Fairness considerations: Increasing understanding of intentionality during adolescence

The development of fairness considerations in decision making is not well understood. Here we tested the hypothesis that increased understanding of intentionality during adolescence underlies increased fairness considerations in social decision making. We conducted three experiments using an adapted version of the Ultimatum Game with participants during four stages of adolescence: 9, 12, 15, and 18 years of age. Participants made or evaluated monetary offers, and we manipulated the intentionality context of offers. Results show that strategic thinking is already present at 9 years of age. There was no age difference in fairness of offers when the responder could not reject an offer (Experiment 1), but when they could reject an offer there was an age-related increase in taking into account the perspective and intentionality of other players when making offers (Experiment 2) and evaluating offers (Experiment 3). Taken together, the results demonstrate a linear developmental transition in fairness considerations that may have important implications for our understanding of social interactions during adolescence.     

Permitting suicide of competent clients in counseling: legal and moral considerations

State statutes, case law, and professional codes of ethics in the mental health professions typically stress either a duty or the permissibility of disclosing confidential information in order to prevent clients from seriously harming themselves. These sources are intended to address cases where clients are deemed to be suffering from cognitive dysfunction for which paternalistic intervention, including involuntary hospitalization, is considered necessary to prevent self-destructive behavior. The counselor's moral and legal responsibility is less apparent when mentally competent clients desire suicide as release from irremediable suffering due to severe physical illness, and this desire is defensible within these clients' value systems. This paper will explore moral and legal dimensions of a counselor's decision not to intervene in such cases. The concept of permitted suicide will be introduced and defined, and guidelines for its application developed.     

Electrophysiological changes during adolescence: A review

While psychological research has long shown that adolescence is a period of major cognitive and affective transition, recent neurophysiological research has shown that adolescence is also accompanied by observable maturational changes in the brain, both in terms of structure and neurotransmitter function. Given this situation, we would expect that there should be observable and perhaps major changes in electrocortical activity and responses. In this review, we discuss developmental reductions in EEG power and alterations in the dominant band of EEG oscillation frequency, moderated by developmental factors such as growth-related changes in grey and white matter, and in the developmental history of cognitive and sociocultural stressors. Similarly, we summarize alterations in event-related potential components reflecting stimulus processing, response monitoring, and response anticipation. We review the literature on such changes in EEG and event-related potentials during the adolescent period and summarize some of the new developments in the field as well as interpretative difficulties.     

Methodological, ethical, and legal considerations in drug court research

Since their inception in the late 1980s, drug courts have become the most prevalent specialty court in the United States. A large body of outcome research conducted over the past two decades has demonstrated that drug courts effectively reduce drug use and criminal recidivism, which has led to the rapid proliferation of these courts. Importantly, drug court research has flourished despite the many challenges faced by researchers when working with a vulnerable population of justice-involved substance users. In this article, we highlight the most common methodological, ethical, and legal challenges encountered in drug court research, and discuss ways in which researchers can overcome these challenges to conduct high-quality research. Drug court research exemplifies how rigorous empirical investigation can be accomplished in the criminal justice system, and it can serve as a useful model for researchers working in other parts of the judicial system.     

Socio-economic status and the developing brain in adolescence: A systematic review

Socioeconomic status is associated with differences in social, cognitive, and behavioral outcomes for adolescents. Correspondingly, the period reflects continued dynamic, complex, and adaptive brain development. Research demonstrates associations between the developing adolescent brain and SES; however, such research has not been systematically integrated. We undertook a systematic search of studies and review 21 papers that examined both SES and brain development or functioning as measured during adolescence or young adulthood in nonclinical populations (13–25 years old). Few studies focused on architecture and such findings were varied. The majority of studies focused on functioning with two themes emerging. First, studies demonstrate different activation in regions of interest to cognitive and behavioral tasks relative to SES. Second, when similar neurological activation is evident, they can be related to different behavioral observations relative to SES. There is also evidence of different neurological functioning associated with SES with regard to different conceptualizations and coding of SES. Further, some of the reviewed studies identified potential mediators to the relationship, such as parenting practices, stress, and IQ. Overall, the findings suggest it is important to consider SES and neighborhood context within neuroscience research and practice.     

The use of consultation in psychological practice: ethical, legal, and clinical considerations

The importance of consulting with other professionals to maintain acceptable standards of care is well documented in many health care professions. However, evidence indicates that many psychologists fail to utilize consultation when needed, and that consultation use varies along dimensions such as the education and training of the consultee, the type of setting, number of years in practice, and proximity to available consultants. In this article, we review the research on the use of consultation by psychologists as well as other health care professionals. We discuss the clinical, ethical, and legal implications of seeking consultation as a professional psychologist. Finally, a detailed and practical model for the regular use of consultation is given to improve the routine use of consultation in clinical practice.     

Munchausen syndrome by proxy: Clinical review and legal issues

Well-established policies and procedures govern the identification, management, and treatment of most variations of child abuse. For many therapists, such cases have become “routine”. Munchausen syndrome by proxy is an under-recognized form of child abuse in which a parent feigns or creates illness in a child specifically to have the child subjected to unnecessary diagnostic tests and treatments by medical practitioners. Variations range from false reports of fevers or allergies, to life-threatening abuse, such as surreptitious poisonings or injections with toxic substances. This article reports a case example of Munchausen syndrome by proxy, provides a review of historical, diagnostic and management issues, and discusses legal issues relevant to detection of the perpetrator and protection of the child victim.     

Impulsivity and Suicidality in Adolescent Inpatients

Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n?=?381; boys?=?106, girls?=?275) aged 13–19 years (M?=?15.62, SD?=?1.41) were recruited from an acute, residential treatment program. Within 48 h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.     

Interoceptive Abnormalities and Suicidality: A Systematic Review

Dysfunction of interoception (i.e., difficulties sensing the physiological state of one's own body) is increasingly linked to different mental health disorders and suicidal outcomes. The aim of this study was to systematically review the literature on the association between suicidality and interoception, as well as identify potential confounders and mediators of the relationship. We conducted a systematic review of four databases, allowing for critical examination of the role of different measures of interoception (accuracy, sensibility, awareness, cognitive/emotional evaluation) across the suicide continuum (ideation, plans, attempts, deaths). The search strategy identified 22 studies (14,988 participants). Preliminary but limited evidence was found for impaired interoceptive accuracy among those reporting suicide attempt histories. We found evidence of interoceptive sensibility disturbances across the suicide continuum, including experiences of not trusting one’s own body sensations and impaired abilities to sustain and control attention to such sensations. Consistent evidence was also reported for disturbances related to cognitive and emotional evaluations of interoceptive sensations. The latter was particularly pronounced for those reporting suicide attempts, relative to those reporting suicidal thinking or planning alone. Overall, this review’s results suggest that interoceptive abnormalities are potentially important indicators of risk for suicidal thinking, intentions, and behaviors. However, due to the inconsistent adjustment for variables of interest, and cross-sectional designs, it is unclear whether interoceptive changes and disturbances have a direct role, or whether the association is explained and mediated by key third variables (e.g. depression, disordered eating, emotional dysregulation). We discuss the implications with respect to suicidal risk and therapeutic interventions.     

Suicidality and psychosis: beyond depression and hopelessness

The present study examined recent suicide attempters with and without psychotic disorders in order to understand factors that contribute to suicide ideation during and following the suicide attempt. Patients with psychotic disorders endorsed higher levels of suicide ideation than patients without psychotic disorders. Even when depression, hopelessness, substance abuse, and social problem solving were controlled for, there was a significant association between psychotic disorder and suicide ideation. During the follow-up period, patients with psychotic disorders subsequently attempted suicide at a significantly higher rate than patients without psychotic disorders. The clinical relevance of these findings is discussed.     

Analysis of recent incidents of on-field violence in sport: legal decisions and additional considerations from psychology

This article focuses on two recent incidents of serious on-field violence in sports and the legal consequences for those involved. The two incidents occurred in Dutch football (soccer) and became infamous owing to the nature of the violent incidents and widespread media coverage. The legal outcomes of these two incidents are described, and some of the difficulties that legal authorities face in considering assaults on the sports field are discussed. A new way of categorizing such violent incidents and the motivation behind them, based on an established psychological theory [reversal theory, Apter, 1982, 2001] is proposed. Taken along with the other points made in this article, being aware of when and how individuals cross the boundaries between play and anger, power or thrill violence may provide an additional perspective to making informed decisions about illegal violent acts on the sports field.     

Neuropsychological correlates of hypertension: review and methodologic considerations.

Essential hypertension is a chronic disorder having many potential physical and behavioral sequelae. This article evaluates the impact of hypertension on neuropsychological test performance. First, cross-sectional and longitudinal studies that examine the neuropsychological correlates of hypertension are reviewed. In general, hypertensives are found to perform more poorly than normotensives, particularly on tests of memory, attention, and abstract reasoning, and less consistently on tests of perception, constructional ability, mental flexibility, and psychomotor speed. Next, the influence of variables that may moderate relationships between hypertension and neuropsychological performance--such as age, education, and medication usage--are examined. Finally, potential mechanisms, both physiological and psychological, underlying associations between hypertension and neuropsychological performance are discussed.     

Music and Suicidality: A Quantitative Review and Extension

This article provides the first quantitative review of the literature on music and suicidality. Multivariate logistic regression techniques are applied to 90 findings from 21 studies. Investigations employing ecological data on suicide completions are 19.2 times more apt than other studies to report a link between music and suicide. More recent and studies with large samples are also more apt than their counterparts to report significant results. Further, none of the studies based on experimental research designs found a link between music and suicide ideation, prompting us to do a brief content analysis of 24 suicide songs versus 24 nonsuicide songs from the same album. Using Linguistic Inquiry and Word Count software, we found no difference in the content of the suicide songs and controls, including the percentage of sad words, negative affect, and mentions of death, thus providing an explanation for nonfindings from experimental research. In summary, ecologically based (which capture at‐risk persons not in typical school‐based samples) and more recent investigations (which have used superior or new methodologies) tend to demonstrate a linkage between music and suicidality. Experimental research is needed with a control group of songs from an alternative genre with low suicidogenic content.     

Child custody disputes: A review of legal and clinical resolution methods

This paper reviews existing practices from the mental health, marriage and family therapy, and legal professions which offer alternatives to traditional adversarial custody resolution methods. Based upon suggestions from legal and mental health professionals, the authors advocate allocating state resources for interprofessional family courts which would provide custody counseling, mediation, evaluation, and consultation as alternatives to adversarial methods.     

Suicidality in Schizophrenia: Implications for the Counseling Profession

Schizophrenia is a common mental disorder treated by many counseling professionals, and it is associated with a high rate of early mortality. The most common reason for early mortality in schizophrenia is suicide. To date, the most recent comprehensive study on correlates of suicidality among clients with schizophrenia is titled “Suicidal Behavior in Schizophrenia: Characteristics of Individuals Who Had and Had Not Attempted Suicide” (J. M. Harkavy‐Friedman et al., 1999). It is the purpose of this Trends article to review this study and discuss its implications for counselors.     

Suicidality in bipolar I disorder

People with bipolar disorder are at high suicide risk. The literature suggests that suicidality is predicted by higher symptom severity and less use of pharmacological agents, but few studies have examined the joint contributions of these variables. The present study examines the conjoint contribution of symptom severity and pharmacological treatment to suicidal ideation and behavior among participants with bipolar disorder. The model was able to account for 53% of the variance in suicidality scores. Depression, mixed state, and hopelessness were significantly associated with suicidality. All other variables were nonsignificant once symptom severity had been controlled. Implications for future research are described.     

Formula: see text]Substance exposure in utero and developmental consequences in adolescence: A systematic review

Background: The impacts of maternal substance use have been observed in both research and clinical experience. Several studies have shown that preschool children are at heightened risk of developing various cognitive, behavioral, and socioemotional difficulties. Most knowledge has been generated concerning alcohol consumption during pregnancy and the postnatal effects thereof. Less is known about substance use other than alcohol (for instance, opiates, marijuana, and cocaine) during pregnancy and the long-term developmental consequences. Objective: The aims of this review are to identify relevant published data on adolescents who have been exposed in utero to alcohol and/or other substances and to examine developmental consequences across functions and mental health at this point in life. Methods: PubMed, Embase, and PsychInfo were searched for publications during the period of 1980-2011 and titles and abstracts selected according to prespecified broad criteria. Results: Twenty-five studies fulfilled all of the specific requirements and were included in this review. Most research covered prenatal alcohol exposure. Other substances, however, included cocaine, marijuana, opiates, and poly-substances. Results showed that prenatal exposure to alcohol has long-term cognitive, behavioral, social, and emotional developmental consequences depending on amount and timing of exposure in utero. Less evidence exists for long-term consequences of exposure in utero to other substances than alcohol. However, recent brain-imaging studies have provided important evidence of serious effects of other substance exposure on the developing brain and recent follow-up studies have found an association with deficits in language, attention, areas of cognitive performance and delinquent behavior in adolescence.