Why Does Disaster Recovery Work Influence Mental Health?: Pathways through Physical Health and Household Income

Disaster recovery work increases risk for mental health problems, yet the mechanisms underlying this association are unclear. We explored links from recovery work to post‐traumatic stress (PTS), major depression (MD), and generalized anxiety disorder (GAD) symptoms through physical health symptoms and household income in the aftermath of the Deepwater Horizon oil spill. As part of the NIEHS GuLF STUDY, participants (N = 10,141) reported on cleanup work activities, spill‐related physical health symptoms, and household income at baseline, and mental health symptoms an average of 14.69 weeks (SD = 16.79) thereafter. Cleanup work participation was associated with higher physical health symptoms, which in turn were associated with higher PTS, MD, and GAD symptoms. Similar pattern of results were found in models including workers only and investigating the influence of longer work duration and higher work‐related oil exposure on mental health symptoms. In addition, longer worker duration and higher work‐related oil exposure were associated with higher household income, which in turn was associated with lower MD and GAD symptoms. These findings suggest that physical health symptoms contribute to workers’ risk for mental health symptoms, while higher household income, potentially from more extensive work, might mitigate risk.     

Of “sleep and dream: A psychoanalytic essay' by Joyce McDougall (discussion)

Abstract

The author describes experiences gathered during several years of teaching psychodynamic psychotherapy with psychologists and psychiatrists within a 2-year-training programme in Shanghai, China. Questions and problems of the reception of psychoanalysis – shame, sexuality, harmony, abstinence – as well as the possibilities and limitations of exporting psychoanalysis are discussed. The possible future development of psychoanalysis in China is also outlined.     

Stressors, Quality of the Child–Caregiver Relationship, and Children's Mental Health Problems After Parental Death: The Mediating Role of Self-System Beliefs

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver–child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7–16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver–child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed.

Divided attention between simultaneous auditory and visual signals

Past studies of simultaneous attention to pairs of visual stimuli have used the “dual-task” paradigm to show that identification of the direction of a change in luminance, whether incremental or decremental, is “capacity-limited,” while simple detection of these changes is governed by “capacity-free” processes. On the basis of that finding, it has been suggested that the contrast between identification and detection reflects different processes in the sensory periphery, namely the responses of magno- and parvocellular receptors. The present study questions that assertion and investigates the contribution of central processing in resource limitation by applying the dual task to a situation in which one stimulus is auditory and one is visual. The results are much the same as before, with identification demonstrating the tradeoff in performance generally attributed to a limited capacity but detection showing no loss compared with single-task controls. This implies that limitations on resources operate at a central level of processing rather than in the auditory and visual peripheries.     

Reenactment: an embodied cognition approach to meaning and linguistic content

A central finding in experimental research identified with embodied cognition (EC) is that understanding actions involves their embodied simulation, i.e., executing some processes involved in performing these actions. Extending these findings, I argue that reenactment??the overt embodied simulation of actions and practices, including especially communicative actions and practices, within utterances??makes it possible to forge an integrated EC-based account of linguistic meaning. In particular, I argue: (a) that remote entities can be referred to by reenacting actions performed with them; (b) that the use of grammatical constructions can be conceived of as the reenactment of linguistic action routines; (c) that complex enunciational structures (reported speech, irony, etc.) involve a separate level of reenactment, on which characters are presented as interacting with one another within the utterance; (d) that the segmentation of long utterances into shorter units involves the reenactment of brief audience interventions between units; and (e) that the overall meaning of an utterance can be stated in reenactment terms. The notion of reenactment provides a conceptual framework for accounting for aspects of language that are usually thought to be outside the reach of EC in an EC framework, thus supporting a view of meaning and linguistic content as thoroughly grounded in action and interaction.     

Placebo effects in developmental disabilities: implications for research and practice

Recent clinical trials of secretin in children with autism showed robust placebo effects and no benefit of secretin over placebo. This article explores the reasons for the observed placebo effects, focusing on the heightening of positive expectancy by media attention and by the sensory experiences associated with intravenous injections. Comparisons are drawn with research involving other novel treatments and other clinical populations of children with developmental disabilities and neurobehavioral disorders. Research regarding mechanisms of placebo effects is reviewed, including patient and clinician attributes, expectancy effects, participation effects, changes in caregiver behavior, and conditioning. New evidence regarding the biological basis of placebo effects is briefly presented. Since placebo effects are ubiquitous and may operate by a variety of mechanisms, research design is critical in designing clinical trials and in evaluating other outcomes research. Measurement issues important for research in developmental disabilities are emphasized. Ethical concerns have been raised regarding the use of placebo in clinical research, but current analysis suggests that placebo controls are necessary and defensible on ethical grounds, if certain conditions are met. The study of placebo effects ("placebology") holds great promise as a new area of research in therapeutics. The author's research in the potential augmentation of stimulant effects in children with attention deficit/hyperactivity disorder (ADHD) by adding placebo in open label is briefly presented. The placebo has always been integral to the practice of medicine, but advances in scientific medicine and medical ethics have diminished the role and use of placebo in practice. An innovative approach to the ethical use of placebo is proposed.