The development and content of an interpersonal psychotherapy group for postnatal depression

Postnatal depression (PND) usually causes distressing symptoms for sufferers and significant impairments in relationships. Group Interpersonal Psychotherapy (IPT-G) provides the experienced therapist with a brief, focused, and manualized approach to helping women recover from the debilitating effects of PND. This paper describes the background and development of IPT-G for PND. The evidence for the effectiveness of individual and group IPT formats with this population is summarized. The triad of theories underpinning IPT are discussed with an emphasis on the important role of attachment styles during the transition to parenthood. Its strengths, which include its unique package of targets, tactics, and techniques, are highlighted. The benefits and challenges of IPT-G are also explored, and the results of a randomized controlled trial are summarized. Finally, a case study illustrates how IPT-G specifically addresses the social role transitions, conflicts, losses, and social isolation that mothers commonly experience.     

Parent-directed cognitive behavioral therapy for young anxious children: a pilot study

Anxiety in children age 8 years and above has been successfully treated with cognitive behavioral therapy (CBT). However, the efficacy of CBT for anxious children ages 4-7 years has not, to date, been fully investigated. This paper piloted a CBT intervention targeting child anxiety that was delivered exclusively to parents of 26 children with anxiety symptoms ages 4-7 years. The intervention consisted of four 2-hour group sessions of four to six parents (couples). These group sessions were followed by four individual telephone sessions, once per week across a 4-week period. The pre- and postintervention assessment involved measures of multiple constructs of child anxiety (anxiety symptoms, children's fears, behavioral inhibition, and internalizing symptoms) from multiple informants (parents, children, and teachers). Parents also reported parenting strategies they were likely to use to manage their children's anxiety pre- and postintervention. Results indicated a significant decrease in child anxiety and behavioral inhibition as reported by parents and teachers. Furthermore, mothers reported significant increases in their use of positive reinforcement, and modeling and reassurance, and a significant decrease in their use of reinforcement of dependency directly after treatment. Taken together, parent-directed CBT appears to be an effective approach for treating children ages 4-7 years with anxiety symptoms. Limitations of the current research are discussed.     

The Miscarriage Experience: More Than Just a Trigger to Psychological Morbidity?

Most quantitative research considers miscarriage a trigger to grief, anxiety and depression. The present qualitative study involved in depth interviews with a heterogeneous sample of 13 women who had experienced a miscarriage up to five weeks previously. The women described their experiences using a range of themes which were conceptualised into three stages: turmoil, adjustment and resolution. For the majority, the turmoil stage was characterised by feelings of being unprepared and negative emotions. Some women who had had an unwanted pregnancy described their shock at the physical trauma of miscarriage but described the experience as a relief. The women then described a period of adjustment involving social comparisons, sharing and a search for meaning. The latter included a focus on causality which left a minority, particularly those who had had previous miscarriages, feeling frustrated with the absence of a satisfactory medical explanation. The final resolution stage was characterised by a decline in negative emotions, a belief by some that the miscarriage was a learning experience and the integration of the experience into their lives. This resolution seemed more positive for those with children and more negative if the miscarriage was not their first. Rather than being a trigger to psychological morbidity a miscarriage should be conceptualised as a process involving the stages of turmoil, adjustment and resolution. Miscarriage could also be considered a pivotal point in the lives of many women resulting in the reassessment of both their past and future experiences.     

Parenting and the dysregulation profile predict executive functioning in children with acquired brain injury

Background: Children with acquired brain injury (ABI) present with high rates of psychological disorders commonly accompanied by deficits in hot and cold executive functions (EFs). Impairments in EFs have been reported to precede mental health problems. Moreover, children who are vulnerable to developing mental health problems in adulthood frequently present with a dysregulation profile in childhood, characterized by impairments in cognitive, behavioral and emotional regulation. Objective: To identify profiles of behaviors associated with impairment in hot and cold EFs and compare injury factors, environmental stressors and dysregulation profile between them. Methods: A latent profile analysis was conducted with 77 children with ABI aged between 6 and 12. Injury factors, child IQ, environmental stressors and the dysregulation profile were compared between these behavioral profiles. Logistic regressions were conducted to predict profile membership. Results: Two profiles were identified: Profile M, with mild deficits (1–2 SD above the mean) in working memory and social skills, and profile C, presenting clinically significant deficits (2–3 SD above the mean) in shift, initiate, working memory, planning and social skills and mild deficits in inhibit, emotional control and task monitor. Proximal environmental stressors (dysfunctional parenting practices, parental stress, parent’s executive dysfunction, anxiety-trait, and depressive symptoms) and dysregulation symptoms predicted profile membership, whereas injury factors, child IQ and distal environmental stressors did not. Conclusion: Following ABI, children with profile C are at risk of mental health problems and present with more proximal stressors. The dysregulation profile may be useful as a proxy for risk for later mental health problems in children with ABI.     

The Role of Self-Compassion in Physical and Psychological Well-Being

The relation of self-compassion to physical and psychological well-being was investigated among 182 college students. The self-compassion scale was delineated into three composites, following the proposition by Neff that self-compassion consists of three main components: self-judgment versus self-kindness (SJ–SK), a sense of isolation versus common humanity (I–CH), and over-identification versus mindfulness (OI–M). Findings support the association between self-compassion and psychological and physical well-being, but the composites demonstrate different influences. SJ–SK and I–CH were predictive of both depressive symptomatology and physical well-being, and SJ–SK and OI–M were predictive of managing life stressors. The results of this study support and expand prior research on self-compassion.     

Perception—Action Coupling during Bimanual Coordination: The Role of Visual Perception in the Coalition of Constraints That Govern Bimanual Action

Constraints pertaining to interlimb coordination have been studied extensively in the past decades. In this debate, F. Mechsner (2004) has taken a provocative position by putting primary emphasis on perceptual principles that mediate coordinative stability. Whereas the present authors agree that the role of perceptual principles is of critical importance during coordination, they take issue with Mechsner's extreme position and with the evidence forwarded to support a purely perceptual-cognitive approach to bimanual coordination. More specifically, the authors emphasize that current knowledge about brain function argues against a dualism between perception and action, criticize the presented evidence that posture manipulations during coordination provide decisive evidence against motoric and muscular constraints, and report on potential pitfalls associated with the use of visual transformation procedures to support complex coordination patterns.     

Notes on unintegration and disintegration from historical and developmental perspectives

Frances Tustin: Autistic States in Children, Published by Routledge and Kegan Paul Ltd. 1981 Price £12.50.

B.A. Farrell The Standing of Psycho-Analysis Published by Oxford University Press. 1981. Price £3.95.

Helen Featherstone: A Difference in the Family. Life with a Disabled Child. Published by Basic Books Inc. 1980.

Martin Richards: Infancy. World of the Newborn. The Life Cycle Series. Published by Harper &; Row. 1980. Price £2.25 (paperback).

Jerome Bruner: Under fives in Britain. Published by Grant McIntyre. 1980. £10.95 (hardback), £4.50 (paperback).     

Transformative Experience of Master of Occupational Therapy Students in a Non-traditional Fieldwork Setting

The purpose of this qualitative pilot study is to further understand the transformative experiences of Master of Occupational Therapy students who engaged in a role emerging fieldwork. Five students were interviewed and their reflective journals were analyzed following a fieldwork experience at an at-risk youth shelter. Four themes emerged through the coding process: fear and anxiety of the unknown, clinical reasoning and self-reflection, personal and professional growth, and further understanding of occupational therapy. Results indicate the powerful impact of role emerging fieldwork on the development of the student and provide a framework for meeting the standards of psychosocial fieldwork experiences.     

The Role of Childhood Neglect and Childhood Poverty in Predicting Mental Health, Academic Achievement and Crime in Adulthood

This study examines the roles of childhood neglect and childhood poverty (family and neighborhood) in predicting Posttraumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), academic achievement, and crime in young adulthood. Using existing data from a prospective cohort design study, 1,005 children with documented histories of neglect (N = 507) and matched controls (N = 497) were interviewed in young adulthood (mean age 29). Official criminal histories were also used to assess outcomes. Data were analyzed using logistic and ordinary least squares regressions and hierarchical linear modeling (HLM) to control for neighborhood clustering. Results from HLM revealed that childhood neglect and childhood family poverty uniquely predicted PTSD and adult arrest, MDD was predicted only by childhood family poverty, and a significant interaction between childhood family poverty and childhood neighborhood poverty predicted academic achievement for the control group only. Childhood neglect, childhood family poverty, and childhood neighborhood poverty each contribute to poor outcomes later in life. While interventions should be developed for neglected children to prevent negative outcomes, the current findings suggest that it is also important to consider the ecological context in which these children are growing up.