Phonemes, Rimes, and the Mechanisms of Early Reading Development

Our paper (Hulme, et al., 2002) provides further evidence that phoneme-level skills are better predictors of children's early progress in learning to read than are onset-rime skills. The commentaries on our paper raise a number of issues including which variables (such as vocabulary knowledge and rime ability) need to be controlled in order to demonstrate a specific relationship between phoneme-level skills and reading ability and whether prereaders are capable of performing phonemic awareness tasks and the factorial structure of phonological skills. None of the commentaries, however, casts any doubt on our basic conclusion that phoneme-level skills are better predictors of early reading skills than are onset-rime skills.     

The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months

The main aim of this study was to investigate the predictive validity of four different optimality indexes, as well as infant perinatal status, in relation to maternal sensitivity in interaction at 3 months. The four optimality indexes comprised items related to substance abuse, psychiatric condition, relational experience and socioeconomic status (SES). Maternal sensitivity in mother-infant interaction was assessed in two different groups of mothers. One group consisted of mothers with substance abuse and psychiatric problems who underwent treatment during pregnancy. The other group of mothers had neither substance abuse nor psychiatric problems. The expectant mothers were interviewed in the third trimester of pregnancy. Medical records and meconium were obtained from the infants at birth. Three months after birth, maternal sensitivity in mother-infant interaction was assessed. Altogether 79 mother-infant dyads participated in the study. The mothers' optimality associated with relational experiences, as well as the infants' perinatal status were found to predict maternal sensitivity in mother-infant interaction at 3 months. The SES index was also significantly related to maternal sensitivity. The relation between group and maternal sensitivity was mediated by the mothers' optimality associated with relational experiences. This study points to the importance of addressing the mothers' own relational experiences and their current representations of motherhood during treatment, in order to support and enhance maternal sensitivity.     

Studying social cognition in patients with schizophrenia and patients with frontotemporal dementia: theory of mind and the perception of sarcasm

We investigated social cognition and theory of mind in patients with schizophrenia and in patients with frontotemporal dementia in order to elucidate the cognitive mechanisms involved in the breakdown of these skills in psychiatric and neurological patients. Our tasks included videotaped scenarios of social interactions depicting sincere, sarcastic and paradoxical remarks, as well as lies. We found impaired performance of the schizophrenia group on all theory of mind conditions despite their intact understanding of sincere statements. In contrast, the FTD group performed poorly only when they had to rely on paralinguistic cues indicating sarcasm or lies, and not on paradoxical remarks or sarcasm when given additional verbal cues. Our findings suggest that, while current deficits in social and interpersonal functioning in patients with FTD may reflect a decrement in previously acquired skills, similar deficits in patients with schizophrenia may reflect an altogether inadequately learned process.     

Are Psychiatric Residents Still Interested in Psychoanalysis? A Brief Report

In spite of the efficacy of the psychodynamic psychotherapies, the number of young psychiatric residents interested in psychodynamic therapies is decreasing. Our psychoanalytical group, Genden (Genève-Denver), explored the possible reasons for psychiatric residents' hesitation to get psychoanalytic training. Five psychoanalytical psychotherapists met weekly for a year in order to debate that question, focusing on personal feedbacks from all of our 100 residents in psychiatry working with us for at least 4 years. Following the residents' responses, our focus group proposed ten commonsense feedbacks for psychoanalysts regarding stimulating young psychiatric residents' interest in psychoanalytic approaches.     

Building Links Between Early Socioeconomic Status,Cognitive Ability,and Math and Science Achievement

The present study examined whether and how socioeconomic status (SES) predicts school achievement in science, technology, engineering, and math (STEM) using structural equation modeling and data from the National Institute of Child Health and Human Development Study of Child Care and Youth Development. The present inquiry addresses gaps in previous research linking SES and STEM achievement in high school. Results indicate that maternal education predicts the child’s early environment, which itself predicts the development of executive function (EF) and language, and thereby, STEM achievement. Moreover, children’s language ability and EF development influenced higher-order cognitive skills, such as relational reasoning, planning, and basic calculation skills. However, only relational reasoning strongly predicted high school math and science achievement, suggesting that relational reasoning, but not planning and calculation skills, was central to STEM thinking and learning.     

Intercultural Therapy with Latino Immigrants and White Partners

SUMMARY

Interethnic and interracial marriages of Latinos and White Americans are on the rise and will continue to reshape the identities of individuals, couples, families, and communities. Clinicians working with these intercultural couples find no systematic training to address what is becoming a significant segment of our society. Couple therapists, however, cannot be culturally competent and effective based solely on knowledge of some dimensions of a couple's cultural backgrounds. Using clinical and theoretical ideas, the author defines clinical work with these couples as an explicit intercultural exchange. Our task as clinicians requires a rethinking of our conversations with these couples. It involves a caring therapeutic approach that is sustained on relational and systemic levels, and intercultural conversational skills inspired by clinical and other literatures that are explicitly dedicated to work with cultural difference and the “other.”     

Supervising Psychoanalytic Psychotherapy: Present Knowledge,Pressing Needs,Future Possibilities

Existing research from the fields of education, cognitive science, neuroscience, and psychoanalytic psychotherapy points us toward possibilities for the future of psychoanalytic supervision. This research suggests that we need to go beyond communicating abstract knowledge and make our supervisory relationships more experiential, participatory, relationship-focused, and personal in order to teach usable knowledge, develop complex psychotherapeutic skills, and facilitate emotional and relational development in our supervisees. The author concludes that a relational model of supervision fits this pedagogical profile. After grappling with our resistances to change, the author hopes that more psychoanalytic supervisors will make use of a relational model of supervision, as well as drawing upon new technologies and neuroscience-based teaching techniques.     

Early risk pathways to physical versus relational peer aggression: The interplay of externalizing behavior and corporal punishment varies by child sex

Children who aggress against their peers may use physical or relational forms, yet little research has looked at early childhood risk factors and characteristics that uniquely predict high levels of relational versus physical aggression in preadolescence. Accordingly, the main aim of our study was to link early corporal punishment and externalizing behavior to children's physical and relational peer aggression during preadolescence and to examine how these pathways differed by sex. Participants were 193, 3‐year‐old boys (39%) and girls who were reassessed following the transition to kindergarten (5.5 years) and preadolescence (10.5 years). A series of autoregressive, cross‐lagged path analyses were conducted to examine the relationships between child externalizing problems and corporal punishment at ages 3 and 5.5 years, and their association with physical and relational aggression at age 10.5. Multiple group analysis was used to determine whether pathways differed by sex. Three developmental pathways were identified: (i) direct associations between stable childhood externalizing problems and later physical aggression; (ii) a direct pathway from early corporal punishment to preadolescent relational and physical peer aggression; and (iii) an indirect pathway from early corporal punishment to later physical aggression via continuing externalizing problems in middle childhood. Child sex moderated the nature of these pathways, as well as the direction of association between risk and outcome variables. These data advance our understanding of the etiology of distinct forms of peer aggression and highlight the potential for more efficacious prevention and intervention efforts in the early childhood years.

     

Group psychotherapy for adolescents comorbid for substance abuse and psychiatric problems: a relational constructionist approach

The group psychotherapy of adolescents comorbid for psychiatric and substance abuse problems is fraught with inconsistent attendance, frequent verbal and physical disruptions by the adolescents, and intense countertransference toward patients and their parents on the part of treating staff. A relational constructionist approach assists staff and patients in overcoming these obstacles and in focusing on the adolescents' search for personal meaning. Multiple group psychotherapy conducted in a combined day treatment and high school program is described and illustrated by case examples during the course of a year of treatment. These examples illustrate the importance of a relational non-hierarchical approach to adolescent patients by treating staff.     

Relational Entitlement,Early Recollections of Parental Care,and Attachment Orientation

The present study examined whether inadequate parental care has a long-term impact on pathological relational entitlement in romantic relations, and whether this impact is mediated by insecure attachment style. Our cohort of 335 Israeli adults completed Sense of Relational Entitlement (SRE), Experience in Close Relationships (ECR), and Parental Bonding Instrument (PBI) questionnaires. The results generally supported our hypotheses. Avoidant attachment style fully and negatively mediated the link between maternal adequate care and SRE total entitlement. Anxious attachment style fully and negatively mediated the link between PBI paternal adequate care and SRE total entitlement. Women were found to report more relational entitlement. These results support the notion that pathological relational entitlement has its roots in recollections of early parental care and attachment experiences. The results of the study are discussed in the context of adult attachment and romantic relationships.     

Reducing assaults on an acute psychiatric unit using a token economy: a 2‐year follow‐up

Token economies are an effective way of changing various behaviors including acquiring new skills, reducing undesired behaviors, reducing aggression, increasing treatment compliance, and improving psychiatric unit management. This study examines the long‐term effect of a token economy on an acute care, inpatient psychiatric unit. The two years following the implementation of a unit based token economy are compared with the 12 months prior to implementation. The results show a significant reduction in total assaults as well as fewer staff injuries resulting in loss of time from work. Copyright © 2003 John Wiley & Sons, Ltd.     

Training counting skills and working memory in preschool

Previous studies have shown that early numeracy skills predict later mathematics learning and that they can be improved by training. Cognitive abilities, especially working memory (WM), play an important role in early numeracy, as well. Several studies have shown that working memory is related to early numeracy. So far, existing literature offers a good few examples of studies in which WM training has led to improvements in early numerical performance as well. In this study, we aim at investigating the effects of two different training conditions: (1) counting training; and (2) simultaneous training of WM and counting on five‐ to six‐year‐old preschoolers' (N = 61) counting skills. The results show that domain‐specific training in mathematical skills is more effective in improving early numerical performance than WM and counting training combined. Based on our results, preschool‐aged children do not seem to benefit from short period group training of WM skills. However, because of several intervening factors, one should not conclude that young children's WM training is ineffectual. Instead, future studies should be conducted to further investigate the issue.     

The role of relational reasoning in children's addition concepts

The study addresses the relational reasoning of different‐aged children and how addition reasoning is related to problem‐solving skills within addition and to reasoning skills outside addition. Ninety‐two 5‐ to 8‐year‐olds were asked to solve a series of conceptually related and unrelated addition problems, and the speed and accuracy of all self‐reported strategies were used to monitor their addition performance. Children were also given a series of general relational reasoning tasks to assess their ability to solve problems based on thematic, causal and visual relations. The results revealed that, while children were able to reason about commutativity relations, recognition of relations based on additive composition was rare. Furthermore, children's ability to reason about addition concepts increased with age and problem‐solving proficiency. Reasoning about addition concepts was related to performance on the thematic, causal and visual reasoning tasks for older children but not for younger children. Overall, the findings suggest that while children's early knowledge of addition relations is domain specific, as children develop in their broader reasoning abilities these developments enhance their addition reasoning.     

A Model for Communication Skills Group Using Structured Exercises and Audiovisual Equipment

Long-term psychiatric patients who are transitioning out of the hospital often lack the social skills necessary to adapt to work and leisure situations. The behaviors that are appropriate in a hospital environment are radically different from behaviors expected in the community. This paper describes a short-term, 12-session, audio-visual group developed for an inpatient psychiatric population. The group's purpose is to provide a laboratory for members to look at their interactional styles and to develop improved social skills. Focused feedback and videotaped exercises allow group members to do this within a supportive atmosphere. The tasks introduced are designed to coincide with the developmental states of the short-term group. As the sessions proceeded, we utilized sequential exercises that would help members to feel safe, to problem solve as a group, and to practice communication skills.     

Embracing the other: Revisiting the epistemological foundations of family systems therapy

Family systems therapy originated in the 1960s, 1970s, and 1980s through the work of innovative thinkers and clinicians. However, despite the creative contributions of the mentioned colleagues and of later innovations in family therapy theory and practice, it seems as though the dominant culture of establishment psychiatry in the United States (and in most Western countries) to this day has not seriously incorporated relationships, social context, or community connectedness into the treatment of individuals with psychiatric diagnoses. For the “psychiatric” patients diagnosed according to the DSM-5, the dominant underlying epistemological perspective is the medical “scientific” paradigm. Within this approach there is a dearth of reflections about the truthfulness of so-called “empirical facts” and a lack of skepticism about the techniques of “measurement” of the psychiatric illness. The alternative, relationship-oriented, context-sensitive, and community-connected thinking paradigm is highlighted here in contrast to the “psychiatric” foundation. This paradigm consists of (a) the awareness that all human Subjects (including “psychiatric” clients) are constituted as such by their relational connection to others; (b) the awareness of our sensitivity to and embeddedness in a socio-economic, cultural, and racial context; and (c) the awareness of our involvement in and connectedness with many kinds of communities.     

Social Skills Training for Psychiatric Patients,II

In this second paper on social skills training for psychiatric patients the author critically reviews the controlled clinical outcome studies of social skills training in a number of psychiatric populations: mentally retarded persons, depressed patients, psychiatric outpatients, and psychiatric inpatients. He points out that more research is needed to determine the effectiveness of social skills training, especially for patients with debilitating chronic mental illness.     

Applying a Transdiagnostic Cognitive-Behavioral Treatment to Adolescents at High Risk for Serious Mental Illness: Rationale and Preliminary Findings

Given the chronic and deleterious course of serious mental illness (SMI; schizophrenia and bipolar disorder), significant efforts have been undertaken to improve prediction of SMI and provide treatment for adolescents in the early, putatively prodromal stage of these illnesses. While risk assessments and disorder-specific treatments for adolescents at risk for SMI have shown some efficacy, significant issues remain around disorder-specific treatments for these youth. There is substantial heterogeneity of psychopathology within adolescents at high risk for SMI that leads to many false-positives and varying diagnostic outcomes. As a result, initial treatment focusing on broad symptoms and skills has been proposed in place of disorder-specific treatments. We discuss the rationale for providing an already-developed and empirically supported transdiagnostic treatment for emotional disorders (termed the Unified Protocol) as a first-line staging of treatment for adolescents experiencing early SMI symptoms. Additionally, we outline the open trial we are piloting using this transdiagnostic treatment in adolescents between the ages of 13 – 17 who have begun experiencing distressing yet subsyndromal psychosis or bipolar mood symptoms. Preliminary findings suggest feasibility and acceptability as well as initial efficacy in improving psychiatric symptoms, quality of life, and difficulties regulating emotions. We also present case studies from our open trial. A unified, cognitive-behavioral treatment for early presentations of SMI has important clinical and public health benefits, including streamlining treatment and providing broad skills that are applicable to a wide range of psychopathology.     

An Interpersonal and Intercultural Embrace

SUMMARY

Using Ono's (1997) “letter” format to share one's multiplicity of “voices,” I discuss the negotiation of interpersonal and intercultural factors of a gay, transcontinental, HIV serodiscordant relational connection with my late partner and a multicultural relational connection with my current partner. In this letter, I work to open paths of inquiry and understanding of our connections by intersecting relational “differences” (e.g., ethnicity, nations of birth, social class, HIV status, and religion/spirituality) with relational “similarities” (e.g., attraction and love, age status, shared gay identity, shared languages, and educational privilege). Finally, I address our learned and practiced skills for sustaining relational healthiness.