Prevention of Postpartum Depression in Low-Income Women: Development of the Mamás y Bebés/Mothers and Babies Course

A prenatal intervention designed to prevent the onset of major depressive episodes (MDEs) during pregnancy and postpartum was pilot tested at a public sector women’s clinic. The Mamás y Bebés/Mothers and Babies Course is an intervention developed in Spanish and English that uses a cognitive-behavioral mood management framework, and incorporates social learning concepts, attachment theory, and socio-cultural issues. The four goals of this project were to develop the intervention, assess its acceptability, test the feasibility of conducting a randomized trial with public sector patients, and obtain estimates of its effect size. Forty-one pregnant women at high risk for developing MDEs were randomized to the Mothers and Babies Course (n = 21) or a comparison condition (n = 20). Assessments occurred during pregnancy and at 1, 3, 6, and 12 months postpartum. Differences in terms of depression symptom levels or incidence of MDEs between the two groups did not reach statistical significance in this pilot trial. However, the MDE incidence rates of 14% for the intervention condition versus 25% for the comparison condition represent a small effect size (h = 0.28) that will be further examined in a larger scale study. The intervention was well received by the participants and implementation of a randomized trial appeared quite feasible as indicated by our follow-up rate of 91% at 12 months. Implications for the continuing development of preventive interventions for perinatal depression are discussed.     

A multivariate analysis of social dominance in children

The social dominance behavior of dyads of unacquainted, same-sex 31/2 year-olds was observed in a familiar laboratory playroom under two conditions: A free play situation and a situation where candy was introduced. In each of the two conditions, a principal components analysis was used to explore two issues: the usefulness of the multivariate approach in devising a definition of dominance, and the cross-situational stability of the construct. In the free play session, the first principal component that emerged was consistent with a theoretical definition of dominance. This picture was disrupted by the introduction of candy in the second condition. However, a high correlation was found between the dominance hierarchies established in each situation. It was concluded that the multivariate analysis is a useful method for the study of dominance. The generalizability of social dominance across settings was discussed as a possible explanation for the high cross-situational stability.     

One Question,Two Answers: Rabbinic Responsa as Legal Advocacy in the Medieval Islamic World

Jewish law has long faced the problem of individual litigants seeking multiple answers to a single halakhic question in order to select what they found to be the most favorable ruling. In this article, I examine the role that forum shopping for legal opinions played in the Jewish community of the medieval Islamic world. Individuals often made recourse to multiple juristic authorities, whether those authorities were leaders serving the geonic academies of Babylonia and the land of Israel or local jurists. I discuss some of the strategies the geonim and local jurists used to reduce competition between judicial rulings and how local judges utilized the various responsa composed on their behalf by these authorities or presented to them by litigants to bolster their case before the Jewish court. In so doing, I aim to refine our understanding of the social and legal role of rabbinic responsa in the medieval Islamic world by suggesting that this literature served as expert testimony to support one side or the other in a particular case rather than as the definitive record of the court’s ruling in that case.     

From neural responses to population behavior: neural focus group predicts population-level media effects

Can neural responses of a small group of individuals predict the behavior of large-scale populations? In this investigation, brain activations were recorded while smokers viewed three different television campaigns promoting the National Cancer Institute's telephone hotline to help smokers quit (1-800-QUIT-NOW). The smokers also provided self-report predictions of the campaigns' relative effectiveness. Population measures of the success of each campaign were computed by comparing call volume to 1-800-QUIT-NOW in the month before and the month after the launch of each campaign. This approach allowed us to directly compare the predictive value of self-reports with neural predictors of message effectiveness. Neural activity in a medial prefrontal region of interest, previously associated with individual behavior change, predicted the population response, whereas self-report judgments did not. This finding suggests a novel way of connecting neural signals to population responses that has not been previously demonstrated and provides information that may be difficult to obtain otherwise.     

Direct-to-Consumer Genetic Testing: Introduction to the Special Issue

This issue of the Journal of Genetic Counseling is devoted to direct-to-consumer (DTC) genetic testing. The 15 articles in this special issue address practice considerations for genetic counselors and other health care professionals; the benefits and limitations of DTC genetic testing; consumer and provider attitudes towards and experience with DTC testing; and the roles and educational needs of genetic counselors and other health care providers in providing and interpreting DTC genetic testing. In this introduction to the special issue, we provide a brief background on DTC genetic testing, summarize the important contribution of the articles included in this issue, and outline the essential work that still needs to be done as genetic counselors are increasingly engaged in discussions, education, and research about DTC genetic testing.     

The Relevance of Countertransference

No abstract available for this article.     

Let's Not Talk About It: Commentary on Michael Shoshani (Rosenbaum's) Dare to be Human

As an outsider, I found myself engaged and at times mystified as I wondered about the unasked and the unspoken in Michael Shoshani (Rosenbaum's) portrayal of an analysis in his book Dare to Be Human. While conceding that every therapy and every representation of therapy must touch on some issues and omit others, and that at times intimate experience can be deadened by conversation, I was curious about the ways Shoshani (Rosenbaum) appeared at times to retreat from talking with his patient about certain areas of relatedness, particularly about varieties of possible erotic transferences. While Dr. Shoshani (Rosenbaum) makes a case for the therapeutic value of the unsaid, I wonder whether in this relationship talking about this complex area might have been a means to further joint attention and an opportunity for co-inquiry and collaboration around significant subject/object and subject/subject forms of relatedness. I ask whether talking about experience may enliven and deepen mutual experience rather than deaden it, by limning mutuality and difference, and nurturing curiosity about process and relationship.     

Giving Words to the Unsayable: The Healing Power of Describing What Happened

This discussion elaborates on Dr. Slade’s paper about the centrality of fear in the etiology of emotional problems and discusses the transmission from parent to child of unaddressed sources of parental fear.