Motherhood in adolescent mothers: Maternal attachment,mother–infant styles of interaction and emotion regulation at three months

Early motherhood is considered a risk factor for an adequate relationship between mother and infant and for the subsequent development of the infant. The principal aim of the study is to analyze micro-analytically the effect of motherhood in adolescence on the quality of mother–infant interaction and emotion regulation at three months, considering at the same time the effect of maternal attachment on these variables. Participants were 30 adolescent mother–infant dyads compared to 30 adult mother–infant dyads. At infant 3 months, mother–infant interaction was video-recorded and coded with a modified version of the Infant Caregiver Engagement Phases and the Adult Attachment Interview was administered to the mother. Analysis showed that adolescent mothers (vs. adult mothers) spent more time in negative engagement and their infants spent less time in positive engagement and more time in negative engagement. Adolescent mothers are also less involved in play with their infants than adult mothers. Adolescent mother–infant dyads (vs. adult mother–infant dyads) showed a greater duration of negative matches and spent less time in positive matches. Insecure adolescent mother–infant dyads (vs. insecure adult mother–infant dyads) demonstrated less involvement in play with objects and spent less time in positive matches. To sum up adolescent mother–infant dyads adopt styles of emotion regulation and interaction with objects which are less adequate than those of dyads with adult mothers. Insecure maternal attachment in dyads with adolescent mothers (vs. adult mother infant dyads) is more influential as risk factor.     

Confidentiality and privileged communication in group psychotherapy

The concept of confidentiality is fundamental to all forms of psychotherapy. The idea of protecting confidential material goes as far back as the Hippocratic Oath in ancient Greek history. Centuries later, authors continue to assert that "only by maintaining confidentiality can the essential groundwork of trust in treatment be developed" (Hough, 1992, p. 106). Others have even argued that without confidentiality, psychotherapy has no value (Epstein, Steingarten, Weinstein, & Nashel, 1977). Confidentiality in group psychotherapy is more complicated than in individual therapy because self-disclosure is at the core of group therapy and there are numerous people hearing the disclosures. Confidentiality in group therapy, once ignored in the literature on ethics, is gaining more attention as this modality becomes more widely practiced; so too is an acknowledgement that ethical dilemmas surrounding confidentiality in groups are commonplace. This article discusses the major considerations and dilemmas on confidentiality in group psychotherapy. We first review confidentiality broadly and discuss the ethical principles that are related to confidentiality. In the next section, we discuss the complexities of confidentiality in group psychotherapy. Finally, we review research on confidentiality in groups and describe common ethical dilemmas.     

Is severe obesity a form of addiction? Rationale, clinical approach, and controlled clinical trial.

For many, obesity is just a problem of energy input and expenditure: more energy input than expenditure. However, the clinical practice and epidemiological data clearly show that weight control is more complex than expected by this simple equation. This is particularly true in morbid obesity, a form of severe obesity in which a person's Body Mass Index (BMI, kg/m(2)) is over 40. If we compare the definitions and diagnostic criteria for "dependence" and "addiction" with the situation of many severe obese subjects, it is apparent that they match very well. Further, different neurological studies confirm this similarity: both addiction and obesity patients have a deficiency of dopamine receptors. Nevertheless, when we compare many of the actual obesity treatments with the ones used in the area of addictions it is possible to find relevant differences: obesity treatments neither consider different levels of type and intensity of care, nor a multidimensional approach. To overcome these limitations, in this paper we propose a bio-psychosocial approach in which the genetic influence (lack of dopamine receptors) is matched by psychosocial issues (pressure for thinness and diet as main body image dissatisfaction treatment). Further, the paper outlines how this approach may influence the treatment options, by focusing both on the lessons coming from actual addiction treatment and the opportunities offered by virtual reality. Finally, the paper presents and discusses the outcome of a controlled trial, based on the proposed approach, including a 6-month follow-up (211 morbid obese females with a BMI of >40 and a documented history of failures.     

Motivating minority older adults to exercise

The purpose of this qualitative study was to explore with minority older adults their experience in the Senior Exercise Self-Efficacy Pilot Program (SESEP) and establish what aspects of the SESEP helped the participants engage in exercise and what decreased their willingness to exercise. A total of 148 older adults from 12 Senior Centers participated. The majority of the participants were African American (77%), and female (79%) and the average age was 72.9+/-8.0. Analysis of the semi-structured interviews revealed 36 codes which were categorized and reduced to 13 major themes. Eleven of these themes focused on factors that facilitated participation in exercise and two themes included factors that decreased willingness to participate in exercise. Findings support the use of the theory of self-efficacy to change behavior among minority older adults, and future research should focus on identifying culturally specific interventions that will strengthen these beliefs and thereby increase exercise behavior.     

Psychoanalysis and the Catholic Church in Italy: the role of Father Agostino Gemelli, 1925-1953

Agostino Gemelli, a Catholic priest, psychiatrist, administrator, and educator, was an important figure in the early history of psychoanalysis in Italy. He was one of the few establishment figures to grapple with Freud's ideas in Italy during the first half of the twentieth century, a period during which Italy, compared to the rest of Europe and to the United States, was relatively impermeable to psychoanalysis. One of the factors that contributed to this was the opposition of the powerful Catholic Church, which identified in psychoanalysis a challenge to its authority. The author argues that Father Gemelli's shifting positions about psychoanalysis between 1925 and 1953 reflected the exigencies of his historical circumstances. Gemelli was able to identify in psychoanalysis an integrated view of the human condition in stark opposition to the brutal reductionism of psychiatry in Italy at that time, but also encountered in it elements intolerable to the Church. Examining specifically what it is that Gemelli could accept of psychoanalysis, and what needed to be rejected, between 1925 and 1953, illustrates the particular challenge posed by psychoanalysis to Catholicism in Italy.     

AIDS/HIV in the work of family therapy trainees

A group of family therapy trainees were asked about their experience at work and knowledge of AIDS/HIV. The majority had already encountered AIDS-related issues in the context of their work. On the whole, they were well informed about AIDS/HIV, although specific gaps in their knowledge were identified. It is recommended that provision be made for the training of family therapists in this area.     

The meaning of bad news in HIV disease: Counselling about dreaded issues revisited

HIV disease is a slow, progressive immunological disorder. As there is neither a cure nor a vaccine, morbidity and mortality arising from HIV infection will continue to challenge health care providers, including those who counsel these patients. Psychological preparation for ‘bad news’ and support for those whose health is deteriorating is an important task in HIV counselling. This paper describes what may be considered bad news for people living with HIV, how to prepare them for unwelcome changes in their medical condition and how to give bad news, should the need arise.     

Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia.

A treatment protocol, called experiential cognitive therapy (ExCT), was developed. It integrated traditional cognitive behavior therapy (CBT) with virtual reality exposure for the treatment of panic disorder with agoraphobia (PDA). The objective of this study was to test the efficacy of short-term (four sessions) ExCT compared with a traditional 12-session panic control program (PCP) for the treatment of PDA. Forty patients diagnosed as having PDA by the diagnostic criteria of DSM-IV were randomly assigned to ExCT and PCP groups of 20 patients each. The treatment effects were measured with self-report questionnaires, including the BDI, STAI, ASI, PBQ, ACQ, and BSQ. The authors also assessed high end-state functioning (HES), including the success rate of stopping or reducing medication at post-treatment and 6-month follow-up. In all ratings, both ExCT and PCP groups showed significant improvement post-treatment compared with pre-treatment scores. There were no significant differences between the two treatment groups in HES and medication discontinuation at post-treatment, but there was a significant difference in medication discontinuation at 6-month follow-up. These results suggested that although short-term effectiveness of ExCT might be comparable to the effectiveness of PCP, long-term effectiveness of ExCT might be relatively inferior to the effectiveness of PCP.     

Suppression mediates the effect of 5‐HTTLPR by stress interaction on depression

A number of studies have shown that the presence of short (S), as opposed to long (L), allele of the serotonin transporter‐linked polymorphic region (5‐HTTLPR) is associated with a higher risk for depression following exposure to stressful life events. However, many other studies failed to confirm this association. One reason for this inconsistency might be the fact that the interaction of the 5‐HTTLPR polymorphism with stress may relate not to depression per se, but rather to adaptive or maladaptive emotion regulation strategies. Here we show that individuals homozygous for the long allele respond to stressful events by reappraising their emotional meaning, which may hamper the harmful effect of stress on mental health. In S genotype carriers, on the other hand, stress triggers the appearance of intrusive thoughts and vain attempts to suppress them, which in this group acts as a mediator between stress and depressive symptoms. These findings are in line with neuroimaging studies showing that 5‐HTTLPR polymorphism has an effect on the connectivity among key areas involved in emotion regulation.     

Who Are the Children Most Vulnerable to Social Exclusion? The Moderating Role of Self-Esteem,Popularity, and Nonverbal Intelligence on Cognitive Performance Following Social Exclusion

Social exclusion has a profound emotional impact on children. However, there is still limited and partly conflicting experimental evidence for the possible effect of social exclusion on children’s cognitive performance. In the present study, we tested the possibility that some children are more vulnerable than others to the negative effects of social exclusion on cognitive performance. We selected 4 potential candidates that could moderate the effects of social exclusion: relational self-esteem, peer ratings of popularity, rejection sensitivity and nonverbal intelligence. Individual differences in these 4 potential moderating factors were first assessed in a sample of 318 children (45.6 % females; mean age = 9.92 years). Then, in a subsequent experimental session, the participants were either socially included or excluded using a typical manipulation (i.e., the Cyberball paradigm). Following the manipulation, the children’s cognitive performance was assessed using a logical reasoning test. The results showed that the children with lower scores for relational self-esteem (the bottom 37.46 % of the sample), lower popularity (43.49 %) or weaker nonverbal intelligence (37.80 %) performed worse on the logical reasoning test following social exclusion. Moreover, children with combined low self-esteem, popularity and nonverbal intelligence were the most affected by social exclusion. This study identified factors that make some children more vulnerable to the negative effects of social exclusion. Overall, the present work underscores the value of considering basic cognitive and relational individual differences when developing interventions aimed at preventing the negative effects of social exclusion among children.