Psychodynamic Importance of “Cyber” and “In the Flesh” Friends in Psychotherapy with College-Aged Adolescents with Eating Disorders

ABSTRACT

It is well established that friends are an important part of child and adolescent emotional and psychological development (Erikson, 1980/1959; Kohut, 1971; Rubin et al., 2004; Sroufe et al., 1999; Sullivan, 1953). Friendships among 21st century children and adolescents develop not only in person but also through social media. Some of these friends are never seen “in the flesh,” yet there is no question they have an impact on the psyches of the youngsters involved. When it comes to eating disorders, both peer pressure and social focus on weight and size have long been recognized as having an impact on the development of eating disorders in children and adolescents. Adolescents susceptible to developing eating disorders often have a particular vulnerability to peer pressure and the demands of friends (Bunnell, 2016; Petrucelli, 2016; Zerbe, 2008, 2016). Friendships conducted through social media and electronic tools can have a significant affect not only on how these young people feel about their bodies, their selves, and their general sense of the world in which they live but also on their specific eating behaviors (Bunnell, 2016; Defeciani, 2016; Lanzieri and Hildebrandt, 2016; Sales, 2016).     

Early group bias in the Faroe Islands: Cultural variation in children's group-based reasoning

Recent developmental research demonstrates that group bias emerges early in childhood. However, little is known about the extent to which bias in minimal (i.e., arbitrarily assigned) groups varies with children's environment and experience, and whether such bias is universal across cultures. In this study, the development of group bias was investigated using a minimal groups paradigm with 46 four- to six-year-olds from the Faroe Islands. Children observed in-group and out-group members exhibiting varying degrees of prosocial behaviour (egalitarian or stingy sharing). Children did not prefer their in-group in the pretest, but a pro-in-group and anti-out-group sentiment emerged in both conditions in the posttest. Faroese children's response patterns differ from those of American children [Schug, M. G., Shusterman, A., Barth, H., & Patalano, A. L. (2013). Minimal-group membership influences children's responses to novel experience with group members. Developmental Science, 16(1), 47–55], suggesting that intergroup bias shows cultural variation even in a minimal groups context.     

Resident-Led Neighborhood Development to Support Health: Identifying Strategies Using CBPR

Evidence suggests that where people live, learn, work, and play affects a range of health outcomes for children and adults. Differential access to social, economic, and environmental supports puts some community members at greater risk, leading to disparities in health and well-being. The 2014 release of the For the Sake of All report highlighted persistent health disparities for African Americans in St. Louis, Missouri, and their social and economic impacts on the St. Louis region. This study extends this work by developing partnerships with community organizations and neighborhood residents to address health disparities. Community-based participatory research (CBPR) methods were utilized to engage partners in a 10-month research process to address community concerns that impact health. Seven community residents, neighborhood researchers, engaged in workshops to learn about the research process and used techniques to gather information to implement action strategies. Neighborhood researchers selected 14 vacant lots to implement their action plan, which included visions for repurposing the land into a community park, produced a report for dissemination, and organized a community action forum to communicate their findings. This study highlights a promising approach to promote healthy communities and health equity by empowering neighborhood residents using participatory methodologies.     

A Neuropsychological Normative Database for Lung Transplant Candidates

Psychologists are increasingly asked to make decisions regarding patient candidacy for transplantation. Despite the growing incidence of lung transplantation, normative research regarding cognitive functioning and end-stage obstructive lung disease is lacking. Hence, data are presented on 100 consecutively referred candidates for lung transplantation. The group data suggest essentially normal functioning on most cognitive tests for the majority of transplant candidates. Exceptions were seen on measures of attentional set shifting and short-term visual memory, which were impaired in nearly one fourth of this population. Additionally, one half of the patients displayed deficient performance on the Buschke Selective Reminding Test, with subjects at greater risk for severe rather than mild deficits. Unlike prior research, our group data suggest that there is potential risk of short-term noncontextual verbal memory difficulties because of end-stage pulmonary disease. Personality testing data, e.g., elevations on MMPI-2 scales measuring depression and anxiety, are also discussed.     

Matching Abilities to Careers for Others and Self: Do Gender Stereotypes Matter to Students in Advanced Math and Science Classes?

Interest in STEM (science, technology, engineering, and mathematics) careers falls off more quickly for young women than for young men over adolescence, and gender stereotypes may be partially to blame. Adolescents typically become more stereotypical in their career interests over time, yet they seem to become more flexible in applying stereotypes to others. Models of career interest propose that career decisions result from the alignment of self-perceived abilities with occupation-required skills and that gender stereotypes may influence this process. To investigate the discrepancy between applying stereotypes to self and others, we examined if these models can be applied to perceptions of others. Focusing on students from fifth grade through college enrolled in advanced STEM courses, we investigated how STEM occupational stereotypes, abilities, and efficacy affect expectations for others’ and own career interests. U.S. participants (n = 526) read vignettes describing a hypothetical male or female student who was talented in math/science or language arts/social studies and then rated the student’s interest in occupations requiring some of those academic skills. Participants’ self-efficacy, interest, and stereotypes for STEM occupations were also assessed. Findings suggest that ability beliefs, whether for oneself or another, are powerful predictors of occupational interest, and gender stereotypes play a secondary role. College students were more stereotypical in their ratings of others, but they did not manifest gender differences in their own STEM self-efficacy and occupational interests. Experiences in specialized STEM courses may explain why stereotypes are applied differentially to the self and others.     

Reply to Crastnopol and Sandmeyer

This response focuses on four points brought up by the discussants: connections between shame and competition, links between competition and envy, the issue of splitting into “all good” and “all bad,” and the question of “digging into” the “dark” side of competition and envy in psychodynamic work. The conclusion: There is no unilateral or definitive explanation for or way of working with the many different issues that can emerge in relation to competition for women in psychoanalysis. However, acknowledging the importance and complexity of competition in women’s lives can make it possible for an analytic dyad to begin to make space for multiple meanings of and defenses against competitive feelings and thoughts, bringing them out of the realm of acting out and into the world of thought representation.     

With Friends Like These,Who Needs Enemies? Split-Off, “Not Me” Competitive Strivings in Women’s Friendships and Sense of Self

Despite changes in attitude toward women in society, there is still interpersonal and intrapsychic ambivalence toward competitive women. Conflict between a desire to connect and a wish to stand out can be particularly unacceptable in relation to other women, especially those who might be friends. In any analytic work, historical constructions and relational/intersubjective exploration can be both useful and also used defensively. A clinical example illustrates some of the ways that traditional analytic techniques can reinforce unrecognized defenses against disruptive competitive impulses in a psychoanalytic dyad composed of two women who might, in other circumstances, have been friends.     

Identifying the Common Elements of Treatment Engagement Interventions in Children’s Mental Health Services

Difficulty engaging families in mental health treatment is seen as an underlying reason for the disparity between child mental health need and service use. Interpretation of the literature on how best to engage families is complicated by a diversity of operational definitions of engagement outcomes and related interventions. Thus, we sought to review studies of engagement interventions using a structured methodology allowing for an aggregate summary of the most common practices associated with effective engagement interventions. We identified 344 articles through a combination of database search methods and recommendations from engagement research experts; 38 articles describing 40 studies met our inclusion criteria. Following coding methods described by Chorpita and Daleiden (J Consul Clin Psychol 77(3):566–579, 2009, doi:10.1037/a0014565), we identified 22 engagement practice elements from 89 study groups that examined or implemented family engagement strategies. Most frequently identified engagement practice elements included assessment, accessibility promotion, psychoeducation about services, homework assignment, and appointment reminders. Assessment and accessibility promotion were two practice elements present in at least 50 % of treatment groups that outperformed a control group in a randomized controlled trial. With the exception of appointment reminders, these frequently identified engagement practice elements had a high likelihood of being associated with winning treatments when they were used. This approach offers a novel way of summarizing the engagement literature and provides the foundation for enhancing clinical decision-making around treatment engagement.