Personal versus interpersonal contributions to depressive symptoms among Hong Kong adolescents

Cross‐cultural theory proposes that an essential distinction between cultures lies in the extent to which individual members see themselves as either independent agents preferentially valuing agency and efficacy, or as embedded within a social context preferentially valuing interpersonal relationships. A nonreferred sample of 605 boys and 503 girls from Hong Kong provided information regarding: (1) perceptions of their personal self‐efficacy or beliefs regarding their own ability to master challenges they face; (2) the degree of harmony in their interpersonal (peer and family) relationships; and (3) depressive symptoms as an assessment of their mood. Cognitive theories of emotions propose that both the individual's assessment of his/her self‐efficacy and of his/her relationships influence mood. Hypotheses, based on cross‐cultural theory, were that in this collective culture, interpersonal evaluations would predict more of the variance in mood than would personal self‐efficacy. Contrary to Western sex‐differences literature, it was predicted that the effect of interpersonal harmony on mood would be equally pronounced for girls and for boys. Structural equation modelling was used to test causal models. Consistent with findings from the West, evaluations of personal self‐efficacy as well as interpersonal relationship harmony were significantly associated with depressed mood. Consistent with cultural theory, interpersonal relationship harmony was more strongly associated with mood than was personal self‐efficacy for the entire sample of adolescents. In contrast to findings of sex differences in the salience of relationships in the West, the prediction of interpersonal relationships to mood was equal for boys and girls in Hong Kong. This preliminary study extends models of cognitive concomitants of mood disruption to a non‐Western culture, and provides a framework to understand relative contnbutors to mood in adolescence. The findings tentatively suggest that treatment for depressive mood in Chinese populations should prioritize enhancement of the perceived quality of interpersonal relationships over increasing a sense of mastery.     

Developing Cognitive Behavioral Therapy to Prevent Depressive Relapse in Youth

Relapse rates for children and adolescents with major depressive disorder (MDD) range from 30% to 40% within 1 to 2 years after acute treatment. Although relapse rates are high, there have been relatively few studies on the prevention of relapse in youth. While acute phase pharmacotherapy has been shown to reduce symptoms rapidly in depressed youth, children and adolescents frequently report ongoing residual symptoms and often relapse following acute treatment. Recent adult trials have begun examining augmentation with psychosocial treatment after successful medication treatment to enhance medication response and prevent future relapse. This strategy has not yet been examined in youth with depression. Here we present initial efforts to develop a sequential, combination treatment strategy to promote rapid remission and to prevent relapse in depressed youth. We describe efforts to adapt CBT to prevent relapse (RP-CBT) in youth who respond to pharmacotherapy. The goals of RP-CBT include: preventing relapse, increasing wellness, and developing skills to promote and sustain well-being. We describe the rationale for, components of, and methods used to develop RP-CBT. The results from a small open series sample demonstrate feasibility and indicate that youth appear to tolerate RP-CBT well. A future test of the treatment in a randomized controlled trial is described.     

Multimodal Treatments for Childhood Attention-deficit/Hyperactivity Disorder: Interpreting Outcomes in the Context of Study Designs

The goal of this article was to outline issues critical to evaluating the literature on incremental benefit of multiple effective treatments used together, vs. a single effective treatment, for childhood ADHD. These issues include: (1) sequencing and dosage of treatments being combined and compared; (2) difficulty drawing valid conclusions about individual components of treatment when treatment packages are employed; (3) differing results emerging from measurement tools that purportedly measure the same domain; and (4) the resultant difficulty in reaching a summary conclusion when multiple outcome measures yielding conflicting results are used. The implications of these issues for the design and conduct of future studies are discussed, and recommendations are made for future research.     

Revolutionary and Familiar, Inevitable and Precarious: Rhetorical Contradictions in Enthusiasm for Nanotechnology

This paper analyses rhetorics of scientific and corporate enthusiasm surrounding nanotechnology. I argue that enthusiasts for nanotechnologies often try to have it both ways on questions concerning the nature and possible impact of these technologies, and the inevitability of their development and use. In arguments about their nature and impact we are simultaneously informed that these are revolutionary technologies with the potential to profoundly change the world and that they merely represent the extension of existing technologies. They are revolutionary and familiar. In debates surrounding possible regulation of these technologies it is claimed both that their development is inevitable, so that regulation would be fruitless, and that increased research funding and legislative changes are necessary in order that we can enjoy their benefits. That is, they are inevitable and precarious. An increased awareness of these rhetorical contradictions may allow us better to assess the likely impact and future of nanotechnology.

Adolescents' relationships with their mothers and fathers: associations with depressive disorder and subdiagnostic symptomatology

Family relationships across 3 groups of adolescents were compared: (a) those with unipolar depressive disorders (n=82); (b) those with subdiagnostic depressive symptoms (n=78); and (c) those without emotional or behavioral difficulties (n=83). Results based on multisource, multimethod constructs indicated that depressed adolescents, as well as those with subdiagnostic symptomatology, experience less supportive and more conflictual relationships with each of their parents than do healthy adolescents. These findings are notable in demonstrating that adverse father-adolescent relationships are associated with depressive symptomatology in much the same way as mother-adolescent relationships. As well, the findings add to the emerging evidence that adolescents with subdiagnostic symptoms experience difficulties in social relationships similar to those experienced by adolescents with depressive disorder.     

Maternal Depressive Symptomatology and Parenting Behavior: Exploration of Possible Mediators

Possible mediators of the relation between maternal depressive symptomatology and parenting behavior were examined for 96 children with ADHD and their mothers drawn from the Multimodal Treatment Study of Children with ADHD (MTA) as part of an add-on investigation conducted by two of the six MTA sites. General cognitions (i.e., maternal locus of control and self-esteem) and parenting-specific factors (i.e., maternal parenting efficacy and parenting stress) were examined as possible mediators. Findings provide initial support that maternal parenting stress, as well as maternal locus of control and self-esteem mediate the relation between maternal depressive symptomatology and parenting behavior. This provides support for the argument that some families of children with ADHD may benefit from an expanded version of parent management training that includes sessions directly targeting affective and cognitive factors in parents, similar to treatment programs used to treat childhood conduct problems.     

Parenting,Family Loneliness,and Peer Functioning in Boys with Attention-Deficit/Hyperactivity Disorder

The goal of the present study was to consider the associations between family functioning (parenting and family loneliness) and peer functioning in a sample of boys with ADHD (N = 110) and their mothers (N = 108) and fathers (N = 53). Results indicated that higher paternal warmth was associated with more peer acceptance, less peer rejection, and less problematic social behavior, but only for boys who reported low levels of family loneliness. In addition, more paternal power assertion was related to less peer acceptance, but only for boys who reported low levels of family loneliness. Maternal warmth and power assertion were not significantly related to boys' peer functioning. We discuss these findings in the context of the processes by which parenting may affect the peer relationships of these children.     

Better Living Through Chemistry? A Reply to Savulescu and Persson on ‘Moral Enhancement’

In ‘Moral Enhancement, Freedom, and the God Machine’, Savulescu and Persson argue that recent scientific findings suggest that there is a realistic prospect of achieving ‘moral enhancement’ and respond to Harris's criticism that this would threaten individual freedom and autonomy. I argue that although some pharmaceutical and neuro‐scientific interventions may influence behaviour and emotions in ways that we may be inclined to evaluate positively, describing this as ‘moral enhancement’ presupposes a particular, contested account, of what it is to act morally and implies that entirely familiar drugs such as alcohol, ecstasy, and marijuana are also capable of making people ‘more moral’. Moreover, while Savulescu and Persson establish the theoretical possibility of using drugs to promote autonomy, the real threat posed to freedom by ‘moral bioenhancement’ is that the ‘enhancers’ will be wielding power over the ‘enhanced’. Drawing on Pettit's notion of ‘freedom as non‐domination’, I argue that individuals may be rendered unfree even by a hypothetical technology such as Savulescu and Persson's ‘God machine’, which would only intervene if they chose to act immorally. While it is impossible to rule out the theoretical possibility that moral enhancement might be all‐things‐considered justified even where it did threaten freedom and autonomy, I argue that any technology for biomedical shaping of behaviour and dispositions is much more likely to be used for ill rather than good.     

Nurses’ recognition and reporting of child abuse: A factorial survey

According to interaction ist theory, responses of professionals to potential deviance will vary by characteristics of the event, characteristics of the biography and training of the observer, and characteristics of the organization in which the process occurs. Hypotheses concerning recognition and reporting of child abuse were tested using a factorial survey design. A probability sample of nurses (N = 1,038) judged vignettes, in which case characteristic variables were systematically manipulated, and responded to a questionnaire on their background, professional work, and organization. Case characteristics involving type and level of seriousness of abuse, perpetrator status, and perpetrator psychology had the greatest effects on the average recognition and reporting scores, as shown in the analysis using ordinary least squares regression. Contrary to interaction ist predictions, only a small additional amount of the variance was accounted for when the nurses’ characteristics and organizational characteristics were added to the equation. Implications of the findings for further research and for social policy and practice concerning child abuse are discussed.     

Book Review

E.S. Batchelor &; R.S. Dean (Eds.) (1995). Pediatric Neuropsychology: Interfacing Assessment and Treatment for Rehabilitation. Boston: Allyn &; Bacon. ISBN 0-205-16486-2. 364 pp.us $37.95