B Stilwell

Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States

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Publications (12)12.12 Total impact

  • Barbara M. Stilwell
    12/2007: pages 123-135;
  • Matthew R Galvin, Jerry Fletcher, Barbara M Stilwell
    Journal of the American Academy of Child & Adolescent Psychiatry 07/2006; 45(6):745-8. · 6.97 Impact Factor
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    ABSTRACT: An I.U. Conscience Project and HELP Collaboration. The presentation describes models for teaching ethics and caring attitudes to undergraduate medical students in both formal and informal medical education curriculum. Competency based curriculum is discussed. Indiana University Conscience Project 1982, Health-professional Ethics Leadership Program (HELP) 1997, Teaching Caring Attitudes (TCA) 1998
    01/2005;
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    M. Gaffney, M. Galvin, B. Stilwell
    01/2002;
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    ABSTRACT: Fifty boys, hospitalized on a school-age and an adolescent unit in an intermediate length psychiatric hospital, were studied while off psychoactive medication to determine how serum dopamine beta hydroxylase (DBH) activity varies with different childhood maltreatment experiences. Childhood maltreatment was categorized according to onset (before 36 months old, between 36-72 months old and over 72 months old). Childhood maltreatment groups were compared with a group of psychiatrically hospitalized boys who had neither been abused nor neglected. Boys who were younger than 72 months at age of onset of maltreatment had significantly lower DBH activity than those who had experienced maltreatment later in childhood and those who had not been subjected to abuse or neglect. This difference appeared attributable to the DBH activity of school age (but not adolescent) boys who had been abused/neglected before 72 months. Boys with a principal diagnosis of conduct disorder solitary aggressive type had lower DBH activity than boys without this diagnosis regardless of whether or not they had been maltreated. Low serum DBH may be a biological sequela of maltreatment early in life that correlates with the development of conduct disorder solitary aggressive type in boys.
    Child Abuse & Neglect 08/1995; 19(7):821-32. · 2.47 Impact Factor
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    ABSTRACT: Fifty boys, hospitalized on a school-age and an adolescent unit in an intermediate length psychiatric hospital, were studied while off psychoactive medication to determine how serum dopamine beta hydroxylase (DBH) activity varies with different childhood maltreatment experiences. Childhood maltreatment was categorized according to onset (before 36 months old, between 36–72 months old and over 72 months old). Childhood maltreatment groups were compared with a group of psychiatrically hospitalized boys who had neither been abused nor neglected. Boys who were younger than 72 months at age of onset of maltreatment had significantly lower DBH activity than those who had experienced maltreatment later in childhood and those who had not been subjected to abuse or neglect. This difference appeared attributable to the DBH activity of school age (but not adolescent) boys who had been abused/neglected before 72 months. Boys with a principal diagnosis of conduct disorder solitary aggressive type had lower DBH activity than boys without this diagnosis regardless of whether or not they had been maltreated. Low serum DBH may be a biological sequela of maltreatment early in life that correlates with the development of conduct disorder solitary aggressive type in boys.RésuméCinquante garçons enaˆge scolaire, hospitalise´s dans une unite´d'adolescents d'un hoˆpital psychiatriquea`se´jour de dure´e interme´diaire onte´te´e´tudie´s. En l'absence de toute me´dication psycho-active les variations de l'activite´se´rique en dopamine beta hydroxylase (DBH) onte´te´e´tudie´es en fonction des diffe´rentes expe´riences de maltraitance infantile. Les maltraitances infantiles onte´te´classe´es en fonction de leur de´but (avant 36 mois), entre 36 et 72 mois et apre`s 72 mois de vie. Les groupes d'enfants maltraite´s onte´te´compare´s avec un groupe de garçons, hospitalise´s pour des raisons psychiatriques, mais qui n'avaient jamaise´te´abuse´s ou ne´glige´s. Les garçons qui avaient moins de 72 mois lors du de´but des mauvais traitements avaient une activite´DBH significativment plus basse que ceux maltraite´s plus tard dans l'enfance et que ceux n'ayant jamaise´te´sujeta`de l'abus ou de la ne´gligence. Cette diffe´rence est apparue attribuablea`l'activite´DBH des garçons enaˆge scolaire abuse´s avant 72 mois et nona`ceux adolescents. Les garçons dont le diagnostic principal de desordre de comportemente´tait de type agressif et solitaire avaient une activite´DBH plus basse que les garçons ne pre´sentant pas ce diagnostique et cela qu'il aiente´te´maltraite´s ou non. Un taux se´rique bas en DBH peuteˆtre une se´quelle biologique de mauvais traitements pre´coces qui est corre´le´s avec le de´veloppement d'un de´sordre de comportement agressif et solitaire chez les garçons.ResumenCincuenta nin˜os de sexo masculino, hospitalizados en una unidad para nin˜os de edad escolar y adolescentes en un hospital psiquia´trico de ingreso de media estancia, fueron estudiados mientras no estaban tomando medicacio´n psicoactiva, para determinar co´mo variaba la actividad de la Dopamina Beta Hidroxilasa (DBH) en suero en funcio´n de diferentes experiencias de maltrato en la infancia. El maltrato en la infancia se categorizo´de acuerdo al momento de su inicio (antes de los 36 meses de edad, entre los 36–72 meses, y despue´s de cumplidos los 72 meses). Se compararon los grupos de maltrato en la infancia con un grupo de nin˜os hospitalizados en dicho centro psiquia´trico que no habi´an sido objeto ni de malos tratos ni de abandono. Los nin˜os que teni´an menos de 72 meses de edad en el momento en el que comenzo´el maltrato, teni´an una actividad de la DBH mucho menor que aquellos que habian comenzado a sufrir el maltrato mas tarde y que aque´llos que no habi´an sido objeto ni de malos tratos ni de abandono. Esta diferencia pareci´a atribuible a la actividad de la DBH en nin˜os de edad escolar (pero no adolescentes) que habi´an sido objeto de malos tratos/abandono antes de los 72 meses. Los nin˜os con un diagno´stico principal de trastorno de conducta de tipo solitario-agresivo teni´an una menor actividad de la DBH que los nin˜os sin ese diagno´stico, independientemente de si habi´an sido o no maltratados. El bajo DBH en suero puede ser una sexuela biolo´gica de una experiencia de maltrato ene´pocas tempranas de la vida, que correlaciona en nin˜os de sexo masculino con el desarrollo de un trastorno de conducta de tipo solitario-agresivo.
    Child Abuse & Neglect. 07/1995;
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    ABSTRACT: Twenty-one psychiatrically hospitalized boys were studied while off psychoactive medication to determine if conduct disorder, solitary type, and abuse or neglect experiences correlated with low levels of dopamine-beta-hydroxylase (DBH) activity. Preliminary results supported earlier findings that undersocialized types of conduct disorder in boys were correlated with low DBH activity. Possible or definite neglect or abuse before 36 months of age was correlated with low DBH activity. Abuse or neglect was not correlated with low DBH activity when time of occurrence was not specified. Low serum DBH may be a biological sequela of seriously disrupted attachment.
    Psychiatry Research 11/1991; 39(1):1-11. · 2.68 Impact Factor
  • Matthew R Galvin, Margaret M Gaffney, Barbara M Stilwell
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    ABSTRACT: Objective: This is the first in a series of articles to characterize and critically consider recently employed forms of conscience sensitive psychiatric treatment of children and adolescents. Method: Modules were designed based upon domains of conscience functioning identified in empirical research and applied to recognized benchmarks for interventions in the treatment of psychopathology. Each module was designed to be sufficiently complete such that full participation from persons entering the cycle of modules at any point would not be compromised. One of the authors paired with interested, experienced therapists in existing programs to conduct and refine interventions in a group psycho-educational therapy format. Results: Over one hundred and fifty hours of conscience sensitive psycho-educational group therapy were conducted in therapeutic loci within a well-established, community-based continuum of care. The therapeutic loci ranged from a child and adolescent psychiatry outpatient clinic to a closed youth residential setting and included adolescent psychiatric intensive outpatient and partial hospitalization programs. Number of participants in any module varied from one in the outpatient locus to fifteen in the intensive outpatient locus. Age of participants varied from school age to late adolescent. Formal intellectual testing was not uniformly available for participants. Most however appeared to be average intellectually. Each participant had, at minimum, an initial assessment by a mental health clinician yielding a DSM IV multiaxial psychiatric diagnosis. No restrictions were placed upon participants in terms of principal or secondary diagnoses or severity of impairment although all had sufficiently severe impairment to be deemed in need of the aforementioned current and standard psychiatric or psychosocial interventions. Length of time for each of the seven modules was permitted to vary according to the stability of the participant population. Individual modules conducted in the adolescent psychiatric intensive outpatient program were limited to one hour each, whereas some modules conducted in the residential and youth day school settings extended over several sessions held once weekly. Seven modules were eventually developed and refined to comprise a full course of conscience sensitive psycho-educational group therapy. Conclusions: Each of the seven modules in its current stage of development and refinement is characterized in terms of praxis, but also considered critically in terms of treatment philosophy. Conscience sensitive group psycho-educational therapy can be conducted in child adolescent psychiatric therapeutic loci ranging from outpatient to closed residential programs. Constraining variables were encountered in the adolescent intensive outpatient program when census became large, and turnover rapid, in consequence of which the full cycle of seven modules conducted at a frequency of one per week could not be completed by many participants. This could be remedied by conducting sessions more frequently, perhaps two to three times per week, and offering a sufficient number of groups to ensure that the number of participants in each group does not exceed eight. In the outpatient setting, there were fewer referrals than had been hoped, perhaps because of limitations upon reimbursement for the total number and/or kind of therapeutic interventions, a condition which, in the local mental health community, favors individual psychotherapy over group psychotherapy. However, the possibility cannot be excluded that there have been referral biases or parental preferences in favor of groups with a more readily recognizable focus such as anger management or social skills over a novel, less familiar approach. Conscience Works: Theory, Research and Clinical Applications, 2005, 1(1): 1-23. Key Words: conscience sensitive, child and adolescent psychiatry, benchmarks for intervention, psycho-educational, group format.
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    M Gaffney, M Galvin, B Stilwell
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    ABSTRACT: An I.U. Conscience Project and HELP Collaboration. The article describes models for teaching ethics and caring attitudes to undergraduate medical students in both formal and informal medical education curriculum. Competency based curriculum is discussed.
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    ABSTRACT: OBJECTIVES : 1) to highlight studies in the last eight years in which functional magnetic resonance imaging or other neuroimaging techniques have been employed in identifying brain activities as putative correlates of various TASKS proposed to represent essential MORAL PSYCHOLOGICAL FUNCTIONS and 2) to consider how NEUROIMAGING STUDIES of CONSCIENCE FUNCTIONAL TASKS might be conducted which provide more depth and meaning in future moral psychobiological investigation. METHOD: Brief descriptions of the principles and caveats of interpreting findings from NEUROIMAGING are provided. A GLOSSARY OF TERMS derived from cognitive sciences including neuropsychology and developmental psychology is presented. These terms, it is suggested, are necessary but not sufficient in understanding the DOMAINS OF CONSCIENCE. Existing NEUROIMAGING STUDIES of putative MORAL PSYCHOLOGICAL FUNCTIONAL TASKS that (at least nominally) address aspects of each CONSCIENCE DOMAIN are reviewed. These STUDIES are organized according to the following subtitles (with the CONSCIENCE DOMAIN of concern identified parenthetically): MORAL COGNITION: MORAL JUDGMENT AND VALENCE (CONSCIENCE DOMAIN: VALUATION), EMPATHY (CONSCIENCE DOMAIN: MORALIZED ATTACHMENT), MORAL EMOTIONS (CONSCIENCE DOMAIN: MORAL EMOTIONAL RESPONSIVENESS), and SELF CONTROL (CONSCIENCE DOMAIN: MORAL VOLITION). No existing NEUROIMAGING STUDIES clearly correspond to the anchor domain, CONCEPTUALIZATION OF CONSCIENCE. The CONSCIENCE DOMAINS are briefly characterized with reference to the empirical research supporting each. CONCLUSIONS: In the last several years, a number of intriguing findings have emerged from NEURO-IMAGING STUDIES relevant to putative MORAL PSYCHOLOGICAL FUNCTIONAL TASKS. However, in addition to caveats attaching to any attribution of activity to neurological structures and their connections based upon signals captured via NEURO-IMAGING, serious concerns also arise regarding the validity of the TASKS currently employed in these studies as truly representative of CONSCIENCE FUNCTIONS. Instruments designed to inquire into relevant CONSCIENCE DOMAINS are put forward. Complementary TASKS more sensitive to each CONSCIENCE DOMAIN are imagined and offered for consideration as ways to provide more depth and meaning to future NEUROIMAGING STUDIES OF CONSCIENCE. Conscience Works Theory, Research and Clinical Applications 3(1): 1-36, 2009.
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    Matthew R. Galvin, Barbara Stilwell