Richard J. Shaw, M.D.

Journal Articles

• Textbook of Pediatric Psychosomatic Medicine Washington DC: American Psychiatric Publishing, Inc. Shaw RJ, DeMaso DR 2010
• Clinical Manual of Pediatric Psychosomatic Medicine: Mental Health Consultation with Physically Ill Children and Adolescents Washington DC: American Psychiatric Publishing, Inc. Shaw RJ, DeMaso DR 2006
• Prevention of Postpartum Traumatic Stress in Mothers with Preterm Infants: Manual Development and Evaluation. Issues in mental health nursing Shaw, R. J., Sweester, C. J., St John, N., Lilo, E., Corcoran, J. B., Jo, B., Howell, S. H., Benitz, W. E., Feinstein, N., Melnyk, B., Horwitz, S. M. 2013; 34 (8): 578-586

  Abstract

  Premature birth has been associated with multiple adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants who are premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent, both as infants and as they get older. In response to these findings, a number of educational and behavioral interventions have been developed that target maternal psychological functioning, parenting, and aspects of the parent-infant relationship. The current study aimed to both develop and evaluate a treatment that integrates, for the first time, effective interventions for reducing symptoms of posttraumatic stress disorder (PTSD) and enhancing maternal-infant interactions. Conclusions from the study indicate that the intervention is feasible, able to be implemented with a high level of fidelity, and is rated as highly satisfactory by participants. Though encouraging, these findings are preliminary, and future studies should strive to reproduce these findings with a larger sample size and a comparison group.

  View details for DOI 10.3109/01612840.2013.789943

  View details for PubMedID 23909669

• Parental coping in the neonatal intensive care unit. Journal of clinical psychology in medical settings Shaw, R. J., Bernard, R. S., Storfer-Isser, A., Rhine, W., Horwitz, S. M. 2013; 20 (2): 135-142

  Abstract

  Fifty-six mothers of premature infants who participated in a study to reduce symptoms of posttraumatic stress disorder (PTSD) completed the Brief COPE, a self-report inventory of coping mechanisms, the Stanford Acute Stress Reaction Questionnaire to assess acute stress disorder (ASD) and the Davidson Trauma Scale to assess PTSD. 18 % of mothers had baseline ASD while 30 % of mothers met the criteria for PTSD at the 1-month follow-up. Dysfunctional coping as measured by the Brief COPE was positively associated with elevated risk of PTSD in these mothers (RR = 1.09, 95 % CI 1.02-1.15; p = .008). Maternal education was positively associated with PTSD; each year increase in education was associated with a 17 % increase in the relative risk of PTSD at 1 month follow-up (RR = 1.17, 95 % CI 1.02-1.35; p = .03). Results suggest that dysfunctional coping is an important issue to consider in the development of PTSD in parents of premature infants.

  View details for DOI 10.1007/s10880-012-9328-x

  View details for PubMedID 22990746

• Personality and Psychopathology in African Unaccompanied Refugee Minors: Repression, Resilience and Vulnerability CHILD PSYCHIATRY & HUMAN DEVELOPMENT Huemer, J., Voelkl-Kernstock, S., Karnik, N., Denny, K. G., Granditsch, E., Mitterer, M., Humphreys, K., Plattner, B., Friedrich, M., Shaw, R. J., Steiner, H. 2013; 44 (1): 39-50

  Abstract

  Examining personality and psychopathological symptoms among unaccompanied refugee minors (URMs), we measured intra-individual dimensions (repression and correlates thereof) usually associated with resilience. Forty-one URMs completed the Weinberger Adjustment Inventory (WAI), assessing personality, and the Youth Self-Report (YSR), describing current symptoms. URMs endorsed high levels of Repressive Defensiveness, Denial of Distress, and Restraint; unexpectedly, URMs reported high Distress and reduced Happiness (WAI, p's < 0.05). Although YSR symptoms were below clinical cut points, there were notable correlations between Distress and Attention Problems, Self-destructive, and Aggressive Behavior (all on the YSR), correcting for multiple comparisons (p's < 0.004). URMs exposed to non-normative stressors reported non-symptomatic outcomes, and high levels of personality dimensions correlating with resilience. However, URMs also endorsed high Distress and low Happiness, calling their resilience into question. Positive correlations between WAI Distress and YSR symptom subscales suggest that URMs harbor vulnerabilities of clinical and forensic significance.

  View details for DOI 10.1007/s10578-012-0308-z

  View details for Web of Science ID 000314065000003

  View details for PubMedID 22661148

• Effectiveness of therapeutic and behavioral interventions for parents of low-birth-weight premature infants: A review INFANT MENTAL HEALTH JOURNAL Brecht, C. J., Shaw, R. J., St John, N. H., Horwitz, S. M. 2012; 33 (6): 651-665

  View details for DOI 10.1002/imhj.21349

  View details for Web of Science ID 000311375600010

• Brief Cognitive-Behavioral Intervention for Maternal Depression and Trauma in the Neonatal Intensive Care Unit: A Pilot Study JOURNAL OF TRAUMATIC STRESS Bernard, R. S., Williams, S. E., Storfer-Isser, A., Rhine, W., Horwitz, S. M., Koopman, C., Shaw, R. J. 2011; 24 (2): 230-234

  Abstract

  Parents of hospitalized premature infants are at risk for developing psychological symptoms. This randomized controlled pilot study examined the effectiveness of a brief cognitive-behavioral intervention in reducing traumatic and depressive symptoms in mothers 1 month after their infant's discharge from the hospital. Fifty-six mothers were randomly assigned to the intervention or control group. Results showed that mothers experienced high levels of symptoms initially and at follow-up. At follow-up, there was a trend for mothers in the intervention group to report lower levels of depression (p = .06; Cohen's f = .318), but levels of traumatic symptoms were similar for both groups. Brief psychological interventions may reduce depressive symptoms in this population. Estimates of the effect sizes can be used to inform future intervention studies.

  View details for DOI 10.1002/jts.20626

  View details for Web of Science ID 000289528300014

  View details for PubMedID 21438016

• Inter-rater reliability of the Pediatric Transplant Rating Instrument (P-TRI): Challenges to reliably identifying adherence risk factors during pediatric pre-transplant evaluations PEDIATRIC TRANSPLANTATION Fisher, M., Storfer-Isser, A., Shaw, R. J., Bernard, R. S., Drury, S., Ularntinon, S., Horwitz, S. M. 2011; 15 (2): 142-147

  Abstract

  The purpose of this study was to assess the inter-rater reliability of the P-TRI, a 17-item instrument developed to identify risk factors associated with poor treatment adherence in pediatric solid organ transplant candidates. Because factors influencing treatment adherence may vary with age, the 89 subject samples were divided into pre-adolescent (0-11 yr) and adolescent (12-19 yr) groups. Each subject received two independent P-TRI ratings based on pretransplant psychosocial assessments separately conducted by a PSYC and a SWTC. Inter-rater reliability was assessed using the delta statistic. Overall, agreement was higher in the pre-adolescent group, with delta>0.70 for five items and delta<0.30 for two items. For the adolescent group, one item had a delta>0.70 and seven items had a delta<0.30. Overall, PSYC P-TRI ratings indicated fewer areas of concern on items assessing family dynamics compared with SWTC P-TRI ratings, whereas the reverse was true for items related to psychiatric history. Results highlight the challenges of conducting a reliable pretransplant assessment of adherence-related risk factors and suggest the need for revisions to the P-TRI prior to its use in clinical practice.

  View details for DOI 10.1111/j.1399-3046.2010.01428.x

  View details for Web of Science ID 000288316300008

  View details for PubMedID 21226810

• Overt and Covert Aggression in College Women with Bulimia Nervosa ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE Huemer, J., Sagar, A., Alquero, K., Denny, K., Shaw, R. J., Steiner, H. 2011; 39 (6): 409-415

  Abstract

  This study examines the prevalence of overt and covert aggression in women with bulimia nervosa (BN) as well as the relationship between the severity of BN and the frequency of aggressive acts.20 female college students with BN and 20 control subjects completed self-report measures of aggressive behavior and eating disorder pathology. They also completed the Juvenile Health and Wellness Survey-76 to assess general risk taking and indices of sexual behavior and mental health.BN subjects reported higher levels of both overt and covert aggression (p < .001). Overt aggression tended to be more premeditated, while the self-report of covert aggression behavior was more impulsive. Levels of aggressive behavior were significantly correlated with severity of BN (p < .01). Subjects with BN reported higher levels of risk-taking and sexual behaviors.Aggression is an important clinical issue in BN. Subtypes of aggression suggest different pathways for overt and covert aggressive acts with impulsive covert aggression being more closely related to the binge-purge cycle. Awareness of subtypes of aggression in BN may have important clinical and treatment implications.

  View details for DOI 10.1024/1422-4917/a000139

  View details for Web of Science ID 000296582300005

  View details for PubMedID 22031013

• Concurrent Treatment of Steroid-Related Mood and Psychotic Symptoms With Risperidone PEDIATRICS Ularntinon, S., Tzuang, D., Dahl, G., Shaw, R. J. 2010; 125 (5): E1241-E1245

  Abstract

  Corticosteroid treatment is an important therapeutic modality for many pediatric medical conditions including acute lymphoblastic leukemia. However, steroid-induced behavioral and mood abnormalities are common and potentially disabling adverse effects that have been widely reported in the pediatric literature. From this case series, we report the efficacy of risperidone in 3 children with acute lymphoblastic leukemia who developed steroid-related mood and psychotic symptoms during treatment with prednisone and dexamethasone. Risperidone is an effective short-term pharmacologic agent for controlling steroid-related psychiatric adverse effects when cessation or dose reduction of steroid therapy is not an option.

  View details for DOI 10.1542/peds.2009-1815

  View details for Web of Science ID 000277232800060

  View details for PubMedID 20385646

• Pediatric psychogenic nonepileptic seizures: A study of assessment tools EPILEPSY & BEHAVIOR Salpekar, J. A., Plioplys, S., Siddarth, P., Bursch, B., Shaw, R. J., Asato, M. R., LaFrance, W. C., Weisbrot, D. M., Dunn, D. W., Austin, J. K., Olson, D. M., Caplan, R. 2010; 17 (1): 50-55

  Abstract

  The goal of this study was to identify assessment tools and associated behavioral domains that differentiate children with psychogenic nonepileptic seizures (PNES) from those with epilepsy. A sample of 24 children with PNES (mean age 14.0 years, 14 female), 24 children with epilepsy (mean age 13.6 years, 13 female), and their parents were recruited from five epilepsy centers in the United States. Participants completed a battery of behavioral questionnaires including somatization, anxiety, and functional disability symptoms. Children with PNES had significantly higher scores on the Childhood Somatization and Functional Disability Inventories, and their parents reported more somatic problems on the Child Behavior Checklist (CBCL). Depression, anxiety, and alexithymia instruments did not differentiate the groups. Measures of somatization and functional disability may be promising tools for differentiating the behavioral profile of PNES from that of epilepsy. Increased somatic awareness and perceived disability emphasize the similarity of PNES to other pediatric somatoform disorders.

  View details for DOI 10.1016/j.yebeh.2009.10.002

  View details for Web of Science ID 000273837700007

  View details for PubMedID 19948427

• Comparison of Short-Term Psychological Outcomes of Respiratory Failure Treated by Either Invasive or Non-Invasive Ventilation PSYCHOSOMATICS Shaw, R. J., Harvey, J. E., Bernard, R., Gunary, R., Tiley, M., Steiner, H. 2009; 50 (6): 586-591

  Abstract

  There is now widespread recognition of the development of symptoms of posttraumatic stress disorder (PTSD) in individuals subjected to treatment in the hospital intensive care unit (ICU).The authors sought to investigate traumatic aspects of the ICU hospitalization experience.A group of 20 adult pulmonary patients requiring ventilation in the ICU were compared with 20 patients treated without ventilation. Subjects completed a semistructured interview about their hospital experience and were given self-report measures to assess PTSD and coping style.Subjects requiring invasive ventilation were significantly more likely to endorse symptoms of PTSD. There was a strong correlation between symptoms of PTSD and recall of memories of traumatic medical events. Symptoms of PTSD were positively associated with habitual experiences of distress and negatively associated with the use of denial of distress.Specific traumatic aspects of a patient's treatment, in this case the experience of intubation and mechanical ventilation, may be an additive risk factor for the development of PTSD.

  View details for Web of Science ID 000272488900006

  View details for PubMedID 19996229

• The Italian version of the Response Evaluation Measure-71 COMPREHENSIVE PSYCHIATRY Prunas, A., Madeddu, F., Pozzoli, S., Gatti, C., Shaw, R. J., Steiner, H. 2009; 50 (4): 369-377

  Abstract

  The aim of the present study was to analyze the psychometric properties of the Italian version of the Response Evaluation Measure (REM-71), a 71-item self-report measure previously developed for the assessment of defenses in adults and adolescents. The authors also examined the differences in the use of defenses based on sex and age (early adolescence, late adolescence, and early adulthood), and the association between defenses, psychosocial health, and psychologic distress in a large community sample.The Italian version of REM-71 was obtained through back-translation and administered to 1648 (1020 female subjects, mean age = 19.5 years, SD = +/-5.77) community subjects, aged between 13 and 68 years, voluntarily recruited among high school and university students in Milan, Italy, and the surrounding area. All subjects completed a self-report measure to assess demographic variables and satisfaction with life. A subsample (n = 1197) completed the Italian version of the Symptom Checklist-90-Revised to assess symptoms of psychologic distress.Results were highly consistent with those obtained in the original English version of the REM-71 and included satisfactory internal consistency of the measure. Factor analyses yielded 2 principal factors that showed overall stability across age and sex subgroups. Factor 1 and factor 2 defenses were significantly correlated, in line with theoretical expectations, with positive and negative aspects of various domains of life.Results provide further support for the structure and validity of the REM-71 as a useful instrument for the assessment of defenses in adolescents and adults and suggest no major cross-cultural differences in the organization of these defenses.

  View details for DOI 10.1016/j.comppsych.2008.09.010

  View details for Web of Science ID 000266820100011

  View details for PubMedID 19486736

• The Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder in the Neonatal Intensive Care Unit PSYCHOSOMATICS Shaw, R. J., Bernard, R. S., DeBlois, T., Ikuta, L. M., Ginzburg, K., Koopman, C. 2009; 50 (2): 131-137

  Abstract

  Having an infant hospitalized in the neonatal intensive care unit (NICU) is a highly stressful event for parents. Researchers have proposed posttraumatic stress disorder (PTSD) as a model to explain the psychological reaction of parents to their NICU experience.The authors sought to examine the prevalence of PTSD in parents 4 months after the birth of their premature or sick infants and the relationship of PTSD and symptoms of acute stress disorder (ASD) immediately after their infant's birth.Eighteen parents completed a self-report measure of ASD at baseline in addition to self-report measures of PTSD and depression at a 4-month follow-up assessment.In the sample, 33% of fathers and 9% of mothers met criteria for PTSD. ASD symptoms were significantly correlated with both PTSD and depression. Fathers showed a more delayed onset in their PTSD symptoms, but, by 4 months, were at even greater risk than mothers.The relatively high levels of psychological distress experienced by parents coupled with the potential negative outcomes on the parent and infant suggest that it is important to try to prepare parents for the expected psychological reactions that may occur in the event of a NICU hospitalization and also to support parents during the transition to home care.

  View details for Web of Science ID 000265270400005

  View details for PubMedID 19377021

• Defence mechanisms in schizophrenia PERSONALITY AND MENTAL HEALTH Shaw, R. J., Geurse, M. K., Steiner, H. 2008; 2 (4): 240-248

  View details for DOI 10.1002/pmh.47

  View details for Web of Science ID 000207692700004

• Posttraumatic stress disorder following traumatic injury: Narratives as unconscious indicators of psychopathology BULLETIN OF THE MENNINGER CLINIC Hashemi, B., Shaw, R. J., Hong, D. S., Hall, R., Nelson, K., Steiner, H. 2008; 72 (3): 179-190

  Abstract

  Current conventional assessment methodologies used to diagnose posttraumatic stress disorder (PTSD) rely heavily on symptom counts obtained from clinical interviews or self-report questionnaires. Such measures may underestimate the impact of traumatic events, particularly in individuals who deny or repress emotional distress. This case report illustrates the use of two methods of narrative analysis to assess unconscious representations of PTSD. Linguistic analysis and a computerized analysis of referential activity were able to capture unconscious aspects of the traumatic experience.

  View details for Web of Science ID 000260482800002

  View details for PubMedID 18990054

• Hypnosis-provoked nonepileptic events in children EPILEPSY & BEHAVIOR Olson, D. M., Howard, N., Shaw, R. J. 2008; 12 (3): 456-459

  Abstract

  The purpose of this study was to describe the use of hypnotic suggestion as a means of precipitating nonepileptic events in children while they are undergoing video electroencephalographic monitoring (VEEG) for differential diagnosis of seizurelike behavior.Nine children aged 8-16 years were referred for VEEG to differentiate between epileptic seizures and nonepileptic events. All subjects underwent psychiatric consultation. Hypnosis was attempted in all subjects to try to provoke typical seizurelike events.In eight of nine patients, their typical seizurelike events were provoked by hypnosis. In all eight children, video and EEG analysis of the provoked events demonstrated them to be nonepileptic. No epileptiform abnormalities were present on interictal EEGs. No epileptic seizures occurred.Hypnosis is a useful and ethical means of provoking psychogenic nonepileptic events in children. Hypnotic suggestion should be considered as a provocative method when possibly psychogenic nonepileptic events have not occurred spontaneously during diagnostic evaluation.

  View details for DOI 10.1016/j.yebeh.2007.12.003

  View details for Web of Science ID 000254553900014

  View details for PubMedID 18249039

• Pediatric Transplant Rating Instrument - A scale for the pretransplant psychiatric evaluation of pediatric organ transplant recipients PEDIATRIC TRANSPLANTATION Fung, E., Shaw, R. J. 2008; 12 (1): 57-66

  Abstract

  Although the majority of pediatric solid organ transplant centers in the United States employ psychosocial criteria to assess the suitability of potential transplant candidates, there are no standardized pretransplant psychosocial assessment measures. Assessment scales that have been developed were designed for adult transplant recipients and are not suitable for use in the pediatric population. The P-TRI was developed to address this gap in the pediatric pretransplant psychosocial evaluation. It is intended to identify areas of psychosocial vulnerability that may be associated with poor treatment adherence and to facilitate the development of informed and focused psychosocial interventions for pediatric patients before and after transplant surgery. Items on the rating instrument were generated based on a review of the major correlates of treatment adherence in the pediatric population. Data are currently being collected for further reliability and validity analyses.

  View details for DOI 10.1111/j.1399-3046.2007.00785.x

  View details for Web of Science ID 000252122200011

  View details for PubMedID 18186890

• EOSINOPHILIC MENINGOENCEPHALITIS: PSYCHIATRIC PRESENTATION AND TREATMENT INTERNATIONAL JOURNAL OF PSYCHIATRY IN MEDICINE Hong, D. S., Bernstein, M., Smith, C., Gans, H., Shaw, R. J. 2008; 38 (3): 287-295

  Abstract

  Eosinophilic meningoencephalitis (EM) is usually a self-limited neurological illness commonly accompanied by a variety of neurological symptoms. The presence of acute psychotic symptoms in EM, however, has not previously been reported, and there is no literature to guide its treatment and management. In this case report, the onset of psychotic symptoms in a hypoactive delirium and their significant improvement following the administration of atypical antipsychotics are described in a boy with EM. This case report demonstrates the efficacy and safety of antipsychotic agents during the acute phase of meningoencephalitis.

  View details for DOI 10.2190/PM.38.3.e

  View details for Web of Science ID 000261315400005

  View details for PubMedID 19069573

• Defense mechanisms in schizophrenia Personality and Mental Health Shaw RJ, Geurse M, Steiner H 2008; 2: 240-248
• Factitious disorder by proxy: Pediatric condition falsification HARVARD REVIEW OF PSYCHIATRY Shaw, R. J., Dayal, S., Hartman, J. K., DeMaso, D. R. 2008; 16 (4): 215-224

  Abstract

  We present a comprehensive overview of the condition factitious disorder by proxy, also known as Munchausen syndrome by proxy. The review begins by highlighting essential definitions and the etiology and epidemiology of the disorder. It then analyzes relevant clinical issues such as assessment and diagnostic methods. The final section is a detailed discussion of the complex issues facing the clinician, including the process of confronting the perpetrator, relevant legal issues, and the treatment of the caretaker, child, and family through a multidisciplinary, team approach.

  View details for DOI 10.1080/10673220802277870

  View details for Web of Science ID 000258001000001

  View details for PubMedID 18661364

• Multidisciplinary management of pediatric nonepileptic seizures JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Plioplys, S., Asato, M. R., Bursch, B., Salpekar, J. A., Shaw, R., Caplan, R. 2007; 46 (11): 1491-1495

  View details for DOI 10.1097/chi.0b013e31814dab98

  View details for Web of Science ID 000250358100011

  View details for PubMedID 18049299

• Psychiatric medications for the treatment of pruritus PSYCHOSOMATIC MEDICINE Shaw, R. J., Dayal, S., Good, J., Bruckner, A. L., Joshi, S. V. 2007; 69 (9): 970-978

  Abstract

  To review the use of psychiatric medications in the treatment of pruritus.A literature review was conducted using the key words pruritus, psychiatric, and treatment.Three categories of pruritus are described: dermatologic, systemic, and psychogenic. Peripheral and central nervous system mechanisms of pruritus are reviewed. Conventional dermatologic treatments for pruritus are contrasted with some of the common psychopharmacologic treatment modalities that include anxiolytic, antidepressant, and antipsychotic agents. A treatment algorithm is offered to help guide the treatment of patients with pruritus.Psychiatric medications have been used successfully in the treatment of pruritus that is associated with both psychocutaneous and systemic disorders, which are resistant to conventional treatment.

  View details for DOI 10.1097/PSY.0b013e3181572799

  View details for Web of Science ID 000251204900024

  View details for PubMedID 17991825

• Subtypes of pediatric delirium: A treatment algorithm PSYCHOSOMATICS Karnik, N. S., Joshi, S. V., Paterno, C., Shaw, R. 2007; 48 (3): 253-257

  Abstract

  Delirium in adult populations of hospitalized patients has been well characterized into hyperactive, hypoactive, and mixed subtypes. The degree to which these subtypes apply to pediatric populations has yet to be fully demonstrated. In this case report, the authors present two cases of delirium that serve as examples of the hyperactive and hypoactive/mixed types and then discuss treatment. They find marked differences in the response of different delirium subtypes to haloperidol and risperidone and theorize as to the neurochemical pathways by which these pharmacological agents might work. This framework provides an algorithm for the treatment of pediatric delirium.

  View details for Web of Science ID 000246210400010

  View details for PubMedID 17478595

• Abdominal migraine and treatment with intravenous valproic acid PSYCHOSOMATICS Tan, V., Sahami, A. R., Peebles, R., Shaw, R. J. 2006; 47 (4): 353-355

  View details for Web of Science ID 000238767900013

  View details for PubMedID 16844896

• Acute stress disorder among parents of infants in the neonatal intensive care nursery PSYCHOSOMATICS Shaw, R. J., Deblois, T., Ikuta, L., Ginzburg, K., Fleisher, B., Koopman, C. 2006; 47 (3): 206-212

  Abstract

  The authors examined the prevalence of acute stress disorder (ASD) in parents of infants hospitalized in the neonatal intensive care unit (NICU). Forty parents were assessed after the birth of their infants. Parents completed self-report measures of ASD, parental stress, family environment, and coping style: 28% of parents developed symptoms of ASD. ASD was associated with female gender, alteration in parental role, family cohesiveness, and emotional restraint. Family environment and parental coping style are significantly associated with the development of trauma symptoms. Results from this study suggest potential interventions to help minimize psychological distress in parents.

  View details for Web of Science ID 000237226100003

  View details for PubMedID 16684937

• Practice patterns in pediatric consultation-liaison psychiatry - A national survey PSYCHOSOMATICS Shaw, R. J., Wamboldt, M., Bursch, B., Stuber, M. 2006; 47 (1): 43-49

  Abstract

  The purpose of this survey was to describe the current status of pediatric consultation-liaison (C-L) services in the United States. A total of 144 pediatric C-L programs were surveyed, with a response rate of 33%. Financial and staffing constraints were cited as common problems; 61% of programs reported an increase in consultation requests over the past 5 years, however, 30% of services reported a decrease in funding. Collection rates for professional billings average 30%; 57% of services reported an increase in clinical service demands at the expense of teaching and liaison activities. Discussion includes recommendations based on the results of the survey.

  View details for Web of Science ID 000234270000005

  View details for PubMedID 16384806

• Medical posttraumatic stress disorder. Psychiatric Times Shaw RJ, Bernard R 2006; 23: 25-38
• A typology of non-adherence in pediatric renal transplant recipients PEDIATRIC TRANSPLANTATION Shaw, R. J., Palmer, L., Blasey, C., Sarwal, M. 2003; 7 (6): 489-493

  Abstract

  We reviewed 112 pediatric renal transplant recipients to document the rate of medication non-adherence (NA) and to examine the relationships between NA, comorbid psychiatric illness, and the outcome variables of acute and chronic rejection and graft loss. A total of 32.5% of subjects had clinically significant NA with treatment based on review of serum immunosuppressant levels. NA was found to be significantly related to acute and chronic rejection, and graft loss (p < 0.001). NA was also related to the presence of comorbid psychiatric illness (p < 0.001). Logistic regression indicated that NA was a significant predictor for acute and chronic rejection, while psychiatric illness predicted graft loss. Adolescents had significantly higher rates of NA as well as shorter intervals between transplant date and onset of NA when compared with child patients (p < 0.001). Physician ratings of the primary reasons for NA suggested that lack of parental supervision and parent-child conflict were the major factors related to NA.

  View details for Web of Science ID 000186500400014

  View details for PubMedID 14870900

• Treatment of feeding disorders in children with Down Syndrome Clinical Child Psychology and Psychiatry Shaw RJ, Garcia M, Thorn M, Farley CA 2003; 8: 105-117
• A comparison of clinical ratings with vocal acoustic measures of flat affect and alogia JOURNAL OF PSYCHIATRIC RESEARCH Alpert, M., Shaw, R. J., Pouget, E. R., Lim, K. O. 2002; 36 (5): 347-353

  Abstract

  In this report we compare clinical ratings of flat affect and alogia with objective measures of the patient's speech prosody and productivity. Thirty schizophrenic patients were evaluated with the Scale for the Assessment of Negative Symptoms (SANS) and the St. Hans Rating Scale for extra pyramidal side effects. Their speech was recorded and analyzed acoustically for measures of prosody and productivity. Correlations between pairs of SANS items and acoustic measures (e.g. Vocal Inflection and Fundamental Frequency Variance) were weak. The SANS item and global ratings were strongly related. Ratings of bradykinesia overlapped with the SANS ratings but not with the acoustic measures. The SANS ratings appear to be derived from global impressions, with diffuse confounding of flat affect with alogia, and with bradykinesia. Acoustic analysis has the potential to provide objective measures that may help develop operational definitions of these constructs and enhance clinical assessment.

  View details for Web of Science ID 000178254700010

  View details for PubMedID 12127603

• Pseudologia fantastica associated with pervasive developmental disorder PSYCHIATRY-INTERPERSONAL AND BIOLOGICAL PROCESSES Teaford, T., Shaw, R. J., Reiss, A., Lotspeich, L. 2002; 65 (2): 165-171

  Abstract

  This case study describes the association of Pseudologia Fantastica (PF) and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) in a 14-year-old girl. PF is seen in a number of diagnostic entities, but has not previously been reported in PDD spectrum disorders. Treatment implications are discussed along with a formulation of the psychological and cognitive functions of PF in a person with a PDD diagnosis.

  View details for Web of Science ID 000176500400007

  View details for PubMedID 12108140

• Acute stress disorder following ventilation PSYCHOSOMATICS Shaw, R. J., Robinson, T. E., Steiner, H. 2002; 43 (1): 74-76

  View details for Web of Science ID 000174337000014

  View details for PubMedID 11927764

• Linguistic analysis to assess medically related posttraumatic stress symptoms PSYCHOSOMATICS Shaw, R. J., Harvey, J. E., Nelson, K. L., Gunary, R., Kruk, H., Steiner, H. 2001; 42 (1): 35-40

  Abstract

  The authors examined the presence of posttraumatic stress symptoms (PTSS) in 20 patients requiring ventilation after acute respiratory distress. The subjects completed a semistructured interview about their ventilation experience that was subject to content and linguistic analysis. Subjects also completed two self-report measures to assess PTSS and socioemotional adjustment. Subjects who endorsed PTSS were more likely to use a narrative style suggesting emotional involvement in their recall of the stressful event. The authors indicate that the presence of PTSS is a common consequence of traumatic medical experiences and that denial of distress may be an adaptive short-term coping strategy.

  View details for Web of Science ID 000166369100006

  View details for PubMedID 11161119

• Treatment adherence in adolescents: Development and psychopathology Clinical Child Psychology and Psychiatry Shaw RJ 2001; 6: 137-150
• Case study: Treatment adherence in a 13-year-old deaf adolescent male Clinical Child Psychology and Psychiatry Shaw RJ, Palmer L, Hyte H, Yorgin P, Sarwal M 2001; 6 (4): 551-562
• The mere exposure effect in patients with schizophrenia SCHIZOPHRENIA BULLETIN Marie, A., Gabrieli, J. D., Vaidya, C., Brown, B., Pratto, F., Zajonc, R. B., Shaw, R. J. 2001; 27 (2): 297-303

  Abstract

  The mere exposure effect refers to the development of an emotional preference for previously unfamiliar material because of frequent exposure to that material. This study compared schizophrenia subjects (n = 20) to normal controls (n = 21) to determine whether implicit memory, as demonstrated by the mere exposure effect, was intact. Patients with schizophrenia demonstrated a normal preference for both verbal and visual materials seen earlier relative to novel materials, despite impaired performance on a recognition task for explicit memory using similar materials. Previous studies of schizophrenia subjects have shown a dissociation between implicit and explicit memory on verbal tasks. We found a similar dissociation demonstrated by normal functioning on an implicit memory task and impaired functioning on an explicit memory task. Potential implications of these findings are discussed with regard to treatment and rehabilitation.

  View details for Web of Science ID 000168512400013

  View details for PubMedID 11354596

• Prosody and lexical accuracy in flat affect schizophrenia PSYCHIATRY RESEARCH Alpert, M., Rosenberg, S. D., Pouget, E. R., Shaw, R. J. 2000; 97 (2-3): 107-118

  Abstract

  To test the hypothesis that flat affect in schizophrenia involves a motor-expressive deficiency, but not an emotional deficiency, we compared the acoustic properties of speech that are used to express emotion with the emotional content of the words. DSM-III-R schizophrenic patients were divided into flat (N=20) and non-flat affect (N=26) groups on the basis of rating-scale scores. Twenty normal subjects also were included. Subjects were recorded on audio tape as they described a happy and a sad experience for about 10 min. The recordings were analyzed acoustically for fluency and for two types of prosody: inflection and emphasis. Words from transcriptions of the recordings were sorted by content analysis software into psychologically meaningful categories; we compared 'pleasure' and 'distress' word categories. Patients with flat affect spoke with less inflection, and were less fluent. However, they were similar to the other groups in the rate at which they used 'pleasure' words to describe happy experiences and 'distress' words to describe sad experiences. The behavioral deficiency in flat affect appears to be restricted to reduced activity in communicative motor channels. Other aspects of emotion processing seem intact.

  View details for Web of Science ID 000166779600003

  View details for PubMedID 11166083

• Case study: selective mutism in an immigrant child Child Psychology and Psychiatry Zelenko M, Shaw RJ 2000; 5 (4): 555-562
• Case study: Suprasellar germinoma presenting with psychotic and obsessive-compulsive symptoms JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY Mordecai, D., Shaw, R. J., Fisher, P. G., Mittelstadt, P. A., Guterman, T., Donaldson, S. S. 2000; 39 (1): 116-119

  Abstract

  This case describes a 13-year-old boy who had a suprasellar germinoma involving the bilateral basal ganglia. His presenting symptoms included left-sided weakness, diabetes insipidus, a decline in academic functioning as well as psychotic and obsessive-compulsive symptoms. His neuroradiological findings and clinical symptoms lend support to the potential role of the basal ganglia in psychotic and obsessive-compulsive symptomatology.

  View details for Web of Science ID 000084518400024

  View details for PubMedID 10638075

• The relationship between affect expression and affect recognition in schizophrenia SCHIZOPHRENIA RESEARCH Shaw, R. J., Dong, M., Lim, K. O., Faustman, W. O., Pouget, E. R., Alpert, M. 1999; 37 (3): 245-250

  Abstract

  To examine the relationship between affect expression and affect recognition, we assessed 30 clinically stable, medicated schizophrenic inpatients. Affect expression was assessed using both a standard clinical rating scale (SANS) and a computerized acoustic voice analysis (VOXCOM). Affect recognition was assessed using the Florida Affect Battery (FAB). The schizophrenics' performance on the FAB was impaired, indicating broad deficits in affect recognition (p<0.05). There were no significant correlations between measures of affect expression and affect recognition, suggesting that the expressive impairment in schizophrenia is not related to their ability to discern emotions in others. SANS Inappropriate Affect, however, was negatively correlated with facial affect recognition (p = 0.001), suggesting that raters' impression of inappropriate affect may indicate a failure in the process of affect attunement.

  View details for Web of Science ID 000080871500005

  View details for PubMedID 10403196

• The pediatric psychiatric pretransplant evaluation Child Psychology and Psychiatry Shaw RJ, Taussig HN 1999; 4: 353-365
• Defense style and family environment CHILD PSYCHIATRY & HUMAN DEVELOPMENT Thienemann, M., Shaw, R. J., Steiner, H. 1998; 28 (3): 189-198

  Abstract

  Prospective observations of the defense styles of normal individuals suggest that the quality of the childhood family environment may influence the maturity of defense styles used in adulthood. In this study, 106 female adolescent psychiatric patients completed the Defense Style Questionnaire, and the Family Environment Scale (FES). Positive family characteristics such as cohesion and expressiveness, as measured by the FES, were correlated with the report of Mature Defenses. Negative family characteristics such as conflict were correlated with the report of Immature Defenses. Similar although weaker correlations were found after controlling for the effects of depression and defensiveness on the self-report measures.

  View details for Web of Science ID 000072516800005

  View details for PubMedID 9540242

• The academy of psychosomatic medicine practice guidelines for psychiatric consultation in the general medical center Psychosomatics Bronheim H, Fulop G, Kunkel E, Muskin P, Schindler B, Yates W, Shaw RJ, Steiner H, Stern TA, Stoudemire A 1998; 39: S8-S30
• Bulimia as a disturbance of narcissism: Self-esteem and the capacity to self-soothe ADDICTIVE BEHAVIORS Steinberg, B. E., Shaw, R. J. 1997; 22 (5): 699-710

  Abstract

  A review of the literature on eating disorders reveals that, although psychodynamic formulations linking narcissistic dynamics--particularly difficulties with self-soothing--and eating disorders are common in the theoretical and clinical literature, little empirical work has attempted to substantiate this claim. In this study, 117 women completed the Eating Disorder Inventory and the Bulimia Test Revised and four scales that measure different components of narcissism (the Multidimensional Self-Esteem Inventory, measuring self-esteem, the Self-Care Questionnaire, and two subscales of the Ego Functioning Assessment Questionnaire, measuring self-soothing). The four scales used to assess narcissism were all highly correlated with each other, indicating that they measure a similar construct. In addition, the eating-disorder measures were correlated with the measures of narcissism, suggesting that a relationship exists between bulimia and narcissism, as assessed using self-report instruments.

  View details for Web of Science ID 000071341900012

  View details for PubMedID 9347071

• Temperament in juvenile eating disorders PSYCHOSOMATICS Shaw, R. J., Steiner, H. 1997; 38 (2): 126-131

  Abstract

  Previous studies have suggested an association between temperament and eating disorder pathology. The purpose of this study was to differentiate on the basis of temperament among patients with anorexia, bulimia, and major depression. In this study, 101 adolescent girls completed the Revised Dimensions of Temperament Survey (Self), a self-report measure that identifies nine dimensions of temperament. Significant differences were found between the diagnostic groups while controlling for disturbances in mood and defensiveness. Specific subscales differentiated the subjects with anorexia from those with bulimia. These data support the concept of using temperament to differentiate patients with related psychiatric syndromes.

  View details for Web of Science ID A1997WL68300006

  View details for PubMedID 9063043

• Temperament as a correlate of adolescent defense mechanisms CHILD PSYCHIATRY & HUMAN DEVELOPMENT Shaw, R. J., Ryst, E., Steiner, H. 1996; 27 (2): 105-114

  Abstract

  The Revised Dimensions of Temperament Survey, which assesses nine dimensions of temperament, and the Defense Style Questionnaire, used to assess defense mechanisms, were completed by 107 female adolescents. Temperament was found to be strongly correlated with defense style, particularly with immature defenses (p = 0.0001). The findings support the hypothesis that the biological dimension of temperament is correlated with specific defense mechanisms.

  View details for Web of Science ID A1996VP57900004

  View details for PubMedID 8936796