Recognizing social class in the psychotherapy relationship: a grounded theory exploration of low-income clients

The process of psychotherapy among 16 low-income clients was explored using grounded theory (Charmaz, 2006; Glaser & Strauss, 1967) in order to understand and identify their unique experiences and needs. Semistructured interviews were conducted with 12 women and 4 men who had attended at least 6 sessions of psychotherapy within 6 months of the interview. Our grounded theory that evolved depicted a tapestry of the dynamic process by which low-income clients experience social class within psychotherapy. Specific therapist behaviors that contribute to more and less positive experiences emerged from the data and pointed to the importance of acknowledging social class within the therapy room. The significance of therapists enhancing the 50-min hour via advocacy and meaningful moments within and outside of the therapy room was highlighted among all participants. Implications for practice with low-income clients and directions for future research are provided.     

Cognitive Development Masks Support for Attributional Style Models of Depression in Children and Adolescents

Attributional style models of depression in adults (Abramson et al. 1989, 1978) have been adapted for use with children; however, most applications do not consider that children's understanding of causal relations may be qualitatively different from that of adults. If children's causal attributions depend on children's level of cognitive development, then support for attributional models of depression in young people will vary with cognitive development. In this paper, a new measure of cognitive development, the Peabody Causal Reasoning Test (PCRT), is introduced to assess children's understanding of ability versus effort, task difficulty, and luck as causal factors. Analyses revealed that in 8- to 16-year-old children, failure to control for level of cognitive development suppressed empirical support for cognitive diathesis-stress models of depression. Statistically controlling for measures of cognitive development strengthened support for this model.     

Inappropriate and Excessive Guilt: Instrument Validation and Developmental Differences in Relation to Depression

Inappropriate or excessive guilt is listed as a symptom of depression by the American Psychiatric Association (1994). Although many measures of guilt have been developed, definitional and operational problems exist, especially in the application of such measures in childhood and adolescence. To address these problems, the current study introduces the Inappropriate and Excessive Guilt Scale (IEGS), assesses its validity for use with children and adolescents, and tests its relation to depression across development. From a sample of 370 children between 7 and 16 years old, results provided (1) evidence that items designed to assess inappropriate and excessive guilt converged onto a single underlying factor, (2) support for the convergent, discriminant, and construct validity of the IEGS in a general youth population, and (3) evidence of incremental validity of the IEGS over-and-above other measures of guilt. Results also supported the hypothesis that inappropriate and excessive guilt as well as negative cognitive errors become less normative and more depressotypic with age.     

Complexity of culture: the role of identity and context in bicultural individuals' body ideals

Culture plays an important role in shaping body image, and people from different cultures have different beliefs about what constitutes the "ideal" body type. This study examines the relationship between culture and body ideals in Asian-American and Black-American women. Results from two studies show that subjective cultural identity and situational cultural cues had different relationships with body ideals. Among Asian-American women, identification with Asian culture was related to a thinner body ideal, but exposure to Asian cultural cues (relative to American cultural cues) was related to a thicker body ideal. Among Black-American women, identification with Black culture was related to a thicker body ideal, but exposure to Black cultural cues (relative to American cultural cues) was related to a thinner body ideal. These results have theoretical and practical implications for understanding how internal and external manifestations of culture can differentially influence body image.     

Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age.

Meta-analyses support the effectiveness of behavioral interventions for the treatment of insomnia, although few have systematically evaluated the relative efficacy of different treatment modalities or the relation of old age to sleep outcomes. In this meta-analysis of randomized controlled trials (k = 23), moderate to large effects of behavioral treatments on subjective sleep outcomes were found. Evaluation of the moderating effects of behavioral intervention type (i.e., cognitive-behavioral treatment, relaxation, behavioral only) revealed similar effects for the 3 treatment modalities. Both middle-aged adults and persons older than 55 years of age showed similar robust improvements in sleep quality, sleep latency, and wakening after sleep onset. A research agenda is recommended to examine the mechanisms of action of behavioral treatments on sleep with increased attention to the high prevalence of insomnia in older individuals.     

Grasp force control in older adults

Diminished tactile sensibility and impaired hand dexterity have been reported for elderly individuals. Reports that younger adults with severely impaired tactile sensibility use excessive grasp force during routine grasp and manipulation tasks raise the possibility that elderly persons likewise produce large grasp forces that may contribute to impaired dexterity. Impaired pseudomotor functioning also occurs in elderly subjects and may yield a slipperier skin surface that enhances the possibility for excessive grasp force. The present study measured grasp force in 10 elderly and 9 young adult individuals, during grasp and vertical lift of a small object, using a precision (pinch) grip of the thumb and index finger. The slipperiness of the object's gripped surfaces was unexpectedly varied. Skin slipperiness was estimated by also measuring the grasp force at which the object slipped from grasp. The older subjects employed grasp forces that were, on average, twice as large as those of the young subjects, with some producing forces many times greater than the young subjects' average grip force. Grip forces also were significantly more variable across trials in older subjects. This increased variability was not caused simply by the elderly subjects' increased grip force. A portion of the increased force was due to increased skin slipperiness. The grip force that the elderly subjects produced in excess of the slip force (the "margin of safety" against object slippage) was larger than would have been predicted from their skin slipperiness, however. It is suggested that, in part, the excessive grasp forces represent a strategic response to tactile sensibility impairment. Twopoint discrimination limina in the older subjects averaged about four times greater than in the younger subjects. Increased grasp forces in elderly persons may result from other factors, such as increased variability in grip force production. The contributions of excessive grasp forces to impaired dexterity in older persons still need to be addressed experimentally.     

Bias in cross-sectional analyses of longitudinal mediation

Most empirical tests of mediation utilize cross-sectional data despite the fact that mediation consists of causal processes that unfold over time. The authors considered the possibility that longitudinal mediation might occur under either of two different models of change: (a) an autoregressive model or (b) a random effects model. For both models, the authors demonstrated that cross-sectional approaches to mediation typically generate substantially biased estimates of longitudinal parameters even under the ideal conditions when mediation is complete. In longitudinal models where variable M completely mediates the effect of X on Y, cross-sectional estimates of the direct effect of X on Y, the indirect effect of X on Y through M, and the proportion of the total effect mediated by M are often highly misleading.     

Functionalism and inverted spectra

Functionalism, a philosophical theory, has empirical consequences. Functionalism predicts that where systematic transformations of sensory input occur and are followed by behavioral accommodation in which normal function of the organism is restored such that the causes and effects of the subject's psychological states return to those of the period prior to the transformation, there will be a return of qualia or subjective experiences to those present prior to the transform. A transformation of this type that has long been of philosophical interest is the possibility of an inverted spectrum. Hilary Putnam argues that the physical possibilty of acquired spectrum inversion refutes functionalism. I argue, however, that in the absence of empirical results no a priori arguments against functionalism, such as Putnam's, can be cogent. I sketch an experimental situation which would produce acquired spectrum inversion. The mere existence of qualia inversion would constitute no refutation of functionalism; only its persistence after behavioral accommodation to the inversion would properly count against functionalism. The cumulative empirical evidence from experiments on image inversion suggests that the results of actual spectrum inversion would confirm rather than refute functionalism.     

Self‐Criticism as a Transdiagnostic Process in Nonsuicidal Self‐Injury and Disordered Eating: Systematic Review and Meta‐Analysis

Nonsuicidal self‐injury (NSSI) and disordered eating (DE) are highly comorbid and may be regarded as belonging to a spectrum of self‐harm behaviors. We investigated self‐criticism as a transdiagnostic correlate of these behaviors, in keeping with etiological theories of both NSSI and DE. We reviewed the literature and meta‐analyzed the relation of self‐criticism to both NSSI (15 studies; 17 effect sizes) and DE (24 studies; 29 effect sizes). Results showed equivalent, moderate‐to‐large effects for the relation of self‐criticism to NSSI (r = .38; CI: .29–.46) and DE (r = .40; CI: .34–.45). The relation of NSSI to self‐criticism generalized across multiple potential moderators. DE behavior type moderated the relation of self‐criticism to DE, with a stronger relation emerging for purging than restriction. Findings support self‐criticism as a possible candidate for transdiagnostic pathways to self‐harm.     

Individual differences in the emergence of depressive symptoms in children and adolescents: a longitudinal investigation of parent and child reports

The authors address questions about the rate that depressive symptoms emerge, developmental and gender differences in this rate, and differences between parent and child estimates of this rate. In a 12-wave, cohort-sequential, longitudinal design, 1,570 children (Grades 4-11) and parents completed reports about children's depression. Cross-domain latent growth curve analysis revealed that (a) the rate of symptom growth varied with developmental level. (b) gender differences symptom growth preceded emergence of mean level gender differences, (c) the rate of symptom development varied with age, and (d) parent-child agreement about rate of symptom change was stronger than agreement about time-specific symptoms. The authors suggest that predictability of depressive symptoms varies with age and the dimension under investigation.