Attachment and Affect between Mothers with Depression and their Children: Longitudinal Outcomes of Child Parent Psychotherapy

The present investigation examined the longitudinal effects of Child-Parent Psychotherapy (CPP) for toddlers and their mothers with depression on: a) maternal affective expression, b) child affective expression, and c) mother-child cohesion. Mothers with depression (M_age?=?31.7 years; 92.8% White, 3.5% Black, 2.1% Hispanic, 2.3% other) and their toddlers were randomized to receive CPP (DI; n?=?66) or to a control group (DC; n?=?64). Mothers without depression and their toddlers (NC; n?=?68) were recruited as an additional comparison group. Dyads were assessed at baseline (T1; 20 months old), post-intervention (T2; 36 months old), and follow-up (T3; 9 years old). Data from a mother-child conflict task was coded as a measure of observed outcome variables. Change in post-intervention attachment security assessed via the Strange Situation was evaluated as a mediator between intervention condition and maternal and child affective expression and dyadic cohesion at T3. Change to secure attachment post-intervention significantly mediated the association between intervention condition and T3 maternal warmth and child anger/problem behavior. Toddlers of mothers with depression who received CPP showed higher rates of change to secure attachment compared to those in both the DC and NC groups. Dyads who changed to secure attachment at T2 displayed higher levels of maternal warmth at T3 and lower levels of child anger and problem behavior at T3. Implications for the use of CPP as a preventive intervention and the importance of attachment as a mediator of long-term outcomes are discussed.

     

Attention and executive functioning profiles in children following perinatal arterial ischemic stroke

Perinatal arterial ischemic stroke (PAIS) is a form of childhood stroke; the majority of those affected experience neurologic sequelae, including motor, language and neurocognitive impairments. This study examines the attention and executive functioning (EF) profiles of children following PAIS, as well as the impact of age and sex. In this single-center cross-sectional study, 40 children aged 3 to 16 years (median age 7.2 years; 58% male) who have suffered a PAIS underwent a comprehensive neuropsychological battery to assess attention and EF. Parents completed behavioral questionnaires regarding real-world functioning. Composite scores were calculated for seven attention and EF domains (Attention, Working Memory, Verbal Retrieval, Inhibitory Control, Flexibility/Shifting, Planning/Organization, and Processing Speed). The results for all measured domains of attention and EF are significantly lower in the participants compared to the normative samples (p < .001), with the exception of Working Memory. However, increasing difficulty with Working Memory is associated with developing age. Older age at time of testing is also associated with a higher incidence of clinically-elevated attention deficit hyperactivity disorder (ADHD) symptoms. Sex is not associated with performance measures or parental report of functioning. The participants demonstrate mild-to-moderate attention and EF impairment compared to the normative population. Clinicians, families, and educators should be informed about the neurocognitive sequelae of PAIS and the need for close developmental surveillance in this population to identify vulnerable children and initiate appropriate therapeutic interventions in a timely fashion.     

Biological attributions for postdeployment distress relate to higher likelihood of seeking mental health treatment in Iraq/Afghanistan service members/veterans

Service members/veterans (SM/Vs) underuse mental health care. Attribution theory suggests that attributions for psychological distress might inform help-seeking. Given recent mental health campaigns leveraging military values aimed at facilitating help-seeking for postdeployment distress, understanding how SM/Vs explain psychological distress may contribute to a better grasp of the low help-seeking rate in this population. The authors examined the association of biological and psychological attributions for postdeployment distress with help-seeking intentions from a mental health professional and medical doctor in 162 Iraq/Afghanistan SM/Vs. At the bivariate level, biological attributions were positively associated with help-seeking intentions from a mental health professional and medical doctor with small effect sizes. Psychological attributions were unrelated to help-seeking intentions from either provider. Path analysis revealed that biological attributions were positively correlated with help-seeking intentions from a medical doctor with a small effect size above and beyond the effects of psychological attributions and correlates. Biological attributions were also positively correlated with help-seeking intentions from a mental health professional with a small effect size but the significance value only trended toward significance (p = .06). Emphasizing the role of biology in postdeployment distress may promote help-seeking in SM/Vs, particularly help-seeking from medical professionals. Interventions that test the effectiveness of promoting biological explanations in campaigns aimed at increasing help-seeking may be a necessary next step in this area of inquiry.     

Desiring Castration: A Reformulation of Castration Theory Illustrated with a Transgender Case

ABSTRACT

This article reviews Freud’s theory of castration, as well as critiques of the theory. I then offer my own elaboration of castration theory, proposing that castration fantasies are universal and refer to a sense of incompleteness—about the body as well as psychic attributes—in both males and females. Such fantasies, I argue, deal with the gap between what one is and what one would like to be and are frequently expressed in envy toward perceived privileges belonging to persons of the opposite sex, same sex, and different generation. Furthermore, these fantasies are intimately tied to object relations. A case of a transgender male who desired castration is presented to illustrate this expanded theory and its usefulness.     

Integrating Internal Family Systems and Solutions Focused Brief Therapy to Treat Survivors of Sexual Trauma

In a recent study 56% of women and 37% of men were survivors of childhood sexual abuse. These individuals who experience sexual trauma may experience depression, anxiety, post-traumatic stress disorder (PTSD) or substance use disorders (Devlin et al., in Fam J 27(4):359–365, 2019). While there are several treatment approaches specifically developed to target trauma and its effects, (e.g., trauma focused cognitive behavioral therapy, and eye movement desensitization and reprocessing) we propose that integrating internal family systems therapy (IFS) and solution focused brief therapy (SFBT) offers a brief, systemic way to improve family relationship patterns in families where one member has experienced sexual trauma. A case vignette is used to show the integration of these two approaches.

     

COVID-19 Adaptations for Health Service Psychology Internship Training in a Medical School

Health service psychology internship directors confronted a myriad of training challenges in response to the COVID-19 pandemic. Specifically, internship training directors were tasked with ensuring that interns received appropriate training in each of the nine profession-wide competency (PWCs) areas while also ensuring the physical and emotional well-being of staff and trainees. The purpose of this paper is to describe one internship’s approach to adapting the nine PWCs during COVID-19 in the context of an academic medical setting. Successes and challenges associated with training adaptations in the context of each of the nine PWCs will be shared along with considerations for improving academic medical training programs’ ability to support interns’ educational goals and training requirements throughout and following the COVID-19 pandemic.

     

Overlap of phonetic features as a determinant of the between-stream phonological similarity effect

Serial recall from working memory is known to be impaired by the presence of irrelevant background speech, but several prior studies have concluded that the magnitude of the impairment is independent of the phonological relationship between to-be-remembered (TBR) and to-be-ignored (TBI) sources of information. In the present study, we examined the influence of between-stream phonological similarity in serial recall while attending to a heretofore uncontrolled variable, the phonetic feature. We found that TBI items sharing many phonetic features with TBR items produced significantly stronger working-memory impairments than TBI items with minimal phonetic feature overlap. In addition, participants were more likely to report remembering incorrect items that incorporated phonological characteristics of the TBI stream in the high-overlap condition. These findings provide evidence for subphonemic between-stream interactions and suggest that multiple parallel processes contribute to the irrelevant speech effect. We propose that a 2-component model, which combines the assumptions of process- and content-based accounts for the irrelevant speech effect, offers the best explanation for these findings.     

Internet gambling, substance use, and delinquent behavior: an adolescent deviant behavior involvement pattern

Internet gambling among adolescents is a growing phenomenon that has received little attention to date. This study examines associations between Internet gambling and the severity of gambling, substance use (SU), and delinquent behavior among 1,870 Quebec students aged 14 to 18. The results show a higher proportion of Internet-gambling (IG) students reporting problematic substance use and delinquency, compared with nongamblers (NG) and non-Internet gamblers (NIG). Furthermore, a higher proportion of at-risk and probable pathological gamblers are found among IG compared with NIG. A moderating effect (Baron & Kenny, 1986) of the gambler categories (NIG, IG) was found in the relationship between the associated problems and the severity of gambling. Among IG, the severity of delinquency and of substance use contributes to explaining gambling severity whereas, among NIG, the severity of delinquency is the only factor that significantly contributes to such an explanation. Discussion of the results is based on Jessor, Donovan, and Costa's (1991) general deviance syndrome theory.     

If at first you don't succeed: the neuroendocrine impact of using a range of strategies during social conflict

Using a variety of cognitive or behavioral strategies to manage stressful situations may be more adaptive than relying on a narrow selection. Although research has explored the psychological benefits of a range of coping responses, the physiological impact within and across stressful situations has not been examined. Moreover, research has primarily relied upon self-reports of what people believe they generally do across stressful situations, which may be subject to recall bias. This study observed and coded the range of behavioral response strategies that young adults (n=74, mean age 18.1) used to manage a laboratory-based, interpersonal conflict task and collected self-reports of the cognitive strategies used to manage similar stressors. Analyses examined the impact of response range on cortisol activity during the task. Greater range of observed response strategies predicted lower cortisol reactivity (t(133)=2.65; p=.009), whereas the range of self-reported strategies was unrelated to cortisol reactivity (t(133)=.53; p=.60). Results support observational assessment as an important supplement to self-reports of responses to stress and suggest that the range of strategies used to manage the momentary demands of a stressful situation may help explain individual differences in the impact of stress on physiological systems.