Parent Perspectives on the Use of Group Well-Child Care to Address Toxic Stress in Early Childhood

We sought to understand the experiences of parents who participated in Group Well-Child Care (GWCC) and Trauma-Informed GWCC (TI-GWCC). Three focus groups and design sessions with parents from either standard GWCC or TI-GWCC (N = 17) were conducted and synthesized into common themes using thematic analysis. Focus group themes included: (1) GWCC can empower parents to recognize toxic stress; (2) Parents identify ways that they role model behaviors for their child(ren); (3) Activities that facilitate reflection on attachment and anger management encourage intentional parenting practices. Our qualitative findings suggest that TI-GWCC supports the prevention of childhood adversity by creating connections between parents, helping families understand and identify toxic stress, and teaching parenting practices that mitigate stressors.     

Trajectories of aggression, delinquency, and substance use across middle school among urban, minority adolescents

This study evaluated bidirectional associations between substance use, aggression, and delinquency across sixth, seventh, and eighth grades using data available from a large study of urban minority youth (n = 2,931). Group-based trajectory analysis revealed trajectories of aggression, delinquency, and substance use which support the existence of both adolescent-limited and life-course persistent offenders. In addition, a pattern of decreasing aggression was observed during middle school. Clear temporal associations were observed between developmental changes in aggression, delinquency, and substance use. Notably, the decreasing aggression trajectory was as likely to be associated with high trajectories of substance initiation as was the high aggression trajectory. Furthermore, trajectories of delinquency were differentially associated with future substance use; however, substance use trajectories did not predict trajectories of delinquency. There were few gender differences in the developmental progression of these problem behaviors during middle school with only two exceptions, males were more likely to follow a trajectory of decreasing aggression and a trajectory of high stable delinquency. Evaluations of ethnic/racial differences in the trajectory group membership also revealed few differences. The results of this study provide important information regarding interconnections between developmental changes in problem behavior that occur during the middle school years, highlighting groups that may be missed via traditional analytic approaches that predict mean changes.     

Toward an Integration of Interpersonal Risk Models of Depression and Cognitive‐Behaviour Therapy

Empirical research has increasingly focused on interpersonal variables associated with the development and maintenance of depression. This article outlines some key interpersonal risk factors for depression, including anxious attachment, sociotropy, excessive reassurance seeking, interpersonal stress generation, reduced social support, social skills deficits, and social avoidance. Recommendations are made for how cognitive‐behavioural therapy may be adapted to address such factors. Specifically, suggestions are offered for how cognitive and behavioural interventions, such as cognitive restructuring, behavioural activation, behavioural experiments, and skills training, may be used with depressed clients to promote positive relationships and reduce maladaptive interpersonal behaviours.     

Best friends and better coping: Facilitating psychological resilience through boys’ and girls’ closest friendships

This is a novel investigation of whether, and how, a single close supportive friendship may facilitate psychological resilience in socio‐economically vulnerable British adolescents. A total of 409 adolescents (160 boys, 245 girls, four unknown), aged between 11 and 19 years, completed self‐report measures of close friendship quality, psychological resilience, social support, and other resources. Findings revealed a significant positive association between perceived friendship quality and resilience. This relationship was facilitated through inter‐related mechanisms of developing a constructive coping style (comprised of support‐seeking and active coping), effort, a supportive friendship network, and reduced disengaged and externalising coping. While protective processes were encouragingly significantly present across genders, boys were more vulnerable to the deleterious effects of disengaged and externalizing coping than girls. We suggest that individual close friendships are an important potential protective mechanism accessible to most adolescents. We discuss implications of the resulting Adolescent Friendship and Resilience Model for resilience theories and integration into practice.     

Why do young infants fail to search for hidden objects?

Recent evidence indicates that infants as young as 3.5 months of age understand that objects continue to exist when hidden (Baillargeon, 1987a; Baillargeon & DeVos, 1990). Why, then, do infants fail to search for hidden objects until 7 to 8 months of age? The present experiments tested whether 5.5-month-old infants could distinguish between correct and incorrect search actions performed by an experimenter. In Experiment 1, a toy was placed in front of (possible event) or under (impossible event) a clear cover. Next, a screen was slid in front of the objects, hiding them from view. A hand then reached behind the screen and reappeared holding the toy. The infants looked reliably longer at the impossible than at the possible event, suggesting that they understood that the hand's direct reaching action was sufficient to retrieve the toy when it stood in front of but not under the clear cover. The same results were obtained in a second condition in which a toy was placed in front of (possible event) or behind (impossible event) a barrier. In Experiment 2, a toy was placed under the right (possible event) or the left (impossible event) of two covers. After a screen hid the objects, a hand reached behind the screen's right edge and reappeared first with the right cover and then with the toy. The infants looked reliably longer at the impossible than at the possible event, suggesting that they realized that the hand's sequence of action was sufficient to retrieve the toy when it stood under the right but not the left cover. A control condition supported this interpretation. Together, the results of Experiments 1 and 2 indicate that by 5.5 months of age, infants not only represent hidden objects, but are able to identify the actions necessary to retrieve these objects. The implications of these findings for a problem solving explanation of young infants' failure to retrieve hidden objects are considered.     

The wizard behind the curtain: programmers as providers

It is almost universally accepted that traditional provider-patient relationships should be governed, at least in part, by the ethical principles set forth by Beauchamp and Childress (Beauchamp and Childress, Principles of biomedical ethics, 1979). These principles include autonomy, beneficence, non-maleficence and justice (Beauchamp and Childress, Principles of biomedical ethics, 1979). Recently, however, the nature of medial practice has changed. The pervasive presence of computer technology in medicine raises interesting ethical questions. In this paper we argue that some software designers should be considered health care providers and thus be subject the ethical principles incumbent upon “traditional” providers. We argue that these ethical responsibilities should be applied explicitly rather than as a passive, implicit, set of guidelines.     

The impact of resilience on role stressors and burnout in elementary and secondary teachers

The role of a teacher is becoming increasingly complex, and it is more important than ever that teachers develop resilience to overcome stress and burnout. A conceptual framework to explain the ability of resilience to decrease role stress and burnout was developed and tested. Participants included 415 teachers (174 elementary, 241 secondary) who taught in three adjacent school districts in the Midwest of the United States. Data were collected through a cross-sectional survey that included measures of resilience, role stressors, and burnout. Structural equation modeling was used to test the conceptual framework, and invariance analysis examined the equivalence of relationships across elementary and secondary teacher groups. Results generally supported the conceptual framework, and commonly experienced pathways were found to be invariant across groups. This study emphasizes the importance of resilience in helping to reduce perceived teacher stress and feelings of burnout.     

The range of autonomy: Informed consent in medicine

Theoretical Medicine and Bioethics - On the basis of the characterization of autonomy set out by Beauchamp and Childress in Principles of Biomedical Ethics, we first explore some of the parameters...