High Behavioral Approach System (BAS) sensitivity, reward responsiveness, and goal-striving predict first onset of bipolar spectrum disorders: a prospective behavioral high-risk design

A prospective, behavioral high-risk design provided a theoretically guided examination of vulnerability to first onset of bipolar spectrum disorder based on the Behavioral Approach System (BAS) model. Adolescents (ages 14-19) at an "age of risk" for bipolar disorder onset were screened on BAS sensitivity by interviewers blind to current symptoms, lifetime history, and family history of psychopathology. Participants were selected with high versus moderate levels of BAS sensitivity and administered a lifetime diagnostic interview. Those with a bipolar spectrum disorder, psychosis, or hypomanic episode with onset prior to the BAS sensitivity assessment were excluded. High BAS (n = 171) and moderate BAS (n = 119) sensitivity participants in the final sample completed baseline measures of symptoms, goal-setting, and reward responsiveness and were followed prospectively with semistructured diagnostic interviews every 6 months. Consistent with the vulnerability hypothesis of the BAS model of bipolar disorder, high BAS participants had a greater likelihood, and shorter time to onset, of bipolar spectrum disorder than moderate BAS participants across an average of 12.8 months of follow-up (12.9% vs. 4.2%), controlling for baseline depressive and hypomanic symptoms, and family history of bipolar disorder. High reward responsiveness on a behavioral task and ambitious goal-striving for popular fame and financial success (but not impulsivity) also predicted first onset of bipolar spectrum disorder controlling for the covariates and BAS risk group, and ambitious goal-striving partially mediated the BAS risk group effect. We discuss implications of the findings for the BAS model of bipolar disorder and early intervention efforts.     

Deconstructing the age-prevalence curve of alcohol dependence: why "maturing out" is only a small piece of the puzzle

Epidemiological studies have consistently demonstrated that heavy alcohol use and alcohol dependence (AD) tend to increase in adolescence and emerging adulthood and then show a large decline in the late 20s, a phenomenon called maturing out. This decline has been explained as an effect of "role incompatibility" in which involvement in new roles and activities interferes with a heavy drinking lifestyle. However, maturing out has been conceived mostly as a decrease in offset, with little attention paid to reductions in new onset or recurrence across decades of life. Moreover, although role incompatibility processes have been studied with young samples, little is known about the effect of life transitions (e.g., marriage, parenthood, changes in employment status) on AD later in life and whether similar effects are observed. Using longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative epidemiologic survey, we examined the patterns of stability and change in AD across the life span and the differential effect of life transitions on AD across different age strata. Results showed that persistence of AD tended to increase with age, although not dramatically, and that onset and recurrence tended to decrease with age. Moreover, the effects of life transitions on the course of AD varied across the life span and were different for men and women. These results indicate that life transitions differentially affect the patterns of stability and change in younger versus older people, have a different impact for men and women, and highlight the need to consider the unique aspects of each stage of adult development on the course of AD.     

An invariant dimensional liability model of gender differences in mental disorder prevalence: evidence from a national sample

Epidemiological studies of categorical mental disorders consistently report that gender differences exist in many disorder prevalence rates and that disorders are often comorbid. Can a dimensional multivariate liability model be developed to clarify how gender impacts diverse, comorbid mental disorders? We pursued this possibility in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 43,093). Gender differences in prevalence were systematic such that women showed higher rates of mood and anxiety disorders, and men showed higher rates of antisocial personality and substance use disorders. We next investigated patterns of disorder comorbidity and found that a dimensional internalizing-externalizing liability model fit the data well, where internalizing is characterized by mood and anxiety disorders, and externalizing is characterized by antisocial personality and substance use disorders. This model was gender invariant, indicating that observed gender differences in prevalence rates originate from women and men's different average standings on latent internalizing and externalizing liability dimensions. As hypothesized, women showed a higher mean level of internalizing, while men showed a higher mean level of externalizing. We discuss implications of these findings for understanding gender differences in psychopathology and for classification and intervention.     

The ontological distinction between units and entities

The base units of the SI include six units of continuous quantities and the mole, which is defined as proportional to the number of specified elementary entities in a sample. The existence of the mole as a unit has prompted comment in Metrologia that units of all enumerable entities should be defined though not listed as base units. In a similar vein, the BIPM defines numbers of entities as quantities of dimension one, although without admitting these entities as base units. However, there is a basic ontological distinction between continuous quantities and enumerable aggregates. The distinction is the basis of the difference between real and natural numbers. This paper clarifies the nature of the distinction: (i) in terms of a set of measurement axioms stated by H?lder; and (ii) using the formalism known in metrology as quantity calculus. We argue that a clear and unambiguous scientific distinction should be made between measurement and enumeration. We examine confusion in metrological definitions and nomenclature concerning this distinction, and discuss the implications of this distinction for ontology and epistemology in all scientific disciplines.     

Is objectification always harmful? Reactions to objectifying images and feedback as a function of self-objectification and mortality salience

From the perspective of terror management theory, awareness of death induces a need for validation of important values. Thus, for women who place a high value on their appearance (e.g., high self-objectifiers), mortality salience should increase positive reactions to objectifying experiences relative to women who do not highly value appearance. Two studies supported this hypothesis. Self-objectification moderated favorable reactions to objectifying stimuli (Study 1) and state self-esteem in response to an objectifying comment (Study 2) when women were primed with death. Together, the studies illustrate the complexity of reactions to objectification and, by highlighting conditions in which objectification serves a psychological function, help to explain the pervasiveness of the phenomena.     

Clinical Reflection and Ritual as Forms of Participation and Interaction: Reply to Bass and Stern

We agree with the commentaries that Relational psychoanalysis has stood firmly against dichotomizing clinical reflection, on one hand, and interactional processes, on the other. Still, we wonder whether the relational literature has skewed toward interaction at the expense of concentrated attention to patients’ internal worlds. Predispositions toward interaction may diminish reflective space and quiet inwardness, which are themselves forms of analytic relating. We raise the possibility that the Relational model’s inclusive breadth, valuable as it is, might sometimes impede and even devalue discussions of specific technical matters. We consider clinical conceptualizations of ritual, “relating,” and “being in contact.”     

Promoting spiritual well-being: a quasi-experimental test of an element of Hay and Nye’s theory of children’s spirituality

This study is one of the first tests of key implicit claims of Hay and Nye’s theory of children’s spirituality and spiritual development. Two quasi-experimental studies tested two claims: that exposure to six conditions posited as fostering relational consciousness in a programme of spiritual formation promotes spiritual well-being; that the effect of the conditions continues after exposure ends. The results for Study One revealed that length of exposure to any of the six conditions was not a significant predictor of spiritual well-being, F(3, 179)?=?1.49, p = 0.22. Study Two results indicated that as the length of time since exposure increased so did spiritual well-being, r(38)?=?0.39, p = 0.01 at the bivariate level, and F(4, 35)?=?2.4, p = 0.06 in the regression. These results reveal a possible relationship between exposure to the six conditions and spiritual well-being.