Associations Between Maternal Mental Health and Child Emotional and Behavioral Problems: Does Prenatal Mental Health Matter?

This study examined associations between elevated symptoms of prenatal depression or anxiety and offspring emotional and behavioral problems during mid to late childhood taking into account the impact of later maternal mental health symptoms. The sample consisted of 2,891 women and their children (49 % male) from a prospective, community-based study, the Avon Longitudinal Study of Parents and Children. Women completed measures of depressive (Edinburgh Postnatal Depression Scale) and anxious (Crown Crisp Experiential Index) symptoms at regular intervals beginning in pregnancy. Mothers and teachers assessed offspring emotional and behavioral problems using the Strengths and Difficulties Questionnaire when children were 10–11 years old. Multivariable regression models were fit to address study hypotheses. Exposure to elevated symptoms of maternal depression during pregnancy was associated with increased total offspring emotional and behavioral problems, even after controlling for later maternal mental health problems and a range of sociodemographic and psychosocial characteristics, according to mothers’ but not teachers’ reports. Similarly, children exposed to elevated symptoms of maternal anxiety during pregnancy were reported to have increased total emotional and behavioral problems by mothers but not by teachers. We found support for modest associations between elevated symptoms of maternal depression and anxiety during the prenatal period and certain domains of offspring emotional and behavioral problems in mid to late childhood above and beyond the impact of later maternal mental health problems. These findings highlight the need for additional clinical and research attention to the prenatal period and to both maternal depression and anxiety.     

Clinical Trial Application in Europe: What Will Change with the New Regulation?

The European framework surrounding clinical trials on medicinal products for human use is going to change as demonstrated by the large debate at European institutional level. One of the major challenges is to overcome the lack of harmonisation of clinical trial procedures among countries. This aspect is gaining more and more importance, considering the increasing number of multicentre and multinational studies. In this work, the actual European rules governing the Clinical Trial Application have been analysed throughout the different steps including the registration of the trial in the European database; the preparation of documents to be submitted and their contents; the preparation of documents related to the information and consent process; the submission to competent bodies. Specific issues related to paediatric research and trials involving non EU/EEA countries have been addressed as well. Results reveal that the European legislation offers a well defined set of European rules covering different aspects of a Clinical Trial Application. However, these are not suitable to meet the challenges from multicentre and multinational clinical studies. A stronger set of rules, such as is available in a composite European Regulation has been adopted and is expected to harmonise practices and enable sponsors to carry out well conducted trials. But will the new regulation overcome the existing criticisms of Directive 2001/20/EC?     

Personality and Health in the 1980s: Psychosomatic Medicine Revisited?

This special issue is a sign of a resurgence of interest in the role of personality in health not seen since the 1940s and early 1950s when the promises of the psychosomatic approach to health and illness appeared to be the greatest. This new look at personality and health represented by contributions to this special issue attempts to address the limitations of earlier work in psychosomatic medicine by making more explicit efforts to define personality variables precisely, to distinguish these variables from conceptually related psychological constructs, and to embed them in a body of theory and empirical research. This new work also attempts to remedy methodological limitations of earlier work by placing greater emphasis on prospective research and highlighting distinctions between symptom reports, illness behavior, and actual illness. However, the new work and earlier work in psychosomatic medicine share certain working assumptions, for example, a primary emphasis on the relatively direct impact of personality on disease onset, an assumption that personality variables operate in interaction with stressful events, and a frequent emphasis on general susceptibility to disease. Moreover, this new work frequently risks the same methodological pitfalls that limited scientific progress in psychosomatic medicine. We argue that the rapid rise and decline of psychosomatic medicine is most likely to be repeated in research on personality and health in the 1980s if reasonable criteria for considering personality variables a risk factor for disease are not precisely defined, disease endpoints (the dependent variable) are not assessed precisely, personality variables of interest (the independent variable) are not empirically distinguished from other related psychological variables, and complex relationships among risk factors are not taken into account. It is emphasized that models drawn from personality research cannot be transferred unchanged to the health arena without risking false inferences about the role of personality in health.     

Can Blended Classroom and Distributed Learning Approaches be Used to Teach Medical Students How to Initiate Behavior Change Counseling During a Clinical Clerkship?

Medical school curricula often provide insufficient time and instruction for health behavior change counseling. We examined the feasibility of blending classroom and distributed learning experiences to teach medical students how to initiate health behavior change counseling and analyzed the impact of this approach on their attitudes, knowledge, and skills. Usage patterns and pre- to post-class attitude and knowledge changes were assessed with self-report questions among 153 third year family medicine clerkship students. Most students viewed at least 90% of the online written content and took an average of 41 min (SD = 24 min 35 s) to view all of the content. Students’ confidence in their ability to help patients change unhealthy behaviors significantly improved (p < .01). The blended learning curriculum facilitated learning of behavior change skills, encouraged interaction with course materials, and improved medical students’ self confidence for using health behavior change skills.     

The Association Between Internalizing and Externalizing Behavior in Childhood and Early Adolescence: Genetic or Environmental Common Influences?

This study analyzed the genetic and environmental influences on internalizing and externalizing behavior problems and the nature of their cooccurrence in a national Norwegian twin sample. The sample comprised 526 identical and 389 fraternal same-sexed twin pairs from five birth cohorts, aged 5-6, 8-9, 12-13, 13-14, and 14-15 years. Behavior problems were assessed by parental ratings on the Child Behavior Checklist. A model of additive genetic, shared, and nonshared environmental influences was fitted to both internalizing and externalizing behavior in four sex and age groups. The considerable covariance,r = .51 to .58, between these traits is accounted for mainly by common environmental components; this effect was most marked in the 5 to 9-year olds. Concordance rates for children scoring above 1 standard deviation from the total sample mean on the internalizing scale only, externalizing scale only, or both indicated stronger genetic influences for internalizing or externalizing problems only than for combined problems.     

The MMPI: Does It Have a Place in Counseling Psychology Training?

Although a number of surveys have examined psychological assessment training in clinical psychology programs, studies about assessment training in counseling psychology programs have been all too few. This survey gathered information about the place of the Minnesota Multiphasic Personality Inventory (MMPI) in the training of counseling psychology students. A 3-page questionnaire was mailed to alt directors of APA-approved counseling psychology programs for completion by the individual primarily responsible for teaching the MMPI. Forty (85%) of the 47 questionnaires were returned, it was found that the MMPI (a) was taught in one or more courses in virtually all programs; (b) was viewed as useful by most respondents: and (c) was included, with same variability, in practicum training and on doctoral qualifying examinations. As in clinical psychology programs, the MMPI appeared to occupy a place of importance in the assessment training of counseling psychologists.     

Addiction‐Specific CACREP Standards in Clinical Mental Health Counseling Programs: How Are They Met?

In 2009, the Council for Accreditation of Counseling and Related Educational Programs (CACREP) included training standards specific to addiction for clinical mental health counseling programs. This study surveyed CACREP‐accredited program coordinators to determine how addiction‐specific standards were addressed.     

The Gender Gap in Delinquency: Does SES Matter?

Some researchers argue that the gender gap in delinquency will vary by socioeconomic status (SES); others argue instead for similarity in the gender gap in delinquency across SES. An important shortcoming of the existing research is the paucity of studies that disaggregate the data on delinquent outcomes to consider the possible impact of socioeconomic status on both the extent of overlap in predictors of females' and males' delinquency, and the extent to which these predictors help to explain the gender gap in delinquency. Using data from the National Longitudinal Study of Adolescent Health, this study addresses the shortfalls in empirical research by examining the gender gap for the juvenile population as a whole as well as across specific SES groupings, focusing on these key mediators of delinquency: grades, parental attachment, and delinquent peers. Data support the argument for similarity in the gender gap across SES, though the effect of predictors varies.     

Counseling Past and Present: Is There a Future?

Major criticisms directed at counseling are identified and prominent suggestions for their elimination are described through an analysis of the counseling literature of the past 10 years. A brief outline of the history of counseling offers a historical perspective to the discussion. One suggestion to improve counseling, that counselors become change agents in their institutions, is examined and described with steps for its implementation. The implementation of the change-agent role for counselors would address much of the substantive criticism directed at counseling, and would remold the profession to more effectively meet today's needs.     

The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children’s Mental Health

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to better prepare family advocates to help bridge the gaps in service access among children with emotional and behavioral problems. Despite the growth of family-led, family support programs nationally, research that demonstrates the positive benefits of such programs is scarce in the children’s mental health literature. The PEP model is based on research data about barriers families face in mental health service utilization (e.g., stigma, perceptions of providers, attitudes towards mental illness, service availability, etc.). PEP is premised on (a) the concept of empowerment as a process, (b) the need to engage parents in becoming active agents of change, and (c) the application of an integrated framework to empower parents, called the Parents as Agents of Change model. Our paper focuses on describing the application of a Unified Theory of Behavior Change as a theoretical framework to help activate parents as change agents in meeting their children’s mental health needs. Based on an integrated model of grassroots driven Principles of Parent Support and research-based Unified Theory of Behavior Change, PEP’s Parents as Agents of Change model provides a conceptual framework for testing the effectiveness of family support services in children’s mental health, a much-needed area for future research.     

Behavioral Intentions: Which Ones Predict Fertility Behavior in Married Couples?1

The published literature on the relationship between behavioral intentions and fertility behavior exhibits four major problems: inconsistent and confusing use of theoretical constructs, limited use of different types of intentions, use of nonbehavioral outcomes, and failure to explore adequately the couple aspects of the intentions/behavior relationship. The study reported here addresses these problems by using a theoretical framework that characterizes the psychological/behavioral sequence leading to a planned conception, three different types of fertility intentions, a behavioral outcome variable, and data from 196 married couples with no children and 185 married couples with one child. Data analysis results in a simultaneous equation, constrained regression model which indicates that child-timing intentions are the most important predictors of proceptive behavior over a 3-1/2 year period and that childbearing intentions are next in importance; that behavioral intentions are the final common pathway through which fertility motivations, attitudes, beliefs, and desires affect behavior; that the use of proceptive behavior as an outcome variable improves the explanatory power of our models; and that the interaction of couple intentions do not demonstrate greater husband or wife influence over couple proceptive behavior but do demonstrate that disagreement has a delaying effect on the onset of that behavior.     

Sound Body,Sound Mind? The Interrelation Between Health Change and Personality Change in Old Age

Personality development is characterized by increasing maturation, that is, people become more conscientious, agreeable and emotionally stable as they age. In late life, however, these trends seem to be reversed. Because many changes and transitions in older age are related to health, we investigated correlated changes in health problems and personality traits, the sources of health changes in later life and the directionality of effects. Our sample consisted of older adult twins, aged 64–85 years at time 1 (n = 410; 135 male/275 female; 134 monozygotic/63 dizygotic twin pairs), assessed at two different time points about five years apart, and we ran bivariate latent change and latent change twin model analyses. Increasing health problems were associated with decreases in agreeableness, extraversion, emotional stability and conscientiousness. Changes in health problems were only due to environmental influences, implying that the association between health and personality changes was exclusively environmental. Directional effects were largely absent, but health and personality were significantly related at the second measurement occasion (age 69–89 years). Our results support the link between health change and personality change in late life and spark the assumption of normative personality adaptations to deterioration of health status as a means of developmental regulation. Copyright © 2017 European Association of Personality Psychology     

Telephone Counseling for Smoking Cessation: What's in a Call?

Telephone counseling for smoking cessation has been gaining popularity as studies have demonstrated its efficacy. What comprises a successful program, however, has not yet been detailed in the literature. In this article, an innovative telephone counseling intervention for smoking cessation is described, with attention to the clinical issues of client assessment, motivation, self-efficacy, planning, coping, relapse-sensitive call scheduling, and self-image. Counselor training and supervision issues, ethical and legal considerations regarding this form of service delivery, and suggestions for future direction also are outlined.     

Health care reform: Can a communitarian perspective be salvaged?

The United States is culturally oriented more toward individual rights and values than to communitarian values. That proclivity has made it hard to develop a common good, or solidarity-based, perspective on health care. Too many people believe they have no obligation to support the health care of others and resist a strong role for government, higher taxation, or reduced health benefits. I argue that we need to build a communitarian perspective on the concept of solidarity, which has been the concept underlying European health care systems, by focusing not on individual needs, but rather, on those of different age groups—that is, what people need at different stages of life.     

Chronic Illness and Child Behavior Problems in Low-SES Families: The Mediation of Caregivers’ Mental Health

Journal of Child and Family Studies - Childhood chronic illness is associated with deleterious effects on caregivers’ mental health and children’s socio-emotional development. This...     

Is There Life After DEBI? Examining Health Behavior Maintenance in the Diffusion of Effective Behavioral Interventions Initiative

The evidence-based interventions that are identified, packaged, and disseminated by the Division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention as part of the Diffusion of Effective Behavioral Interventions (DEBI) initiative—commonly referred to the "DEBIs"—currently represent a primary source of HIV prevention interventions for community-based providers. To date, little attention has focused on whether the intended outcomes of the DEBIs, i.e., reductions in HIV-related risk behaviors, are maintained over time. This review summarized evidence for the sustainability of the effects of the DEBIs on HIV sexual risk behavior and intravenous drug use from studies of original and adapted DEBIs. Evidence of intervention decay or a lack of any intervention effect was identified in several original and adapted versions of the DEBIs included in this review. Recommendations include modifications to current criteria for inclusion in the DEBI portfolio, in addition to the development of remediation strategies to address intervention decay. Further, theoretical models that specify the processes that underlie the maintenance of health behaviors over time should be used in developing HIV prevention interventions.     

The Dialogue Between Religion and Science: Which God?

As exemplified by three cases, difficulties in the dialogue between religion and science not infrequently arise from differing views of God's omnipotence and omniscience. From the side of theology, reflections on the biblical and church-related sources of those views, on Auschwitz and theproblem of theodicy, on God as Creator of the universe, and on how to read and interpret the Bible show that a view of a God who self-limits almightiness and all-knowing in order to grant freedom and functional integrity to a Creation about which God cares can be multiply justified. Such a view is not dissonant with regard to a self-organized, open universe, producing "unexpected" emergent features as seen by science     

For Your Health? The Relationship Between Magazine Reading and Adolescents' Body Image and Eating Disturbances

Research has indicated female adolescents are more vulnerable to body image disturbance than male adolescents. However, scholars have begun to examine the increased emphasis on muscularity for men. The current supposition is that a drive to be muscular may be as dangerous for adolescent boys as a drive to be thin is for adolescent girls. Sports, health, and fitness magazines may be a meaningful training ground for adolescents to learn the importance of muscularity and the methods to obtain these perfect sports bodies. Magazines also reinforce the rewards that accompany the attainment of “perfect” bodies. Nearly 400 high school and college students from an urban area in the Midwest were surveyed to test the extent to which reading fashion, sports, and health/fitness magazines is related to body image and eating disturbances, including the added dimension of muscularity. Results indicate that magazine reading, social comparisons, and critical body image processing are important predictors of body image and eating disturbances for adolescent boys and girls.