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Biomedical subjects

L C Mayes

Publications and source records attributed to L C Mayes.

At least 19 recordsLinked to original sources
PubMed1995

Thrombocytopenia in pregnant women who use cocaine.

OBJECTIVE: Our purpose was to determine the prevalence of cocaine-associated thrombocytopenia. STUDY DESIGN: This cohort study was conducted in an inner-city prenatal center. A total of 1907 patients were screened by the Mother's Project, which is an intervention project for inner-city cocaine-abusing parturients. Platelet counts were grouped by illicit drug usage. RESULTS: Platelet counts were available in 37% (709) of subjects; there were no differences between subjects with available platelet counts and those without on illicit drug use or other demographic measures. Five groups were defined: drug-free group (n = 331), cocaine group (n = 104), cocaine and opiates group (n = 11), opiates group (n = 18), and other-drug group (n = 236). Nineteen subjects had a low platelet count (< 150 x 10(9)/L). The medical records of all subjects with a low platelet count were reviewed for any medical condition known to be associated with thrombocytopenia, and two subjects were excluded. The rate of thrombocytopenia in the drug-free group was 1.5%, whereas the rate in the cocaine group was 6.7% (relative risk 4.4, p < 0.05). Because of the reported association of thrombocytopenia with seropositive human immunodeficiency virus status, seropositive women were excluded from the analysis. Even after human immunodeficiency virus status adjustments for the estimated rate, the cocaine-using group continued to have a significantly higher rate of thrombocytopenia (5.4% to 7.2% vs 1.23% to 1.26%, p < 0.05 to p < 0.005). CONCLUSIONS: These results indicate that cocaine use is an independent risk factor for thrombocytopenia in an inner-city parturient population.

Adult↗
PubMed1995

Information processing and developmental assessments in 3-month-old infants exposed prenatally to cocaine.

OBJECTIVE: To determine the effect of prenatal cocaine exposure on 3-month infant information processing and developmental assessments. METHODS: One hundred and eight infants, 61 cocaine-exposed and 47 controls, participated at 3 months of age in an infant-control habituation and novelty responsiveness procedure and in a developmental assessment using the Bayley Scales of Infant Development both administered by experimenters blind to the drug exposure status of the infant. RESULTS: Compared to the non-drug-exposed group, infants exposed prenatally to cocaine were significantly more likely to fail to start the habituation procedure and, for those who did, significantly more likely to react with irritability early in the procedure. The majority of infants in both groups reached the habituation criterion, and among those who did there were no significant differences between cocaine and non-cocaine-exposed infants in habituation or in recovery to a novel stimulus. Infants who were cocaine-exposed showed comparatively depressed performance on the motor (Psychomotor Developmental Index) but not the mental (Mental Developmental Index (MDI)) scales of the Bayley. These results obtained for habituation and Bayley MDI controlling for both perinatal and sociodemographic factors. CONCLUSIONS: Differences in reactivity to novelty but not in information processing between cocaine-exposed and non-cocaine-exposed infants suggest that the effects of prenatal cocaine exposure may be on arousal and attention regulation rather than early cognitive processes.

Adult↗
PubMed1994

Understanding adaptive processes in a developmental context. A reappraisal of Hartmann's problem of adaptation.

Hartmann's theory of adaptation introduced the metapsychology of ego as an agent of adaptation to external reality as well as a defense against internal conflict. His notions of autonomous ego functions serving adaptation and of the child's biological preparedness for adaptation made a significant contribution to psychoanalytic developmental theory. However, the study of children developing in the midst of environmental discord and violence who enter such environments with or without an adequate endowment encourages a reappraisal of three issues in Hartmann's view of adaptation: (1) the developmental vicissitudes of adaptation, (2) the notion of an average expectable environment; and (3) the distinction between adaptation as state and as process. These issues are reviewed to outline factors that may preserve and foster adaptation for children in the face of adversity and chronic trauma. It is suggested that adaptation is better understood as the individual's reaching a relative state of autonomy vis-à-vis deviations from average expectable endowment, experience, or environment and as one that occurs not in spite of but in the context of adversity.

Adaptation, Psychological↗
PubMed1994

Monitoring the analytic surface.

How do we listen during an analytic hour? Systematic analysis of the speech patterns of one patient (Mrs. C.) strongly suggests that the clustering of shared pronouns (e.g., you/me) represents an important aspect of the analytic surface, preconsciously sensed by the analyst and used by him to determine when to intervene. Sensitivity to these patterns increases over the course of treatment, and in a final block of 10 hours shows a striking degree of contingent responsivity: specific utterances by the patient are consistently echoed by the analyst's interventions.

Association↗
PubMed1994

Experiencing self and others: contributions from studies of autism to the psychoanalytic theory of social development.

Psychoanalysts have long been interested in autism as a disorder in which the development of a sense of self and other is altered dramatically. This paper outlines how our psychoanalytic understanding of the process of emergence and maintenance of the self and of inner world may be informed by recent findings from developmental psychology about how normal and autistic children develop the capacity to attribute mental states such as desires, feelings, and beliefs to others. Because autistic individuals frequently fail to develop an understanding of the relation between feelings or beliefs and the behaviors of themselves or others, studies of autism provide a clinical model for how these neurocognitively based functions, related to acquiring a so-called theory of mind, are involved in the elaboration of an inner world and in the ongoing definition of self. Understanding how both autistic and normal children develop, or fail to develop, the capacity to attribute meaning to others' actions, beliefs, and feelings speaks to psychoanalytic notions of internalization, identification, and introjection and provides a neurocognitive frame for how representations of self and others are created in the inner world. Conversely, the psychoanalytic view that the infant's emerging sense of self is also shaped by the infant's desire for mother underscores that affective precursors are absolutely necessary for a theory of mind to emerge.

Autistic Disorder↗
PubMed1994

Understanding therapeutic action in the analytic situation: a second look at the developmental metaphor.

A root metaphor for the psychoanalytic therapeutic process is the mother-infant caretaking relationship. This developmental metaphor has assumed a dominant role for some analysts in how the psychoanalytic process and therapeutic relationship are conceptualized. In this paper, a distinction is made between two uses of the developmental metaphor--naïve and informed. The naïve view as commonly applied constrains our view of the unique relationship between analyst and analysand. The informed view takes into account current research in early social development that has emerged in the last decade of empirical studies with infants, young children, and their parents. While the parent-child relationship may be an inexact model for the analytic connection, some of the implications of the former, as they become more clearly understood in the course of careful research, may provide useful information about how change does or does not occur as a result of the analytic process, and how an analytic process needs to be in place in the analysand before that change can occur.

Child Development↗
PubMed1993

Playing and therapeutic action in child analysis.

From its inception, child psychoanalysis has used fantasy play as a window to both the content and process of children's inner worlds. Because of the link to action and primary process, young children's imaginary play is rich in symbolic expressions that facilitate analytic interpretive interventions addressing the conflicts impeding development. There are inevitable tensions between allowing play to emerge as a therapeutic process in its own right and the usual psychoanalytic emphasis on clarification, verbalisation and, above all, interpretation within and about the transference. For many children, the very act of playing carries much of the therapeutic work aimed toward facilitating their return to developmentally appropriate and adaptive psychic functioning. The mobilisation of capacities for play in the analysis allows children to do what is needed for their development to continue and makes use of the developmentally restorative functions of play in the service of therapeutic action.

Adolescent↗
PubMed1993

The social matrix of aggression. Enactments and representations of loving and hating in the first years of life.

In this paper, we build on a developing body of work that addresses the various contributions to the child's emerging definition of self in the first five years of life. Described is the role of aggression in the shaping of the child's predominant modes of viewing and experiencing the world. How aggression toward another mixes with desire for another in the formation of early capacities for object relatedness is a central question for any developmental theory of aggression, for aggression is first experienced, shaped, refined, and remodeled in the context of loving relations. Studies from related disciplines provide observational data about how aggression is modified in the first five to six years of life and how the capacity to interpret the intentions of others is crucial to those modifications. Understanding the intentions of others relates also to the capacity to attribute affects, beliefs, and other mental states to others, a capacity referred to elsewhere as a theory of mind. The ability to reflect upon thoughts and feelings in oneself and others provides children with a fuller range of responses to their own and others' perceived aggression. Finally, external experiences of violence, abuse, and deprivation influence the child's experience of his own and others' aggression and prevent the normal modulation of aggression in the social matrix.

Aggression↗
PubMed1993

Neurobehavioral profiles of neonates exposed to cocaine prenatally.

This study examined the effects of maternal cocaine use on performance on the Neonatal Behavioral Assessment Scale (NBAS). Cocaine-exposed newborns (n = 56) were compared with a non-cocaine-exposed group (n = 30) born to mothers with similar sociodemographic characteristics. Cocaine-exposed newborns showed significant reduction in birth weight but did not experience greater obstetric or postnatal complications. On neurobehavioral assessments using the NBAS, cocaine-exposed newborns showed significantly depressed performance on the habituation cluster but not on other NBAS clusters when differences in birth weight were controlled. In a sample of 30 cocaine-exposed newborns matched on birth weight, gestational age, and race to the 30 non-cocaine-exposed newborns, cocaine-exposed newborns continued to show depressed habituation performance. The significance of a selective effect of cocaine exposure on early habituation performance is discussed in terms of the implications for attentional regulation in the first year of life.

Adult↗
PubMed1992

The development of a capacity for imagination in early childhood.

Imagination as a mental capacity is part of a line of development that begins in the earliest symbiotic interactions between mother and infant, takes further shape as the child moves from dyadic to triadic relations, and culminates in a fully mature capacity to reflect upon in thought one's wishes and feelings vis-à-vis multiple others. Particularly for the 3- to 5-year-old child, imagination represents a special mode of mental functioning which allows him to expand his internal object world, motivates him toward increasingly complex relationships with others, and is a central precondition for the creation of the self-defining fantasies characteristic of the oedipal phase. The central neurocognitive precondition for an imaginative capacity is the ability to distinguish thought from action and understand that others as well as oneself are motivated to act because of mental states such as feelings, beliefs, and fantasies. In this paper, we present a view of imagination that integrates observations from psychoanalytically informed studies of the emergence of fantasy play in the oedipal phase with findings from recent work on how children acquire an understanding of their own and others' mental processes.

Child↗
PubMed1992

An observational study of the affective concomitants of mastery in infants.

The hypothesis that attempts at motor mastery were accompanied by positive affective responses was tested in an observational study of 9-11-month old infants in a daycare setting. Five infants were observed as they attempted three age-appropriate motor tasks--pulling to stand, standing with support, and taking steps with support. Positive affective responses included smiling, babbling, and laughing. The five infants were observed for a total of 82 hours. The proportion of positive affective behaviors associated with practicing new motor tasks was compared to the proportion associated with well-practiced tasks. The hypothesis that more positive affective behaviors would be associated with attempts at mastering the new motor tasks was confirmed. There was no diminution in the association between the new motor tasks and positive affect as the infants continued to practice and master the three motor tasks. The results are discussed in terms of individual differences in mastery motivation and the often suggested continuity between early mastery motivation and later competencies.

Child↗
PubMed1991

Exploring internal and external worlds. Reflections on being curious.

Curiosity is a complex function that is related to a number of other psychological functions such as motivation, arousal, attention, and novelty preference. This paper presents the thesis that curiosity represents a separate ego function which is closely tied to objects and is centrally organizing in all phases of development. It is an integrative function that regulates arousal, motivation, and affect, begins in infancy, has a neurobiological base, and is channeled by the child's social experience. Psychologically, curiosity may serve both libidinal and aggressive aims. Psychoanalytic views of curiosity are considered in light of data from studies of infants' and young children's exploratory activities and a model is presented for the developmental function of curiosity throughout the life-span.

Adolescent↗
PubMed1991

Reflections on stillness: mothers' reactions to the still-face situation.

The still-face procedure, in which mothers maintain a neutral face and are noninteractive with their infants, has been used to study the effects of maternal withdrawal on the mother-infant interaction. In this study, 56 mothers' reactions to their own experience during a still-face procedure were explored using an open-ended interview. The associations between the mothers' reported experience, the infants' behavior during the procedure, and the mothers' behavior during subsequent play were examined. Over half of the mothers reported experiencing discomfort during the session and were more likely to report discomfort if their infants protested their affective absence. Mothers reporting discomfort were significantly more likely to pick up their infants and continue to reflect verbally on their own feelings after the still-face ended. These results are discussed in terms of their clinical implications for understanding the early development of the social dialogue between mother and infant.

Adult↗
PubMed1990

Emerging social regulatory capacities as seen in the still-face situation.

Early mother-infant interactions support infants' abilities to deal with stressful situations such as the withdrawal of maternal attention. The "still-face" paradigm provides a framework for studying the range of social regulatory capacities available to infants during stressful times. This study examined the responses of 62 3-4-month-old infants during the still-face situation. Infants' responses were coded in real time along 3 dimensions: gaze, affect, and state. 3 findings are presented: (1) Generally, infants responded to the still-face situation with predominantly neutral affect and looking away from their mothers. (2) Infants who looked longer at their mothers early in the still-face showed longer early positive affect and protested her absence less. (3) Girls more often showed an intensely negative response to the still-face. These findings are discussed in the context of the development of social regulatory capacities in infancy.

Affect↗
PubMed1990

The role of dyadic affect in play and infant sex in predicting infant response to the still-face situation.

This study was designed to examine mothers' and 3-month-old infants' affect in play and infant sex as predictors of infants' response to the still-face situation. Infants who evidenced negative affect in play were likely to respond with negative displays during a subsequent still-face situation. Maternal positivity in play was positively correlated with infants' social gaze in the still-face situation. In addition, maternal positivity and infant sex significantly interacted in predicting infant affective response in the still-face situation. For girls, maternal positivity was associated with decreased expressivity. For boys, maternal positivity was associated with early positive bids, which were followed by negative bids and moderately negative affect. Finally, maternal positivity and its interaction with infant sex provide unique information beyond the carry-over effect from infant affect in play to infant response to the still-face. Results are discussed in terms of patterns of individual and joint regulation.

Affect↗
PubMed1989

Investigations of learning processes in infants.

This brief review has covered three major areas: what kinds of information can infants encode in the first 6 to 9 months and what methods are available to measure their responses; the status of memory functions in infancy; and current models of synaptogenesis, a process likely underlying the emerging cognitive processes during infancy. We can conclude that infants are capable of learning even from the first hours after birth and show a rapid increase in their capacity to recall information and use it for further learning. Furthermore, neurobiologic models of development are beginning to define a more detailed picture of crucial phases in the first months for learning processes. There are four notable omissions in the above points and in the material covered in this review. Mentioning these in this summary serves to caution the reader that there is much more to consider, and to point to other active areas of investigation of infants' cognitive capacities. These points also serve as a partial response to the questions asked in the beginning of the paper about how far we have yet to go in our understanding of infants' learning and about what may be the observational blind spots for our generation of infancy investigators. First, we have not discussed what drives learning--why infants seek actively to acquire information and seem motivated to retain that information for later use? Lipsitt points out that much of early infant behavior is based on positive and negative responses to diverse stimuli of varying degrees of attractiveness, and that the "hedonic overtones," or the amount of pleasure, involved in a stimulus situation, certainly contribute to the infant's response. Until recently, studies of social and affective development have been essentially separate from studies of cognition. Currently, the field of "social cognition" symbolizes the link between studies of basic cognitive processes and social development.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗