Is the Continuity of Externalizing Psychopathology the Same in Adolescents and Middle–Aged Adults? A Test of the Externalizing Spectrum’s Developmental Coherence

Externalizing psychopathology (EXT) is a framework for understanding diagnostic comorbidity and etiology of antisocial and substance-use behaviors. EXT indicates continuity in adulthood but the structure of adolescent EXT is less clear. This report examines whether adolescent EXT is trait-like, as has been found with adults, or categorical. We use tests of measurement invariance to determine how diagnostic indicators of EXT differ in adolescents compared to adults. The EXT measures employed were DSM-IIIR diagnoses of adult antisocial behavior, conduct disorder, and alcohol, marijuana, and drug dependence. Latent trait, latent class, and hybrid models were fit to two separate data sets: 2,769 seventeen-year-old adolescents and 2,619 adults from the Minnesota Twin Family Study. The best model in both samples was a single-trait LT model. Parameters from the adolescent and adult models were equivalent for all disorders except alcohol dependence. It appears that EXT in adolescence can be accurately represented by a single-trait model, and the measurement properties of EXT are similar during these time periods with the exception of alcohol dependence.     

Using facial muscular movements to understand young children's emotion regulation and concurrent neural activation

Individual differences in young children's frustration responses set the stage for myriad developmental outcomes and represent an area of intense empirical interest. Emotion regulation is hypothesized to comprise the interplay of complex behaviors, such as facial expressions, and activation of concurrent underlying neural systems. At present, however, the literature has mostly examined children's observed emotion regulation behaviors and assumed underlying brain activation through separate investigations, resulting in theoretical gaps in our understanding of how children regulate emotion in vivo. Our goal was to elucidate links between young children's emotion regulation‐related neural activation, facial muscular movements, and parent‐rated temperamental emotion regulation. Sixty‐five children (age 3–7) completed a frustration‐inducing computer task while lateral prefrontal cortex (LPFC) activation and concurrent facial expressions were recorded. Negative facial expressions with eye constriction were inversely associated with both parent‐rated temperamental emotion regulation and concurrent LPFC activation. Moreover, we found evidence that positive expressions with eye constriction during frustration may be associated with stronger LPFC activation. Results suggest a correspondence between facial expressions and LPFC activation that may explicate how children regulate emotion in real time.     

Ethics,Changing Populations,and the Dental Profession

This review emphasizes the worldwide and U.S. evolving population demographics and the need for the dental profession to exercise its professional and ethical duty to expand its traditional patient base to provide needed services.     

The effect of contingent reinforcement on target variables in outpatient psychotherapy for depression: a successful and unsuccessful case using functional analytic psychotherapy

The current study investigated a behavior-analytic treatment, functional analytic psychotherapy (FAP), for outpatient depression utilizing two single-subject A/A+B designs. The baseline condition was cognitive behavioral therapy. Results demonstrated treatment success in 1 client after the addition of FAP and treatment failure in the 2nd. This study highlights the challenges in measuring treatment progress and outcome idiographically in this population.     

Creative Writing as a Medical Instrument

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination.     

Autobiographical memory specificity in adults reporting repressed,recovered, or continuous memories of childhood sexual abuse

Some psychotherapists believe that adult survivors of childhood sexual abuse (CSA) are characterised by memory deficits for their childhood. Using the Autobiographical Memory Test (AMT), we asked nonabused control participants and participants who reported either continuous, recovered, or repressed memories of CSA to retrieve a specific personal memory in response to either positive or negative cue words from either childhood or adolescence/adulthood. The results indicated that participants who believed they harboured repressed memories of abuse tended to exhibit the greatest difficulty retrieving specific memories from their childhood. Neither posttraumatic stress disorder (PTSD) nor major depression was related to diminished memory specificity.     

Attention to distinguishing features in object recognition

This study advances the hypothesis that, in the course of object recognition, attention is directed to distinguishing features: visual information that is diagnostic of object identity in a specific context. In five experiments, observers performed an object categorization task involving drawings of fish (Experiments 1–4) and photographs of natural sea animals (Experiment 5). Allocation of attention to distinguishing and non-distinguishing features was examined using primed-matching (Experiment 1) and visual probe (Experiments 2, 4, 5) methods, and manipulated by spatial precuing (Experiment 3). Converging results indicated that in performing the object categorization task, attention was allocated to the distinguishing features in a context-dependent manner, and that such allocation facilitated performance. Based on the view that object recognition, like categorization, is essentially a process of discrimination between probable alternatives, the implications of the findings for the role of attention to distinguishing features in object recognition are discussed.