SUBSTANCE-ABUSING MOTHERS IN RESIDENTIAL TREATMENT WITH THEIR BABIES: IMPORTANCE OF PRE- AND POSTNATAL MATERNAL REFLECTIVE FUNCTIONING

A residential treatment program has been developed specifically for substance-abusing pregnant and parenting women in Finland, focusing on simultaneously supporting maternal abstinence from substances and the mother-baby relationship. The aims of the study are to explore maternal pre- and postnatal reflective functioning and its association with background factors, maternal exposure to trauma, and psychiatric symptoms, postnatal interaction, child development, and later child foster care placement. Participants were 34 mother-baby pairs living in three residential program units during the pre- to postnatal period. We employed self-report questionnaires on background, trauma history, and psychiatric symptoms (Brief Symptom Inventory: L.R. Derogatis, 1993; Edinburgh Postnatal Depression Scale: J.L. Cox, J.M. Holden, & R. Sagovsky, 1987; Traumatic Antecedents Questionnaire: B. Van der Kolk, 2003), videotaped mother-child interactions coded for sensitivity, control, and unresponsiveness (Care Index for Infants and Toddlers: P. Crittenden, 2003); a standardized test of child development (Bayley Scales of Infant Development-II: N. Bayley, 1993); and semistructured interviews for maternal reflective functioning (Pregnancy Interview: A. Slade, E. Bernbach, J. Grienenberger, D.W. Levy, & A. Locker, 2002; Parent Development Interview: A. Slade et al., 2005). Pre- and postnatal maternal reflective functioning (RF) was on average low, but varied considerably across participants. Average RF increased significantly during the intervention. Increase in RF level was found to be associated with type of abused substance and maternal trauma history. Mothers who showed lower postnatal RF levels relapsed to substance use more often after completing a residential treatment period, and their children were more likely to be placed in foster care. The intensive focus on maternal RF is an important direction in the development of efficacious treatment for this very high risk population.     

Attachment‐based intervention for substance‐using mothers: A preliminary test of the proposed mechanisms of change

Although randomized controlled trials examining the efficacy of attachment‐based interventions have been increasing in recent years, adequate measurement of treatment integrity, integrity–outcome associations, and mechanisms of change has been rare. The aim of this investigation was to conduct a rigorous test of proposed mechanisms of change in the Mothers and Toddlers Program (MTP) treatment model, a 12‐session, attachment‐based individual therapy for substance‐using mothers of children birth to 3 years of age. The MTP aims to improve maternal reflective functioning (RF) and representation quality (RQ) to bring about second‐order change in maternal caregiving behavior. Following guidelines from M.K. Nock ( 2007 ), it was hypothesized that (a) therapist adherence to unique MTP treatment components would uniquely predict improvement in RF and RQ and that (b) improvement in RF and RQ would function as unique mechanisms of change (when compared with other potential mechanisms—reduction in depression and increase in abstinence from drug use) in the improvement of caregiving behavior. Findings supported each hypothesis, confirming the proposed mechanisms of the treatment model. However, improvement in maternal depression also uniquely predicted improvement in caregiving behavior. Results underscore the potential value of attachment‐based parenting interventions for improving mother–child relations and the importance of providing these interventions in clinic settings where mothers have access to comprehensive care (e.g., psychiatric services).     

The competent community: Toward a vital reformulation of professional ethics

Psychologists are ethically obligated to ensure their own competence. When problems of professional competence occur, psychologists must take appropriate steps to regain competence while protecting those they serve. Yet conceptualizations of the competence obligation are thoroughly intertwined with Western ideals of individualism and a model of the person as self-contained, self-controlled, and perpetually rational. Research in health care, education, and multicultural and social psychology raise serious doubts about psychologists' capacity for consistently accurate self-assessments of competence. To address this problem, the authors advocate that education, training, professional ethics standards, and credentialing criteria be infused with a robust communitarian ethos and a culturally pervasive ethic of care. The authors propose a shift in discourse about competence to incorporate both competent individuals and competent communities. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Economic Hardship, Neighborhood Context, and Parenting: Prospective Effects on Mexican�CAmerican Adolescent��s Mental Health

This study examined family and neighborhood influences relevant to low-income status to determine how they combine to predict the parenting behaviors of Mexican-American mothers and fathers. The study also examined the role of parenting as a mediator of these contextual influences on adolescent internalizing and externalizing symptoms. Study hypotheses were examined in a diverse sample of Mexican-American families in which 750 mothers and 467 fathers reported on their own levels of parental warmth and harsh parenting. Family economic hardship, neighborhood familism values, and neighborhood risk indicators were all uniquely associated with maternal and paternal warmth, and maternal warmth mediated the effects of these contextual influences on adolescent externalizing symptoms in prospective analyses. Parents' subjective perceptions of neighborhood danger interacted with objective indicators of neighborhood disadvantage to influence maternal and paternal warmth. Neighborhood familism values had unique direct effects on adolescent externalizing symptoms in prospective analyses, after accounting for all other context and parenting effects.     

Mobilizing Communities to Implement Evidence-Based Practices in Youth Violence Prevention: The State of the Art

Community mobilization can increase the effective implementation of evidence-based practices (EBPs) in youth violence prevention. These strategies bring together people and organizations in a community to try to solve or reduce a problem. They help communities address the challenges of identifying EBPs, disseminating them to local decision-makers, and then implementing and sustaining them if they are successful. Science-based systems for implementing EBPs such as PROSPER and Communities That Care can help to integrate this complex work in communities. Further insight about implementing EBPs in youth violence prevention is being developed through the CDC-funded Academic Centers for Excellence in Youth Violence Prevention. Community mobilization approaches for seven of these programs are discussed, highlighting successful approaches and challenges encountered.     

Longitudinal Interviews of Couples Diagnosed with Diminished Ovarian Reserve Undergoing Fragile X Premutation Testing

About 10 % of infertile/subfertile women are diagnosed with diminished ovarian reserve (DOR), of which?<?5 % will become pregnant spontaneously. Fragile X (FMR1) genetic testing may provide a reason for her early ovarian aging and/or have reproductive implications. Seven women with DOR (genetic study subset) and the male partners of six of these women were separately interviewed about the experience of being asked to undergo this unanticipated genetic test. Three interviews were conducted (before, within 1 week after, and 3 months after learning the test results). None of the participants carried the FMR1 premutation (largest FMR1 allele 27–50 CGG repeats). For women, their pregnancy-seeking journey was long and exhausting. Women understood the reproductive implications of carrying the FMR1 premutation, and hoped for a negative result. Being offered a genetic test caused women to pause and re-think their future reproductive plans. Husbands viewed the infertility journey as filled with unknowns, of which the genetic test results would be one more puzzle piece. The expense of fertility testing/treatment was mentioned by both spouses, though more notably by husbands. The introduction of a possible genetic cause of infertility, with additional potential health consequences for future biological children, caused women to re-think their quest for pregnancy. In contrast, the genetic test was viewed as an additional source of information for their husbands as opposed to raising concern regarding potential reproductive ramifications.     

Domain‐specific development of face memory but not face perception

How does the remarkable human ability for face recognition arise over development? Competing theories have proposed either late maturity (beyond 10 years) or early maturity (before 5 years), but have not distinguished between perceptual and memory aspects of face recognition. Here, we demonstrate a perception–memory dissociation. We compare rate of development for (adult, human) faces versus other social stimuli (bodies), other discrete objects (cars), and other categories processed in discrete brain regions (scenes, bodies), from 5 years to adulthood. For perceptual discrimination, performance improved with age at the same rate for faces and all other categories, indicating no domain‐specific development. In contrast, face memory increased more strongly than non‐face memory, indicating domain‐specific development. The results imply that each theory is partly true: the late maturity theory holds for face memory, and the early maturity theory for face perception.     

How Bad Can Good People Be?

Can a virtuous person act contrary to the virtue she possesses? Can virtues have “holes”—or blindspots—and nonetheless count as virtues? Gopal Sreenivasan defends a notion of a blindspot that is, in my view, an unstable moral category. I will argue that no trait possessing such a “hole” can qualify as a virtue. My strategy for showing this appeals to the importance of motivation to virtue, a feature of virtue to which Sreenivasan does not adequately attend. Sreenivasan’s account allows performance alone to be a reliable indicator of the possession of virtue. I argue that, at least with respect to a classical, Aristotelian conception of virtue, this assumption is mistaken: a person is said to possess a virtue only when she is properly motivated. In my view, the nature of motivation required for the possession of Aristotelian virtue does not admit of blindspots. I am not primarily interested in details about the situationist critique of virtue theory but rather the implications that blindspots have for our conception of virtue. I argue that because the practical reasoning of the virtuous requires both cognitive and motivational coherence, the motivational structure of the virtuous agent cannot accommodate blindspots. My conclusion is neither a defense of motivational internalism nor of an idealized conception of Aristotelian virtue. My aim is to show that because blindspotted virtue does not cohere well with Aristotle’s conception of virtuous agency, friends of virtue theory must choose one or the other; they cannot have both.