THE EFFECTS OF MEAL SCHEDULE AND QUANTITY ON PROBLEMATIC BEHAVIOR

We present 2 case examples that illustrate the effects of meal schedule and quantity on displays of problematic behavior. In the first example, self-injury displayed by a toddler with severe developmental delays was maintained by parent attention, but only when he was satiated for food. When he was food deprived, self-injury decreased but did not appear to be differentiated across low or high social conditions. In the second example, crying and self-injury displayed by an elementary-aged girl with severe disabilities were correlated: Both behaviors were associated with food quantity, and neither behavior was responsive to social stimuli. These results replicate and extend previous findings demonstrating that meal schedule or food quantity can affect problematic behavior. In the present studies, brief functional analyses of aberrant behavior provided useful information for interpreting distinct patterns of behavior displayed by each child. We discuss these results in terms of the concept of establishing operations.     

Attributional Modesty in Women

Three experiments were conducted to test a two-factor model of the determinants of attributional modesty in women. Women tended to make modest attributions for success when they were concerned about how others would evaluate them and when they were concerned about their own self-image. Specifically, the knowledge that one's attributions would be public and the anticipation of future performance on similar tasks led to modesty. Self-derogatory attributions for failure occurred when the subjects thought their attributions would be public.     

Effects of escape to alone versus escape to enriched environments on adaptive and aberrant behavior

Escape-maintained aberrant behavior may be influenced by two outcomes: (a) a break from the activity and (b) subsequent access to preferred activities. To assess this hypothesis, a treatment was developed that analyzed response allocation across two break options: break alone and break with access to preferred social activities. The break with preferred activities decreased aberrant behavior and increased appropriate behavior.     

Before and after entering school: The development of attention and executive functions from 6 to 8 years in Finnish children

In this 2‐year prospective follow‐up study we examined typical and atypical development of attention and executive function (AEF) across the transition to school. The NEPSY‐battery was used to evaluate the AEFs of the children before school at 6 years of age. Two subgroups, typical AEF (n = 25) and atypical AEF (n = 25), were formed according to the performance in AEF tasks. Children were assessed again at 8 years, when they were at the 2nd grade. The same subtests of the NEPSY‐battery and the ATTEX behavioral rating completed by a teacher were used. The effects of AEF deficits were compared with and without controlling for IQ. The group effect was significant in four out of the six NEPSY subtests used. The atypical AEF group had problems especially on subtests measuring motor inhibition both at the age of 6 and 8. The group‐time interaction effect was found in the subtest measuring attentional shifting. A catch‐up effect on shifting skills was observed in the atypical AEF group by the age of 8 years. In school at the 2nd grade, the early AEF problems were still observable, and related especially to inattention problems. Our results support the interpretation that inhibitory problems are at the core of executive dysfunction, that the problems are stable from preschool to 2nd grade, and that the effects of early AEF problems go over and beyond intellectual deficits. Our results also support the use of performance based measures of inhibition as an important part of the neuropsychological evaluation for school readiness.     

Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth—a randomized controlled trial

The aim of this study was to analyse the effects of trauma-focused guided Internet-based cognitive behaviour therapy for relieving posttraumatic stress disorder (PTSD) symptoms following childbirth, a problem that about 3% women encounter postpartum. Following inclusion, 56 traumatized women were randomized to either treatment or to a waiting list control group. Primary outcome measures were the Traumatic Event Scale (TES) and Impact of Event Scale—Reversed (IES-R). Secondary measures were Beck depression inventory II, Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Quality Of Life Inventory and the EuroQol 5 Dimensions. The treatment was guided by a clinician and lasted eight weeks and comprised eight modules of written text. The between-group effect size (ES) was d = .82 (p < .0001) for the IES-R. The ES for the TES was small (d = .36) and not statistically significant (p = .09). A small between-group ES (d = .20; p = .02) was found for the PHQ-9. The results from pre- to post-treatment showed large within-group ESs for PTSD symptoms in the treatment group both on the TES (d = 1.42) and the IES-R (d = 1.30), but smaller ESs in the control group from inclusion to after deferred treatment (TES, d = .80; IES-R d = .45). In both groups, the treatment had positive effects on comorbid depression and anxiety, and in the treatment group also on quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects.     

A developmental-contextual model of couples coping with chronic illness across the adult life span

A developmental-contextual model of couples coping with chronic illness is presented that views chronic illness as affecting the adjustment of both the patient and the spouse such that coping strategies enacted by the patient are examined in relation to those enacted by the spouse, and vice versa. The developmental model emphasizes that dyadic coping may be different at various phases of the life span, changing temporally at different stages of dealing with the illness as well as unfolding daily as spouses interact around dyadic stressors. In addition, couples engaged in dyadic coping are affected by broad sociocultural factors (culture and gender) as well as more proximal contextual factors (quality of the marital relationship and the specific demands of the chronic illness). The model provides a framework for understanding how couples coping with chronic illness may together appraise and cope with illness during adulthood and for determining when spousal involvement is beneficial or harmful to both patient and spousal adjustment. The developmental-contextual model to dyadic appraisal and coping has numerous research implications for the field, and the authors conclude with specific recommendations for future research.     

Profiles of successful aging in middle-aged and older adult married couples

The study identified coupled profiles of successful aging in middle-aged (n = 139; wives, M = 43.8 years old; husbands, M = 45.6 years old) and older adult married couples (n = 148; wives, M = 62.0 years old; husbands, M = 64.4 years old). Latent profile analysis was applied to variables reflecting the domains of cognition, physical health, personality, and social support. A 2-profile solution and a 4-profile solution were interpreted. Both solutions indicated that a large group of couples scored favorably across domains of successful aging. A small group of largely middle-aged couples who were experiencing extreme marital distress was identified. Unevenness across domains was identified, in that some groups involved a disassociation between marital satisfaction and health outcomes. Spouses were substantially similar in the pattern of their profile of aging. Older adults were not always associated with less favorable profiles. Profiles of successful aging did discriminate on external measures of well-being. The results point to the value of a multidimensional notion of successful aging in couples across the life span.     

“Hall of Broken Mirrors”—Enactment in an Analytic Group of “Difficult Patients”

This article focuses on the transformation of dissociated self-states as a curative factor in an analytic group of “difficult patients.” Foulkes (1964) referred to the analytic group as a “curative hall of mirrors.” I would like to integrate group analytic theory with relational psychoanalytic concepts. I propose that when dissociated self-states are expressed in a group, this creates a “broken mirrors” experience that is sometimes expressed through enactment. I develop this idea, and argue that the group mirrors to the patient his image—distorted and defective—and forces him to cope with his “not me” states. I demonstrate, through three clinical vignettes, how dissociated states hinder the reflective space and create a “hall of broken mirrors” experience. I would argue that in a safe space, the patients’ “not me” states can be transformed, and the hall of broken mirrors can turn into a curative hall of mirrors.