Epigenetics and Child Psychiatry: Ethical and Legal Issues

Epigenetics has the potential to revolutionize diagnosis and treatment in psychiatry, especially child psychiatry, as it may offer the opportunity for early detection and prevention, as well as development of new treatments. As with the previous introduction of genetic research in psychiatry, there is also the problem of unrealistic expectations and new legal and ethical problems. This article reviews the potential contributions and problems of epigenetic research in child psychiatry. Previous legal and ethical issues in genetic research serve as a guide to those in epigenetic research. Recommendations for safeguards and guidelines on the use of epigenetics with children and adolescents are outlined based on the identified issues. Copyright © 2015 John Wiley & Sons, Ltd.     

Parental Religious Socialization Practices, Connectedness With Others, and Depressive Symptoms in Late Life

This purpose of this study is to examine two constructs that have been largely overlooked in the study of religious involvement among older people: parental religious socialization practices and feelings of connectedness with others. The data are from an ongoing nationwide survey of older people. Findings from a latent variable model that was designed to examine the two focal constructs provides support for the following relationships:(1) older people whose parents encouraged them to become more involved in religion are more likely to attend worship services; (2) older people whose parents promoted religious involvement and older individuals who attend church more often are more likely to report that they see a fundamental connection among all human beings; (3) older adults who feel more closely connected to others will be more likely to forgive people for the things they have done; and (4) older people who are more forgiving are likely to experience fewer symptoms of depression over time.     

Parental Religious Socialization Practices,Connectedness With Others,and Depressive Symptoms in Late Life

This purpose of this study is to examine two constructs that have been largely overlooked in the study of religious involvement among older people: parental religious socialization practices and feelings of connectedness with others. The data are from an ongoing nationwide survey of older people. Findings from a latent variable model that was designed to examine the two focal constructs provide support for the following relationships: (a) older people whose parents encouraged them to become more involved in religion are more likely to attend worship services, (b) older people whose parents promoted religious involvement and older individuals who attend church more often are more likely to report that they see a fundamental connection among all human beings, (c) older adults who feel more closely connected to others will be more likely to forgive people for the things they have done, and (d) older people who are more forgiving are likely to experience fewer symptoms of depression over time.     

My Mug Is Valuable,But My Partner's Is Even More So: Economic Decisions for Close Others

In three experiments, we investigated how people make economic decisions for close others. Participants performed an imaginary valuation task for objects of theirs, a close other, and a stranger. Replicating the endowment effect, people valued their objects more than a stranger's. Of interest, participants valued a close other's objects more than their own. Further experiments showed that the inflated values for a close other's objects were not due to social desirability or task demands. These results convey the importance of considering for whom an economic decision is being made, as people respond differently for themselves, close others, and strangers.     

Less Engagement in Pleasurable Activities Is Associated With Poorer Quality of Life for Veterans With Comorbid Postdeployment Conditions

The presence of multiple comorbid conditions is common after combat deployment and complicates treatment. A potential treatment approach is to target shared mechanisms across conditions that maintain poorer health-related quality of life (HRQOL). One such mechanism may be decrements in pleasurable activities. Impairment in pleasurable activities frequently occurs after deployment and may be associated with poorer HRQOL. In this brief report, we surveyed 126 veterans who had previously sought an assessment at a Veterans Affairs postdeployment health clinic and assessed pleasurable activities, HRQOL, and postdeployment health symptoms. Forty-three percent of veterans met our criteria for all 3 postdeployment conditions (posttraumatic stress disorder, depression, and chronic widespread physical symptoms). Greater engagement in pleasurable activities was associated with better HRQOL for all veterans regardless of type or level of postdeployment health symptoms. Future research should study if interventions that encourage veterans with postdeployment health conditions to engage in pleasurable activities are effective rehabilitation strategies.     

Mentalization-based Interventions in Child Psychiatry and Youth Protection Services II: A Model Founded on the Child’s Prementalizing Mode of Psychic Functioning

ABSTRACT

The systematic and rigorous observations of children in child psychiatry and Youth Protection Services in Quebec revealed that most of these children presented multiple, complex and often severe problems, and did not seem to benefit much from classic psychodynamic psychotherapy. Owing to a poorly developed mentalizing capacity, many of these children did not use symbolic play as a means of expressing their intrapsychic conflicts and relational difficulties and did not communicate much verbally with clinicians. It was noted also that these children’s inner world was dominated by prementalizing modes of thinking, namely, the teleological mode, the psychic equivalence mode, and the pretend mode. This article is the last in a series of three. The first concerns the clinical assessment of prementalizing modes of psychic functioning in children and their parents. The second lays out the general objectives, principles and interventions of a mentalization-based treatment for children. This third article presents specific intervention strategies adapted to children’s predominant mode of thinking. The objectives and techniques regarding each mode are discussed. Three clinical examples serve to illustrate the interventions. The authors suggest that these children must develop a certain degree of mentalizing capacity before they can benefit from classic psychodynamic psychotherapy.     

Positive Illusions in Parenting: Every Child Is Above Average

This study examined the paradox between the difficulties of parenting and the high levels of parenting satisfaction in terms of positive illusions. Results were consistent with a positive illusions model, as biological parents with a child between the ages of 2 and 5 reported unrealistically positive views of their children. They rated their own children as possessing more positive and less negative attributes than the average child. The more positively parents rated themselves, the more positively they rated their children. Parents' self-esteem scores, unrealistically positive ratings of the child, and positive illusions of parenting were related to 3 aspects of the parenting experience. This study extends the literature on positive illusions to encompass parents' positive illusions about their young children.     

Filial Therapy With Incarcerated Fathers: Effects on Parental Acceptance of Child,Parental Stress,and Child Adjustment

The rationale for filial therapy is explored and the effectiveness of a 10-week filial therapy parent training group for incarcerated parents is described. Results of the analysis of covariance revealed that incarcerated fathers in the experimental group scored significantly higher after training than incarcerated fathers in the control group on both their attitude of acceptance and their empathic behavior toward their children. They also scored significantly lower than the control group fathers on level of stress related to parenting and identified child problem behaviors. In addition, t-test results showed that the self-concepts of the children of fathers in the experimental group increased significantly as a result of interactions with their fathers in structured filial play sessions.     

Synchronizing Loss With Life Over a Life Span: A Dynamic Perspective

Synchronizing loss with life is a dynamic journey. This article explores the myths, beliefs, and dynamics of loss and life. The purpose of the article is to help clinicians assist and support their clients with the difficulties of synchronizing loss with life as they progress on their life span journey.     

琉球家族的宗教观与宗教生活——以祈愿文、结愿文为例

本文以家文书中祈愿文、结愿文为基本资料,分析琉球家族的宗教观和宗教生活。由于受到特殊的自然地理和历史文化的影响,琉球家族的宗教观是多神信仰,其中御岳、火神、祖灵、观音为其信仰的主体。琉球家族的宗教活动主要围绕着与现实生活密切相关的祈福禳灾而展开,具有浓厚的功利性色彩。琉球家族的宗教观和宗教活动,从一个侧面反映了琉球王国的宗教信仰。     

Maternal ADHD: Parent-Child Interactions and Relations With Child Disruptive Behavior

This study examined how ADHD symptoms in mothers of children with ADHD relate to their behavior during parent-child interactions and to their children's disruptive behavior. Findings indicated that mothers’ retrospective self-ratings of ADHD symptoms were related to their present negativity during parent-led play. Mothers’ self-ratings of current inattentive symptoms were related to their impatience during child-led play. Maternal ADHD symptoms were also related to their ratings of their children's ADHD and oppositional-defiant behaviors. Identifying relations between maternal psychopathology, such as ADHD symptomatology, and behaviors during parent-child interactions may yield clues to additional parent behavioral changes that would enhance treatment outcomes for young children with ADHD.     

Responsive Parenting and Child Socialization: Integrating Two Contexts of Family Life

Developmental and behavioral research traditions differ in their prioritization of certain interpersonal contexts. Developmentalists focus on what might be called the attunement context and investigate how parent responsiveness impacts child symbolic capacities and social behavior. Behaviorists, on the other hand, focus primarily on limit-setting encounters and how reinforcement impacts rates of coercive and cooperative child behavior. The present paper discusses parental attunement from a reinforcement perspective. It illustrates that child behavior is related not only to how parents respond to prior episodes of coercion and cooperation, but to a wide range of child social behaviors.     

Living With Genetic Vulnerability: a Life Course Perspective

This is the second article of a two part series about utilizing the life course perspective (LCP) in genetic counseling. Secondary data analysis was conducted on a grounded theory, longitudinal study which provided a wide focus on living with hereditary breast and ovarian cancer (HBOC) risk. The aim of this analysis was to explore the longitudinal data for both the temporal and social context of living with BRCA mutation genetic test results. Sixteen women from two previous studies were interviewed on multiple occasions over an 8 year time period. The LCP was used to direct a thematic analysis of the data. Families experience the consequences of knowing they carry a BRCA1 or BRCA2 gene mutation long after the initial diagnosis. These women’s experiences across time reflect the concepts of the LCP and show how life is changed when families know they live with a genetic vulnerability to an adult-onset and potentially life-threatening disease. Different emphases on concepts from the LCP were evident across the different age groups. For example, the group of 40–50 year old women emphasized the concept of linked lives, those in their 30’s focused on human agency and women in their 20’s were more focused on timing of events. This study helps give direction to healthcare providers counseling women living with a BRCA mutation.     

Telling Others to Do What You Believe Is Morally Wrong: The Case of Confucius and Zai Wo

Can it ever be morally justifiable to tell others to do what we ourselves believe is morally wrong to do? The common sense answer is no. It seems that we should never tell others to do something if we think it is morally wrong to do that act. My first goal is to argue that in Analects 17.21, Confucius tells his disciple not to observe a ritual even though Confucius himself believes that it is morally wrong that one does not observe the ritual. My second goal is to argue against the common sense answer and explain how Confucius can be justified in telling his disciple to do what Confucius thought was wrong. The first justification has to do with telling someone to do what is second best when the person cannot do what is morally best. The second justification has to do with the role of a moral advisor.     

Mentalization-Based Interventions in Child Psychiatry and Youth Protection Services I: Objectives,Setting, General Principles and Strategies

ABSTRACT

Many of the children who receive services in child psychiatry or are in the care of Youth Protection Services present with complex, multiple and often severe problems. Classic psychodynamic psychotherapy seems to be of little benefit to them. The majority of these children tend to not use symbolic play as a means of expressing their intrapsychic conflicts or relational difficulties and they do not verbally communicate much with clinicians. They are more likely to display an imaginative poverty that translates into boredom, motor discharge, and an inability to use the material put at their disposal for therapeutic purposes. The systematic and rigorous observations of these children in Quebec revealed that the majority of them present with severe mentalizing difficulties. They often show attitudes and behaviors linked to the prementalizing modes of psychic functioning. This article presents a mentalization-based intervention adapted to these children’s difficulties. The objectives, adaptation of the work setting, and general principles underlying this intervention are discussed. In addition, general intervention strategies are also covered. These interventions are considered as preparatory work whose principal purpose is to enable children to benefit later on from psychodynamic psychotherapy. The authors also recommend specific intervention strategies adapted to children’s predominant mode of psychic functioning. The details of these strategies will be shared in a separate article.