What predicts depression in cardiac patients: sociodemographic factors, disease severity or theoretical vulnerabilities?

Depression is associated with increased cardiovascular risk in acute coronary syndrome (ACS) patients, but some argue that elevated depression is actually a marker of cardiovascular disease severity. Therefore, disease indices should better predict depression than established theoretical causes of depression (interpersonal life events, reinforcing events, cognitive distortions, type D personality). However, little theory-based research has been conducted in this area. In a cross-sectional design, ACS patients (n = 336) completed questionnaires assessing depression and psychosocial vulnerabilities. Nested logistic regression assessed the relative contribution of demographic or vulnerability factors, or disease indices or vulnerabilities to depression. In multivariate analysis, all vulnerabilities were independent significant predictors of depression (scoring above threshold on any scale, 48%). Demographic variables accounted for <1% of the variance of depression status, with vulnerabilities accounting for significantly more (pseudo R2 = 0.16, χ2(change) = 150.9, df = 4, p < 0.001). Disease indices accounted for 7% of the variance in depression (pseudo R2 = 0.07, χ2 = 137.9, p < 0.001). However, adding the vulnerabilities increased the overall variance explained to 22% (pseudo R2 = 0.22, χ2 = 58.6, df = 4, p < 0.001). Theoretical vulnerabilities predicted depression status better than did either demographic or disease indices. The presence of these proximal causes of depression suggests that depression in ACS patients is not simply a result of cardiovascular disease severity.     

Albert Ellis and Rational Emotive Behavior Therapy: A Personal Reflection

This article provides an overview of the contributions to this special issue celebrating Dr. Albert Ellis and Rational Emotive Behavior Therapy. Members of The Albert Ellis Institute’s International Training Standards and Policy Review Committeee (ITS-PRC) were invited to reflect on the personal and professional influences Dr. Ellis had on each of them. In addition, several of the contributors offer their praise as well as critiques of both Albert Ellis and his theory, as well as recommendations for future directions.     

Genetic Counseling and Screening of Consanguineous Couples and Their Offspring: Recommendations of the National Society of Genetic Counselors

The objective of this document is to provide recommendations for genetic counseling and screening for consanguineous couples (related as second cousins or closer) and their offspring with the goals of1. providing preconception reproductive options2. improving pregnancy outcome and identifying reproductive choices3. reducing morbidity and mortality in the 1st years of life, and4. respecting psychosocial and multicultural issues.The recommendations are the opinions of a multicenter working group (the Consanguinity Working Group (CWG)) with expertise in genetic counseling, medical genetics, biochemical genetics, genetic epidemiology, pediatrics, perinatology, and public health genetics, which was convened by the National Society of Genetic Counselors (NSGC). The consensus of the CWG and NSGC reviewers is that beyond a thorough medical family history with follow-up of significant findings, no additional preconception screening is recommended for consanguineous couples. Consanguineous couples should be offered similar genetic screening as suggested for any couple of their ethnic group. During pregnancy, consanguineous couples should be offered maternal–fetal serum marker screening and high-resolution fetal ultrasonography. Newborns should be screened for impaired hearing and detection of treatable inborn errors of metabolism. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a health care provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

Development of gaze aversion as disengagement from visual information

Older children, but not younger children, were found to look away more from the face of an interlocutor when answering difficult as opposed to easy questions. Similar results were found in earlier work with adults, who often avert their gaze during cognitively difficult tasks (A. M. Glenberg, J. L. Schroeder, & D. A. Robertson, 1998). Twenty-five 8-year-olds and 26 5-year-olds answered verbal reasoning and arithmetic questions of varying difficulty. The older children increased gaze aversion from the face of the adult questioner in response to both difficult verbal reasoning questions and difficult arithmetic questions. In contrast, younger children (5-year-olds) responded less consistently to cognitive difficulty. It is concluded that adultlike patterns of gaze aversion in response to cognitive difficulty are certainly acquired by 8 years of age. The implications of appropriate gaze aversion for children's management of cognitive processing resources are considered.     

Fear of abandonment as a mediator of the relations between divorce stressors and mother-child relationship quality and children's adjustment problems

This study examines whether fear of abandonment mediates the prospective relations between divorce stressors and mother–child relationship quality and adjustment problems of children of divorce. Participants were 216 children, ages 8–12, and their primary residential mothers. Children reported on divorce stressors and fear of abandonment; mothers and children reported on mother–child relationship quality and internalizing and externalizing problems. Structural equation models indicated that Time 1 fear of abandonment mediated the relation between Time 1 divorce stressors and Time 2 internalizing and externalizing problems. Time 1 fear of abandonment also mediated the relation between Time 1 mother–child relationship quality and Time 2 internalizing and externalizing problems. Implications of these results for understanding variability in children's postdivorce adjustment problems and interventions for divorced families are discussed.     

Self-Regulation: Learning Across Disciplines

The capacity to self-regulate is a key developmental ability that has become a focal point for research across multiple disciplines. Yet interdisciplinary collaboration on self-regulation is rare and the term is often applied in different ways across studies. Drawing on literature from psychology, medical sciences, sociology, and economics, this article provides a synthesis of disciplinary approaches to research on self-regulation. A review of search returns from one prominent database per discipline is used to investigate overlap and divergence on the topic. This review argues that interdisciplinary collaboration has the potential to integrate perspectives on self-regulation into a more coherent body of work, resulting in advances that could not be achieved through any one discipline alone. The review also identifies and discusses three current impediments to collaboration: terminology, measurement, and disciplinary conventions.     

Character Development within Youth Development Programs: Exploring Multiple Dimensions of Activity Involvement

We examined links among three dimensions of youth involvement (intensity, duration, and engagement) in Boy Scouts of America (BSA), an international out‐of‐school time (OST) youth development program designed to promote moral and performance character in boys. Using data from 737 youth and their parents who participated in one of 40 BSA program sites (commonly referred to as “packs”), we first considered how individual‐ and pack‐level measures of program involvement were differentially linked with character development. Next, we examined whether pack‐level involvement characteristics moderate individual‐level involvement characteristics, hypothesizing that highly involved packs would serve to further enhance the positive effects of high levels of individual involvement. Results indicated engagement was the strongest, most frequent predictor of increases in both moral and performance character. Although there were no direct effects of pack‐level intensity, duration, or engagement, the effects of individual‐level engagement were moderated by pack‐level engagement, suggesting that the largest increases in moral and performance character occurred among highly engaged youth who were enrolled in highly engaged packs. These results highlight the need to examine multiple dimensions of OST program involvement simultaneously, and suggest that strengthening youth engagement in programming may provide a means for enhancing the positive effects of high‐quality youth programming.