Further evaluation of latency measures in the assessment and treatment of severe self‐injurious behavior

Recent research has demonstrated the utility of latency measures during the functional analysis of problem behavior; however, few studies have evaluated the utility of latency measures during subsequent treatment analyses. The current study seeks to extend the literature on the use of latency measures during the treatment of severe self‐injurious behavior (SIB). Following a latency‐based functional analysis, a treatment analysis was conducted using a hybrid procedure in which baseline sessions were terminated following the first instance of SIB, and test sessions ended after a fixed length of time. Latency to SIB was compared across conditions, whereas latency and rate measures for both SIB and functional communication responses were compared for the functional communication training condition. Results suggest that latency measures may be too sensitive during treatment analyses and that it is beneficial to use a hybrid procedure that allows for both latency and rate comparisons.     

Self-reference and emotional memory effects in older adults at increased genetic risk of Alzheimer’s disease

The present study investigated whether cognitively healthy older adults who are carriers of the ε4 allele of apolipoprotein E, the most prevalent genetic risk factor for late-onset Alzheimer’s disease, benefit from self-referential processing and emotional processing to the same degree as noncarriers of this gene. Participants encoded emotional and nonemotional narratives using a baseline-orienting task, semantic elaboration, or imagination-based self-referential processing and then completed a recognition memory test. Both groups of older adults showed enhanced recognition memory for narrative information following self-referential processing relative to semantic elaboration, and the magnitude of this memory effect was not affected by ε4 status. However, older adult ε4 carriers did not show an emotional enhancement effect, whereas older adult ε4 noncarriers did. These results indicate that whereas the self-reference effect is not attenuated in cognitively healthy older adults ε4 carriers, deficits in emotional memory may be an early cognitive marker of abnormal decline.     

Cognitive emotion regulation in adulthood and old age: positive gaze preferences across two strategies

While positive emotional functioning may be enhanced across adulthood and old age, research is mixed as to the types of regulatory strategies that are more or less beneficial for facilitating well-being. The goal of the present study was to examine how specific cognitive emotion regulation strategies assumed to rely on varying levels of effortful processing (selective attention vs. reappraisal) would impact regulatory behaviors (via eye gaze deployment) and resultant affective outcomes. Participants viewed a series of positive, negative, and neutral film clips while their eyes were tracked across three conditions: passive viewing, selective attention, and reappraisal. Results revealed that (a) both younger and older adults displayed positive fixation preferences and showed mood improvement across both regulatory conditions and (b) there was a marginal association between positive fixation and post-regulation mood. Implications for linking positivity to emotion regulation and well-being across adulthood are discussed.     

Hume’s better argument for motivational skepticism

On a standard interpretation, Hume argued that reason is not practical, because its operations are limited to “demonstration” and “probability.” But recent critics claim that by limiting reason’s operations to only these two, his argument begs the question. Despite this, a better argument for motivational skepticism can be found in Hume’s text, one that emphasizes reason’s inability to generate motive force against contrary desires or passions. Nothing can oppose an impulse but a contrary impulse, Hume believed, and reason cannot generate an impulse. This better argument is here developed and defended. Two lines of objection to it can be anticipated: (1) that reason actually can generate impulsive force, based on contents of its normative judgments and (2) that reason neither can nor needs to generate an impulse, since the actions of rational agents are not determined by forceful impulses of desire, as Hume supposed. These objections are answered by pointing out their unsatisfying consequences.     

Reciprocal relations among motivational frameworks,math anxiety,and math achievement in early elementary school

School-entry math achievement is a strong predictor of math achievement through high school. We asked whether reciprocal relations among math achievement, math anxiety, and entity motivational frameworks (believing that ability is fixed and a focus on performance) can help explain these persistent individual differences. We assessed 1st and 2nd graders’ (N = 634) math achievement, motivational frameworks, and math anxiety 2 times, 6 months apart. Cross-lagged path analyses showed reciprocal relations between math anxiety and math achievement and between motivational frameworks and math achievement. Entity motivational frameworks predicted higher math anxiety. High math achievement was a particularly strong predictor of lower math anxiety and less entity-oriented motivational frameworks. We concluded that reciprocal effects are already present in the first 2 years of formal schooling, with math achievement and attitudes feeding off one another to produce either a vicious or virtuous cycle. Improving both math performance and math attitudes may set children onto a long-lasting, positive trajectory in math.     

Non-binary youth: Access to gender-affirming primary health care

ABSTRACT

Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.     

The Caregivers' Attachment and Relationship Education Class: A New and Promising Group Therapy for Caregivers of Individuals with Parkinson's Disease

The authors examined whether a newly developed group therapy, based on principles of attachment theory and emotionally focused couples therapy, can potentially address the unique mental health and relationship difficulties in caregivers of individuals with Parkinson's disease. A comprehensive outreach effort, involving a review of 251 military veterans' medical records, yielded enrollment of seven spousal caregivers in the group therapy. At 1-month follow-up, caregivers who initially reported mild or greater levels of caregiver burden demonstrated statistically reliable declines in psychological distress, relationship distress, or both. Posttreatment surveys indicated positive perceptions in overall helpfulness of treatment goals, as well as positive changes in insight (e.g., greater understanding of the patient's attachment needs) and behaviors (e.g., greater social contact and self-care of the caregiver). Results are considered in the context of inadequate access to treatment for caregivers of spouses with Parkinson's disease or other major medical issues.