The analyst's participation: a new look

Over the past fifteen years or so, advocates of a relational theory of psychoanalytic process have developed a compelling challenge to the classical approach to clinical work. Their critique of a fixed "standard technique," applicable across the board to all analyzable patients, has been particularly effective. The new approach opens the possibility of tailoring technique to individual analysands, negotiating the best way of working within each unique analytic dyad. But despite the openness of relational theory, many of the most influential clinical vignettes in the recent literature emphasize the analyst's risk-taking, engaging patients in a highly personal way that breaks the traditional analytic frame. Various implications of the tendency of relational analysts to emphasize this sort of intervention are discussed, and questions raised about the way this may affect how relational thinking is received.     

Alcohol consumption, drinking patterns, and alcohol problems among managerial versus non-managerial women and men

In the present study, we examined alcohol consumption and alcohol problems between managerial and nonmanagerial men and women. We also examined alcohol problems as a function of drinking context (i.e., when they drink and with whom they drink) for each of these four groups. Survey data and data from company records were collected from a large sample of blue and white collar employees (n = 2279). Participants completed a detailed questionnaire aimed at assessing many work-related attitudes, general mental and physical health-related perceptions, motivations for alcohol use, alcohol consumption indices, and alcohol problems. We found that several of the demographic variables differentially predicted alcohol consumption and problems for the four groups. In addition, drinking alone and immediately after work were associated with alcohol problems for women managers at a significantly higher rate than for the other groups of employees. These results support the assertion that more complex models are needed to understand the linkages between work and alcohol use. The research reported in this paper was supported by Grant AA 10690-02, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health.     

Neuropsychological characteristics and test behaviors of boys with early onset conduct problems.

School-age children and adolescents with conduct problems typically exhibit deficits in verbal IQ, language abilities, and executive functions. This study examined the extent to which this pattern was evident in a clinic group of preschool boys with early onset conduct problems who met criteria for oppositional defiant disorder (ODD) with and without attention deficit hyperactivity disorder (ADHD). A 2nd question focused on the strength of relation between clinic boys' uncooperative or inattentive test behaviors and their test performance. As expected, the clinic boys showed a neuropsychological profile highly similar to the one found in older conduct problem populations. Verbal tests distinguished clinic from matched comparison boys even after controlling for observers' ratings of disruptive behavior during testing. Clinic boys with ODD and ADHD had lower verbal and executive function scores than clinic boys with ODD alone. After general vocabulary knowledge and test behavior were controlled, clinic boys were found to have poorer vocabularies for describing affective states than comparison group boys.     

Understanding of Genetic Inheritance among Xhosa-Speaking Caretakers of Children with Hemophilia

Hemophilia A and B are X-linked recessive inherited bleeding disorders that have a profound impact on the family of affected individuals. Education is vital to enable women to appreciate the implications of being a carrier and the implications for a prospective child. Prior research has shown that cultural, socio-economic and linguistic issues in South Africa are major barriers to communication for first-language Xhosa-speakers. This exploratory study aimed to investigate the basic knowledge of genetic inheritance among this cultural group in order to promote culturally-sensitive, effective genetic counseling. Ten in-depth interviews were conducted with Xhosa-speaking mothers or caregivers of boys with hemophilia. Results suggest that the participants had a very limited understanding of the clinical management, genetic consequences and cause of hemophilia. While treatment and care by health care service providers was fully accepted, several participants believed that traditional methods would provide them with more satisfactory explanations. These findings suggest that there is a critical need for socio-culturally tailored, language-specific education for families with hemophilia.     

Trends in Telehealth versus On-site Clinical Genetics Appointments in Manitoba: A Comparative Study

Telehealth involves the use of information and communications technology to deliver health services to patients over distance. Canada is well suited to benefit from telehealth since many individuals live in remote, rural and isolated locations. Manitoba is the easternmost prairie province and MBTelehealth is an active Canadian program that currently has 105 sites in 73 communities. Although studies of patient satisfaction comparing telehealth to on-site clinical visits have been conducted, a comparative study of the types of genetics patients seen via these two modalities has not been performed previously. In this study we: (1) examined the uptake of telehealth in Genetics in Manitoba; (2) contrasted telehealth usage in Genetics with other clinical programs; and (3) performed a comparative study of the types of Genetics referrals seen in 2008 on-site versus via telehealth. Results indicate the uptake of telehealth is increasing and has made genetics outreach clinics unnecessary. The Program of Genetics and Metabolism is consistently one of the top ten utilizers of telehealth within the province. With respect to discipline, chi square analysis revealed the trends were not significantly different for on-site and telehealth encounters, with prenatal referrals being the most common and Hereditary Breast and Ovarian Cancer referrals being the least common. Referrals within each discipline varied depending on the need for fetal assessment and physical examination. Telehealth was utilized regularly for test results sessions across all disciplines.     

Rewards and creative performance: a meta-analytic test of theoretically derived hypotheses

Although many scholars and practitioners are interested in understanding how to motivate individuals to be more creative, whether and how rewards affect creativity remain unclear. We argue that the conflicting evidence may be due to differences between studies in terms of reward conditions and the context in which rewards are offered. Specifically, we examine 5 potential moderators of the rewards-creative performance relationship: (a) the reward contingency, (b) the extent to which participants are provided information about their past or current creative performance, (c) the extent to which the reward and context offer choice or impose control, (d) the extent to which the context serves to enhance task engagement, and (e) the extent to which the performance tasks are complex. Using random-effects models, we meta-analyzed 60 experimental and nonexperimental studies (including 69 independent samples) that examined the rewards-creativity relationship with children or adults. Our results suggest that creativity-contingent rewards tend to increase creative performance-and are more positively related to creative performance when individuals are given more positive, contingent, and task-focused performance feedback and are provided more choice (and are less controlled). In contrast, performance-contingent or completion-contingent rewards tend to have a slight negative effect on creative performance.     

Six-Year Sustainability of Evidence-Based Intervention Implementation Quality by Community-University Partnerships: The PROSPER Study

There is a knowledge gap concerning how well community-based teams fare in implementing evidence-based interventions (EBIs) over many years, a gap that is important to fill because sustained high quality EBI implementation is essential to public health impact. The current study addresses this gap by evaluating data from PROSPER, a community-university intervention partnership model, in the context of a randomized-control trial of 28 communities. Specifically, it examines community teams' sustainability of implementation quality on a range of measures, for both family-focused and school-based EBIs. Average adherence ratings approached 90% for family-focused and school-based EBIs, across as many as 6 implementation cohorts. Additional indicators of implementation quality similarly showed consistently positive results. Correlations of the implementation quality outcomes with a number of characteristics of community teams and intervention leaders were calculated to explore their potential relevance to sustained implementation quality. Though several relationships attained statistical significance at particular points in time, none were stable across cohorts. The role of PROSPER's continuous, proactive technical assistance in producing the positive results is discussed.     

Maternal Depressive Symptoms and Child Social Preference During the Early School Years: Mediation by Maternal Warmth and Child Emotion Regulation

This longitudinal study examined processes that mediate the association between maternal depressive symptoms and peer social preference during the early school years. Three hundred and fifty six kindergarten children (182 boys) and their mothers participated in the study. During kindergarten, mothers reported their level of depressive symptomatology. In first grade, teachers rated children’s emotion regulation at school and observers rated the affective quality of mother-child interactions. During second grade, children’s social preference was assessed by peer nomination. Results indicated that mothers’ level of depressive symptomatology negatively predicted their child’s social preference 2 years later, controlling for the family SES and teacher-rated social preference during kindergarten. Among European American families, the association between maternal depressive symptoms and social preference was partially mediated by maternal warmth and the child’s emotion regulation. Although the relation between maternal depressive symptoms and children peer preference was stronger among African American families than Europrean American families, its mediation by the maternal warmth and child’s emotion regulation was not found in African American families.