havana city, Cuba, in the period 2005-2006. Those interviewed responded a version to Spanish of the Job Content Questionnaire and of the Effort Reward Imbalance Questionnaire. Results. The pregnant workers referred high work tension and they recognized that their work generated those discharges psychological demands and that they considered its work as of high effort extrinsic and low recompense that is the reason of more probability of generating work stress. It was that the threat of childbirth preterm, of abortion and the time of work during the pregnancy were associated with high levels of psychosocial stress at work. Conclusions. There is a high level of stress at work on pregnancy health workers from the Havana city.

Hypnotherapie bei vorzeitiger Wehentätigkeit

Hintergrund: Viele Schwangerschaften, die zu einer Frühgeburt führen, weisen einen höheren Grad an psychosozialem Stress der werdenden Mutter auf. Hypnotherapie kann hier einen Beitrag zur Reduzierung der Zahl von Frühgeburten leisten. Methodik: Bei der Durchsicht von 13 856 Artikeln über Frühgeburtlichkeit wurden nur 7 Forschungsberichte zu Hypnose und Frühgeburtenrate identifiziert (Evidenzlevel 3 und 4 a). Ergebnisse: Schwarz (1963) und Logan (1963) berichteten beide über je drei Schwangere, deren vorzeitige Wehentätigkeit nach Hypnotherapie sistierte. Brown und Massarelli (2002) nutzten Hypnotherapie bei einer Vierlingsschwangerschaft. Goldman (1992) zeigte, dass Hypnotherapie vorzeitige Wehentätigkeit auf unterschiedlichen Ebenen beeinflusst: die Patientinnen erlernen die Kontrolle von psychosozialem Stress; sie üben die bewusste Wahrnehmung vorzeitiger Wehen ein; der Entspannungseffekt kann die Nebenwirkungen der Medikamente erträglicher machen, ermöglicht auch eine direkte Entspannung der uterinen Muskulatur und bewirkt eine Reduzierung der Wahrscheinlichkeit der vorzeitigen Entbindung. Die erste Studie von Omer (1987) verglich die Hypnotherapie mit einer Kontrollgruppe, die nur eine Standardtherapie (Medikamente) erhielt. Die Hypnosegruppe zeigte eine signifikante Schwangerschaftsverlängerung und erhöhtes Geburtsgewicht im Vergleich zur Kontrollgruppe (Schwangerschaftsverlängerung: t [111] = 3,09; p < 0,002; Geburtsgewicht: 2917 vs. 2692 g, t [111] = 1,64; p = 0,05). Cheek (1995) beschreibt einen besonderen Effekt von Psychotherapie und Hypnotherapie zur Verhinderung vorzeitiger Wehentätigkeit durch Verarbeitung von bewussten und unbewussten Ängsten. Zahlreiche Studien bestätigen einen Zusammenhang zwischen Stress und vorzeitiger Wehentätigkeit. Brown et al. (2007) berichteten, dass durch Einführung ideomotorischer Signale in Hypnose die Frühgeburtenrate von 6,8 % auf 2,6 % reduziert wurde. Schlussfolgerung: Aus den bisher vorliegenden Studien ergibt sich, dass Hypnotherapie eine neue, wirkungsvolle und nebenwirkungsarme Therapieoption darstellt, die eine Schwangerschaftsdauer bei drohender Frühgeburt verlängert. Es fehlen bisher jedoch noch prospektiv randomisierte multizentrische Studien.

The Luebeck interview for psychosocial screening in patients with inflammatory bowel disease

Psychosocial factors play an important role in the course of inflammatory bowel disease (IBD). However, a simple, valid psychosocial screening instrument that is suitable for short patient-physician contacts does not exist. Therefore, the Luebeck semistructured Interview for Psychosocial Screening was developed as a rating tool for psychosocial stress in IBD patients (LIPS-IBD). The entire interview requires approximately 10 minutes. Interrater reliability was tested. Depression, anxiety, social support, impact of the disease, global level of psychosocial stress, and demand for psychosocial support were rated in 92 patients with IBD on 5 point Likert scales. Patients from the in- and out-patient clinic for gastroenterology were included. In addition, patients filled out self-report questionnaires regarding depression, anxiety, social support, and impact of the disease. Indices of disease activity (Colitis Activity Index, Crohn's Disease Activity Index) were recorded. Both patients and physicians found the interview feasible. Reliability was good, with interrater reliability ranging from .76 to .94. Convergence with self-report instruments was also high (r = .5-.6). Ratings of depression and impact of the disease were correlated with indices of disease activity. LIPS helps to identify patients with high levels of psychosocial stress and provide them with more detailed psychologic assessments. It was found to be a suitable instrument for daily clinical routine. It is potentially a valuable screening tool to obtain reliable, valid, and useful information in daily practice in IBD treatment settings.

Child and Parental Self-Monitoring as Determinants of Success in the Treatment of Morbid Obesity in Low-Income Minority Children

To examine self-monitoring by children and parents as related to weight control over 6 months within a long-term multidisciplinary program for low-income minority children with morbid obesity. The weight changes of 228 children with obesity were evaluated according to frequency of child and parental self-monitoring. Predictors of self-monitoring were also evaluated. Children who self-monitored on most days lost more weight over 6 months of treatment compared with less-consistent self-monitors. Children whose parents self-monitored were also more likely to self-monitor and lose weight. Self-monitoring seems just as critical for successful weight control among low-income minority children with obesity as it is in the middle-class populations. Although lower education and higher levels of psychosocial stress may decrease self-monitoring and participation by these families, they might still benefit from targeting highly consistent self-monitoring (by parents and children) as a primary goal in weight-control programs.

Prenatal Stress Alters Cytokine Levels in a Manner That May Endanger Human Pregnancy

Recent data suggest that prenatal stress negatively affects pregnancy and infant outcome. Existing studies implicate dysregulation of the immune and endocrine systems in stress-related increases in premature labor and poor birth outcome, but no published studies have directly addressed the relationships among these variables during pregnancy. We sought to test the hypothesis that high levels of psychosocial stress and low levels of social support during pregnancy alter maternal cytokine profiles in a manner that contributes to poor birth outcomes. Psychosocial stress and social support were measured in 24 women with overtly normal pregnancies once during each trimester of pregnancy. Levels of interleukin-10 (IL-10), IL-6, and tumor necrosis factor-alpha (TNF-alpha) were assessed concurrently with stress and support measurements. High social support was associated with low stress scores. Elevated stress scores were positively correlated with higher levels of the proinflammatory cytokines IL-6 and TNF-alpha, and with low levels of the antiinflammatory cytokine IL-10. These findings provide initial support for our hypothesis that stress-related neural immune interactions may contribute to pregnancy complications and poor outcome, but require further study to determine the mechanism and significance of these effects.

Development of the Yale Children's Global Stress Index (YCGSI) and Its Application in Children and Adolescents With Tourette's Syndrome and Obsessive-Compulsive Disorder

The Yale Children's Global Stress Index (YCGSI) is a new clinical rating instrument designed to provide objective global clinician ratings of psychosocial stress in studies of children and adolescents. This study was designed to evaluate the psychometric properties of the YCGSI. Independent ratings of clinical severity and psychosocial stress were obtained at two time points separated by 4 months from 33 subjects with Tourette's syndrome (TS) and/or early-onset obsessive-compulsive disorder (OCD), aged 7 to 17 years, and 25 age-matched control subjects. Parents and children were interviewed separately. Multiple measures of stress were obtained including the YCGSI and the Daily Life Stressors Scale (DLSS). Data support the interrater reliability and convergent and divergent validity of the YCGSI. At both time points, children and adolescents with TS and OCD had, on average, experienced significantly more psychosocial stress than did the controls. Cross-sectional ratings of tic and obsessive-compulsive symptom severity did not correlate with the YCGSI, but did correlate with self-report ratings of stress on the DLSS. In contrast, ratings on the YCGSI were associated with clinician ratings of depression. The YCGSI has acceptable psychometric properties. Children and adolescents with TS and OCD appear to be at increased risk of experiencing higher levels of psychosocial stress and adversities compared with their peers in the community. Future studies need to examine the possible differential contributions of distinctive forms of stress on the intramorbid course of these disorders.

Frequent job change and associated health

The contemporary labour market is widely regarded as having become more “flexible”. It is proposed that such flexibility is a characteristic of employment histories which will have effects on psychosocial status, health-related behaviour, and physical health. Recent increases in flexibility are unlikely to have accumulated over sufficient portions of individual employment histories for any effect on health to be apparent, but a “preview” of these effects may be gained from study of older cohorts. This cross-sectional study is based on data collected in the early 1970s from 5399 men and 945 women in paid work, recruited from 27 workplaces in the west of Scotland. A flexible employment history was defined as one encompassing a large number of changes between jobs. Perceived psychological stress, health behaviour (cigarette smoking, alcohol consumption, physical exercise), physiology (diastolic blood pressure, body mass index, forced expiratory volume, plasma cholesterol concentration) and current health (angina, myocardial ischaemia) were assessed. Those individuals who reported having experienced frequent job change were more likely to smoke, consume greater amounts of alcohol, and perhaps to exercise less. Similar findings were observed in both males and females, and for different age and socio-economic groups. We found no suggestion that this association was due to higher levels of psychosocial stress, and the expected consequences for health were not observed. Interpretation of these findings is not straightforward due to an uncertain direction of causation, and a possible selection bias. However, the observed relationship between frequent job changing and a higher incidence of health risk behaviours, in the absence of a relationship with poorer health, invites further research.

Risk and resistance factors in the adaptation in mothers of children with juvenile rheumatoid arthritis.

To examine the importance of illness severity, child functional status, psychosocial stress, intrapersonal factors, stress processing, and social-ecological factors in predicting psychological symptoms among mothers of children with juvenile rheumatoid arthritis (JRA). Mothers of 92 children with JRA completed surveys while waiting with their children for physician appointments or during JRA meeting breaks. Mothers reported higher mean levels of psychological symptoms than a normative group. Higher levels of psychosocial stress predicted increased psychological symptoms after accounting for disease severity and functional status. Maternal appraisal of the illness tended to moderate the relationship between illness stress and psychological symptoms, and maternal education moderated the relationship between daily hassles stress and psychological symptoms. These data indicate that mothers of children with JRA are at risk for psychological distress. Inteventions that take into account the buffering effects of maternal education and appraisal may serve to decrease the effects of maternal stress.

Social Work in Primary Care

ABSTRACT A neighborhood primary health care program serving a socially and economically oppressed community, and a graduate school of social work have collaborated to create a social work student field work unit in a primary health care setting, to demonstrate emerging and innovative social work roles in an ever-increasing managed care environment. Patients with high levels of psychosocial stress make large demands on the primary care system and consume considerable laboratory and diagnostic treatment resources. Development of social services in primary care settings is a relatively new concept, however it has been clearly demonstrated that primary care physicians need the skills of social workers to handle the psychosocial and environmental aspects of illness. The principal goal was to demonstrate social work practice in a primary care health setting, utilizing practice research approaches. Validation of effectiveness was noted, as depression, anxiety, adjustment reactions (to name a few) were decreased, resulting in fewer physician visits, less somatization and improved compliance with medical and diet/nutrition regimens. The case examples and single subject data presented provide qualitative evidence, in the context of a natural experiment, for the profession to pursue this model further in both program development and research.

A Case‐comparison Study of the Characteristics of Children with a Short Stature Syndrome Induced by Stress (Hyperphagic Short Stature) and a Consecutive Series of Unaffected “Stressed” Children

Recently a type of growth failure (Hyperphagic Short Stature) has been described, in which there is potentially reversible severe impairment of growth hormone secretion, in association with excessively high levels of psychosocial stress. This condition is a variant of the disorder formerly known as Psychosocial Dwarfism. In the present study we compared children with Hyperphagic Short Stature (N = 25, aged 9.04 years+/-3.78, 72% male) and a closely matched sample with normal height, drawn from comparably stressful family circumstances (N = 25, aged 10.61+/-3.04, 60% male). Measures of the psychosocial environment, anthropometry, and developmental history from infancy were obtained. Many symptoms thought previously to be characteristics of psychosocial dwarfism were found to be nonspecific stress responses. Hypotonia (p < .05), enuresis/encopresis (p < .01), and sleep cycle disruption (p < .05) did differentiate the groups. Growth, appetite, and sleep are all influenced by hypothalamic nuclei, suggesting hypothalamic pathology could account for most of the clinical features of Hyperphagic Short Stature.

Parents with Intellectual Disability in Germany: Results of a Nation‐wide Study

A nation‐wide questionnaire survey conducted in Germany found 969 persons with intellectual disabilities who had become parents of 1366 children. Thirty examples of parenthood were investigated further by interviewing mothers, fathers or adult children and staff members or assisting relatives. High levels of psychosocial stress were often found. Unhelpful reactions to the pregnancies of mothers with intellectual disabilities were more the rule than the exception. Nevertheless, mothers and fathers with intellectual disabilities often looked forward to having a baby, seemed to be proud of their children and reported having good emotional relationships with them, even when the children did not live with them. Institutional support services, if any, were not always judged to be helpful.

Psychosocial stress moderates the relationship of cancer history with natural killer cell activity.

Data suggest that both cancer history and psychosocial stress may be associated with reductions in natural killer cell activity (NKA). Therefore, we tested whether individual differences in cancer history, chronic/perceived stress, and their interactions would be associated with decreased levels of NKA. We tested these hypotheses in 80 spouse caregivers of victims of Alzheimer's Disease (AD) (persons known to report high levels of psychosocial stress) and in 85 age- and sex-matched spouses of non-demented controls. Participants were assessed at study entry (Time 1) and 15-18 months later (Time 2). Individuals with cancer histories (N = 43) had not been treated with immune altering medications within the last year. At both Times 1 and 2, cross-sectional main effects were weak or absent for cancer history, perceived stress (e.g. high hassles, low uplifts), and caregiver status; however, interactions occurred between cancer history and perceived stress, such that persons with cancer histories and high hassles/low uplifts had the lowest NKA values (p < .05). These results occurred even after controlling for age, gender, beta-blocker use, hormone replacement therapy, alcohol, and exercise. At Time 1, an interaction also occurred between caregiver status and cancer history--caregivers with cancer histories had lower NKA than did controls with cancer histories and caregivers/controls without cancer histories (p < .05). At Time 2, this interaction only showed a trend (p < .08), primarily because caregivers with cancer histories experienced increases in NKA (p < .05) from Time 1 to Time 2, whereas in the other three groups NKA did not change. Importantly, in caregivers with cancer histories, high perceived stress at Time 1 predicted low NKA at Time 2 (p < .05). This research suggests that the combinations of biological vulnerabilities and chronic/perceived stress may have interactive effects resulting in reduced NKA.

Use of Chaos Theory and Complex Systems Modeling to Study Alcohol Effects on Fetal Condition

A systems dynamics computer model to predict birth complications for individual pregnant woman was developed from prospectively conducted data on a database of 125 pregnant women. The model is based upon nonlinear mathematics derived from the study of chaos and complex systems. The model was then tested prospectively on 27 additional pregnant women, making predictions on their level of obstetrical risk. The model was refined until it correctly predicted the outcomes of all 125 cases in the development database. Prediction was made with an accuracy of 25/27 cases for the prospective test cases. Predictions were made for fetal condition at birth, presence or absence of operative delivery, and presence or absence of uterine dysfunction. Then the model was used to explore alcohol use during pregnancy. A reasonable spread or alcohol use existed among subjects, allowing consideration of alcohol effects. Alcohol was found to have differential effects on fetal condition at birth depending upon the presence or absence of high levels of psychosocial stress and the use or other substances. In all cases, the effect of alcohol was only evident after the 10 drinks per week level was reached. For the high-stress/one other substance group, there could be an 18-fold effect on fetal condition at birth. For the low-stress/one other substance group, the effect was only 3-fold, and for the alcohol alone group, the effect was negligible.

Satanism in a psychiatric adolescent population.

In a university affiliated adolescent psychiatric facility, providing approximately 250 consultations per year, an unsuspectedly high prevalence of preoccupation with "satanism" was found in referred adolescents. Interested by the phenomenon, the authors have identified and documented eight cases in an attempt to isolate common characteristics among the cases. Initially a link between the marginal cult belief and general maladjustment was hypothesized, specifically delinquent behaviour. The study confirmed this trend and showed a significant impairment in the social adjustment of these adolescents. One of the most striking findings was the high prevalence of family disruption and parental abuse. Furthermore, a wide range of psychiatric symptoms were found in our subjects. This study raises concerns over the psychological development of adolescents who are subject to high levels of psychosocial stress. It will hopefully encourage further work in the area of increased susceptibility towards beliefs and indoctrination.