Reducing Psychotropic Medications in an Intensive Residential Treatment Center

Medication rates in behaviorally disordered children and youth have greatly increased to current high levels and are very controversial. This study examined changes in psychotropic medication use, levels of behavioral disturbance, and use of personal restraint and seclusion in a population of youth with serious behavioral disorders receiving medically directed cognitive-behavioral treatment in an intensive residential setting. The hypothesis was that there would be significant reductions in medication rates, without the unintended consequences of increased rates of problem behavior or offsetting increases in the use of seclusion or personal restraint. Results showed significant reductions in both the number of youth on medication and the average number of psychotropic medications during the residential stay. There were also significant reductions in behavioral disturbance, seclusions, and personal restraints. These results demonstrate that psychotropic medication can be significantly reduced without increases in problem behavior or the use of seclusions or personal restraints. We conclude that it is possible to significantly reduce psychotropic medication rates to far more conservative levels within the context of a clinically directed cognitive-behavioral treatment milieu.     

Psychotropic Medication Management Within Residential Treatment Centers: Physician Opinions About Difficulties and Barriers

Research has shown that between 40 and 98 % of youth entering residential treatment are taking at least one psychotropic medication and that psychotropic medication management is often an integral component of treatment in residential settings. To determine physician opinion about the difficulty of managing psychotropic medications for youth in residential treatment and to determine the resources that are used in the process, a survey study was conducted. Overall, physicians indicated that youth involved in residential settings were much more complex than those in traditional outpatient settings, due to multiple mental health diagnoses, polypharmacy, and unknown treatment histories. They also reported that many existing resources are not applicable to youth, particularly those in residential settings, and that they are difficult to read and interpret.     

Interaction Between the Parenting Alliance and Parent–Child Activities in a Clinic-Referred Sample of 2 to 18-year-olds

Several decades of research have demonstrated a link between marital, parenting, and child domains. The present study examined the nature of these links by testing the moderating effect of the parent–child relationship on the association between the parenting alliance and internalizing and externalizing problems in 324 dual-parent families of 2-to-18-year-old clinic-referred youth. Findings indicated that positive parent–child activities directly related to children’s internalizing and externalizing problems, and modified the nature of the association between the parenting alliance and internalizing problems in families of 6-to-10-year-olds. Interestingly, in families where parents engaged in fewer positive activities with their children, a strong parenting alliance actually related to greater child internalizing problems. Findings support the importance of understanding the interaction between the marital and child domains in order to effectively intervene with families of children experiencing behavior problems.     

Scaling space with the mirror illusion: The influence of body plasticity on perceived affordances

How do body representations influence decisions about action? We developed a novel paradigm using the mirror illusion (Holmes, Crozier, & Spence, in Cognitive, Affective, & Behavioral Neuroscience, 4, 193–200, 2004) to examine two ways of evoking body plasticity—extension of body capabilities and visual capture—and its influence on perceived affordances. In two experiments, we manipulated the action capabilities of a seen left hand by lengthening the arm with a rod (Exp. 1) or enlarging the hand with a glove (Exp. 2). The right hand was unaltered physically and was occluded by placement in a mirror box. We induced visual capture through synchronous finger movements of both hands. Right-hand estimates of reaching and of fitting through apertures increased relative to actual capabilities during visual capture, supporting the claim that visual capture can induce the incorporation of an apparent body extension into action decisions. The results suggest that both perceptual and cognitive influences on bodily awareness underlie perceived affordances.     

A Basic Bivariate Structure of Personality Attributes Evident Across Nine Languages

Here, two studies seek to characterize a parsimonious common‐denominator personality structure with optimal cross‐cultural replicability. Personality differences are observed in all human populations and cultures, but lexicons for personality attributes contain so many distinctions that parsimony is lacking. Models stipulating the most important attributes have been formulated by experts or by empirical studies drawing on experience in a very limited range of cultures. Factor analyses of personality lexicons of nine languages of diverse provenance (Chinese, Korean, Filipino, Turkish, Greek, Polish, Hungarian, Maasai, and Senoufo) were examined, and their common structure was compared to that of several prominent models in psychology. A parsimonious bivariate model showed evidence of substantial convergence and ubiquity across cultures. Analyses involving key markers of these dimensions in English indicate that they are broad dimensions involving the overlapping content of the interpersonal circumplex, models of communion and agency, and morality/warmth and competence. These “Big Two” dimensions—Social Self‐Regulation and Dynamism—provide a common‐denominator model involving the two most crucial axes of personality variation, ubiquitous across cultures. The Big Two might serve as an umbrella model serving to link diverse theoretical models and associated research literatures.     

The Influence of Secular and Theological Education on Pastors’ Depression Intervention Decisions

Will a pastor refer to a mental health center? If they feel qualified to intervene themselves, they may not. Because pastors often provide grief counseling, it is important to understand the decisions they make when intervening with depressed individuals. A random sample of 204 Protestant pastors completed surveys about their treatment practices for depression. Fisher’s exact analyses revealed that more pastors with some secular education yet no degree felt that they were the best person to treat depression than pastors who had no secular education or pastors who had at least a secular bachelor’s degree. However, the level of theological education did not influence beliefs about the pastor being the best person to treat depression. In addition, neither secular nor theological education level influenced pastors’ views on referring people to mental health centers for depression treatment. Based on findings, this paper discusses implications for best practices in training pastors on depression and other mental health topics.     

The Affect Misattribution Procedure: Ten Years of Evidence on Reliability,Validity, and Mechanisms

The affect misattribution procedure (AMP) measures automatically activated responses based on the misattributions people make about the sources of their affect or cognitions. The AMP is one of the most widely used implicit attitude measures, and evidence regarding its reliability and validity has grown rapidly. In this brief review, we survey the evidence of reliability and validity while discussing the mechanisms that drive priming effects in the AMP. We consider the unique capabilities of this procedure to measure implicit and explicit cognition with simplicity and greater experimental control than other measures. Finally, we offer recommendations for using the AMP effectively for a wide variety of research purposes.     

Lonely Adolescents and Their Best Friend: An Examination of Loneliness and Friendship Quality in Best Friendship Dyads

Friendship experiences have been shown to be important predictors of adolescents’ loneliness. The current study examined selection and socialization effects of loneliness within reciprocal best friendships, while controlling for friendship quality. Analyses were conducted on a sample of 884 adolescents (42.08% boys), making up 442 dyads, who were on average 13.51 years old (SD?=?1.37). Adolescents completed the peer-related loneliness subscale of the Loneliness and Aloneness Scale for Children and Adolescents as well as the Friendship Qualities Scale. A longitudinal actor-partner interdependence model, which accounts for the interdependencies in the data of best friends, suggested the presence of a selection effect for loneliness but no socialization effect. This finding within best friendships contrasts with studies on friendship networks where both selection and socialization were established.     

Seventh-day Adventist Clergy: Understanding Stressors and Coping Mechanisms

This article examines the extent and types of clergy stress, the strategies used in coping with stressors, and the relationship between stressors and coping mechanisms in a sample of 261 Seventh-day Adventist pastors in North America. The results indicate that the most commonly reported stressors in order are: (1) lack of social support, (2) financial stress, and (3) time and workload stress. In terms of coping strategies, pastors sought relief most often through: (1) reflective growth/internal change; (2) social/emotional coping; (3) passive coping; and lastly (4) action-oriented coping. Significant correlational relationships existed between passive coping and financial stress, relocating stress, and congregational stress. In addition, we found significant inverse correlations between coping through reflective growth or internal change and relocating stress and congregational stress. There were no significant relationships with action coping or social/emotional coping and any stressor. Multi-regression analysis reveals that passive coping strategies were significantly related to financial stress. Thus, the greater the financial stress, the more likely pastors were to engage in passive coping strategies. Other coping strategies showed no significant relationships when included in multi-regression analysis. We conclude with recommendations for Church administrators to address structures and practices in place for pastors including an expansion of coping mechanisms to help pastors address their stress.     

Wealth inequality and activism: Perceiving injustice galvanizes social change but perceptions depend on political ideologies

What motivates people to engage in activism against wealth inequality? The simple answer is perceiving injustice. However, the current work demonstrates that these perceptions depend on political ideologies. More specifically, for political liberals who frequently question the fairness of the economic system, messages simply describing the extent of the inequality (distributive injustice) are enough to motivate activism (Study 1). For political conservatives, who are inclined to believe that inequality results from fair procedures, messages must also detail how the system of economic forces is unjust (procedural injustice; Studies 2 and 3). Together, these studies suggest perceiving injustice can galvanize social change, but for conservatives, this means more than simply outlining the extent of the inequality.