Screening for and Preventing Perinatal Depression

New York City (NYC) public hospitals recently mandated that all pregnant women be screened for depression, but no funds were allocated for screening or care coordination/treatment, and research suggests that unfunded mandates are not likely to be successful. To address this, we implemented an on-site depression prevention intervention (NYC ROSE) for positive depression screens among pregnant, mostly Black and Hispanic, lower-income women in one public hospital. In this paper, we used Aarons’ implementation model to describe the successes and challenges of screening and intervention. Patient tracking sheets and electronic medical records were abstracted. Key informant interviews and an informal focus group were conducted, and staff observations were reviewed; common implementation themes were identified and fit into Aarons’ model. We found that a lack of funding and staff training, which led to minimal psychoeducation for patients, were outer context factors that may have made depression screening difficult, screening results unreliable, and NYC ROSE enrollment challenging. Although leadership agreed to implement NYC ROSE, early involvement of all levels of staff and patients would have better informed important inner context factors, like workflow and logistical/practical challenges. There was also a mismatch between the treatment model and the population being served; patients often lived too far away to receive additional services on site, and economic issues were often a higher priority than mental health services. Screening and interventions for perinatal depression are essential for optimal family health, and a detailed, thoughtful and funded approach can help ensure effectiveness of such efforts.     

Overparenting and Narcissism in Young Adults: The Mediating Role of Psychological Control

Overparenting, or “helicopter parenting,” can be generally characterized as parenting that is well-intentioned, but over-involved and intrusive. This style of parenting has been especially highlighted in the lives of young adults, who may be inhibited by this form of parenting in the appropriate development of autonomy and independence. Overparenting shares conceptual similarities with parents’ psychological control practices, which involve emotional and psychological manipulation of children (e.g., inducing guilt, withholding love as a form of control). Although these constructs contain key differences, both have been linked to narcissism in young adults, by way of parental over-involvement in children’s lives. Thus, we sought to explore parental psychological control as a mediator between overparenting and narcissism, including in regard to both grandiose and vulnerable narcissistic phenotypes. Participants included 380 young adult college students (age range: 18–26 years) who completed the Pathological Narcissism Inventory, as well as reports of their parents’ behaviors related to overparenting and psychological control. Mediation analyses through Process in SPSS supported the hypothesized role of parental psychological control as a mediator between overparenting and narcissistic traits, including traits related to both grandiose and vulnerable narcissism. Effect sizes for each analysis were modest. This study further clarifies the nature of overparenting, and speaks to the need for further research in establishing the mechanisms by which overparenting may lead to narcissistic traits among young adults.     

Irrational choice behavior in human and nonhuman primates

Choice behavior in humans has motivated a large body of research with a focus on whether decisions can be considered to be rational. In general, humans prefer having choice, as do a number of other species that have been tested, even though having increased choice does not necessarily yield a positive outcome. Humans have been found to choose an option more often only because the opportunity to select it was diminishing, an example of a deviation from economic rationality. Here we extend this paradigm to nonhuman primates in an effort to understand the mechanisms underlying this finding. In this study, we presented two groups of laboratory monkeys, capuchins (Cebus apella) and rhesus macaques (Macaca mulatta), as well as human subjects, with a computerized task in which subjects were presented with two differently colored icons. When the subject selected an icon, differing numbers of food pellets were dispensed (or points were assigned), making each icon correspond to a certain level of risk (one icon yielded 1 or 4 pellets/points and the other yielded 2 or 3). Initially, both options remained constantly available and we established choice preference scores for each subject. Then, we assessed preference patterns once the options were not continuously available. Specifically, choosing one icon would cause the other to shrink in size on the screen and eventually disappear if never selected. Selecting it would restore it to its full size. As predicted, humans shifted their risk preferences in the diminishing options phase, choosing to click on both icons more equally in order to keep both options available. At the group level, capuchin monkeys showed this pattern as well, but there was a great deal of individual variability in both capuchins and macaques. The present work suggests that there is some degree of continuity between human and nonhuman primates in the desire to have choice simply for the sake of having choice.     

Psychophysical investigation of vigilance decrement in jumping spiders: overstimulation or understimulation?

The inability to maintain signal detection performance with time on task, or vigilance decrement, is widely studied in people because of its profound implications on attention-demanding tasks over sustained periods of time (e.g., air-traffic control). According to the resource depletion (overload) theory, a faster decrement is expected in tasks that are cognitively demanding or overstimulating, while the underload theory predicts steeper decrements in tasks that provide too little cognitive load, or understimulation. Using Trite planiceps, a jumping spider which is an active visual hunter, we investigated vigilance decrement to repetitive visual stimuli. Spiders were tethered in front of two stimulus presentation monitors and were given a polystyrene ball to hold. Movement of this ball indicates an attempt to turn towards a visual stimulus presented to a pair of laterally facing (anterior lateral) eyes for closer investigation with high acuity forward-facing (anterior median) eyes. Vigilance decrement is easily measured, as moving visual stimuli trigger clear optokinetic responses. We manipulated task difficulty by varying the contrast of the stimulus and the degree of ‘noise’ displayed on the screen over which the stimulus moved, thus affecting the signal:noise ratio. Additionally, we manipulated motivation by paired testing of hungry and sated spiders. All factors affected the vigilance decrement, but the key variable affecting decrement was stimulus contrast. Spiders exhibited a steeper decrement in the harder tasks, aligning with the resource depletion theory.     

A Survey of Genetic Counselors' Use of Informed Consent Documents for Prenatal Genetic Counseling Sessions

Thirty six members of the Prenatal Diagnosis Special Interest Group of the National Society of Genetic Counselors were interviewed about their use of informed consent documents for the genetic counseling component of their prenatal genetic counseling sessions and their perceptions of the utility and feasibility of such documents. Major findings include (1) None of the genetic counselors currently used a consent document describing the genetic counseling component of the session itself; (2) Only three participants stated that they had ever used an informed consent document for this component of the session; (3) They disagreed about the importance and usefulness of such a document; (4) There was variability in their reported likelihood of using a document if one were available; (5) There was a fair amount of agreement about the types of information to include on an informed consent document for genetic counseling; over half of the sample endorsed 8 of 10 topics; and (6) Participants identified 10 obstacles to using such a document. Recommendations for genetic counseling practice, policy, and research are given.     

From dyad to dialogue: language and the early relationship in American psychoanalytic theory

The centrality of language for a Freudian theory of mind and treatment has not been retained by most post-Freudian theorists. American writers have turned to academic developmental research on mother-child interactions to depict the preoedipal period as preverbal, presymbolic, nonconscious. This view presents the early relationship as developing in linear stages in which visual observational data (e.g., contingent behavior action patterns between two persons) are privileged over aural-oral data of communicational exchanges. An alternative view is presented that redefines the earliest relationship in terms of communicational exchanges, mediation, and dialogue. The claim is that understanding the nature of mediated communication keeps language central to psychoanalysis and reestablishes an intrapsychic dimension in the concept of relationship that is lost when relationship is reduced to behavioral patterns.     

U.S. Muslim women and body image: links among objectification theory constructs and the hijab

This study tested tenets of objectification theory and explored the role of the hijab in body image and eating disorder symptoms with a sample of 118 Muslim women in the United States. Results from a path analysis indicated that individual differences in wearing the hijab were related negatively with reported sexual objectification experiences. Sexual objectification experiences, in turn, had significant positive indirect relations with body surveillance, body shame, and eating disorder symptoms, primarily through the mediating role of internalization. Internalization of cultural standards of beauty also had a significant positive direct relation with body shame and significant positive direct and indirect relations with eating disorder symptoms. By contrast, the direct and indirect relations of body surveillance were significant only when the role of internalization was constrained to 0 (i.e., eliminated), suggesting that internalization of cultural standards of beauty subsumed the hypothesized role of body surveillance in the model. Taken together, these results support some of the tenets of objectification theory with a sample of U.S. Muslim women, point to the importance of internalization of dominant cultural standards of beauty within that framework, and suggest the utility of considering individual differences in wearing the hijab among U.S. Muslim women.