Background. This report describes the development and validation of a brain subscale for the Functional Assessment of Cancer Therapy (FACT) scale, and the revalidation of the subscales of the general version (FACT‐G), which measure physical, social, family, emotional, and functional well‐being and the quality of the relationship with the physician. Methods. 101 patients with primary brain tumors, after giving informed consent, participated in the last two phases of a four‐phase validation process: item generation, item reduction, validation, and reliability testing. In the validation phase, FACT‐G subscale and total scores as well as the brain subscale scores were correlated with other tests of mood, response, bias, and quality of life (QOL). Test‐retest reliability testing was performed with 46 patients who had primary brain tumors. Results. Validity and reliability coefficients were high for the FACT‐G and brain subscale, except for the comparison with a second QOL measure (FP‐QLI) and the Karnofsky Performance Status (KPS). The lower scores were the result of inherent differences in the two QOL instruments and the relatively high performance status of the brain tumor patients, which restricted the KPS score range. Conclusion. The FACT‐G has good psychometric properties supporting its broad generalizability and the brain subscale tests substantially different QOL issues than the core instrument. Use of this scale with the addition of the brain subscale provides a well rounded view of the various aspects of QOL from the patient's perspective. With modifications and further psychometric testing, the brain subscale may have broader applicability to subpopulations of patients with other brain disorders. Cancer 1995;75:1151–61.

This investigation examined the neural and personality correlates of processing infant facial expressions in mothers with substantiated neglect of a child under 5 years old. Event-related potentials (ERPs) were recorded from 14 neglectful and 14 control mothers as they viewed and categorized pictures of infant cries, laughs, and neutral faces. Maternal self-reports of anhedonia and empathy were also completed. Early (negative occipitotemporal component peaking at around 170 ms on the scalp [N170] and positive electrical potential peaking at about 200 ms [P200]) and late positive potential (LPP) components were selected. Both groups of mothers showed behavioral discrimination between the different facial expressions via reaction time and accuracy measures. Neglectful mothers did not exhibit increased N170 amplitude at temporal leads in response to viewing crying versus laughing and neutral expressions compared to control mothers. Both groups had greater P200 and LPP amplitudes at centroparietal leads in response to viewing crying versus neutral facial expressions. However, neglectful mothers displayed an overall attenuated brain response in LPP that was related to their higher scores in social anhedonia but not to their empathy scores. The ERP data suggest that the brain's failures in the early differentiation of cry stimuli and in the sustained processing of infant expressions related to social anhedonia may underlie the insensitive responding in neglectful mothers. The implications of these results for the design and evaluation of preventive interventions are discussed.

The neurobiological alterations resulting from adverse childhood experiences that subsequently may lead to neglectful mothering are poorly understood. Maternal neglect of an infant’s basic needs is the most prevalent type of child maltreatment. We tested white matter alterations in neglectful mothers, the majority of whom had also suffered maltreatment in their childhood, and compared them to a matched control group. The two groups were discriminated by a structural brain connectivity pattern comprising inferior fronto-temporo-occipital connectivity, which constitutes a major portion of the face-processing network and was indexed by fewer streamlines in neglectful mothers. Mediation and regression analyses showed that fewer streamlines in the right inferior longitudinal fasciculus tract (ILF-R) predicted a poorer quality of mother–child emotional availability observed during cooperative play and that effect depended on the respective interactions with left and right inferior fronto-occipital fasciculi (IFO-R/L), with no significant impact of psychopathological and cognitive conditions. Volume alteration in ILF-R but not in IFO-L modulated the impact of having been maltreated on emotional availability. The findings suggest the altered inferior fronto-temporal-occipital connectivity, affecting emotional visual processing, as a possible common neurological substrate linking a history of childhood maltreatment with maternal neglect.

Objectives: To examine the components affecting the quality of the implementation and their impact on the outcomes of the ''Growing Up Happily in the Family'' program targeted at parents with children aged 0-5. Method: At-risk and non-at-risk parents (N ¼ 196) participated in 26 groups in local social services. Adherence, adaptations, quality of delivery, group and participant responsiveness, and implementation barriers were examined as predictors of attendance rate and changes in parental child-rearing attitudes, parental sense of competence, and parenting stress using hierarchical linear regressions analyses. Results: Greater participant responsiveness and fewer implementation barriers predicted higher attendance rates. These implementation variables, as well as greater program adherence, fewer crucial adaptations, and better didactic functioning of the sessions, predicted positive parental changes. Conclusions: The level of implementation contributes to the program effectiveness, suggesting the need to provide a high-quality and well-coordinated implementation to achieve the intended program outcomes in child welfare populations.

This study investigated: a) mothers' use and satisfaction with informal and formal supports in at-risk psychosocial contexts, and b) the relationships between satisfaction with help and the mothers' perception of their role (personal agency). Self-report data about the use and satisfaction with sources of help, and levels of internal control, self-efficacy, couple agreement, role difficulty and motivation for change were obtained from 519 mothers referred by Social Services and 519 non-referred mothers. Results indicated that at-risk mothers relied less upon close informal support and more on formal support than non atrisk mothers. They were also more satisfied with the formal sources of support and had lower levels of personal agency. There were beneficial effects of satisfaction with informal help and school support on several aspects of personal agency for both groups. However, satisfaction with school and social services support had a detrimental effect on couple agreement in the at-risk group. Implications of the results for providing social support to at-risk families are discussed.

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