Children with Autism Spectrum Disorders: A structured teaching and experience-based program for therapists,teachers, and parents

This study is aimed at validating the Separation Anxiety Scale for Children (SASC) in a sample of 802 Italian children aged 8–11. Confirmatory factor analysis replicated the original model. The tool showed adequate reliability and good convergent validity with the Spence Children Anxiety Scale. Results confirmed a decrease of separation Anxiety Disorder (SAD) with age and girls reported higher levels of SAD than boys. Findings suggested that the SASC is a suitable measure to assess SAD in Italian children.     

Moving From Efficacy to Effectiveness in Eating Disorders Prevention: The Sorority Body Image Program

Although eating disorders prevention research has begun to produce programs with demonstrated efficacy, many such programs simply target individuals as opposed to engaging broader social systems (e.g., schools, sororities, athletic teams) as participant collaborators in eating disorders prevention. Yet, social systems ultimately will be responsible for the real-world delivery of eating disorder prevention programs, suggesting that an important issue has yet to be addressed. Namely, it is unclear to what degree efficacious individual-focused eating disorder prevention programs remain effective when incorporated into critical social systems under real-world conditions. Over the past 5 years, we have collaborated with the campus sororities in the development of a sustainable eating disorders prevention program that is based on the prevention efficacy literature. This paper describes both challenges and helpful strategies that we encountered in tailoring an evidence-based eating disorders prevention program to the needs of a relevant social system.     

Live supervision in the postmodern era of family therapy: Issues,reflections, and questions

This article asserts that the family therapy field is approaching an epistemological shift from structuralism and positivism to postmodernism and relativism. The confluence of these movements: feminism, constructivism/constructionism, and cultural relativism is cited as a major impetus for the shift. Live supervision is examined within the context of this transformation, with a discussion of implications for the future.     

Hospital based parenting support for first-time parents: The Perinatal Positive Parenting program at the William Beaumont Hospital

A demonstration of the Perinatal Positive Parenting program was initiated at the William Beaumont Hospital in 1980. This article outlines the background of that demonstration and provides an introduction to the articles that follow which describe the PPP program in more detail.     

Ridicule and being laughed at in the family: Gelotophobia,gelotophilia, and katagelasticism in young children and their parents

The fear of being laughed at (gelotophobia), the joy of being laughed at (gelotophilia), and the joy of laughing at others (katagelasticism) were tested in a sample of 189 7‐ and 8‐year‐olds and their parents (185 mothers, 160 fathers). The dispositions were widely unrelated in the full sample. There was a positive relation between girls' and mothers' katagelasticism as well as between the 7‐year‐old boys' katagelasticism and their parents' gelotophilia. Furthermore, the 8‐year‐old boys' fear of being laughed at correlated robustly positively with their parents' gelotophobia and their gelotophilia with their parents' katagelasticism. Similarities/dissimilarities in the parental expression in the dispositions had no impact on the scores in the children. The findings are different from relations reported for parents and their adult children. The study provides ground for further studies on how families deal with ridicule and being laughed at.     

Disorders of excessive crying,feeding, and sleeping: The Munich Interdisciplinary Research and Intervention Program

The Munich Interdisciplinary Research and Intervention Program (MIRIP 1991) is an inter-disciplinary diagnostic and intervention service for families with regulatory disturbed infants (excessive crying, feeding/sleeping disturbances, disturbances of attachment/exploration, disturbances of autonomy/control). In addition, the systematic collection of data serve to investigate the etiology, clinical course, and possible treatments of regulatory problems in infancy. The program is based on a systemic model of early developmental psychopathology. Diagnostic procedures include a semistructured clinical interview, a developmental neuropediatric examination; behavioral diaries; questionnaires on infant temperament, the mother's psychological condition, marital satisfaction, and social support; and videotaped mother–infant interactions in age-related contexts. As is evident from the data analysis, regulatory disturbances in infancy may be associated with (1) maladaptive regulatory patterns in several domains (e.g., excessive crying and disturbed sleep-wake organization), (2) high maternal distress and multiple psychosocial risk factors, and (3) considerable distress of the early mother/parent–infant relationship and communication. Interaction-centered infant–parent psychotherapy is an interdisciplinary, multidimensional therapeutic approach for families with regulatory disturbed infants. It targets upon dysfunctional patterns of mother/parent–infant communication. Particular emphasis is put on restoring the parents' intuitive capacities. The approach has proved to be effective within short time periods and aims at preventing later developmental problems. © 1998 Michigan Association for Infant Mental Health     

Lesbians, gay men, and their parents: family therapy for the coming-out crisis

It is considered psychologically healthy for lesbians and gay men to come out and live outside of the closet. However, parents tend to react with shock, disappointment, and shame when they learn of a son's or daughter's gay sexual orientation. Disclosure often precipitates a painful family crisis, which can lead to cutoffs between members. This article describes family therapy theories and interventions that can aid therapists in sheparding families through the initial stages of the coming-out crisis. Family therapists are advised to acknowledge and address the distinct emotional needs of coming-out individuals and their parents. Parents must grieve and obtain accurate information about gay lifestyles. Lesbians and gay men need support as they struggle to cope with their parents' negative reactions. Family members should be coached to maintain non-combative communication following the disclosure, even if contacts are initially brief and superficial. Case examples, drawn from the author's clinical work, will demonstrate how to address the separate needs of lesbians, gay men, and their parents while maintaining (or rebuilding) family relationships and ultimately guiding families toward successful resolution of this crisis.     

Changes in adolescent and parent hopefulness in psychotherapy: effects on adolescent outcomes as evaluated by adolescents,parents, and therapists

We examined the role of hope in the behavioral and socioemotional outcomes of adolescents referred to psychotherapy. Adolescents (n = 3517), aged 12–17 years, and their parents rated adolescents’ behavior problems, adolescents’ adaptive behavior, and their own subjective experience of hopefulness at intake and at 3-month follow-up. Therapists also rated adolescents’ behavior problems and adaptive behavior at intake and follow-up. Adolescents who reported increased hopefulness during treatment showed significantly fewer problems and significantly greater adaptive behavior at follow-up than adolescents who reported stable or decreased hopefulness. Similarly, adolescents’ outcomes were significantly associated with parents’ change in hopefulness during treatment. Results were consistent for adolescent, parent, and therapist ratings of outcomes. Our findings provide some of the first empirical evidence for the importance of hopefulness in the psychosocial treatment of adolescents and highlight the need to attend to hopefulness in both youths and their parents.     

Psychodynamic Improvement in Eating Disorders: Welcoming Ignored,Unspoken, and Neglected Concerns in the Patient to Foster Development and Resiliency

ABSTRACT

Drawing upon case examples from their clinical, supervisory, and teaching experience, the authors suggest eating disorder treatment that primarily addresses behavioral change and is relatively short term leaves many patients behind in the search for a fuller sense of self and resilience. They have found that improvement rests upon ferreting out developmental deficits and other factors in early life that have been ignored, unspoken, and neglected; and without reflecting on, working through, and integrating these early experiences patients feel a part of themselves is still missing after symptom reduction. The authors assert that longer-term psychodynamic treatment facilitates therapeutic improvement by addressing six major domains: 1) mitigation of shame; 2) integration of split off affects and defenses; 3) achievement of greater intimacy and/or capacity to play; 4) confrontation of the tendency to spoil forward movement and self-sabotage; 5) identification with benign introjects and amelioration of a primitive, highly punitive superego; and 6) recognition and confrontation of denial of death. By describing the benefits of longer-term work with eating disorder patients, the authors hope to encourage others to expand the knowledge base of what constitutes therapeutic improvement and resilience, leading to lives that that are fuller, more creative, and productive.     

Children's Cooperation at School: The Comparative Influences of Teacher Responsiveness and the Children's Home-Based Behavior

Examined the school social interactions of 33 child-teacher dyads who volunteered to participate in a 1-hr classroom observation. Observers coded child compliance, aggregate measures of the children's responsiveness and negativity, and the teachers' responsiveness to the children. In addition, observers coded the same three child behaviors in 1-hr observation sessions in the children's homes. Based on a state-trait model of social behavior, correlational analyses were used to predict the children's school behavior using measures of the children's home behavior and teacher responsiveness. Results showed that teachers' responsiveness covaried with children's responsiveness and negativity, and the children's home behavior also accounted for significant variance in their school behavior. When these home and school predictors were compared, teachers' responsiveness accounted for most of the variance in the children's classroom negativity, but children's home responsiveness was the better predictor of their responsiveness in the classroom. The findings were discussed within a state-trait model of children's social behavior.     

Stress,coping, and life change in the single-parent family

Self-perceived competence in three roles (parent, social participant, self-supporter) was examined in relation to life satisfaction in a sample of 47 divorced, employed, single parent, middle-income women. Parenting was found to be the role of greatest perceived competence, and self-supporter the role of lowest perceived competence. Competence as a self-supporter was the strongest predictor of life satisfaction. Life satisfaction did not differ significantly between groups defined by length of time as single parents. For women separated less than 3 years, the social participant was the role of least perceived competence and the best predictor of life satisfaction. For those separated more than 3 years, the three roles were nearly equal in perceived competence, but competence as self-supporter was the best predictor of life satisfaction.     

New parents at work: Jobs, families and the psychological contract

Interviews with seven women and six men who had recently returned to work after becoming first-time parents were carried out to examine experiences of the policies, practices and attitudes of their employers towards new parents, and to assess how far they felt able to discuss their circumstances and changed expectations with their managers. Findings pointed to considerable differences in the attitudes of employers to the men and women. Almost all the women had changed to part-time work, but arranging this had not been easy and some had found it difficult to come to terms with a difference in status. Many of the respondents had reservations about discussing their positions and altered expectations with their managers, and it seemed unlikely that mutually beneficial psychological contracts could be negotiated without changes in organisational cultures and policies. The findings have implications for our understanding of organisational careers and for career-planning interventions in organisations.     

Screening for Eating Disorders in Undergraduate Women: Norms and Validity of the Spanish Version of the Eating Disorder Examination Questionnaire (EDE-Q)

The purpose of this investigation was to examine the internal consistency reliability and the convergent validity of the Spanish version of the Eating Disorder Examination Questionnaire (EDE-Q) and to provide EDE-Q norms for Spanish undergraduate women. Seven hundred eight college women, aged 18–30 years, volunteered to complete the EDE-Q, BSQ and EDI-2. Satisfactory internal consistency for the four subscales and the global score of the EDE-Q was obtained (Cronbach’s α ≥ .81). The EDI-2 Drive for Thinness and Body Dissatisfaction subscales and the BSQ global factor score correlated highly and positively with the corresponding EDE-Q subscales (r ≥ .72). Average scores, standard deviations and percentile ranks for the raw EDE-Q subscales and data on the occurrence of binge eating and compensatory behaviors are presented. Most of these values were lower than those found in other non-European developed countries. Results support the satisfactory internal consistency and convergent validity of the Spanish version of the EDE-Q. Lower scores in EDE-Q subscales suggest the need to study a lower cut-off point for clinical significance in Spanish college women. These data will help clinicians and researchers to interpret the EDE-Q scores of college women in Spain.     

Children's perceptions of parents and their roles: A cross-national study in Australia,England, North America,and Sweden

Within a broader project on children's sexual thinking, 838 children and 5 to 15 years in Australia, England, North America, and Sweden were interviewed (Goldman & Goldman, 1980, 1981.) Two items were focused upon: how children perceive differences between mothers and fathers, and how children perceive the roles of mothers and fathers. Five categories of differences between mother and father were located. Attitudinal differences positively correlated with age in all four countries. Parental roles contained five response categories. All categories show the traditional sex bias. Mother is seen by all children as predominantly concerned with domestic duties, care of children, and low status occupations, while father is seen overwhelmingly in a leisure role, as occupier of high status occupations, and playing authority-leadership roles in the family. Implications are discussed in terms of the need for society to accept and promote androgynous persons.     

The premodern and the postmodern: Some parallels,with special reference to Hinduism

Insofar as the postmodern exists, it is held to represent a break with the modern, a break no less radical than that of the modern with the premodern. In this paper I point to certain similarities between on the one hand what are said to be key aspects of the postmodern and on the other hand the premodern. It may well be fruitful to look for further parallels on either side of modernity.     

Multiple risk expert systems interventions: impact of simultaneous stage-matched expert system interventions for smoking, high-fat diet, and sun exposure in a population of parents.

Three stage-based expert system interventions for smoking, high-fat diet, and unsafe sun exposure were evaluated in a sample of 2,460 parents of teenagers. Eighty-four percent of the eligible parents were enrolled in a 2-arm randomized control trial, with the treatment group receiving individualized feedback reports for each of their relevant behaviors at 0, 6, and 12 months as well as a multiple behavior manual. At 24 months, the expert system outperformed the comparison condition across all 3 risk behaviors, resulting in 22% of the participants in action or maintenance for smoking (vs. 16% for the comparison condition), 34% for diet (vs. 26%), and 30% for sun exposure (vs. 22%). Proactive, home-based, and stage-matched expert systems can produce significant multiple behavior changes in at-risk populations where the majority of participants are not prepared to change.     

Chapter 3: Beyond the Symptoms: Generalizations and Distinctions between Eating Disorders with Different Symptom Manifestations in Psychoanalysis

ABSTRACT

In this article, I attempt to describe in detail the eating disorders of anorexia and bulimia. Although often lumped together as the same kind of eating-disordered pathology, I explore, in part by using my personal experience, how their origins and symptoms are different and why their psychoanalytic treatment modalities need to be responsive to these differences.     

综合医院非专科心理障碍诊治的现状、困难及对策

毋庸置疑,随着社会的迅速变迁,心理障碍正成为影响人类健康的主要疾病之一,综合医院也逐渐成为心理障碍诊治的主要战场,但与之相应的是我们还没有充分准备好应对之策,综合医院尤其是心理非专科医生,作为面对这新一轮疾病浪潮的主体更是无所适从,其结果在临床上造成心理障碍的漏诊误治屡见不鲜,这也是一个全球性的问题,对此虽然也有不断的呼吁要重视和加强相关措施的改进,但经过数年努力,问题并没有得到根本改善,所以,需要从观念上的突破和方法的创新才能扭转这一状态.笔者结合自己长期的研究结果及临床经验,将就此对综合医院特别是心理非专科面临心理障碍的现状、遇到的困难以及如何有效应对的策略进行阐述,提出了一些较新的观点和方法,希望有所启示.     

Prevalence of Personality Disorders at Midlife in a Community Sample: Disorders and Symptoms Reflected in Interview,Self, and Informant Reports

This report is concerned with the prevalence of symptoms of specific personality disorders in a representative community sample and draws attention to the importance of different sources of diagnostic information. We recruited a sample of 1,630 people between the ages of 55 and 64 to participate in a study regarding personality and health. Using careful recruitment methods, our participation rate was 43 %. Participants completed the SIDP-IV interview as well as a questionnaire (self-report MAPP). Informants completed the same questionnaire (informant MAPP), describing the participant’s maladaptive personality characteristics. According to the diagnostic interview, 7 % of participants met criteria for exactly one PD, 1 % met criteria for 2 or 3 PDs, and 2 % met criteria for PD NOS (defined as 10 or more miscellaneous criteria). Avoidant and obsessive compulsive PDs were the most common types. Correlations between the three sources of information indicated significant agreement among these measurement methods, but they are not redundant. In comparison to interview and self-report data, informants reported more symptoms of personality pathology (except for avoidant PD). Symptoms of personality pathology are continuously distributed, and subthreshold features may have an important impact on health and social adjustment. In this community sample, rates of co-morbidity among PDs and the proportion of PDNOS diagnoses are substantially lower than reported from clinical samples. Future research must evaluate the validity of diagnostic thresholds and competing sources of diagnostic information in relation to important life outcomes.