Neglect Behavior Research Articles

Anxiety, Stress, and Fear Response in Mice With Reduced Endocannabinoid Levels

BackgroundDisruption of the endocannabinoid system through pharmacological or genetic invalidation of cannabinoid CB1 receptors has been linked to depression in humans and depression-like behaviors in mice. The two main endogenous cannabinoids, anandamide and 2-arachidonoyl glycerol (2-AG), are produced on demand from phospholipids. The pathways and enzymes involved in endocannabinoid biosynthesis thus play a major role in regulating the activity of this system. This study investigates the role of the main 2-AG producing enzyme diacylglycerol lipase α (DAGL-α). MethodsWe generated and used knockout mice lacking DAGL-α (Dagla−/−) to assess the behavioral consequences of reduced endocannabinoid levels in the brain. We performed different behavior tests to determine anxiety- and depression-related behavioral changes in Dagla−/− mice. We also analyzed expression of genes related to the endocannabinoid system via real-time polymerase chain reaction and used the mitotic marker 5-bromo-2′-deoxyuridine to analyze adult neurogenesis. ResultsDagla−/− animals show an 80% reduction of brain 2-AG levels but also a reduction in cortical and amygdalar anandamide. The behavioral changes induced by Dagla deletion include a reduced exploration of the central area of the open field, a maternal neglect behavior, a fear extinction deficit, increased behavioral despair, increased anxiety-related behaviors in the light/dark box, and reduced hippocampal neurogenesis. Some of these behavioral changes resemble those observed in animals lacking the CB1 receptor. ConclusionsOur findings demonstrate that the deletion of Dagla adversely affects the emotional state of animals and results in enhanced anxiety, stress, and fear responses.

Understanding the Role of Context-Specific Drinking in Neglectful Parenting Behaviors.

Child neglect is the most common form of child maltreatment, yet little is known about how drinking context may be related to particular subtypes of child neglect. This study examines the relationship between parental drinking in multiple contexts and the use of supervisory and physical neglectful. A sample of 2152 parents of children 12 years or younger in 50 cities in California was obtained using a computer-assisted telephone interview. Past-year prevalence of child neglect was measured using the Multidimensional Neglectful Behavior Scale. Information was collected on past month or past-year frequency of having at least one drink in five contexts, continued drinking measures (e.g. number of drinks after the first drink) and sociodemographics. Data were analyzed using multilevel random effects logit models. Frequency of drinking in various contexts was related to different neglect subtypes. Specifically, frequency of drinking with friends was positively related leaving a child home alone when an adult should be present. Parents who drank more frequently with family were less likely to leave their child home alone in the past year yet more likely to unsafely monitor their child in the past year. Drinking at parties more often was related to being more likely to leave a child alone in a car sometime during the past year. That no single drinking context is universally problematic for supervisory and physical neglect suggests that different social mechanisms may underlie the relationships observed between different drinking contexts and neglect subtypes.

In their own words: abused children's perceptions of care provided by their birth parents and foster carers

There are many theories as to what form good-quality parenting should take. Attachment theory emphasises providing a secure base through sensitive responding at times of emotional need. Social learning theory outlines the need for firm limits in addition to the promotion of positive interchanges. These theories are supported by numerous quantitative research studies investigating which parenting styles are associated with better outcomes for children in general and for those with additional needs due to prior abuse or emotional and behavioural difficulties. However, there have been few systematic qualitative studies asking children themselves about their care experiences, particularly with abused or neglected children who are now safe in foster care. Using an adapted version of the Child Attachment Interview, we interviewed 12 children aged 13 to 15 years, who had been taken into care due to abuse and fostered for at least six months, with the aim of exploring their attachment to their birth parents, foster carers and attitudes to different parenting styles in general. Transcripts were analysed using the qualitative technique of Interpretative Phenomenological Analysis. Overall, the abused children spoke more positively of foster care than the care provided by their birth parents. Parenting techniques mentioned in positive terms were a clear disciplinary style, setting firm boundaries, nurturing care, enjoyable time together and mentoring further development. Negative themes included angry or inconsistent disciplinary styles, failure to set appropriate boundaries, rejecting and neglectful behaviour, a lack of joint activities, a chaotic lifestyle and parental illness. This study provides a unique perspective on parenting, as the children studied have experienced both poor parenting and reasonably normal care. The findings are applicable to care provided for fostered children and could be relevant to the upbringing of children in general.

Nursing care of unilateral neglect patients

The prevalence of unilateral neglect among stroke patients has risen to 82% and 69%, respectively, in acute wards and rehabilitation units. Neglect may restrict the activities of patients and reduce their quality of life. Patients are often unaware of their neglect behavior and of their inability to see or feel persons or objects on their affected side. Healthcare providers should pay greater attention to the signs of neglect behavior in patients. Neglect is a silent syndrome for both patients and healthcare providers. This article reviews the definition of unilateral neglect as well as its associated characteristics, theoretical interpretations, rehabilitation, and nursing care. The authors hope that the contents of this article may help healthcare professionals assess and provide care to patients with neglect problems in order to decrease the negative impacts of neglect on patients and improve their daily functions.

Perceived conflict avoidance by managers and its consequences on subordinates' attitudes

Conflict handling by managers gives rise to significant emotional and cognitive experiences for affected employees and has far‐reaching effects on the effectiveness of a group and an organization. In this conceptual paper, we argue that despite many claims made by managers in their self‐reports that they engage in either dominant or compromising conflict‐handling strategies when managing conflict within a group, they may be perceived by employees as adopting neglect or avoidance behaviors. We examine how such perceived managers' avoidance styles could influence employees' perceptions with regard to justice, trust, and politics within an organization.

Corticosterone, prolactin and egg neglect behavior in relation to mercury and legacy POPs in a long-lived Antarctic bird

Seabirds often have high loads of contaminants. These contaminants have endocrine disrupting properties but their relationships with some endocrine mechanisms are still poorly investigated in free-living organisms. This is the case for the stress response which shifts energy investment away from reproduction and redirects it towards survival. In birds, this stress response is achieved through a release of corticosterone and is also accompanied by a decrease in circulating prolactin, an anterior pituitary hormone widely involved in regulating parental cares. We measured blood concentrations of some legacy persistent organic pollutants (POPs) and mercury (Hg) and examined their relationships with the corticosterone and prolactin responses of known-age (9–46years old) incubating snow petrels (Pagodroma nivea) to a standardized capture/handling stress protocol. In this Antarctic seabird, we also investigated whether high contaminant burden correlates with a higher occurrence of egg neglect, a frequently observed behavior in snow petrels. POPs and Hg were unrelated to age. Stress-induced corticosterone concentrations were positively related to POPs in both sexes, and stress-induced prolactin concentrations were negatively related to Hg in males. Egg-neglect behavior was not related to POPs burden, but males with higher Hg concentrations were more likely to neglect their egg. This suggests that in birds, relationships between age and contaminants are complex and that even low to moderate concentrations of POPs and Hg are significantly related to hormonal secretion. In this Antarctic species, exposure to legacy POPs and Hg could make individuals more susceptible to environmental stressors such as ongoing disturbances in Polar Regions.

Methods to explore productive behaviors in personal and extrapersonal space.

Methods to explore productive behaviors in personal and extrapersonal space.

P.3.e.003 Recurrence risk and protective factors in patients with a first episode of psychosis

While considerable data support the relationship between childhood trauma and adult personality pathology in general, there is little research investigating the specific relationships between different types of childhood maltreatment and adult personality disorders. The present study tested a model incorporating five a priori hypotheses regarding the association between distinct forms of childhood maltreatment and personality pathology in 231 psychiatric patients using multiple self-report measures (Personality Diagnostic Questionnaire-4th Edition, Child Trauma Questionnaire, Conflict in Tactics Scale Parent-Child Child-Adult, and Multidimensional Neglectful Behavior Scale). Step-wise linear regressions supported three out of five hypotheses, suggesting independent relationships between: physical abuse and antisocial personality disorder traits; emotional abuse and Cluster C personality disorder traits; and maternal neglect and Cluster A personality disorder traits after controlling for co-occurring maltreatment types and personality disorder traits. Results did not support an independent relationship between sexual abuse and borderline personality traits nor between emotional abuse and narcissistic personality disorder traits. Additionally, there were three unexpected findings: physical abuse was independently and positively associated with narcissistic and paranoid traits and negatively associated with Cluster C traits. These findings can help refine our understanding of adult personality pathology and support the future development of clinical tools for survivors of childhood maltreatment.

Bias in child maltreatment self-reports using interactive voice response (IVR)

Few methods estimate the prevalence of child maltreatment in the general population due to concerns about socially desirable responding and mandated reporting laws. Innovative methods, such as interactive voice response (IVR), may obtain better estimates that address these concerns. This study examined the utility of interactive voice response (IVR) for child maltreatment behaviors by assessing differences between respondents who completed and did not complete a survey using IVR technology. A mixed-mode telephone survey was conducted in English and Spanish in 50 cities in California during 2009. Caregivers (n=3,023) self-reported abusive and neglectful parenting behaviors for a focal child under the age of 13 using computer-assisted telephone interviewing and IVR. We used hierarchical generalized linear models to compare survey completion by caregivers nested within cities for the full sample and age-specific ranges. For demographic characteristics, caregivers born in the United States were more likely to complete the survey when controlling for covariates. Parenting stress, provision of physical needs, and provision of supervisory needs were not associated with survey completion in the full multivariate model. For caregivers of children 0–4 years (n=838), those reporting they could often or always hear their child from another room had a higher likelihood of survey completion. The findings suggest IVR could prove to be useful for future surveys that aim to estimate abusive and/or neglectful parenting behaviors given the limited bias observed for demographic characteristics and problematic parenting behaviors. Further research should expand upon its utility to advance estimation rates.

Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support

Supervisory neglect, or the failure of a caregiver to appropriately supervise a child, is one of the predominant types of neglectful behaviors, with alcohol use being considered a key antecedent to inadequate supervision of children. The current study builds on previous work by examining the role of parental drinking and alcohol outlet densities while controlling for caregiver and child characteristics. Data were obtained from 3023 participants via a telephone survey from 50 cities throughout California. The telephone survey included items on neglectful parenting practices, drinking behaviors, and socio-demographic characteristics. Densities of alcohol outlets were measured for each of the 203 zip codes in the study. Multilevel Bernoulli models were used to analyze the relationship between four supervisory neglect parenting practices and individual-level and zip code-level variables. In our study, heavy drinking was only significantly related to one of our four outcome variables (leaving a child where he or she may not be safe). The density of on premise alcohol outlets was positively related to leaving a child home alone when an adult should be present. This study demonstrates that discrete relationships exist between alcohol related variables, social support, and specific supervisory neglect subtypes at the ecological and individual levels.

Four subtypes of self-neglect in older adults: results of a latent class analysis.

To determine whether there are subtypes of elder self-neglect (SN) with different risk factors that can be targeted using medical and social interventions. Cohort study using archived data of Adult Protective Services (APS) substantiated cases of elder SN between January 1, 2004, and December 31, 2008. Houston, Harris County, Texas. Adults aged 65 and older with APS region VI substantiated SN between January 1, 2004, and December 31, 2008 (N = 5,686). Adult Protective Services caseworkers used the Client Assessment and Risk Evaluation (CARE) tool during home investigations, assessing risk of harm in the domains of living conditions, financial status, physical and medical status, mental health, and social connectedness. Latent class analysis was used to identify unique subtypes of elder SN. Four unique subtypes of elder SN were identified, with approximately 50% of individuals manifesting physical and medical neglect problems. Other subtypes included environmental neglect (22%), global neglect (21%), and financial neglect (9%). Older age, Caucasian descent, and mental status problems were more strongly associated with global neglect behaviors. African Americans were more likely to experience financial and environmental neglect than Caucasians and non-white Hispanics. Elder SN consists of unique subtypes that may be amenable to customized multidisciplinary interventions. Future studies are needed to determine whether these subtypes impose differential mortality risks and whether multidisciplinary tailored interventions can reduce SN and prevent early mortality.

Come rain or come shine: supervisor behavior and employee job neglect

Purpose– The purpose of this paper is to investigate the extent to which supervisor behavior is associated with employees’ job neglect.Design/methodology/approach– The paper investigates the extent to which supervisor behavior is associated with employees’ job neglect.Findings– Results from hierarchical regression analyses support the hypothesis that both positive and negative supervisor behaviors have significant effects on job neglect. Negative supervisor behavior was more strongly associated with job neglect than positive supervisor behavior.Research limitations/implications– Changing the style of supervision might help to reduce job neglect of employees, benefitting the organization by reducing the associated costs of job neglect and counterproductive behavior.Originality/value– The findings provide additional evidence for the important effects supervisors can have on employees. They also indicate that – in addition to studying abusive supervision – there is a need to consider the effects of a broad spectrum of supervisor behavior.

Volunteers’ Reactions to Psychological Contract Fulfillment in Terms of Exit, Voice, Loyalty, and Neglect Behavior

Psychological contract fulfillment—an individual’s perception of the degree to which an organization fulfills its promises—is critical to understand how people behave in exchange relationships. I examine if fulfillment explains exit, (aggressive and considerate) voice, loyalty, and neglect behaviors of volunteers. Moreover, I test whether these relationships are mediated by violation and trust. Data were collected from 215 volunteers using an online survey and analyzed using structural equation modeling. Results indicated that fulfillment related negatively to exit, aggressive voice, and neglect behavior and positively to considerate voice behavior. Mediation analyses confirmed that violation and trust acted as mediators. I conclude that fulfillment is critical to understand why volunteers display exit, (aggressive and considerate) voice, and neglect behavior. Moreover, I propose that violation and trust are able to explain how fulfillment is related to these behaviors, through a “hot” and “cool” response system, respectively.

A structural model of mechanisms predicting depressive symptoms in women following childhood psychological maltreatment

Two underlying mechanisms, emotion dysregulation and negative internalized beliefs, were examined as potential mediators of the association between childhood psychological maltreatment (PM) and depression in emerging adult women. PM was assessed as a multi-faceted construct including aspects of psychological abuse (e.g., corrupting) and psychological neglect (e.g., emotional unresponsiveness) that occurred by parents. Female undergraduates (n=771) completed anonymous, retrospective, self-report surveys assessing childhood PM, current depressive symptoms, emotion dysregulation (lack of emotional clarity and regulation strategies), and negative internalized beliefs (mistrust, shame, and defectiveness). Psychological maltreatment was represented as four subtypes of psychological abuse or neglectful behavior: Emotional Non-Responsiveness, Spurning/Terrorizing, Corrupting, and Demanding/Rigid (i.e., controlling behavior). Both emotion dysregulation and negative internalized beliefs significantly mediated the link between childhood PM and depressive symptoms, accounting for approximately 68% of the variance in symptomatology. Findings suggest the importance of focusing intervention on development of emotion regulation capacity including emotional awareness and regulatory strategies, as well as a focus on core negative beliefs including shame, defectiveness, and mistrust of others. Implications for future research are discussed.

Are there differential relationships between different types of childhood maltreatment and different types of adult personality pathology?

While considerable data support the relationship between childhood trauma and adult personality pathology in general, there is little research investigating the specific relationships between different types of childhood maltreatment and adult personality disorders. The present study tested a model incorporating five a priori hypotheses regarding the association between distinct forms of childhood maltreatment and personality pathology in 231 psychiatric patients using multiple self-report measures (Personality Diagnostic Questionnaire-4th Edition, Child Trauma Questionnaire, Conflict in Tactics Scale Parent-Child Child-Adult, and Multidimensional Neglectful Behavior Scale). Step-wise linear regressions supported three out of five hypotheses, suggesting independent relationships between: physical abuse and antisocial personality disorder traits; emotional abuse and Cluster C personality disorder traits; and maternal neglect and Cluster A personality disorder traits after controlling for co-occurring maltreatment types and personality disorder traits. Results did not support an independent relationship between sexual abuse and borderline personality traits nor between emotional abuse and narcissistic personality disorder traits. Additionally, there were three unexpected findings: physical abuse was independently and positively associated with narcissistic and paranoid traits and negatively associated with Cluster C traits. These findings can help refine our understanding of adult personality pathology and support the future development of clinical tools for survivors of childhood maltreatment.

The impact of neglect on initial adaptation to school.

This study examined the impact of child neglect during the first 4 years of life on adaptation to school during kindergarten and first grade in the context of neighborhood poverty (NP). Processes related to the development of school competencies were examined, including the mediational role of cognitive functioning and ego-resiliency (ER) in shaping children's school outcomes. A total of 170 low-income urban children were followed prospectively for 2 years (ages 4-6). Results indicated that neglected children had significantly lower scores on kindergarten classroom behavior and first-grade academic performance than nonneglected children. Children's cognitive performance at age 4, controlling for maternal intelligence quotient, mediated the relation between severity of neglect and children's behavior in kindergarten as well as their academic performance in first grade. Moreover, severity of neglect was related to children's ER at age 4. However, additional ecological adversity in the form of NP moderated the link between ER and classroom behavior, such that at lower levels of poverty, ER mediated the relation between severity of neglect and school adaptation. Conversely, when NP was extreme, the effects of ER were attenuated and ER ceased to predict behavioral performance in kindergarten. The implications of these findings for prevention and intervention are discussed.

Maternal depression and rapid subsequent pregnancy among first time mothers.

To examine differences in prenatal depression among first-time mothers who had a subsequent pregnancy within 6 months of first birth and those who did not. Mothers with depression symptoms were expected to have a greater likelihood of rapid subsequent pregnancy. The Parenting for the First Time study is a longitudinal multisite prospective descriptive study designed to identify and understand the dynamics of subthreshold neglectful parenting behaviors among first-time mothers. Data were collected from the prenatal period through the child's first 3 years of life. The Parenting for the First Time sample consisted of 684 first-time mothers between 15 and 36 years. Data were available on prenatal depression and subsequent pregnancy at 6 months for 279 participants (n = 279). Multiple logistic regression analysis was conducted to determine the odds of subsequent pregnancy within 6 months of first birth. Twelve mothers (5.9%) became pregnant within 6 months of first birth. The odds of subsequent pregnancy were 7.24 greater (95% confidence interval [CI]: 2.18-24.04) among mothers with moderate-to-severe depression. White versus non-White race did not influence subsequent pregnancy (0.91, 95% CI: 0.18-4.49). Pregnancy was not significantly different between teen and adult mothers (odds ratio: 0.92, 95% CI: 0.24-3.68). In this sample of first time mothers, moderate-to-severe depression symptoms were associated with subsequent pregnancy within 6 months of first birth. Routine depression screening by nurses during the prenatal period offers opportunities for intensive contraceptive counseling and may help mothers achieve optimal birth spacing.

Patient neglect in healthcare institutions: a systematic review and conceptual model.

BackgroundPatient neglect is an issue of increasing public concern in Europe and North America, yet remains poorly understood. This is the first systematic review on the nature, frequency and causes of patient neglect as distinct from patient safety topics such as medical error.MethodThe Pubmed, Science Direct, and Medline databases were searched in order to identify research studies investigating patient neglect. Ten articles and four government reports met the inclusion criteria of reporting primary data on the occurrence or causes of patient neglect. Qualitative and quantitative data extraction investigated (1) the definition of patient neglect, (2) the forms of behaviour associated with neglect, (3) the reported frequency of neglect, and (4) the causes of neglect.ResultsPatient neglect is found to have two aspects. First, procedure neglect, which refers to failures of healthcare staff to achieve objective standards of care. Second, caring neglect, which refers to behaviours that lead patients and observers to believe that staff have uncaring attitudes. The perceived frequency of neglectful behaviour varies by observer. Patients and their family members are more likely to report neglect than healthcare staff, and nurses are more likely to report on the neglectful behaviours of other nurses than on their own behaviour. The causes of patient neglect frequently relate to organisational factors (e.g. high workloads that constrain the behaviours of healthcare staff, burnout), and the relationship between carers and patients.ConclusionA social psychology-based conceptual model is developed to explain the occurrence and nature of patient neglect. This model will facilitate investigations of i) differences between patients and healthcare staff in how they perceive neglect, ii) the association with patient neglect and health outcomes, iii) the relative importance of system and organisational factors in causing neglect, and iv) the design of interventions and health policy to reduce patient neglect.

How Do Different Types of Childhood Maltreatment Relate to Adult Personality Pathology?

There are insufficient data investigating the relative associations between different kinds of childhood maltreatment and the severity of adult personality pathology. Personality pathology and childhood maltreatment (sexual, physical, and emotional abuse and neglect) were assessed in 156 nonpsychotic psychiatric patients. Measures included the Personality Diagnostic Questionnaire for DSM-IV (PDQ-4+), the Childhood Trauma Questionnaire (CTQ), the Multidimensional Neglectful Behavior Scale (MNBS), and the Conflict Tactics Scales Parent-Child version (CTSPC-CA). Bivariate logistic regression analyses revealed each maltreatment type to significantly correlate with adult personality pathology. However, in multivariate logistic analyses controlling for education, neglect and emotional abuse were the only significant predictors of adult personality pathology (adjusted odds ratio [AOR] for MNBS neglect, 3.60; AOR for CTQ emotional abuse, 3.81). Analysis of the CTSPC-CA yielded a strong effect on maternal (AOR, 3.71) but not paternal neglect. These data suggest that clinicians should routinely evaluate for histories of neglect and emotional abuse, particularly in patients with marked personality pathology.

Spatial compression impairs prism adaptation in healthy individuals.

Neglect patients typically present with gross inattention to one side of space following damage to the contralateral hemisphere. While prism-adaptation (PA) is effective in ameliorating some neglect behaviors, the mechanisms involved and their relationship to neglect remain unclear. Recent studies have shown that conscious strategic control (SC) processes in PA may be impaired in neglect patients, who are also reported to show extraordinarily long aftereffects compared to healthy participants. Determining the underlying cause of these effects may be the key to understanding therapeutic benefits. Alternative accounts suggest that reduced SC might result from a failure to detect prism-induced reaching errors properly either because (a) the size of the error is underestimated in compressed visual space or (b) pathologically increased error-detection thresholds reduce the requirement for error correction. The purpose of this study was to model these two alternatives in healthy participants and to examine whether SC and subsequent aftereffects were abnormal compared to standard PA. Each participant completed three PA procedures within a MIRAGE mediated reality environment with direction errors recorded before, during and after adaptation. During PA, visual feedback of the reach could be compressed, perturbed by noise, or represented veridically. Compressed visual space significantly reduced SC and aftereffects compared to control and noise conditions. These results support recent observations in neglect patients, suggesting that a distortion of spatial representation may successfully model neglect and explain neglect performance while adapting to prisms.