Futility in Chronic Anorexia Nervosa: A Concept Whose Time Has Not Yet Come

Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa (AN). A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity in this serious mental illness. Parallels between the futility disputes in medical and psychiatric disorders, where applicable, will be drawn to further illuminate whether or not the concept that continued psychiatric treatment for AN is ever truly futile.     

Exploring the Relationship Between Religious Coping and Spirituality Among Three Types of Collegiate Substance Abuse

Religion and spirituality are protective factors against collegiate substance abuse; however, considering the variance among different types of drug abuse is important. We investigated religious coping and spirituality in relation to hazardous drinking, marijuana use, and psychostimulant use. Results indicated that positive religious coping and several dimensions of spirituality protect against hazardous drinking and marijuana use. Furthermore, differences in religious coping and spirituality may not exist between groups of psychostimulant users.     

Blessed be the Children: A Case–Control Study of Sexual Abusers in the Catholic Church

Individuals working in churches and other youth-serving institutions have a unique level of access to children, yet the problem of sexual abuse in institutional settings has received scant research attention. To address this gap, we analyzed data from a large sample of clergy (N = 1,121) and applied a social–ecological model of offending to identify risk factors for sexual abuse perpetration. Using a case–control study design that compared clergy sexual abusers with three control groups of clergy, this study focuses specifically on individual-, relationship-, and community-level factors associated with a higher risk of abuse in professional populations. Findings revealed that clergy sexual abusers tended to have more truncated pre-seminary dating histories, and that their dating and sexual partners were more likely to have been male than female. Self-reported sexual abuse history was associated with a greater likelihood of sexual abuse perpetration among clergy. Clergy abusers tended to be more involved with youth and adolescents in their ministries; however, they were observed to relate less well to youth and adolescents than their clergy counterparts. Given widespread changes in our cultural understanding of abuse as well as more specific changes in the organizational approach to seminary education, these differences underscore the role that youth-serving institutions and society can have in the primary prevention of child sexual abuse. Copyright © 2015 John Wiley & Sons, Ltd.     

Views of a good life and allostatic load: Physiological correlates of theories of a good life depend on the socioeconomic context

This research examines the relationship between one’s theory of a good life and allostatic load, a marker of cumulative biological risk, and how this relationship differs by socioeconomic status. Among adults with a bachelor’s degree or higher, those who saw individual characteristics (e.g. personal happiness, effort) as part of a good life had lower levels of allostatic load than those who did not. In contrast, among adults with less than a bachelor’s degree, those who saw supportive relationships as part of a good life had lower levels of allostatic load than those who did not. These findings extend past research on socioeconomic differences in the emphasis on individual or relational factors and suggest that one’s theory of a good life has health implications.     

The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research

Background and Objectives: Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Design and Methods: Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Results: Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. Conclusions: This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.     

I owe you: age-related similarities and differences in associative memory for gains and losses

Older adults often experience associative memory impairments but can sometimes remember important information. The current experiments investigate potential age-related similarities and differences associate memory for gains and losses. Younger and older participants were presented with faces and associated dollar amounts, which indicated how much money the person “owed” the participant, and were later given a cued recall test for the dollar amount. Experiment 1 examined face-dollar amount pairs while Experiment 2 included negative dollar amounts to examine both gains and losses. While younger adults recalled more information relative to older adults, both groups were more accurate in recalling the correct value associated with high-value faces compared to lower-value faces and remembered gist-information about the values. However, negative values (losses) did not have a strong impact on recall among older adults versus younger adults, illustrating important associative memory differences between younger and older adults.     

Child and Family Emotional Functioning: A Cross-National Examination of Families from China and the United States

Scant research has examined links between particular emotion socialization processes and child emotion functioning cross-nationally. In this study, we assessed a sample of 55 families from the United States (U.S.; 28 boys and 27 girls) and 49 families from China (27 boys and 22 girls) on family emotional expressiveness and children’s emotional experiences and regulation. Results indicated that children and families from the U.S. reported greater emotional expressiveness than their Chinese counterparts. Children from the U.S. also reported greater undercontrolled emotion than Chinese youth. Family expression of positive emotion was related to effortful emotion regulation in U.S. youth only, whereas family expression of negative emotion was associated with undercontrolled emotion for both U.S. and Chinese children. Our findings advance context-specific models of emotional development by illustrating similarities and differences in emotional functioning among U.S. and Chinese families. From a clinical perspective, the findings suggest that practitioners should consider the cultural variations of emotion communication within families when conducting both assessment and therapy.     

Review of State Medication Policies/Guidelines Regarding Psychotropic Medications in Public Schools

It is currently estimated that up to 6 million children take psychotropic medications for the treatment of mental health problems. The highest prevalence rates (50–76 %) are typically found among students with special needs, especially among those with ADHD and emotional disturbance. The Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 require medications be administered by schools whenever it is deemed necessary for the child to have access to educational services. However, these requirements do not extend to all students, nor do they provide guidance regarding the safest and most efficacious manner in which psychotropic medications should be administered. The authors reviewed existing state medication policies and guidelines to assess the level of guidance currently provided to school staff. Results showed the vast majority of states (48) provided guidance related to the administration of medications to students, with slightly fewer (44) states discussing required documentation procedures. Surprisingly, only 15 states addressed monitoring students for adverse side effects of medications, and even fewer (11) states specifically discussed psychotropic medication in their policies/guidelines. The vast majority (42) of states also addressed requirements for the safe and proper storage of medications, while slightly more than half of all states (31) provided any guidance regarding training of unlicensed personnel (e.g., secretaries) who frequently administer medications to students. The authors highlight several model guidelines/policies and review recommendations for best practice.