A Psychoanalytically Oriented Approach as Primary and Secondary Prevention: Discussion of Joy Osofsky's “Psychoanalytically Based Treatment for Traumatized Children and Families”

Violence prevention programs can help children cope with trauma if effective strategies are developed to address youth victimization and children's exposure to domestic violence and trauma. Psychoanalysts are in a unique position to develop such primary and secondary prevention programs for children for whom violence is part of everyday life. An intense long-term relationship is an essential treatment ingredient for these profoundly troubled youngsters. In such a relationship, the therapist/analyst cannot react automatically to the inevitable hostile, destructive aggression that emerges in the treatment of severely traumatized children. A particularly key contribution by Osofsky is her discussion of the ubiquity of “countertransference every day in people who work with traumatized children.” Here I provide a clinical example of a failure that resulted from my own countertransference.     

Christian Churches and the Prevention of Preadolescent Aggression and Violence in Puerto Rico: Regional Leaders’ Perspective

Journal of Religion and Health - Preadolescents’ involvement in religious congregations may serve as a distal protective factor against aggression. Interviews were conducted to...     

The Evolutionary Significance of the Primary Process—The Freudian Concept and Its Revision

Freud’s Lamarckian beliefs contributed to his theory of instincts, as well as his concepts regarding the unconscious primary process. Freud’s theory of the primary and secondary process is fundamentally biological, as he placed it within an evolutionary context and hypothesized that the two systems were distinguished by free and bound psychic energy. Freud’s distinction between the primary and secondary process is one of the few psychoanalytic theories that has been confirmed by science. We believe that Freud was correct in maintaining that the primary process is of earlier evolutionary origin than the secondary process. But Freud failed to recognize the distinction between primary-process thinking that occurs in dreams and that which occurs in the waking state. In the waking state, the primary process is not wish fulfilling, as Freud believed, but functions as an inference making tool utilizing metaphor and metonymy. As such, rapid, unconscious primary process thinking is at the heart of our survival.     

African-American and Latino Parents’ Attitudes and Beliefs Regarding Adolescent Fighting and Its Prevention

Adolescent fighting affects 25 % of youth, with the highest rates among African-Americans and Latinos but little is known about parental views on youth fighting. The purpose of this study was to examine African-American and Latino parents’ perspectives on adolescent fighting and methods to prevent fighting. We conducted four focus groups with parents of African-American and Latino urban adolescents. Focus groups were stratified by race/ethnicity and fighting status. Groups were audiotaped, transcribed, and analyzed by three independent coders using thematic content analysis. Seventy-six percent of the 17 participants were female. Latino parents condoned fighting only as a last resort, and taught children about consequences of fighting, emotional regulation, and non-violent conflict-resolution strategies. African-American parents endorsed teaching non-violent strategies, but expressed some doubts about their effectiveness. African-American parents also suggested corporal punishment, but acknowledged that this may not be an optimal long-term strategy. Positive role modeling and involvement by teachers and other adults were cited as having important roles in fighting prevention. Suggested interventions included teaching adolescents non-violent conflict-resolution skills, anger management, and alternatives to fighting. Parents recommended that violence prevention programs incorporate the experiences of former fighters and be tailored to community needs. Study findings suggest that youth violence-prevention programs may benefit from addressing parental attitudes towards fighting and parent–child communication about fighting, teaching adolescents non-violent conflict-resolution skills, and tailoring programs by race/ethnicity. Promoting positive modeling and involvement by teachers and other adults also may be beneficial.     

Gray Matter Atrophy in the Cortico-Striatal-Thalamic Network and Sensorimotor Network in Relapsing–Remitting and Primary Progressive Multiple Sclerosis

Neuropsychology Review - Gray matter atrophy in multiple sclerosis (MS) is thought to be associated with disability and cognitive impairment, but previous studies have sometimes had discordant...     

Prevention Rather Than Cure? Primary or Secondary Intervention for Dealing With Media Exposure to Terrorism

The authors examined the efficacy of primary versus secondary intervention in moderating state anxiety and state anger from media‐based exposure to terrorism. Two hundred participants, allocated to a terrorism or nonterrorism media exposure and to antecedent or subsequent therapeutic or control intervention, were assessed for state anxiety and state anger responses. Results confirmed that higher postexposure response in the terrorism media exposure group was successfully moderated by primary but not by secondary therapeutic intervention. Findings illuminate the need in this domain for intervention that is sensitively assessed for content and sequencing.     

Propranolol and the Prevention of Post-Traumatic Stress Disorder: Is it Wrong to Erase the “Sting” of Bad Memories?

The National Institute of Mental Health (Bethesda, MD) reports that approximately 5.2 million Americans experience post-traumatic stress disorder (PTSD) each year. PTSD can be severely debilitating and diminish quality of life for patients and those who care for them. Studies have indicated that propranolol, a beta-blocker, reduces consolidation of emotional memory. When administered immediately after a psychic trauma, it is efficacious as a prophylactic for PTSD. Use of such memory-altering drugs raises important ethical concerns, including some futuristic dystopias put forth by the President's Council on Bioethics. We think that adequate informed consent should facilitate ethical research using propranolol and, if it proves efficacious, routine treatment. Clinical evidence from studies should certainly continue to evaluate realistic concerns about possible ill effects of diminishing memory. If memory-attenuating drugs prove effective, we believe that the most immediate social concern is the over-medicalization of bad memories, and its subsequent exploitation by the pharmaceutical industry.     

Primary Intersubjectivity: Empathy,Affective Reversibility, ‘Self-Affection’ and the Primordial ‘We’

The arguments advanced in this paper are the following. Firstly, that just as Trevarthen’s three subjective/intersubjective levels, primary, secondary, and tertiary, mapped out different modes of access, so too response is similarly structured, from direct primordial responsiveness, to that informed by shared pragmatic concerns and narrative contexts, to that which demands the distantiation afforded by representation. Secondly, I propose that empathy is an essential mode of intentionality, integral to the primary level of subjectivity/intersubjectivity, which is crucial to our survival as individuals and as a species. Further to this last point, I argue that empathy is not derived on the basis of intersubjectivity, nor does it merely disclose intersubjectivity, rather it is constitutive of intersubjectivity at the primary level. Empathy is a direct, irreducible intentionality separable in thought from the other primary intentional modes of perception, rationality, memory and imagination, but co-arising with these. In regard to the inter-personal level, the concrete relations with others, primary empathy is both the ground for the possibility of the secondary manifestations—pity, sympathy, perspective taking, etc., and motivates them. Thirdly, it is the movement in the core of subjectivity initially generated by shifting attention between the ‘I’ and ‘we’ perspectives and later ‘solidified’ through affect to become shifting identification, which opens up the intersubjective domain. So we can affirm that we are not only born into sociality but our sociality goes to the roots of our being as Husserl, Heidegger and Merleau-Ponty have claimed.     

How Has the Economic Downturn Affected Communities and Implementation of Science‐Based Prevention in the Randomized Trial of Communities That Care?

This study examined implications of the economic downturn that began in December 2007 for the Community Youth Development Study (CYDS), a longitudinal randomized controlled trial of the Communities That Care (CTC) prevention system. The downturn had the potential to affect the internal validity of the CYDS research design and implementation of science-based prevention in study communities. We used archival economic indicators and community key leader reports of economic conditions to assess the extent of the economic downturn in CYDS communities and potential internal validity threats. We also examined whether stronger economic downturn effects were associated with a decline in science-based prevention implementation. Economic indicators suggested the downturn affected CYDS communities to different degrees. We found no evidence of systematic differences in downturn effects in CTC compared to control communities that would threaten internal validity of the randomized trial. The Community Economic Problems scale was a reliable measure of community economic conditions, and it showed criterion validity in relation to several objective economic indicators. CTC coalitions continued to implement science-based prevention to a significantly greater degree than control coalitions 2 years after the downturn began. However, CTC implementation levels declined to some extent as unemployment, the percentage of students qualifying for free lunch, and community economic problems worsened. Control coalition implementation levels were not related to economic conditions before or after the downturn, but mean implementation levels of science-based prevention were also relatively low in both periods.     

A Comparison of the Interactive Systems Framework (ISF) for Dissemination and Implementation and the CDC Division of HIV/AIDS Prevention’s Research-to-Practice Model for Behavioral Interventions

Translating evidence-based HIV/STD prevention interventions and research findings into applicable HIV prevention practice has become an important challenge for the fields of community psychology and public health due to evidence-based interventions and evidence-based practice being given higher priority and endorsement by federal, state, and local health department funders. The Interactive Systems Framework (ISF) for Dissemination and Implementation and the Division of HIV/AIDS Prevention (DHAP) Research-to-Practice model both address this challenge. The DHAP model and the ISF are each presented with a brief history and an introduction of their features from synthesis of research findings through translation into intervention materials to implementation by prevention providers. This paper describes why the ISF and the DHAP model were developed and the similarities and differences between them. Specific examples of the use of the models to translate research to practice and the subsequent implications for support of each model are provided. The paper concludes that the ISF and the DHAP model are truly complementary with some unique differences, while both contribute substantially to addressing the gap between identifying effective programs and ensuring their widespread adoption in the field.     

Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Crisis?

Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending their own lives, ruling out PAD. Since both practices have compelling underlying justifications, the most reasonable accommodation might seem to be to allow PAD for persons with mental illness whose suffering is severe enough to justify self-killing, but prohibit PAD for persons whose suffering is less severe. This compromise, however, would require the articulation of standards by which persons’ mental as well as physical suffering could be evaluated. Doing so would present a serious philosophical challenge.     

Racial–Ethnic Protective Factors and Mechanisms in Psychosocial Prevention and Intervention Programs for Black Youth

Extending previous reviews related to cultural responsiveness in the treatment of ethnic minority youth, the current review provides a critical assessment and synthesis of both basic and applied research on the integration of three racial–ethnic protective factors (racial identity, racial socialization, Africentric worldview) in psychosocial prevention and intervention programs for Black children and adolescents. Seventeen programs meeting inclusion and exclusion criteria were evaluated for the extent to which racial–ethnic protective factors and related mechanisms were integrated, applied, and tested in such programs. A systematic assessment of these programs revealed that several prevention and intervention programs drew upon the three factors, particularly Africentric worldview. In addition, a number of studies hypothesized and assessed mechanisms, both those previously identified in conceptual literature and those that emerged from the interventions themselves. A set of recommendations encouraging the implementation of these factors into future prevention and intervention programs, examples of how clinicians can infuse these factors into psychotherapy, and areas for future research are discussed.     

Freedom and the Dynamics of the Self and the ‘Other’; Re-constructing the Debate Between Tagore and Gandhi

Tagore and Gandhi shared a relationship across 26 years. They argued about many things including the means for the attainment of swaraj/freedom. In terms of this central concern with the nature of freedom they came fairly close to an issue that has perhaps dominated the (European) Enlightenment. For the Enlightenment has sought to clarify what is meant by individual freedom and attempted to secure such freedom to the individual. This article argues that the Tagore-Gandhi debate can perhaps be reconstructed around the issue of freedom and the collective. Gandhi was able to employ the idea of collective action with conceptual and practical ease. He seemed to have felt no tension between individual freedom and the notion of the collective of which an individual becomes a part in his/her attempt to deal with the contending ‘other’ and secure his /her freedom/swaraj. To understand Tagore’s opposition to the Gandhian idea of swaraj this article draws a philosophical parallel between Tagore and Kant on individual freedom as primarily the freedom to reason. Tagore’s argument seemed to have centered on the insight that the location of the individual in a collective hypostatized self in order to protect his or her freedom from ‘others’ reaffirms the self other divide. The insider-outsider exclusionary dynamics that are generated not only consolidate such distinctions as external to (and outside of) the collective self, but they also initiate internal dynamics that create the ‘silenced insider.’     

Family Impact Analysis of Section?6 (Sexual Transmission) of the Kenya HIV and AIDS Prevention and Control Act No. 14 of 2006

We have analyzed the impact of Section 6 of The Kenya HIV and AIDS Prevention Act on Kenyan families and especially within marriage. In 2006 Kenya passed two bills into law: The Kenya HIV and AIDS Prevention Act and The Sexual Offences Act. The latter addresses sexual offenses including rape, incest and other acts of sexual violence and relates to the Prevention Act in that HIV infection may be transmitted during a sexual offense. Section 6 of the Prevention Act focuses on the sensitive issue of secondary and tertiary transmission of HIV. Although protection is accorded to individuals living with HIV, this section of the law places responsibility on this group to reduce infections among positive individuals as well as the spread of infection between spouses {when only one partner is positive} by criminalizing recklessness leading to HIV infection. By asking questions proposed in the family impact analysis such as, does the law enhance family stability, and commitment or does it acknowledge diverse family forms, interdependence and target vulnerable groups, the framework allows us to examine the impact of Section 6 of the law on families. Under the FIA framework, the ability of The Prevention Act to enhance family functions, promote wellbeing, marital stability, commitment and responsibility is considered while taking into account the contextual realities in Kenya.     

Opposing Affective and Cognitive Effects of Prevention Focus on Counterproductive Work Behavior

Purpose

Regulatory focus is a crucial self-regulation variable that influences employee workplace behavior. However, research findings to date have been equivocal with respect to the relation of prevention focus with counterproductive work behavior (CWB). On the one hand, prevention focus sensitizes people to experience high activation negative emotions. Such emotions prompt aggressive behavior, suggesting a positive relation of prevention focus with CWB through this affective route. On the other hand, prevention focus also sensitizes people to fulfill obligations and abide by rules. Such obligations align employee behavior with organizational norms, suggesting a negative relation of prevention focus with CWB through this cognitive route. To better understand the nature of this prevention focus–CWB relationship, we examined these underlying affective and cognitive mechanisms simultaneously in two multi-wave studies.

Methodology and Findings

In study 1, data were collected from 151 full-time employees across two time points, and the results showed that prevention focus was positively related to both deviant behavior and withdrawal. In study 2, data were collected from 199 full-time employees across four time points, and we found that prevention focus has a significant negative indirect effect on withdrawal via felt obligation. We discuss the theoretical and practical implications of our findings for the regulatory focus and CWB literatures.

     

Can learning about the Holocaust be spiritual? Reflections on a teaching and learning experience with Primary School children.

In April 2017, I spent a week in Poland researching the Holocaust in Europe. Most notably, I visited the Auschwitz and Birkenau concentration camps. Following the visit, I facilitated three History lessons with 10- and 11-year-old children on the role of Auschwitz in the Second World War. As the sessions unfolded, the spiritual themes of meaning, identity and remembering emerged from the children’s responses; therefore, this article forms a reflection on how the lessons impacted the children’s spiritual lives. It also considers how the History curriculum might include a critical dimension to pedagogy. In particular, it explores how issues such as theology, morality and the role of representation open up a space for critical questioning. I suggest that such questioning is also spiritual. Thus, the self-awareness and criticality inspired might contribute to transformation – of both the teachers and learners and the world around them.     

Assessing Reading Rate in the Primary Grades (1–3)

In this study we explore students' reading rates in grades 1–3. We begin with a short history of reading rate as an assessment measure in the early grades. Next, we share rate data from a recent study (N = 305) where children's contextual reading was assessed with a traditional passage-reading inventory. A comparison of our average grade-level rates with those rates reported in the DIBELS literature shows that they match closely. Finally, we introduce the concept of minimum grade-level rates, emphasizing its practical significance to teachers and researchers alike.     

Do Parents Know Best? Examining the Relationship Between Parenting Profiles,Prevention Efforts,and Peak Drinking in College Students1

The study examined parent profiles among high school athletes transitioning to college and their association with high‐risk drinking in a multi‐site, randomized trial. Students (n = 587) were randomized to a control or combined parent‐based and brief motivational intervention condition and completed measures at baseline and at 5‐ and 10‐month follow‐ups. Four parent profiles (authoritative, authoritarian, permissive, indifferent) were observed among participants. Findings indicated control participants with authoritarian parenting were at the greatest risk for heavy drinking. Alternately, students exposed to permissive or authoritarian parenting reported lower peak drinking when administered the combined intervention, compared to controls. Findings suggest the combined intervention was efficacious in reducing peak alcohol consumption among high‐risk students based on athlete status and parenting profiles.