Sustaining Civil Society: Lessons from Five Pooled Funds in Eastern Europe

After 1990, US and European foundations and government agencies invested in a series of Partnerships and Trusts to support civil society in Central and Eastern Europe, the Baltics, the Balkans and the Black Sea regions. Analyzing the long-term impact of these investments is crucial, especially as many politicians across these regions increase their anti-civil society rhetoric. Three long-time US foundation staff look back at the legacy and impact of this funding and derive a series of lessons for practitioners seeking to understand how best to sustain civil societies for the long term

Self‐injurious behaviour: limbic dysregulation and stress effects in an animal model

Background  Self‐injurious behaviour (SIB) is prevalent in neurodevelopmental disorders, but its expression is highly variable within, and between diagnostic categories. This raises questions about the factors that contribute to aetiology and expression of SIB. Expression of SIB is generally described in relation to social reinforcement. However, variables that predispose vulnerability have not been as clearly characterised. This study reports the aetiology and expression of self‐injury in an animal model of pemoline‐induced SIB. It describes changes in gross neuronal activity in selected brain regions after chronic treatment with pemoline, and it describes the impact that a history of social defeat stress has on the subsequent expression of SIB during pemoline treatment. Methods  Experiment 1 – Male Long‐Evans rats were injected on each of five consecutive days with pemoline or vehicle, and the expression of SIB was evaluated using a rating scale. The brains were harvested on the morning of the sixth day, and were assayed for expression of cytochrome oxidase, an index of sustained neuronal metabolic activity. Experiment 2 – Male Long‐Evans rats were exposed to a regimen of 12 daily sessions of social defeat stress or 12 daily sessions of handling (i.e. controls). Starting on the day after completion of the social defeat or handling regimen, each rat was given five daily injections of pemoline. The durations of self‐injurious oral contact and other stereotyped behaviours were monitored, and the areas of tissue injury were quantified. Results  Experiment 1 – Neuronal metabolic activity was significantly lower in a variety of limbic and limbic‐associated brain structures in the pemoline‐treated rats, when compared with activity in the same regions of vehicle‐treated controls. In addition, neuronal activity was low in the caudate–putamen, and in subfields of the hypothalamus, but did not differ between groups for a variety of other brain regions, including nucleus accumbens, substantia nigra, ventral tegmentum, thalamus, amygdala, and cortical regions. Experiment 2 – All the pemoline‐treated rats exhibited SIB, and whereas the social defeat regimen did not alter the total amount of self‐injurious oral contact or other stereotyped behaviours, it significantly increased the severity of tissue injury. Conclusions  A broad sampling of regional metabolic activity indicates that the pemoline regimen produces enduring changes that are localised to specific limbic, hypothalamic and striatal structures. The potential role of limbic function in aetiology of SIB is further supported by the finding that pemoline‐induced self‐injury is exacerbated by prior exposure to social defeat stress. Overall, the results suggest brain targets that should be investigated further, and increase our understanding of the putative role that stress plays in the pathophysiology of SIB.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91181/1/j.1365-2788.2011.01485.x.pd

Non-pharmacological interventions for adults with intellectual disabilities and depression

Background: Although high rates of depression symptoms are reported in adults with intellectual disabilities (IDs), there is a lack of knowledge about non-pharmacological treatment options for depression in this population. The first research question of this paper is: Which non-pharmacological interventions have been studied in adults with ID and depression? The second research question is: What were the results of these non-pharmacological interventions?. Method: Systematic review of the literature with an electronic search in six databases has been completed with hand searches. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines have been followed. Selected studies met predefined inclusion criteria. Results: Literature search resulted in 4267 papers of which 15 met the inclusion criteria. Five different types of non-pharmacological interventions have been studied: cognitive behavioural therapy, behavioural therapy, exercise intervention, social problem-solving skills programme and bright light therapy. Conclusion: There are only a few studies of good quality evaluating non-pharmacological interventions for adults with ID and depression. Some of these studies, especially studies on cognitive behavioural therapy, show good results in decreasing depressive symptoms. High-quality randomised controlled trials evaluating non-pharmacological

Autism in Down's syndrome: presentation and diagnosis

Although autism is said to occur rarely with Down's syndrome, it may be more common in those persons with Down's syndrome who also show superimposed behavioural problems. In this brief report, the authors explore this possibility. They describe three patients with Down's syndrome who were referred for behavioural reasons and were found to have coexisting autism. They propose that a systematic study of the association of these two conditions may have implications on research and clinical practice.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72085/1/j.1365-2788.1992.tb00563.x.pd

Anxiety disorders in children with Williams syndrome, their mothers, and their siblings: Implications for the etiology of anxiety disorders

This study examines the prevalence of anxiety disorders in children with Williams syndrome (WS), their sibling closest in age, and their mothers as well as the predictors of anxiety in these groups. The prevalence of anxiety disorders was assessed and compared to that in the general population. Children with WS had a significantly higher prevalence of specific phobia, generalized anxiety disorder (GAD), and separation anxiety in comparison to children in the general population. While mothers had a higher prevalence of GAD than population controls, the excess was accounted for by mothers who had onset after the birth of their WS child. The siblings had rates similar to the general population. This pattern of findings suggests the presence of a gene in the WS region whose deletion predisposes to anxiety disorders. It is also worthwhile to investigate relations between genes deleted in WS and genes previously implicated in anxiety disorders

The catatonic dilemma expanded

Catatonia is a common syndrome that was first described in the literature by Karl Kahlbaum in 1874. The literature is still developing and remains unclear on many issues, especially classification, diagnosis, and pathophysiology. Clinicians caring for psychiatric patients with catatonic syndromes continue to face many dilemmas in diagnosis and treatment. We discuss many of the common problems encountered in the care of a catatonic patient, and discuss each problem with a review of the literature. Focus is on practical aspects of classification, epidemiology, differential diagnosis, treatment, medical comorbidity, cognition, emotion, prognosis, and areas for future research in catatonic syndromes

Comorbidity of autistic disorder in children and adolescents

Although considerable research has been done on various aspects of autism, information about the prevalence of coincident psychiatric disorders that may complicate this syndrome, is negligible. In this paper, we present preliminary data on the presentation of other psychiatric disorders in children and adolescents with autism. Out of an outpaticent sample of 68 autistic children and adolescents, 6 (9%) presented with an associated psychiatric disorder. Depression was the most common diagnosis. None of the patients was given a diagnosis of schizophrenia. Clinical and research implications of the findings are discussed. Bien qu'une recherche considérable ait été enterprise concenant les différents aspects de l'autisme, l'information sur la prévalence des troubles psychiatriques coïcidant et pouvant compliquer ce syndrome reste négligeable. Dans ce travail, nous présentons des faits préliminaires concernant les autres troubles psychiatriques chez les enfants et les adolescents avec autisme. Parmi un échantillon de 68 enfants et adolescents autistes vus en consultation: 6 (9%) présentaient un trouble psychiatrique associé La dépressio était le diagnostic le plus commun. Aucun des patients n'a eu un diagnostic de schizophrénie. Les implications de ces faits pour la clinique et la recherche sont discutées. Obwohl zu verschiedenen Aspekten des Autismus viel geforscht wurde, gibt es kaum Informationen zur koinzidentiellen Prävalenz von psychiatrischen Störungen, die das Syndrom komplizieren könne. In dieser Arbeit stellen wir vorläufige Daten über begleitende psychiatrische Störungen bei Kindern und Jugedlichen mit Autismus vor. Von 68 ambulant behandelten Kindern und Jugendlichen mit Autismus zeigten 9% eine assoziierte psychiatrische Störung. Depression war die häufigste Diagnose. Bei keinem der Patienten war die Diagnose Schizophrenie gestellt worden. Klinische und wissenschaftliche Implikationen dieser Befunde werden diskutiert.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41754/1/787_2005_Article_BF02094180.pd