Treatment of Maternal Depression With In-Home Cognitive Behavioral Therapy Augmented by a Parenting Enhancement: A Case Report

Depression is prevalent among mothers who participate in home visitation programs. This case study describes In-Home Cognitive Behavioral Therapy (IH-CBT), an empirically based treatment for depressed mothers that is strongly integrated with ongoing home visitation. The use of a Parenting Enhancement for Maternal Depression (PEMD) module was added to address parenting difficulties in a depressed mother. This case describes issues and challenges encountered in delivering treatment in the home with low-income, depressed mothers. Issues involving engagement, adaptation to the setting, responding to the unique needs of low-income mothers, and partnership with concurrent home visiting to optimize outcomes are considered. Long-term follow-up (18 months after the end of treatment) permits examination of sustainability of gains. Implications for treating this high-risk population are discussed.     

Endowment effect despite the odds

Can ownership status influence probability judgements under condition of uncertainty? In three experiments, we presented our participants with a recording of a real horse race. We endowed half of our sample with a wager on a single horse to win the race, and the other half with money to spend to acquire the same wager. Across three large studies (N = 750), we found the endowment effect – owners demanded significantly more for the wager than buyers were willing to pay to acquire it. However, we also found that probability estimates of each horse winning the race did not differ between owners and non-owners of the betting slip. Our results demonstrate that distorted perception of probability is unlikely to be a mechanism explaining the endowment effect.     

Parent Emotion Expression and Autonomic-Linked Emotion Dysregulation in Childhood ADHD

Despite evidence that ADHD is associated with disruptions in emotion regulation, few studies have examined the biological correlates of emotion dysregulation among children with this disorder. Prior work has pointed to roles of the parasympathetic and sympathetic nervous system, as indexed via respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP), respectively. Work in typically developing populations suggests that parenting behavior and parental emotion expression may shape the development of these systems. To date, a single study has examined the independent and interactive roles of autonomic nervous system functioning and parent emotion expression in youth with ADHD. This study seeks to extend that work. 86 children (42 with ADHD), aged 8–12 years, and a parent completed a parent-child interaction task, while electrocardiography and impedance cardiography data were recorded to derive RSA and PEP. Parent and child emotion word use (positive and negative valence) were coded from recordings of the task. Parents of youth with ADHD used fewer positive emotion words throughout the task. Additionally, throughout the task, children with ADHD engaged in excessive RSA withdrawal from baseline. Further, the association between RSA reactivity and ADHD diagnosis was moderated by parent positive emotion word use. Specifically, those with RSA augmentation and parents displaying high positive affect across the task conditions were least likely to have an ADHD diagnosis. If replicated and extended, these results support the use of interventions specifically designed to increase parental modeling of positive emotions, while simultaneously focusing on building emotion regulation skills in youth with ADHD.     

How do we process novel conceptual combinations in context?

Most theories of how people interpret novel noun-noun combinations (e.g., ghost forest) do not sufficiently address the role of context, which is surprising given that novel combinations are generally encountered in discourse contexts. We evaluated three hypotheses for the role of context in interpretation. The generation hypothesis states that interpretation is based on sense generation both in and out of context. The anaphor resolution hypothesis states that interpretation initially involves identifying a referent from the prior discourse context, and meaning generation occurs only if anaphoric processing fails. The dual-process hypothesis states that sense generation and anaphor resolution operate in parallel, and both may influence initial interpretation. In two experiments, we examined reading times on novel combinations when the dominant meaning (most likely interpretation) or subordinate meaning (infrequent interpretation) preceded or followed the combination in text. Results supported the dual-process hypothesis.     

Quantifying self‐motives: Functional links between dispositional desires

Previous research has sought to establish the existence, or gauge the relative strength, of key self‐evaluation motives (i.e., self‐enhancement, self‐verification, self‐assessment, self‐improvement). Here, we attempted, across five samples, to quantify individual differences in self‐motive strength and explore their empirical ramifications. We devised brief self‐report indices for each self‐motive and checked their factor structure, reliability, and validity. We found that self‐enhancement covaried mainly with self‐verification, and that self‐assessment covaried mainly with self‐improvement, thus validating key hypotheses regarding their functional links. Moreover, self‐enhancement and self‐verification covaried with positive personality traits, as well as with preferences for receiving positive feedback and perceptions of its accuracy. In sum, self‐reported variations in dispositional self‐motive strength form theoretically meaningful patterns. Copyright © 2011 John Wiley & Sons, Ltd.     

Emotion Regulation via the Autonomic Nervous System in Children with Attention-Deficit/Hyperactivity Disorder (ADHD)

Despite growing interest in conceptualizing ADHD as involving disrupted emotion regulation, few studies have examined the physiological mechanisms related to emotion regulation in children with this disorder. This study examined parasympathetic and sympathetic nervous system reactivity via measures of respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP) in children with ADHD (n = 32) and typically developing controls (n = 34), using a novel emotion task with four conditions: negative induction, negative suppression, positive induction, and positive suppression of affect. Both groups showed strong task-response effects in RSA. However, typically developing children showed systematic variation in parasympathetic activity (RSA) depending on both emotion valence (more activation for negative emotion, reduced activation for positive emotion) and task demand (more activation for suppression than induction). In contrast, children with ADHD displayed a stable pattern of elevated parasympathetic activity (RSA) across all task conditions compared to baseline. No group differences in sympathetic activity (PEP) were observed. It is concluded ADHD in childhood is associated with abnormal parasympathetic mechanisms involved in emotion regulation.     

Motivated expectations of positive feedback in social interactions

People self-enhance in a variety of ways. For example, they generally expect to perform better than others, to be in control of events, and to have a brighter future. Might they also self-enhance by expecting to receive positive feedback in social interactions? Across five studies, we found that they did. People's desire for feedback correlated with how positive they expected it to be (Study 1), and their feedback expectations were more positive for themselves than for others (Study 2). People's positive feedback expectations also covaried with trait tendencies to self-enhance (i.e., self-esteem and narcissism; Study 3) and with a direct situational manipulation of self-enhancement motivation (Study 4). Finally, people expected to receive positive feedback but did not consistently expect to receive self-verifying feedback (Study 5). These findings are consistent with social expectations being driven in part by the self-enhancement motive.     

Parental criticism and externalizing behavior problems in adolescents: the role of environment and genotype-environment correlation

Genetic factors are important for the association between parental negativity and child problem behavior, but it is not clear whether this is due to passive or evocative genotype-environment correlation (rGE). In this study, we applied the extended children-of-twins model to directly examine the presence of passive and evocative rGE as well as direct environmental effects in the association between parental criticism and adolescent externalizing problem behavior. The cross-sectional data come from the Twin and Offspring Study in Sweden (N = 909 pairs of adult twins) and from the Twin Study of Child and Adolescent Development (N = 915 pairs of twin children). The results revealed that maternal criticism was primarily due to evocative rGE emanating from their adolescent's externalizing behavior. On the other hand, fathers' critical remarks tended to affect adolescent problem behavior in a direct environmental way. This suggests that previously reported differences in caretaking between mothers and fathers also are reflected in differences in why parenting is associated with externalizing behavior in offspring.     

Trauma and sex surveys meet minimal risk standards: implications for institutional review boards

Institutional review boards assume that questionnaires asking about "sensitive" topics (e.g., trauma and sex) pose more risk to respondents than seemingly innocuous measures (e.g., cognitive tests). We tested this assumption by asking 504 undergraduates to answer either surveys on trauma and sex or measures of cognitive ability, such as tests of vocabulary and abstract reasoning. Participants rated their positive and negative emotional reactions and the perceived benefits and mental costs of participating; they also compared their study-related distress with the distress arising from normal life stressors. Participants who completed trauma and sex surveys, relative to participants who completed cognitive measures, rated the study as resulting in higher positive affect and as having greater perceived benefits and fewer mental costs. Although participants who completed trauma and sex surveys reported slightly higher levels of negative emotion than did participants who completed cognitive measures, averages were very low for both groups, and outliers were rare. All participants rated each normal life stressor as more distressing than participating in the study. These results suggest that trauma and sex surveys pose minimal risk.