Postnatal trajectories of maternal depressive symptoms: Postpartum antecedents and differences in toddler adjustment

Infants are uniquely vulnerable to maternal depression's noxious effects, but few longitudinal studies have tried to identify discrete postnatal trajectories of maternal depressive symptoms (MDS) beginning in infancy. This study extends evidence of heterogeneous change in postnatal MDS by examining their cross-contextual antecedents in infancy and their consequences for children's early behavior problems and language skills in late toddlerhood. A community sample of mother–child dyads (N = 235, 72% Caucasian) was assessed when children were 7, 15, and 33 months old. Mothers reported their socioeconomic status (SES), social support, marital relationship quality, family dysfunction, parenting stress, and infants’ functional regulatory problems at 7 months postpartum, and children's internalizing and externalizing symptoms at 33 months. Children completed a receptive vocabulary assessment at 33 months in the lab. Latent class growth analysis identified three postnatal MDS trajectory classes that fit the data best: low-decreasing, moderate, and increasing. Psychosocial measures at seven months postpartum primarily predicted membership to these postnatal trajectory classes, which subsequently differed in children's internalizing, externalizing, and receptive vocabulary in late toddlerhood, controlling for family SES and functional regulatory problems in infancy. We discuss salient antecedents and consequences of postnatal depression for mothers and their offspring.     

Proactive Vitality Management,Work Engagement,and Creativity: The Role of Goal Orientation

This study tested the hypothesis that individuals can proactively manage their own energetic, affective, and cognitive resources in order to be creative at work. Building on proactivity and creativity literatures, we propose a theoretical model in which employees who proactively manage their vitality are more engaged in their work and show improved creative performance. We also tested the boundary conditions of this process. Participants were Dutch employees from various occupations who filled out a background questionnaire and five weekly surveys. The results of multilevel modelling analyses offered support for our model. Weekly proactive vitality management was positively related to changes in weekly creativity through changes in weekly work engagement. As predicted, learning goal orientation strengthened and performance goal orientation weakened the links between proactive vitality management and engagement, and between engagement and creativity. We discuss the theoretical contributions, and indicate how these findings can be used in daily working life.     

Subjectifying the Personality State: Theoretical Underpinnings and an Empirical Example

Recent developments in personality research highlight the value of modelling dynamic state-like manifestations of personality. The present work integrates these developments with prominent clinical models addressing within-person multiplicity and promotes the exploration of models centred on state-like manifestations of personality that function as cohesive organizational units. Such units possess distinct subjective qualities and are characterized by specific affects, behaviours, cognitions, and desires that tend to be co-activated. As background, we review both theory and research from the fields of social cognition, psychotherapy, and psychopathology that serve as the foundation for such models. We then illustrate our ideas in greater detail with one well-supported clinical model—the schema therapy mode model, chosen because it provides a finite and definite set of modes (i.e. cohesive personality states). We assessed these modes using a newly developed experience-sampling measure administered to 52 individuals (four times daily for 15 days). We estimated intraindividual and group-level temporal and contemporaneous networks based on the within-person variance as well as between-person network. We discuss findings from exemplar participants and from group-level networks and address cross-model particularities and consistencies. In conclusion, we consider potential idiographic and nomothetic applications of subjective states dynamic personality research based on intensive longitudinal methods. © 2020 European Association of Personality Psychology     

Enactment as understanding and as misunderstanding

The author considers the concept of enactment as a ubiquitous event that is best seen as part of a sequence in the process of understanding a patient. As such, enactments are not unusual or special save as they are often subject to disavowal or to being singled out by the analyst as especially subject to scrutiny. Once recognized, enactments need to be interpreted: not so much in terms of their unconscious origins, but more with regard to the need to include them in the analytic dialogue.     

Reflections on creative aspects of psychoanalytic diagnosing

This paper explores the therapeutic value of considering psychoanalytic diagnoses as co-constructions, and emphasizes two interrelated points: First, there are distinctions between medical, psychiatric, and psychoanalytic diagnoses, and similarly, a distinction may be drawn between diagnoses as nouns and the activity of diagnosing. Second, the author stresses that psychoanalytic diagnoses are theory bound. Various competing theories facilitate or interfere with the maintenance of an optimal analytic attitude. Some theories facilitate an analyst's urge to engage in the activity of diagnosing, which may reflect a destructive countertransference enactment. Analytic data in support of these premises is presented and discussed.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased     

Family Processes and Treatment Outcome in the MTA: Negative/Ineffective Parenting Practices in Relation to Multimodal Treatment

To elucidate processes underlying therapeutic change in a large-scale randomized clinical trial, we examined whether alterations in self-reported parenting practices were associated with the effects of behavioral, medication, or combination treatments on teacher-reported outcomes (disruptive behavior, social skills, internalizing symptoms) in children with attention-deficit hyperactivity disorder (ADHD). Participants were 579 children with Combined-type ADHD, aged 7–9.9 years, in the Multimodal Treatment Study of Children with ADHD (MTA). We uncovered 2 second-order factors of parenting practices, entitled Positive Involvement and Negative/Ineffective Discipline. Although Positive Involvement was not associated with amelioration of the school-based outcome measures, reductions in Negative/Ineffective Discipline mediated improvement in children's social skills at school. For families showing the greatest reductions in Negative/Ineffective Discipline, effects of combined medication plus behavioral treatment were pronounced in relation to regular community care. Furthermore, only in combination treatment (and not in behavioral treatment alone) was decreased Negative/Ineffective Discipline associated with reduction in children's disruptive behavior at school. Here, children in families receiving combination treatment who showed the greatest reductions in Negative/Ineffective Discipline had teacher-reported disruptive behavior that was essentially normalized. Overall, the success of combination treatment for important school-related outcomes appears related to reductions in negative and ineffective parenting practices at home; we discuss problems in interpreting the temporal sequencing of such process-outcome linkages and the means by which multimodal treatment may be mediated by psychosocial processes related to parenting.