Parental involvement and adjustment during the diagnostic evaluation of autism spectrum disorder at two diagnostic centers

OBJECTIVES

The primary objective of this study was to determine the effects of permanent, mediated parental presence during all autism spectrum disorder diagnostic evaluations on parental adjustment (perceived parental stress and sense of parental competence) compared with procedures that traditionally only involve parents in pivotal periods of the diagnosis. The level of satisfaction with the diagnostic procedure and parents' needs were also evaluated to complete this first objective. The secondary objective was to assess the effects of psychosocial, individual, and contextual variables on perceived parental stress and sense of parental competence.

METHODS

The total sample of 49 parents was divided (using simple randomization) into two subgroups, each for a different procedure. Participants were met with once before the first consultation and once after. They completed self-reported questionnaires on parental stress, sense of parental competence, satisfaction with the procedure, social support, locus of control, and appraisal of life events. Statistical analysis was conducted using SPAD and SPSS software.

RESULTS

There was no difference between the two groups in the variables assessed. Satisfaction with the diagnostic procedure was high in both groups, but parents highlighted that they had important needs following the diagnosis. The child's level of autonomy, the presence of disruptive behaviors, and satisfaction with social support were found to be important for determining parental adjustment.

CONCLUSIONS

Several hypotheses may explain the lack of differences between the two groups, including that parents may not yet have been in a position to benefit from the procedure aimed at integrating them. Our suggestion is that professional interventions should focus on improving the child's autonomy and helping the parent to develop a satisfactory support network. Finally, parents' needs for the post-diagnosis phase should be given greater consideration, particularly in future research.

[Can health forums dedicated to breast cancer be useful to caregivers? Analysis of initial messages on the National League Against Cancer forum over a one-year period]

OBJECTIVES

Forums are a source of health information and exchange. They can be studied to determine patients' needs and improve caregivers' practices. The aim of this study was to identify the needs of breast cancer patients based on messages posted on a discussion forum.

METHODS

Initial messages posted in 2021 on the Ligue nationale contre le cancer (LNCC) breast cancer forum were analyzed quantitatively. Message content was classified into three categories: testimonial, request for advice or request for medical opinion. The tone of the message (positive, neutral, or negative) was recorded. The temporality of the illness during which the patient expressed herself was defined. Analysis was carried out on the initial messages using the Chi2, Fisher, and Kruskal-Wallis tests, with a significance level of<0.05.

RESULTS

In 2021, 640 initial messages posted on the LNCC forum dedicated to breast cancer were analyzed. Messages were posted by 312 authors, including 275 patients and 37 family members. Three main types of messages were identified: requests for medical advice (n=339), advice (n=164), and testimonials (n=137). Requests for medical advice elicited fewer responses than testimonials (P<0.001). A need for supportive care was identified in 42.8% of messages, mostly concerning social (17.3%) and psychological (13%) care.

CONCLUSION

Our study revealed a need for more information especially regarding the social impact of the disease and the side-effects of treatment. The period of greatest need of information was the diagnostic waiting time. However, patients using discussion forums are not representative of all women with breast cancer and our results should not be generalized to all patients treated for breast cancer.

Prevalence of depression and protective factors in a population of children aged 8 to 10 years, suffering from specific learning disorders, in a special education and home care service (SESSAD)

OBJECTIVES

Evaluate the prevalence of depression in a population of children aged 8 to 10 years with learning disabilities treated in a Special Education and Home Care Service (SESSAD) and identify the protective factors that might preserve these children from depressive and affective problems.

METHODS

Twenty children, aged 8 to 10, with learning disabilities were evaluated prior to their admission in SESSAD. Depression had been assessed through the Multiscore Depression Inventory for Children (MDIC), adapted to the French population as well as their developmental position in relation with their perceptual maturity of their body schema, through the Draw your family drawing. The protective factors were assessed through the qualitative analysis of the stories told on the Draw your family projective drawing and card 4, 9, 20 of The Socialization Test for Children (TSEA). Quantitative data were computed through descriptive statistics and non-parametric tests (Spearman's correlation test) by the jamovi© statistic software (V.2.3.24), and the qualitative data were analyzed through thematic content analysis and lexical text analysis through the TROPES software (V.8.3).

RESULTS

Quantitative data showed for the entire group: (1) a perceptual maturity delay of the body schema in 75% of the sample; (2) a low incidence of depression in this population with, however, 40% of the sample, (aged 8 and 9) displaying a critical threshold for feelings of helplessness. The qualitative analysis of the Draw your family and TSEA stories allowed to underline some of the protective factors against depression and those which refer, in decreasing order, to the social support given by family members, peers, and the emotional substitutes (animals).

CONCLUSIONS

This research highlighted the precocity of the feelings of helplessness in this population and the importance given by these children to the social support. These findings and future research on the topic might be used to guide the design and implementation of adjusted interventions addressing both the development of their learning capability and psychological empowerment.

Experiences of Occupational Performance in Survivors of Stroke Attending Peer Support Groups

BACKGROUND.

Survivors of stroke often experience environmental isolation and decreased occupational performance after discharge from the hospital. Peer groups benefit psychological, social, and cognitive functioning, though few studies have examined their influence on occupational performance of survivors of stroke.

PURPOSE.

This study explores the experiences of occupational performance in survivors of stroke attending an outpatient peer support group.

METHOD.

An interpretive qualitative study using semi-structured interviews was conducted with seven survivors of stroke attending an outpatient peer support group. Data was thematically analyzed.

FINDINGS.

Four themes related to the experience of peer support on occupational performance emerged: finding hope to return to meaningful occupation, a place for belonging, problem-solving occupational concerns, and finding purpose beyond oneself.

IMPLICATIONS.

This research adds to the existing literature that peer support groups help survivors of stroke reengage in meaningful occupations, manage their stroke experience, and move positively through recovery.

Social support and the consequences of heart failure compared with other cardiac diseases: The contribution of support received within an attachment relationship

BACKGROUND

Interpersonal support is protective in heart disease, but sources of support and the quality of support may change over time, especially with aging and disease progression.

AIMS

To determine if support received within an attachment relationship with a spouse is more protective than other types.

METHODS

Subjects were sex- and age-matched cardiac outpatients with (n=40) or without (n=43) heart failure; they were studied with an observer-rated measure of attachment and self-report measures of other variables.

RESULTS

Having heart failure was associated with more depressive symptoms and illness intrusiveness. Although perceived social support did not differ in people with or without heart failure, those with heart failure had a spouse as the primary source of attachment functions less frequently than those without heart failure (50% vs 79%; P=0.006). Not having a spouse as the main provider of attachment functions was a partial mediator of the relationship between disease type (heart failure or no heart failure) and depressive symptoms (β=-0.24, t=-2.2; P=0.03) and deficits in non-attachment support made a further independent contribution (β=-0.24, t=-2.4; P=0.02). Neither perceived social support nor having a spouse serving attachment needs made a significant contribution to illness intrusiveness.

CONCLUSION

Having someone other than a spouse to provide attachment support is more common in cardiac patients who have heart failure and is associated with an increased risk of depressive symptoms.

[Self-esteem, coping, perceived social support and substance use in young adults with a cannabis dependence disorder]

INTRODUCTION

Self-esteem, coping strategies and perceived social support play a role in the adaptive functioning of the human being: they allow the adjustment of the subject to his/her environment. These dimensions could be protective factors regarding multiple risks associated with adolescent development, and particularly substance use. Thus our objective was twofold: to evaluate self-esteem, coping strategies and perceived social support in adolescents and young adults with a cannabis dependence in comparison with subjects from the general population; to establish the correspondence between these psychological dimensions and the patients' substance use pattern.

METHOD

Data from 43 young patients (36 males; mean age=19.6±3), consulting for their cannabis dependence, and 50 young adults from the general population (39 males; mean age=19.7±3.4) were included. Participants completed the Rosenberg Self-Esteem Inventory, the Social Self-Esteem Inventory of Lawson, the Coping Inventory for Stressful Situation of Endler & Parker, and the Perceived Social Support Questionnaire of Sarason. The MINI was administered to evaluate cannabis abuse or dependence; a semi-structured clinical interview was given to determine psychoactive substance use.

RESULTS

Between-group comparisons (two independent sample t-tests) showed that the patients had significantly lower scores on global (P=0.002) and social (P=0.035) self-esteem, task-oriented coping (P<0.001) and both availability and satisfaction regarding perceived social support (respectively P=0.029 and P<0.001). Conversely, patients had significantly higher scores on emotion-focused coping subscale (P=0.003). Logistic regressions showed that the satisfaction regarding social support and task-oriented coping scores were the more powerful to distinguish the patients from the controls (respectively β=1.16, P=0.043 and β=1.06, P=0.015). Unvaried linear regression analyses revealed a negative association between the age of first cannabis use and the avoidant-social coping score (P=0.025), and positive associations between the length of daily cannabis use and emotion-focused coping score (P=0.028), and frequency of cannabis use and global self-esteem scores (P=0.028). Moreover, polysubstance misuse is associated with low distraction-avoidant coping scores. No association was found between clinical scores and tobacco and alcohol uses variables.

CONCLUSION

These results suggest that cannabis dependent patients may present a lack in individual and interpersonal resources. This clinical study underscores the potential contribution of maladaptive coping to the development or maintenance of substance use in young adulthood.