Co-morbidity of crying and feeding problems with sleeping problems in infancy: Concurrent and predictive associations

The co-morbidity of crying, feeding and sleeping problems at 5 months of age was investigated in a representative sample of 432 infants in South Germany. A crying, sleeping or feeding problem was reported in 32.7% of these infants by their parents and a further 14.6% had two or more of these problems. Little co-morbidity between crying and feeding problems was found. There were moderate to strong associations between crying and sleeping behaviours. Feeding problems showed little relationship to sleeping behaviour, but feeding type and frequency of feeds were related to night waking. Breastfed infants woke much more often at night. Crying and feeding problems at 5 months were poor predictors of sleeping behaviour at 20 or 56 months of age. Later sleeping behaviour was best predicted by infant sleeping behaviour. At 56 months, maternal distress due to sleeping and co-sleeping practices was predicted by maternal distress due to crying and feeding practices at 5 months of age. The predictions were significant but generally weak to modest in strength. Future studies on the consequences of crying or feeding problems should take into account patterns of co-morbidity. So-called ‘post-colicky’ sleep problems are not due to increased crying per se but rather appear to be the consequence of associated infant sleeping problems and parental caretaking patterns for dealing with night waking in infancy.     

Cradling in the prevention of excessive crying and colic symptoms in infants

To evaluate lying in a cradle in the prevention of excessive infant crying or colic symptoms, and to investigate potential protective or risk factors for the phenomenon, 220 newborns were randomized to sleep either in a bed or cot (control group, N = 108) or in a cradle (cradle group, N = 112). During three months, the parents filled in diaries on the sleeping place most used and the amount of crying of their infants. Three infants in the cradle group and one control fulfilled the criteria of colic. The percentages of extremely weepy infants (25.7% vs 24.4 %) and the intensity of crying did not differ between the groups. Medication for colic symptoms was used equally frequently in both groups. A high educational (OR 3.18, 95% CI 1.01; 10.04) and socioeconomic (OR 3.76, 95% CI 1.34; 10.52) level of the family and having a sibling with a history of colic (OR 6.46, 95% CI 1.17; 35.73) were predictors for the infant being weepy. Absence of nursing problems and having no sibling with a history of colic seemed to be related with a low amount of crying. Excessive infant crying was less common in families with unemployed fathers compared to those in which the father had an occupation (p = 0.018). Cradling seems not to prevent excessive crying or colic symptoms in infants. Breast‐feeding guidance during rooming‐in period and presence of father or another adult supporter at home might be preventive means against excessive crying.     

A Description of the Continuum of Eating Disorders: Implications for Intervention and Research

Many authors have proposed the notion of an eating disorder continuum to aid in the understanding of similarities and differences among various types of eating disturbances and disorders. The purpose of this article is to present an eating disorders continuum and to describe groups on the continuum by highlighting differences among the groups on behavioral, cognitive-attitudinal, and self-esteem issues. The relationship of the continuum to the developmental course of eating disorders is discussed. Prevention, early intervention, and treatment programs for various groups on the continuum are presented. Recommendations for future research on the continuum of eating disorders are provided.     

Parent Training for Childhood Anxiety Disorders: The SPACE Program

Anxiety disorders are the most prevalent disorders of childhood and adolescence. Cognitive behavioral therapy (CBT) for anxiety poses a challenge for clinicians as it requires active client participation, and many children either decline or do not adequately comply with treatment. In addition, even after treatment with CBT, up to 50% of children remain symptomatic, and many still meet diagnostic criteria. Parent-directed clinical work has been advocated as a potential enhancer of treatment outcomes, and exclusively parent-based interventions might replace child treatment when the child is reluctant. However, parent involvement has yet to be shown to significantly improve outcomes, relative to child-only therapy. Studies so far have focused mainly on including parents in children’s therapy, training parents as lay therapists, or teaching parenting skills. Parent training focused on parental behaviors specific to childhood anxiety, such as family accommodation, may be more effective. In this treatment development report we present the theoretical foundation, structure, and strategies of a novel parent-based intervention for childhood anxiety disorders. We will also present the results of an open trial of the treatment, with an emphasis on feasibility, acceptability, and initial outcomes. Participants in the trial were parents of 10 children, aged 9 to 13. Children had declined individual child treatment. Multiple excerpts from the treatment manual are included with the hope of “bringing the treatment to life” and conveying a rich sense of the therapeutic process. Parents participated in 10 weekly sessions. Significant improvement was reported in child anxiety and family accommodation as well as in the child’s motivation for individual treatment. No parents dropped out and satisfaction was high. The SPACE Program (Supportive Parenting for Anxious Childhood Emotions) is a novel, manualized parent-based intervention that is feasible and acceptable and may be effective in improving childhood anxiety.     

Infant crying: Acoustics,perception and communication

This paper first reviews briefly the literature on the acoustics of infant cry sounds and then presents two empirical studies on the perception of cry and noncry sounds in their social-communicative context. Acoustic analysis of cry sounds has undergone dramatic changes in the last 35 years, including the introduction of more than a hundred different acoustic measures. The study of cry acoustics, however, remains largely focused on neonates who have various medical problems or are at risk for developmental delays. Relatively little is known about how cry sounds and cry perception change developmentally, or about how they compare with noncry sounds. The data presented here support the notion that both auditory and visual information are important in caregivers' interpretations of infant sounds in naturalistic contexts. When only auditory information is available (Study 1), cry sounds become generally more recognizable from 3 to 12 months of age; perception of noncry sounds, however, generally does not change over age. When auditory and visual information contradict each other (Study 2), adults tend to perform at chance levels, with a few interesting exceptions. It is suggested that broadening studies of acoustic analysis and perception to include both cry and noncry sounds should increase our understanding of the development of communication in infancy. Finally, we suggest that examining the cry in its developmental context holds great possibility for delineating the factors that underlie adults' responses to crying.     

A Mother-Instruction Program: Analysis of Intervention Procedures

A variety of techniques have been used to train parents as therapists, and while many research efforts have produced carefully controlled studies documenting behavior change, few have analyzed in detail the procedures used to produce the change. As part of a larger research program aimed at teaching mothers to alter their interaction with their children, detailed analysis of the intervention procedures was carried out. These procedures consisted of instructions given to the mothers via a “bug-in-the-ear” device while they were actively engaged in interaction with their children. Instructions were categorized according to two principles: (a) the type of statements made to mothers; and (b) the kinds of behaviors we were encouraging mothers to exhibit. Results show that the amount of interpersonal behavior change was not related to intervention statements. Intervention statements were related to specific problem behaviors indicated by mothers at inital contact, and to the age of the child. Behavior change tended to be related to the number of problem behaviors indicated by mothers but not to any one specific behavior problem. Several issues raised by this study are discussed.     

The Working for Wellness Program: RCT of an Employee Well-Being Intervention

This paper details the design and evaluation of a positive psychology-based employee well-being program. The effect of the program on well-being was evaluated using a mixed method design comprising of an RCT to assess outcome effectiveness, and participant feedback and facilitator field notes to assess process and impact effectiveness. Fifty government employees were randomly allocated to either an intervention or a control group (reduced to n = 23 for complete case analysis). The intervention group participated in the 6-week Working for Wellness Program and completed measures of subjective, psychological, affective and work-related well-being (SWB, PWB, AWB and WWB) at pre-intervention, post-intervention, and three and 6 month follow-ups. The control group completed the questionnaires only. As predicted, mixed ANOVAs revealed improvements in SWB and PWB for intervention group participants over time relative to control participants but these effects had reduced by time 4. There was a main effect of group on AWB in the predicted direction but no effect on WWB. Participant feedback indicated that the focus on strengths and group delivery were the most effective components of the program. Key issues were sample attrition and a lack of on-the-job support for change. Findings suggest employees can learn effective strategies for sustainably increasing their subjective and psychological well-being.     

The Second Essential Tension: on Tradition and Innovation in Interdisciplinary Research

In his analysis of “the essential tension between tradition and innovation” Thomas S. Kuhn focused on the apparent paradox that, on the one hand, normal research is a highly convergent activity based upon a settled consensus, but, on the other hand, the ultimate effect of this tradition-bound work has invariably been to change the tradition. Kuhn argued that, on the one hand, without the possibility of divergent thought, fundamental innovation would be precluded. On the other hand, without a strong emphasis on convergent thought, science would become a mess created by continuous theory changes and scientific progress would again be precluded. On Kuhn’s view, both convergent and divergent thought are therefore equally necessary for the progress of science. In this paper, I shall argue that a similar fundamental tension exists between the demands we see for novel insights of an interdisciplinary nature and the need for established intellectual doctrines founded in the classical disciplines. First, I shall revisit Kuhn’s analysis of the essential tension between tradition and innovation. Next, I shall argue that the tension inherent in interdisciplinary research between, on the one hand, intellectual independence and critical scrutiny and, on the other hand, epistemic dependence and trust is a complement to Kuhn’s essential tension within mono-disciplinary science between convergent and divergent thought.     

The Electronic Home Note Program: An Internet-Based Intervention to Improve On-Task Behavior,Academic Performance,and Parental Review

The authors examined the effectiveness of the electronic home note program (EHNP). The program features an emailed version of the traditional home note intervention. In addition, the program uses motivational strategies for increasing rates of on-task behavior, academic productivity, and parent involvement. The authors used a multiple-probe, multiple-baseline design to evaluate implementation effects of the EHNP with four elementary-grade participants. Across all participants, there was an average Tau-U of 0.76 for on-task behavior, with gains maintained at two weeks postintervention. Inconsistent academic gains were found. Parent involvement was high, as most reviewed behavioral ratings data over the course of the intervention. Results also reflect high acceptability of the intervention program from parents, teachers, and participants.     

The Nurturing Program: An Intervention for Parents of Children with Special Needs

Evidence-based psychosocial family interventions enhancing empathy and empowerment are particularly beneficial to families of children who have developmental disabilities. This study assessed the effectiveness of an intervention called the Nurturing Program for Parents and Their Children with Special Needs and Health Challenges (SNHC). Eighty-seven families were enrolled and randomly assigned to a control or treatment group. Forty-six families in the control group received individualized case management (CM) services and forty-one families in the treatment group were assigned to 12 sessions of the SNHC curriculum along with case management services. Before and after the intervention, participants in both conditions completed the Adult and Adolescent Parenting Index-2 assessing parents’ attitudes toward child rearing and the Family Empowerment Scale (FES) measuring family empowerment. Caregivers in the intervention condition improved in empathy towards children’s needs, F(1, 54)?=?4.52, p?=?.04; and all families, both control group and treatment group, improved their attitudes towards the use of corporal punishment by posttest, F(1, 54)?=?6.56, p?=?.013. Also, all caregivers increased in their empowerment over the course of the intervention, F(1, 50)?=?13.28, p?=?.001. Attrition, 22–26% among CM and 51–56% among SNHC+CM, limited generalizability as did participants not completing all SNHC sessions. Despite these limitations, findings suggest that early interventions catering to families of children with developmental disabilities have a positive impact on parenting. To varying degrees, both conditions provided caregivers with tools that positively affected the quality of the parent–child relationships and promoted empowerment.     

The FOCUS Family Resilience Program: An Innovative Family Intervention for Trauma and Loss

This article describes the core principles and components of the FOCUS Program, a brief intervention for families contending with single or multiple trauma or loss events. It has been administered nationally to thousands of military family members since 2008 and has been implemented in a wide range of civilian community, medical, clinical, and school settings. Developed by a team from the UCLA and Harvard Medical Schools, the FOCUS Program provides a structured approach for joining with traditional and nontraditional families, crafting shared goals, and then working with parents, children, and the entire family to build communication, make meaning out of traumatic experiences, and practice specific skills that support family resilience. Through a narrative sharing process, each family member tells his or her story and constructs a timeline that graphically captures the experience and provides a platform for family discussions on points of convergence and divergence. This narrative sharing process is first done with the parents and then the children and then the family as a whole. The aim is to build perspective‐taking skills and mutual understanding, to reduce distortions and misattributions, and to bridge estrangement between family members. Previous studies have confirmed that families participating in this brief program report reductions in distress and symptomatic behaviors for both parents and children and increases in child pro‐social behaviors and family resilient processes.     

Treatment of Insomnia within an Interdisciplinary Pain Rehabilitation Program: A Randomized Trial

Background/ObjectivePrior research indicates interdisciplinary pain rehabilitation program (IPRP) usual care (UC) does not sufficiently address sleep problems among individuals with comorbid chronic pain and clinical levels of insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based insomnia intervention. The current study investigates the translation of CBT-I into an IPRP.MethodIn this single-site, prospective, randomized controlled pilot study, insomnia and pain-related outcomes were examined for adults participating in a 10-week IPRP (N = 79) who were allocated to a 4-session group-based CBT-I (IPRP+CBT-I) or usual care (IPRP-UC) condition.ResultsPatients in the IPRP+CBT-I group showed improvements in insomnia symptoms at the end compared to the beginning of the CBT-I group; however, there were no IPRP outcome differences relative to the IPRP-UC condition. Both groups reported statistically significant reductions in insomnia, pain severity, pain-related life interference, and depressed mood. Fewer than one-third of participants reported clinically meaningful reductions in insomnia symptoms following IPRP participation.ConclusionsFurther efforts are needed to address sleep problems in pain rehabilitation settings.     

The Impact of Legislative Standards on Batterer Intervention Program Practices and Characteristics

Changes in social policy are often pursued with the goal of reducing a social problem by improving prevention efforts, intervention program practices, or participant outcomes. State legislative standards for intimate partner violence intervention programs have been adopted nearly universally across the US, however, we do not know whether such standards actually achieve the intended goal of affecting programs’ policies and practices. To assess the effect that batterer intervention program (BIP) standards have on policies and practices of programs, this study used longitudinal surveys collected as part of an ongoing evaluation conducted from 2001 to the present to compare intervention program (N = 74) characteristics and practices at three time points before and after the adoption of standards in Oregon. Analyses were conducted to examine all BIPs in Oregon at each time point, as well as change among a subset of programs in existence at all survey assessments. Results indicate that across all programs, the use of mixed gender group co-facilitation increased by 14 % between 2004 and 2008, while program length increased by approximately 12 weeks. However, other practices such as programs’ coordination with community partners were unchanged. Analyses of within-program change revealed fewer differences, with only program length increasing significantly over the three assessments. These and other findings indicate that while standards affected program length as intended, other practices commonly addressed by legislative standards remained unchanged. The findings provide needed information regarding programs’ compliance with components of the standards, the potential need for compliance monitoring, and the potential impact of state standards on program effectiveness and on the prevalence of intimate partner violence.     

The Juvenile Counseling and Assessment Model and Program: A Conceptualization and Intervention for Juvenile Delinquency

This article presents a model of conceptualization and intervention for juvenile delinquency. The model includes the characteristics of the adolescent, the ecological context in which the adolescent lives, and the interaction among these variables. Intervention addressing these variables is presented. A specific integrated service, training, and research project that is based on the model is described. The Juvenile Counseling and Assessment Program is a collaborative approach, joining university counseling faculty, educators, graduate students, and juvenile court system personnel in the mutual goals of reducing delinquency and increasing adaptive skills.