Effect of Client and Counselor Ethnicity on Preference for Counselor Disclosure

Preferences for counselor self‐disclosure based on the ethnicity of both the respondent and the counselor were examined for African American and Caucasian students. Results suggested that respondent ethnicity affected preferences for certain types of information about the counselor (personal feelings, sexual issues, professional issues, and success/failure) and that there were interaction (respondent by counselor ethnicity) effects on preference for disclosure in other areas (interpersonal relationships and success/failure). Implications for research and practice are discussed.     

Vulvar pain: a phenomenological study of couples in search of effective diagnosis and treatment

Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of ... the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships.     

Caregiver Involvement in the Intensive Mental Health Program: Influence on Changes in Child Functioning

We examined behavioral markers of caregiver involvement and the ways in which family participation was related to treatment outcomes in 47 elementary school children with SED enrolled in a school-based intensive mental health program. Measures of caregiver involvement included therapeutic home visits, attendance at therapeutic meetings, completion of ratings on the daily point sheet, and extra communications with the therapeutic team on the point sheet. Greater initial impairment was associated with greater caregiver involvement. Greater caregiver involvement was linked to improvement in child thought processes, increased ability to provide emotional and social supports for the child, and greater overall child functioning at discharge. Our findings also reflected increased therapists’ attempts to provide additional in-home services in cases where caregivers demonstrated a decline in their ability to provide for their children’s physical and material needs, or in which therapists discovered that the family functioning was more impaired than what was initially assessed. We provide a case study that exemplifies many of these findings.     

Satisfaction with Components of the Therapeutic Model: Perspectives of Consumers and Professionals

We provide information about consumer and provider perceptions using a mixed-model pilot study within the Intensive Mental Health Project (IMHP), a school-based treatment service for children with SED and their families. Caregiver, youth, and provider questionnaires developed for this project elicited quantitative and qualitative information on treatment satisfaction, therapeutic alliance, and active involvement in treatment. Caregivers and children overall had positive perceptions of the services they received through IMHP. Providers reported very good working relationships with most children and families. Consumers also provided constructive comments about how to improve services. Our results add support to the importance of therapeutic alliance and collaboration, which are guiding principles of the IMHP.     

Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety

Many individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.     

Epidemiology of Down syndrome

Down syndrome (DS) is the most commonly identified genetic form of mental retardation and the leading cause of specific birth defects and medical conditions. Traditional epidemiological studies to determine the prevalence, cause, and clinical significance of the syndrome have been conducted over the last 100 years. DS has been estimated to occur in approximately 1 in 732 infants in the United States, although there is some evidence that variability in prevalence of estimates exist among racial/ethnic groups. Progress has been made in characterizing the specific types of chromosome errors that lead to DS and in identifying associated factors that increase the risk of chromosome 21 malsegregation, i.e., advanced maternal age and recombination. Studies to examine the variability of the presence of specific DS-associated birth defects and medical conditions provide evidence for genetic and environmental modifiers. Here, we provide a brief survey of studies that address the current state of the field and suggest gaps in research that can soon be filled with new multidisciplinary approaches and technological advances.     

The importance of narcissism in predicting proactive and reactive aggression in moderately to highly aggressive children

The present study examined the importance of psychopathy-linked narcissism in predicting proactive and reactive aggression and conduct problems in a group of 160 moderately to highly aggressive children (mean age of 10 years, 9 months). Children's self-report of self-esteem and parent and teacher report of dimensions of psychopathy [narcissism, callous-unemotional (CU) traits, and impulsivity], proactive and reactive aggression, and conduct problems were collected. Composites of parent and teacher ratings of children's behavior were used. Consistent with the study's hypotheses, narcissism predicted unique variance in both proactive and reactive aggression, even when controlling for other dimensions of psychopathy, demographic variables associated with narcissism, and the alternative subtype of aggression. As hypothesized, impulsivity was significantly associated with only reactive aggression. CU traits were not related to proactive or reactive aggression once the control variables were entered. All dimensions of psychopathy predicted unique variance in conduct problems. Consistent with prediction, narcissism was not significantly related to general self-esteem, providing support that narcissism and self-esteem are different constructs. Furthermore, narcissism and self-esteem related differentially to proactive aggression, reactive aggression, and conduct problems. Furthermore, narcissism but not self-esteem accounted for unique variance in aggression and conduct problems. The importance of narcissism in the prediction of aggressive behaviors and clinical implications are discussed.     

Mourning beyond melancholia: Freud's psychoanalysis of loss

Freud's mourning theory has been criticized for assuming a model of subjectivity based on a strongly bounded form of individuation. This model informs "Mourning and Melancholia" (1917), in which Freud argued that mourning comes to a decisive end when the subject severs its emotional attachment to the lost one and reinvests the free libido in a new object. Yet Freud revised his mourning theory in writings concerned with the Great War and in The Ego and the Id (1923), where he redefined the identification process previously associated with melancholia as an integral component of mourning. By viewing the character of the ego as an elegiac formation, that is, as "a precipitate of abandoned object-cathexes," Freud's later work registers the endlessness of normal grieving; however, it also imports into mourning the violent characteristics of melancholia, the internal acts of moralized aggression waged in an effort to dissolve the internal trace of the other and establish an autonomous identity. Because it is not immediately clear how Freud's text offers a theory of mourning beyond melancholy violence, his account of the elegiac ego is shown here to ultimately undermine the wish for an identity unencumbered by the claims of the lost other and the past, and to suggest the affirmative and ethical aspects of mourning.     

Skew and internal consistency

The effects of skew on the standardized item alpha were examined with Monte Carlo techniques. Alphas computed from normal variables were compared with alphas from lognormal variables, ranks, and skewed versus normal Likert-type variables. The extent and direction of skew were varied, as was the size of the population interitem correlation (rho), the number of items, and the number of categories for Likert-type variables. Because the average interitem correlation affects alpha and skew affects the average interitem correlation, the effect of skew on the average interitem correlation also was examined. Results indicated that skew decreased the average interitem correlation and produced small decreases in alpha that were largest when skew was large, rho was small, items were skewed in opposite directions, and there were fewer items.     

Adolescent computer use and academic achievement

The main purpose of this study was to investigate the relationship between adolescent computer use and academic achievement. Questionnaires and seven-day time logs were used to gather data from 101 tenth-grade students in southwestern Ohio. The adolescents both estimated and documented their computer use. The correlation between computer use and grade point average was not found to be significant. However, gender differences were found across grade point average and time spent doing homework on and off the computer. Estimates of time spent per week using the computer were correlated with the time recorded in logs.