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Biomedical subjects

L Beckwith

Publications and source records attributed to L Beckwith.

At least 19 recordsLinked to original sources
PubMed2000

Intrusive caregiving and quality of attachment in prenatally drug-exposed toddlers and their primary caregivers.

The relation between caregiver intrusiveness and the quality of attachment was tested among 51 prenatally drug-exposed toddlers and their primary caregivers. Biological mothers and kinship/foster caregivers neither differed as to caregiver intrusiveness nor as to their toddlers' attachment security and attachment organization. Insecure and disorganized/disoriented attachments were found to be more prevalent in this sample than in normal samples. In keeping with recent findings in non-drug-abusing samples (Isabella & Belsky, 1991; Lyons-Ruth, Repacholi, McLeod, & Silva, 1991), more caregivers of toddlers with avoidant or disorganized/disoriented attachments were found to be intrusive than caregivers of toddlers with secure or resistant attachments.

Adult↗
PubMed1999

Psychopathology, mother-child interaction, and infant development: substance-abusing mothers and their offspring.

The course of severe depressive symptoms from pregnancy to 6 months postpartum, as well as the occurrence of severe paranoid symptoms prenatally, were examined by the Millon Clinical Multiaxial Inventory I and the Beck Depression Inventory, in 78 women who were heavy, chronic cocaine users and who retained custody of their children after birth. Six months postpartum, the quality of caregiving was observed and assessed in the home, and the children were assessed on the Bayley MDI Index in the laboratory. Mothers who were depressed and paranoid prenatally, regardless of whether the depression continued to 6 months postpartum, were less sensitive in caregiving than women without severe symptoms of paranoia or depression during pregnancy or those who reported only depression that lifted by 6 months postpartum. Mothers who were depressed prenatally and continued to be depressed by 6 months postpartum, regardless of the presence or absence of paranoia, had infants who earned lower Bayley MDI scores than the offspring of women without severe psychological symptoms or women whose depression had lifted. Severe depressive symptoms during pregnancy, if they did not continue to 6 months postpartum, did not appear to adversely influence either caregiving or infant functioning.

Adult↗
PubMed1999

Maternal sensitivity during infancy and subsequent life events relate to attachment representation at early adulthood.

A prospective longitudinal research study of 86 prematurely born children from birth to age 18 years provided empirical evidence for continuity from infancy experience to representations of attachment at age 18 years. Young adults whose representation of attachment was dismissing had been objectively observed during infancy, 16-17 years earlier, to receive less sensitive maternal care than those infants who were later judged at early adulthood to have secure or preoccupied representations. Infancy experience alone did not differentiate young adults with secure representations from those with preoccupied representations. Rather, adverse life events through age 12, particularly parental divorce, reduced the likelihood of secure representations and increased the likelihood of preoccupied representations. The absence of adverse life events did not increase the likelihood of security for those who had not experienced early sensitive caregiving.

Adolescent↗
PubMed1999

Maltoma of the thyroid in a man with Hashimoto's thyroiditis.

We report the case of a 42-yr-old man with primary thyroid lymphoma arising from mucosa-associated lymphoid tissue (MALT-lymphoma, maltoma). The patient underwent a hemithyroidectomy for a growing mass in the right lobe of the thyroid while being treated with 1-thyroxine for Hashimoto's thyroiditis. The clinical diagnosis of Hashimoto's disease was confirmed by aspiration biopsy of the mass during the course of L-thyroxine treatment. Postoperatively, histology showed atypical lymphoproliferative infiltrates suspicious of low-grade non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue-type, coexisting with a reactive process typical of chronic lymphocytic thyroiditis. Immunophenotyping showed a mixed B- and T-lymphocyte population, which was nondiagnostic. However, Southern blot analysis revealed a clonal rearrangement of the Ig heavy chain gene. This case demonstrates that cytology or histology may not distinguish between reactive or low-grade lymphomatous thyroid processes. The use of molecular technique was essential to prove clonality and the presence of lymphoma.

Adult↗
PubMed1996

Issues in subject recruitment and retention with pregnant and parenting substance-abusing women.

To advance knowledge about the treatment of addiction among pregnant women and other women of childbearing age, investigators must adhere to the requirements of a strict experimental research design while concurrently providing clinical services. This means that researchers must address a variety of difficult questions, including the following: Was the sample large enough? Were the criteria for subject inclusion and exclusion well defined? Did the process of recruitment result in a sample that could be generalized to a larger population, or was the sample biased in some way? Was assignment to groups clearly random? What was the attrition rate? Was attrition the same in both experimental and comparison groups? Did baseline measures collect enough information to permit a description of the facts that were associated with attrition in each group? Was the attrition rate so high that the retained sample had special characteristics? If so, what were these features? This chapter highlights several problems related to these questions, describes the difficulties that investigators have faced in meeting clinical and research challenges to date, and suggests strategies for overcoming some obstacles. In establishing the Perinatal-20 project, the National Institute on Drug Abuse took an informed first step in organizing a substantial research effort to investigate treatment modalities that incorporate services specific to the needs of substance-abusing women who have children. This initial effort has resulted in a beginning knowledge base that can be used to refine and expand future treatment efforts. Even the issue of the "study unit" for this population is evolving. Today's researchers are attempting to determine whether the mother alone or the mother along with her dependent children constitutes the study unit. This question also has led professionals in the field to examine a range of specific outcome priorities, and investigators just now are beginning to determine exactly what needs to be evaluated in gauging the effectiveness of treatment. Is success measured on the basis of the woman's progress with abstinence alone, or does it also include her role with her children? Is it determined on the basis of her relationship with her children or the children's growth and development? Compared with providing services for and studying single adult subjects, developing treatment for women and their children presents researchers with a more complex task and requires expanded clinical services (Gallagher 1990, pp. 540-559). As in most fields of study, initial research data in substance abuse treatment for pregnant and parenting women are derived from samples of convenience, as described above. To put this information in perspective, future research will require a wider and more representative spectrum of the population. Furthermore, tensions between clinical needs and research requirements must be considered in advance, and methods for relaxing these tensions will be critical to the success of future efforts. For example, members of both the research and clinical staff teams must be absolutely clear about the study design and the requirements of reliable research. Where possible, potential ambiguities about group assignment, project services, subjects' responsibilities, and so forth must be incorporated into subject consent forms so that the subjects also are apprised of potential problems and their solutions. A final caution to future investigators is to be aware of the economic, physical, and personnel limitations of the range of treatment services that can be provided in a research demonstration study involving this population. Because of these limitations and the extensive range of services the subjects of the studies require, treatment components must be discrete and carefully defined to prevent programs from becoming impractically diverse and unclear. Research goals must be attainable and measurable.(ABSTRACT TRUNCATED)

Adult↗
PubMed1992

Preterm children at early adolescence and continuity and discontinuity in maternal responsiveness from infancy.

Patterns in mother-child interaction from infancy to age 12 were investigated in a prospective, longitudinal study of 44 English-speaking mothers and their preterm children. Maternal responsiveness was assessed by home observations during infancy and the Family Interaction Q-Sort at age 12, derived from 2 structured laboratory situations requiring cooperation of mother and child. A cluster of maternal behaviors of critical control toward the toddler was assessed at age 2 years. Children of mothers who were consistently more responsive during both infancy and early adolescence, as well as children whose mothers became more responsive by age 12, achieved higher IQ and arithmetic scores, had more positive self-esteem, and their teachers reported fewer behavioral and emotional problems than children of mothers who were consistently less responsive both during infancy and at age 12. Continuity in parenting behaviors was related to control and criticism beginning in the toddler period and not to degree of responsiveness to the infant.

Birth Order↗
PubMed1990

Mothers' use of personal pronouns when talking with toddlers.

The verbal interaction of 2-year-old children (N = 46; 16 girls, 30 boys) and their mothers was audiotaped, transcribed, and analyzed for the use of personal pronouns, the total number of utterances, the child's mean length of utterance, and the mother's responsiveness to her child's utterances. Mothers' use of the personal pronoun we was significantly related to their children's performance on the Stanford-Binet at age 5 and the Wechsler Intelligence Scale for Children at age 8. Mothers' use of we in social--vocal interchange, indicating a system for establishing a shared relationship with the child, was closely connected with their verbal responsiveness to their children. The total amount of maternal talking, the number of personal pronouns used by mothers, and their verbal responsiveness to their children were not related to mothers' social class or years of education.

Child, Preschool↗
PubMed1989

Prenatal exposure to drugs: behavioral distortions reflecting CNS impairment?

In order to disentangle the effects on development of prenatal drug exposure from the effects of poor prenatal care, perinatal complications, and low socioeconomic status, toddlers prenatally exposed to drugs were compared to high risk preterm toddlers of similar ethnicity and social class. Intellectual functioning and quality of play were assessed. The drug exposed toddlers had significantly lower developmental scores and less representational play. Furthermore elements of their play were characterized by the investigators as a soft neurological sign. The question of possible CNS impairment is raised.

Central Nervous System Diseases↗
PubMed1988

Intervention with disadvantaged parents of sick preterm infants.

Infants born preterm are, as a group, at increased risk for a wide variety of later developmental problems (Kopp and Parmelee 1979), although many preterm infants do well (Hack et al. 1983; Saigal et al. 1984). The perinatal vulnerability, however, is amplified in disadvantaged families (Sameroff and Chandler 1975), increasing the likelihood of later emotional and cognitive difficulties (Werner and Smith 1977). A preventive intervention project was designed, therefore, that would provide and then evaluate the effectiveness of supportive home visitor services to parents of infants who were at double jeopardy, both biologically and socially--that is, sick preterm infants being reared by low-income parents. E. Baxter, K. Weiler and I hypothesized that if intervention could increase mothers' involvement and level of responsive interactions with their children, that increased maternal commitment and responsiveness to the infant would act as a protective factor ameliorating or preventing later problems in the child (Beckwith and Cohen 1984; Werner and Smith 1982).

Adult↗
PubMed1988

Infants and children with convulsions and hypotonic-hyporesponsive episodes following diphtheria-tetanus-pertussis immunization: follow-up evaluation.

In a prior prospective study, we evaluated the nature and rates of adverse reactions occurring within 48 hours following 15,752 diphtheria-tetanus-pertussis (DTP) immunizations. Nine children had convulsions, and nine had hypotonic-hyporesponsive episodes. After an interval of 6 to 7 years, we were successful in contacting the families of 16 of these children to determine whether any had evidence of neurologic impairment too subtle to have been detected at the time of initial evaluation. All 16 were considered normal by their parents and were doing well in school. A complete neurologic and psychometric evaluation was performed on 13 of these children. No child had significant neurologic deficit, although four had minor neurologic abnormalities. Psychometric testing revealed normal performance IQ scores (104.3 +/- 15.8) but low verbal IQ scores (91.8 +/- 18.4); however, these lower verbal IQ scores can be explained by the proportion of Hispanic and bilingual children in this sample. Therefore, there is no evidence that any of these 16 children have any serious neurologic damage as a result of a convulsion or a hypotonic-hyporesponsive episode temporally associated with a prior diphtheria-tetanus-pertussis immunization.

Child, Preschool↗
PubMed1986

Spectral analysis of infant EEG and behavioral outcome at age five.

Power spectral and discriminant analysis techniques were used to compare EEG records obtained at term and at 3 months past term from 5 groups of varying risk and developmental outcome. The groups were: healthy full-terms; healthy pre-terms with normal outcomes; sick pre-terms with normal outcomes; sick pre-terms with delayed development; sick pre-terms with later neurological problems. The EEG samples recorded at term were identified as belonging to the correct subject group at 52-70% accuracy, 20% being chance for 5 groups. The accuracy varied with the 4 classes of EEG patterns used. The individual subjects were also classified into their correct groups with few exceptions. Similar success was obtained with EEG samples selected from recording at 3 months past term. The predominant power spectral discriminating features were changes in intra- and inter-hemispheric coherence, and increased power, particularly in the middle and higher frequency range. Thus, computer analyses of EEG samples, using features not readily identified visually, differentiated risk from non-risk infants and also differentiated infants with substantial neonatal medical complications who have good or poor developmental outcomes.

Brain↗
PubMed1986

Cognitive development in preterm infants: birth to 8 years.

This report summarizes the outcome at age 8 of a group of preterm infants followed intensively from birth. The study was designed primarily to follow the processes of interaction between biological and environmental factors in determining the childhood outcome of infants born preterm rather than to report the incidence of particular types of outcomes for special subgroups of infants. A high percentage of the children were performing within the normal range. Social factors played a major role in determining the outcome regardless of neonatal complications. Functional assessment of newborn visual attention and sleep organization showed a modest relation to outcome. A subgroup of preterm infants from Spanish-speaking families, for cultural and language integration reasons, followed a somewhat different course from infancy to childhood outcome than did the group from English-speaking families. The results suggest that in longitudinal studies of preterm infants, different cultural and language groups should be analyzed separately so that one may understand the developmental processes and outcomes.

Attention↗
PubMed1986

EEG patterns of preterm infants, home environment, and later IQ.

As part of a prospective longitudinal study of preterm infants, sleep state organization and EEG patterns were studied at term date in 53 preterm infants as an index of the maturity and integrity of neurophysiological organization that might have implications for their later development. The rearing environments of the infants were also assessed, using time sampling of caregiver-infant interaction during home observations when the infants were 1, 8, and 24 months. The infants were tested at 4, 9, and 24 months on the Gesell Developmental Scale. At age 5 the children were tested by the Stanford-Binet Intelligence Scale, and at age 8 by the Wechsler Intelligence Scale for Children. In general, children who at term date showed less 407-Tracé Alternant EEG pattern in the entire record and particularly in quiet sleep had lower IQs beginning at 4 months and continuing to age 8. There was an exception, however, for those children being reared in consistently attentive, responsive environments. They, by 24 months and continuing to age 8, had higher IQ scores, equal to those of infants with more 407-Tracé Alternant, even if they had shown decreased amounts of 407-Tracé Alternant earlier.

Arousal↗