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Biomedical subjects

H L Caplan

Publications and source records attributed to H L Caplan.

7 recordsLinked to original sources

Maternal depression and the emotional development of the child.

Ninety-two women and their first-born children took part in a longitudinal survey of maternal mental health. When the children were four years old, their mothers were interviewed by means of the Behavioural Screening Questionnaire, and the children's problems were rated by a psychiatrist, who was unaware of the mothers' psychiatric histories or of assessments of their current health. As expected, mothers who were concurrently depressed reported significantly more behavioural difficulties in their children. Marital disharmony during pregnancy and a history of paternal psychiatric problems were also associated with later childhood behavioural difficulties. Children who scored below average on the McCarthy scales of cognitive abilities were also reported by their mothers to have more behavioural problems, but the children's behavioural difficulties at four showed no clear links with post-natal depression.

Adult↗

Impact of maternal postnatal depression on cognitive development of young children.

Ninety four women and their first born children took part in a longitudinal study of maternal mental health during pregnancy and after delivery. The children's cognitive functioning was assessed at age 4 using the McCarthy scales, without knowledge of the mothers' psychiatric history or current health. As expected girls performed slightly better than boys and children from middle class and professional families did better than children from working class homes, as did children whose mothers had achieved at least one A level at school. Significant intellectual deficits were found in the children whose mothers had suffered with depression, but only when this depression occurred in the first year of the child's life. Marital conflict and a history of paternal psychiatric problems were independently linked with lower cognitive test scores; together with a working class home background these were the only factors that contributed to the deleterious effect of maternal postnatal depression.

Child Development↗

Duration of circulatory arrest does influence the psychological development of children after cardiac operation in early life.

Published works on intelligence quotient (IQ) and development following the use of profound hypothermia and circulatory arrest (TCA) to repair congenital heart defects in infants and young children suggest that little or no psychomotor impairment results. IQ scores derived from cognitive, memory, perceptual, quantitative, and verbal tests (McCarthy scale of the children's abilities, mean score 100, SD 16) were measured in 31 patients 5 years following operations performed with TCA between 1972 and 1976. These patients were compared with three control groups: (1) 19 patients with similar defects but operated upon using moderate hypothermia and continuous cardiopulmonary bypass (CPB); (2) 16 children who were the siblings of the TCA patients; and (3) 14 children who were the siblings of the CPB patients. The hypothermic temperatures reached were closely clustered around 15 degrees C in the TCA group and 28 degrees C in the CPB group. TCA time ranged from 22 to 71 minutes. Statistical analysis, which included, t test, chi square test of association, and Wilcoxon test, showed that the only baseline characteristic which differed between the two patient groups in respect to age at operation, age at testing, and preoperative physiological variables (level of cyanosis, weight, oxygen saturation, and hemoglobin concentration) was weight (p = 0.03). The mean score of the TCA group (91 +/- 4.0, SE) was significantly lower (p = 0.002) than that of their siblings (106 +/- 4.1, SE). The score for the CPB patients (102 +/- 5.2, SE) was not demonstrably different from that of their siblings (96 +/- 5.9, SE). The sibling and patient (TCA) IQ differences were associated with duration of arrest in verbal (p = 0.06), quantitative (p = 0.07), and general cognitive (p = 0.003) scores. A decrease of 0.53 point per minute of arrest time was estimated for the entire group of 31 patients; that is, in the 19 patients with siblings, for each minute increase in circulatory arrest time, the patients dropped 0.69 IQ point below their siblings. These results and analysis of other published data do not support the generally accepted view that TCA can be used entirely without penalty. We question the accepted "safe" limit of circulatory arrest of 60 minutes.

Cardiopulmonary Bypass↗

Personal questionnaire changes and their correlates in a psychotherapeutic group.

Personal questionnaires were constructed for seven members of a psychotherapy group. Self-reported changes during group sessions and over a period of up to 10 months' treatment were analysed. There was no general pattern of 'improvement' either during sessions or in the longer term. There was evidence suggestive of an inverse relationship between changes during sessions and over the period of the study. Some clinically meaningful relationships were discerned between the present data and repertory grid and verbal behaviour measures on the same group members reported in a previous paper. Theoretical and methodological implications are discussed.

Evaluation Studies as Topic↗

Some correlates of repertory grid measures used to study a psychotherapeutic group.

Repertory grid data provided monthly by the members of a psychotherapeutic group were related to measures of verbal behaviour during group sessions in ways which were both statistically significant and psychologically meaningful. There was evidence that the group members re-enacted earlier patterns of family relationship in their mutual interaction. For individual patient members of the group, speaking, being spoken to, and introducing several kinds of topic into the group discussion had significant associations with grid variables implicating self-esteem and patterns of identification with parents; but the correlation patterns varied between patients.

Evaluation Studies as Topic↗