Multi-domain Models of Risk Factors for Depression and Anxiety Symptoms in Preschoolers: Evidence for Common and Specific Factors

Relatively few studies have examined multiple pathways by which risk factors from different domains are related to symptoms of anxiety and depression in young children; even fewer have assessed risks for these symptoms specifically, rather than for internalizing symptoms in general. We examined a theoretically- and empirically-based model of variables associated with these symptom types in a diverse community sample of 796 4-year-olds (391 boys, 405 girls) that included factors from the following domains: contextual (SES, stress and family conflict); parent characteristics (parental depression); parenting (support/engagement, hostility and scaffolding); and child characteristics including negative affect (NA) effortful control (EC) sensory regulation (SR), inhibitory control (IC) and attachment. We also compared the models to determine which variables contribute to a common correlates of symptoms of anxiety or depression, and which correlates differentiate between those symptom types. In the best-fitting model for these symptom types (a) SES, stress and conflict had indirect effects on both symptom types via long-chain paths; (b) caregiver depression had direct effects and indirect ones (mediated through parenting and child effortful control) on both symptom types; (c) parenting had direct and indirect effects (via temperament and SR); and temperament had direct effects on both symptom types. These data provide evidence of common risk factors, as well as indicate some specific pathways/mediators for the different symptom types. EC was related to anxiety, but not depression symptoms, suggesting that strategies to improve child EC may be particularly effective for treatment of anxiety symptoms in young children.     

On creating a psychoanalytic mind

The term process knowledge is introduced to highlight a particular way of analyzing that centers on how our patients gain knowledge. It is suggested that analyzing with heightened awareness to process knowledge is crucial for the patients' capacity for self-analysis, and differs from helping patients primarily gain knowledge of their unconscious fantasies and conflicts as the primary curative factor in psychoanalysis.     

Executive Functioning Predicts Social Skills Following Prenatal Alcohol Exposure

Adverse sequelae of prenatal alcohol exposure include executive function and social skills impairments, although these two domains have not been empirically linked in alcohol-exposed individuals. This study investigated this relationship using the BRIEF and the SSRS in 98 children aged 6 to 11 years. Executive functions explained a significant percentage of variance in parent and teacher rated social skills. No differences were found among children with diagnoses of FAS, partial FAS, or alcohol-related neurodevelopmental disorder. It may be helpful to consider executive functioning in designing social skills interventions for alcohol-exposed children whether or not they have full FAS.     

Positive und negative Metakognitionen über Krankheitssorgen

Background

Metacognitions have been shown to be relevant in the emergence and maintenance of worry processes, particularly for generalized anxiety disorder (GAD). In contrast, metacognitions have been neglected in hypochondriasis and health anxiety, perhaps due to the traditional assignment of hypochondriasis to the somatoform disorders. Is worrying about illness associated with metacognitions and are these associated with other features of health anxiety?

Material and methods

In this study 1,246 people took part in an online survey. Items capturing positive (PM) and negative metacognitions (NM) were presented together with instruments for the assessment of health anxiety and depressive symptoms. The dimensional structure of PM and NM over illness worries was examined with nonlinear confirmatory factor analyses. Associations with depressivity and the number of consultations by different physicians were examined in structural equation models (SEM), separately for subgroups with and without a diagnosed somatic disease.

Results

The PMs and NMs about illness worries varied relatively independently from one another along two dimensions. The PMs were specifically associated with health anxiety and the number of different physician consultations and NMs were related to all dimensions of the Whiteley index and particularly strongly to depressivity.

Conclusions

Illness-related anxiety provokes metacognitions, similar to other worries as known from GAD. Considering the strong associations of PMs and NMs with several facets of health anxiety found, it appears promising to take them into account for the formulation of cognitive-behavioral models of health anxiety and its treatment.     

The Changing Role of Fatherhood: The Father as a Provider of Selfobject Functions

Fatherhood is evolving. The way that men carry out their paternal role is reflective of the historical time era in which they live, social and cultural forces, both the mother and the father's expectations for fathering behaviors, as well as the father's own innate capabilities, wishes, and desires. Fatherhood is also greatly influenced by men's relationships with their own fathers, the quality of that relationship, and the extent to which the father was emotionally available. The ever-changing role of fathers has been a challenge for the psychoanalytic literature. There is no comprehensive theoretical body of knowledge about fatherhood that takes into account the changing nature of fathering, especially considering men's desires to be emotionally responsive and nurturing parents. This article examines the changing role of the father and suggests a model of paternal involvement that expands the nurturing and available father role to include the father as a selfobject. It discusses the importance of understanding men's relationships with their fathers, a central dynamic in shaping fathers’ involvement with their children. The residual impact of paternal deprivation is explored, followed by two clinical vignettes that symbolize the search for missing selfobject functions. This article concludes by outlining clinical implications and questions to pose to assess the selfobject relationship with one's father.     

Faith-Based Organizations: Sexual Harassment and Health in Accra-Tema Metropolis

Sexual harassment occurs frequently in many faith-based organizations (FBOs). This study investigated whether sexual harassment in FBOs was a public health concern in Ghana. A cross-sectional exploratory approach was used to assess the prevalence and incidence of traditional or contrapower sexual harassment in FBOs. We also investigated the correlation between sexual harassment and health. Respondents completed a self-administered open-ended questionnaire in an anonymous survey about sexual harassment during the 12 months preceding the study. We hypothesized that both traditional and contrapower harassment were prevalent in FBOs of Ghana and also that the health effects were the same for both sexes in both forms of harassment. The two hypotheses were generally supported. We found that sexual harassment is a public health concern. Women were more likely to be sexually harassed (73%) than men were (27%). Sexual harassment negatively affects the victims’ health outcome. Secondly, both the traditional and contrapower forms of sexual harassment were prevalent in FBOs in Ghana. The health consequences of sexual harassment in Ghana are the same as in an industrialized country. The implications for policy and research are discussed.     

Practice Effects on Motor Control in Healthy Seniors and Patients with Mild Cognitive Impairment and Alzheimer's Disease

ABSTRACT

This research was designed to test the hypothesis that motor practice can enhance the capabilities of motor control in healthy controls (NC) and patients with a diagnosis of probable Alzheimer's disease (AD) and mild cognitive impairment (MCI), and consequently results in better motor performance. Approximately half of the subjects in the NC (n = 31), AD (n = 28), and MCI (n = 29) either received or did not receive practice on a task of fast and accurate arm movement with a digitizer. Changes in movement time (MT), movement smoothness (jerk), and percentage of primary submovement (PPS) were recorded and compared among the three groups across six blocks of trials (baseline and five training sessions). For all subjects, practice improved motor functions as reflected by faster and smoother motor execution, as well as a greater proportion of programming control. Compared to unaffected matched controls, AD and MCI subjects exhibited a greater reduction in movement jerk due to practice. Movement time and PPS data revealed that motor practice appeared to reduce the use of “on-line” correction adopted by the AD or MCI patients while performing the aiming movements. Evidently, their arm movements were quicker, smoother, and temporally more consistent than their untrained peers. The findings of this study shed light on how MCI and AD may affect motor control mechanisms, and suggest possible therapeutic interventions aimed at improving motor functioning in these impaired individuals.