Relationships between early and final reports of treatment outcome in long-term group psychotherapy

A study of the report of treatment outcome in three long-term therapy groups focused on two questions: 1) Are early reports of treatment outcome significantly related to final reports, i.e., is there substantial consistency in outcome reports over the course of therapy? 2) Are final reports of treatment outcome significantly more favorable than early reports, i.e., do patients experience significant improvement after the early part of therapy? Affirmative answers to these two questions for a number of outcome variables led to a consideration of a number of clinical and research implications.     

Long-term outcome after discontinuation of benzodiazepines for insomnia: a survival analysis of relapse

Discontinuation of benzodiazepine (BZD) treatment for insomnia can be a difficult task. Cognitive-behavior therapy (CBT) for insomnia, combined with a supervised medication taper, can facilitate withdrawal but there is limited evidence on long-term outcome after discontinuation. The objective of this study was to examine medication-free survival time and predictors of relapse (i.e., resumed BZD hypnotics) over a 2-year period in 47 older adults (mean age 62.1 years) with persistent insomnia and prolonged BZD use (average duration of 18.9 years), who had successfully discontinued BZD following CBT for insomnia, a supervised medication taper program, or a combined approach. The Kaplan-Meier product-limit method was used to estimate survival time, defined as time between end-of-treatment and relapse or end of follow-up. By the end of the 24-month follow-up, 42.6% of the samples had resumed BZD use. Participants in the Combined (33.3%) and Taper (30.8%) groups relapsed significantly less than their counterparts from the CBT group (69.2%). Survival rates at 3 months were 61.5% (CBT), 100% (Taper), and 80.9% (Combined). At 12 months, they were 38.5%, 83.3%, and 70.8%, respectively; and, at 24 months, they were 28.9%, 64.8% and 64.9%, respectively. Mean survival time was significantly longer for both the Taper (18.6 months, SE = 2.1) and Combined groups (12.6 months, SE = 1.4), relative to the CBT group (8.5 months, SE = 1.8). Significant predictors of relapse included treatment condition, end of treatment insomnia severity, and psychological distress. In conclusion, there is a substantial relapse rate following BZD discontinuation among prolonged users. CBT booster sessions might enhance compliance with CBT and prove useful in preventing relapse.     

Controversies in counseling for mitochondrial conditions

A healthy woman sought preconceptional genetic counseling regarding a family history of a mitochondrial myopathy in her brother and retinitis pigmentosa (RP) in her two maternal aunts. Several questions were raised: (1) What is the likelihood of a familial mitochondrial condition? (2) What molecular tests or prenatal screening can we offer? (3) How would these tests help assess the likelihood of a familial mitochondrial condition? A mitochondrial mutation previously identified in the brother consisted of a heteroplasmic 2.9 kb deletion. We detected this deletion in the peripheral blood of the brother by PCR amplification of the deletion breakpoint, but not in his mother, the consultand, nor in one of the two aunts affected with RP. Although the molecular analysis was encouraging to the consultand, a familial mitochondrial disorder could not be eliminated with certainty. The pros and cons of prenatal testing for mitochondrial disorders are discussed in general, and as specifically related to this family.     

Influencing and adjusting in daily emotional situations: a comparison of European and Asian American action styles

Emotions are for action, but action styles in emotional episodes may vary across cultural contexts. Based on culturally different models of agency, we expected that those who engage in European-American contexts will use more influence in emotional situations, while those who engage in East-Asian contexts will use more adjustment. European-American (N=60) and Asian-American (N=44) college students reported their action style during emotional episodes four times a day during a week. Asian Americans adjusted more than European Americans, whereas both used influence to a similar extent. These cultural differences in action style varied across types of emotion experienced. Moreover, influencing was associated with life satisfaction for European Americans, but not for Asian Americans.     

Longitudinal associations between the quality of parent-child interactions and children's sleep at preschool age

This study aimed to examine the prospective longitudinal links between the quality of mother-child and father-child interactions and preschoolers' sleep. Three dimensions of maternal interactive behavior were considered using 70 mother-child dyads, while the quality of father-child interactions was assessed using 41 of these families. Maternal mind-mindedness was assessed at 12 months during a mother-infant free-play sequence, maternal sensitivity was rated at 12 months based on observations performed throughout a home visit, maternal autonomy support was assessed at 15 months with a 10-min problem-solving situation, and the quality of father-child interactions was scored at 18 months, during father-child free play. Children's sleep was assessed at 3 and 4 years using a sleep diary completed by mothers during 3 consecutive days. Results indicated that, after controlling for family socioeconomic status and daycare attendance, the quality of both mother-infant and father-infant interactions was positively related to children's percentage of night-time sleep at preschool age. These findings add to previous literature in suggesting that early caregiving behavior by both mothers and fathers is related to subsequent child sleep.     

Racial/ethnic differences in the influence of cultural values, alcohol resistance self-efficacy, and alcohol expectancies on risk for alcohol initiation

Prior research has reported racial/ethnic differences in the early initiation of alcohol use, suggesting that cultural values that are central to specific racial/ethnic groups may be influencing these differences. This 1-year longitudinal study examines associations between two types of cultural values, parental respect (honor for one's parents) and familism (connectedness with family), both measured at baseline, and subsequent alcohol initiation in a sample of 6,054 (approximately 49% male, 57% Hispanic, 22% Asian, 18% non-Hispanic White, and 4% non-Hispanic Black) middle school students in Southern California. We tested whether the associations of cultural values with alcohol initiation could be explained by baseline measures of alcohol resistance self-efficacy (RSE) and alcohol expectancies. We also explored whether these pathways differed by race/ethnicity. In the full sample, adolescents with higher parental respect were less likely to initiate alcohol use, an association that was partially explained by higher RSE and fewer positive alcohol expectancies. Familism was not significantly related to alcohol initiation. Comparing racial/ethnic groups, higher parental respect was protective against alcohol initiation for Whites and Asians, but not Blacks or Hispanics. There were no racial/ethnic differences in the association between familism and alcohol initiation. Results suggest that cultural values are important factors in the decision to use alcohol and these values appear to operate in part, by influencing alcohol positive expectancies and RSE. Interventions that focus on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Mother Like Mothers and Work Like Fathers: U.S. Heterosexual College Students’ Assumptions About Who Should Meet Childcare and Housework Demands

Sex Roles - Many U.S. women report balancing competing demands for labor within the family and the workplace. Prior research has found that young adult heterosexual U.S. women are still...     

Blossoming Child,Mourning Parent: A Qualitative Study of Trans Children and Their Parents Navigating Transition

Journal of Child and Family Studies - An increasing number of jurisdictions now facilitate transitions for trans and non-binary youth (TNBY), allowing them to legally change their name and gender...