MATERNAL SELF‐REPORTED DEPRESSIVE SYMPTOMS AND MATERNAL CORTISOL LEVELS INTERACT TO PREDICT INFANT CORTISOL LEVELS

Three basic findings have emerged from research on maternal depressive symptoms and offspring hypothalamic–pituitary–adrenal functioning: (a) Mothers’ depressive symptoms are positively associated with their offsprings’ cortisol stress response, (b) numerous individual and interpersonal maternal characteristics moderate this association, and (c) maternal and infant cortisol levels are highly correlated. In combination, these findings have suggested that maternal cortisol levels may moderate the relation between maternal depressive symptoms and infant cortisol responsivity; the current study assessed this hypothesis. Participants were 297 mother–infant dyads who were recruited from the community. Maternal depressive symptoms were assessed via self‐report. Dyads participated in two differentially stressful infant challenges when infants were 16 and 17 months old. Mother and infant salivary cortisol was collected before and after challenges. Results indicate that maternal cortisol levels moderated associations between maternal depressive symptoms and infant cortisol levels across both challenges. Infants showed higher cortisol levels if their mothers had both higher depressive symptoms and higher cortisol levels, as compared to infants of mothers with higher depressive symptoms and lower cortisol, and to infants of mothers with lower depressive symptoms and either higher or lower cortisol levels. We discuss findings in relation to environmental and biological factors that may contribute to the intergenerational transmission of depressive symptoms.     

Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n?=?107) or head and neck cancers (n?=?99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs.

Methods: Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses.

Results: More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption.

Conclusions: Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.     

Dimensional Personality Traits Broadly and Selectively Associated with Normative Externalizing Behavior

This study aimed to distinguish personality traits that are widely associated with several types of externalizing behaviors from personality traits that are more selectively associated with one or only a few specific types of externalizing behavior. A wide range of externalizing behaviors (e.g. alcohol and drug use, risky driving, aggressive acts, sexual promiscuity and relationship infidelity, academic misconduct) typical among an undergraduate population (N?=?257) were examined along with a range of personality traits measured using the Section III personality model for the DSM-5. We found that externalizing behavior was best associated with the domain level trait Antagonism and, to a lesser degree, Disinhibition. Antagonism’s association with problematic behavior was primarily accounted for by the facet trait Deceitfulness. Deceitfulness was found to be associated with a wide range of behaviors including relationship infidelity, theft, aggressive acts, and drug and alcohol use. Associations between Disinhibition and problem behavior, especially risky driving and poor work or school performance, were best accounted for by the Irresponsibility facet, as opposed to the Impulsivity or Distractibility facet traits. This comprehensive multivariate approach is important for a more complete understanding of the complex relationship that exists between personality traits and externalizing behavior. A better understanding of factors precipitating externalizing behavior could ultimately lead to an increased ability to target interventions to individuals most susceptible to engage in problematic behavior.     

Executive Functioning Correlates of <Emphasis Type="Italic">DSM-5</Emphasis> Maladaptive Personality Traits: Initial Evidence from an Italian Sample of Consecutively Admitted Adult Outpatients

In order to evaluate the associations between computer-administered tasks of executive functioning (EF), and maladaptive personality domains and traits listed in DSM-5 Alternative Model of Personality Disorders, 53 consecutively admitted psychotherapy outpatients (female participants: n?=?27, 50.9%; male participants: n?=?26, 49.1%; participants’ mean age?=?37.28 years, SD?=?11.50 years) were administered the Psychology Experiment Building Language (PEBL) EF tasks and the Personality Inventory for DSM-5 (PID-5). According to rank-order correlation analyses, a number of non-negligible and specific associations were observed between selected PID-5 scales and indices of participants’ performance on EF tasks. MM robust regression models showed that participants’ performance on computer-administered EF tasks explained a non-negligible amount of variance in selected PID-5 scale scores (median R² value?=?.17). As a whole, our trait-level analyses of PID-5 dimensions suggest the clinical usefulness of integrating self-reports and EF laboratory tasks in routine clinical assessment.     

Treatment Outcome of 18-Month, Day Hospital Mentalization-Based Treatment (MBT) in Patients with Severe Borderline Personality Disorder in the Netherlands

Psychoanalytically oriented day hospital therapy, later manualized and named mentalization-based treatment (MBT), has proven to be a (cost-) effective treatment for patients with severe borderline personality disorder and a high degree of psychiatric comorbidity (BPD) in the United Kingdom (UK). As to yet it has not been shown whether manualized day hospital MBT would yield similar results when conducted by an independent institute outside the UK. We investigated the applicability and treatment outcome of 18-month, manualized day hospital MBT in the Netherlands by means of a prospective cohort study with 45 Dutch patients with severe BPD and a high degree of comorbid Axis I and Axis II disorders. Outcomes were assessed each six months. Symptom distress, social and interpersonal functioning, and personality pathology and functioning all improved significantly, with effect sizes between 0.7 and 1.7. Suicide attempts, acts of self-harm, and care consumption were also significantly reduced. The results indicate that MBT can effectively be implemented in an independent treatment institute outside the UK. This study also supports the clinical effectiveness of manualized day hospital MBT in patients with severe BPD and a high degree of psychiatric comorbidity.     

Getting the big picture: Development of spatial scaling abilities

Spatial scaling is an integral aspect of many spatial tasks that involve symbol-to-referent correspondences (e.g., map reading, drawing). In this study, we asked 3–6-year-olds and adults to locate objects in a two-dimensional spatial layout using information from a second spatial representation (map). We examined how scaling factor and reference features, such as the shape of the layout or the presence of landmarks, affect performance. Results showed that spatial scaling on this simple task undergoes considerable development, especially between 3 and 5 years of age. Furthermore, the youngest children showed large individual variability and profited from landmark information. Accuracy differed between scaled and un-scaled items, but not between items using different scaling factors (1:2 vs. 1:4), suggesting that participants encoded relative rather than absolute distances.     

Multisystemic therapy for young offenders: families' experiences of therapeutic processes and outcomes

Multisystemic Therapy (MST) has been found to be effective in reducing youth antisocial behavior, but little is known about the process and impact of MST from the perspective of families themselves. This qualitative study explored parents' and young people's experiences of MST, focusing on aspects of the intervention that promoted or limited change. Thirty-seven semistructured interviews were conducted with a consecutive sample of 21 families (21 parent interviews, 16 young people) who had participated in a randomized controlled trial of MST for young offenders in the United Kingdom. Thematic analysis yielded 10 themes, organized into two domains: (a) engagement in MST and initial processes of change captures the central importance of the therapeutic relationship and the MST engagement model in families' positive experiences of MST; and (b) outcomes are complex reflects the range of positive outcomes reported (notably increased parental confidence and skills, improved family relationships, a return to education, and greater reflection and aspiration on the part of the young person) and mixed behavior outcomes. Even when the young person had reoffended, respondents indicated a range of other benefits for the family. The findings support the MST theory of change as well as point to some outcomes not usually measured in MST outcome studies. They also suggest some adaptations that may increase the impact of the intervention, including more attention to the influence of deviant peers, and ongoing support for families struggling to maintain strategies beyond the prescribed treatment period.     

Can the Innate Right to Freedom Alone Ground a System of Public and Private Rights?

The state regulates the way in which social power is exercised. It sometimes permits, enables, constrains, forbids how we may touch others, make offers, draw up contracts, use, alter, possess and destroy things that matter to people, manipulate, induce weakness of the will, coerce, engage in physical force, persuade, selectively divulge information, lie, enchant, coax, convince, … In each of these cases, we (sometimes unintentionally) get others to act in ways that serve our interests. Which such exercises of power should the state forbid? Which should it permit? An intuitively appealing way to answer this question is, with Ripstein and Kant, to point to the role of freedom: exercises of social power can be legitimately prohibited when (and only when) they restrict people's freedom. But this raises a further question: How do we identify when such exercises of power make people unfree in the relevant sense? Ripstein, in defending Kant, draws a crucial distinction between actions that subject others’ wills to our choices (and which it would therefore be presumptively legitimate for the state to forbid) and actions that merely affect the contexts in which others act (and which it would therefore be presumptively illegitimate for the state to forbid). I query that distinction, and argue that the idea of independence cannot bear, on its own, the weight it is expected to bear within the Kantian framework.     

The relationship between cognitive function and life space: the potential role of personal control beliefs

We examined the relationship of cognitive and functional measures with life space (a measure of spatial mobility examining extent of movement within a person's environment) in older adults, and investigated the potential moderating role of personal control beliefs. Internal control beliefs reflect feelings of competence and personal agency, while attributions of external control imply a more dependent or passive point of view. Participants were 2,737 adults from the ACTIVE study, with a mean age of 74 years. Females comprised 76% of the sample, with good minority representation (27% African American). In multiple regression models controlling for demographic factors, cognitive domains of memory, reasoning, and processing speed were significantly associated with life space (p < .001 for each), and reasoning ability appeared most predictive (B = .117). Measures of everyday function also showed significant associations with life space, independent from the traditional cognitive measures. Interactions between cognitive function and control beliefs were tested, and external control beliefs moderated the relationship between memory and life space, with the combination of high objective memory and low external control beliefs yielding the highest life space (t = -2.07; p = .039). In conclusion, older adults with better cognitive function have a larger overall life space. Performance-based measures of everyday function may also be useful in assessing the functional outcome of life space. Additionally, subjective external control beliefs may moderate the relationship between objective cognitive function and life space. Future studies examining the relationships between these factors longitudinally appear worthwhile to further elucidate the interrelationships of cognitive function, control beliefs, and life space.