SUBSTANCE-ABUSING MOTHERS IN RESIDENTIAL TREATMENT WITH THEIR BABIES: IMPORTANCE OF PRE- AND POSTNATAL MATERNAL REFLECTIVE FUNCTIONING

A residential treatment program has been developed specifically for substance-abusing pregnant and parenting women in Finland, focusing on simultaneously supporting maternal abstinence from substances and the mother-baby relationship. The aims of the study are to explore maternal pre- and postnatal reflective functioning and its association with background factors, maternal exposure to trauma, and psychiatric symptoms, postnatal interaction, child development, and later child foster care placement. Participants were 34 mother-baby pairs living in three residential program units during the pre- to postnatal period. We employed self-report questionnaires on background, trauma history, and psychiatric symptoms (Brief Symptom Inventory: L.R. Derogatis, 1993; Edinburgh Postnatal Depression Scale: J.L. Cox, J.M. Holden, & R. Sagovsky, 1987; Traumatic Antecedents Questionnaire: B. Van der Kolk, 2003), videotaped mother-child interactions coded for sensitivity, control, and unresponsiveness (Care Index for Infants and Toddlers: P. Crittenden, 2003); a standardized test of child development (Bayley Scales of Infant Development-II: N. Bayley, 1993); and semistructured interviews for maternal reflective functioning (Pregnancy Interview: A. Slade, E. Bernbach, J. Grienenberger, D.W. Levy, & A. Locker, 2002; Parent Development Interview: A. Slade et al., 2005). Pre- and postnatal maternal reflective functioning (RF) was on average low, but varied considerably across participants. Average RF increased significantly during the intervention. Increase in RF level was found to be associated with type of abused substance and maternal trauma history. Mothers who showed lower postnatal RF levels relapsed to substance use more often after completing a residential treatment period, and their children were more likely to be placed in foster care. The intensive focus on maternal RF is an important direction in the development of efficacious treatment for this very high risk population.     

Therapist effects and the dissemination of cognitive behavior therapy for chronic fatigue syndrome in community-based mental health care

ObjectiveThe purpose of the present study was to explore the role of the therapist in the dissemination of manualized cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) outside specialized treatment settings.MethodWe used the routinely collected outcome data of three community-based mental health care centers (MHCs) which implemented and sustained CBT for CFS during the course of the study. Ten therapists, who all received the same training in CBT for CFS, and 103 patients with CFS were included.ResultsRandom effects modeling revealed a significant difference in mean post-treatment fatigue between therapists. The effect of the therapist accounted for 21% of the total variance in post-treatment fatigue in our sample. This effect could be explained by the therapists’ attitude toward working with evidence-based treatment manuals as well as by the MHC where CBT for CFS was delivered.ConclusionThe context in which CBT for CFS is delivered may play an important role in the accomplishment of established therapy effects outside specialized treatment settings. Due to the small sample size of MHCs and the different implementation scenarios in which they were engaged, our findings should be interpreted as preliminary results which are in need for replication.     

Dopamine, working memory, and training induced plasticity: implications for developmental research

Cognitive deficits and particularly deficits in working memory (WM) capacity are common features in neuropsychiatric disorders. Understanding the underlying mechanisms through which WM capacity can be improved is therefore of great importance. Several lines of research indicate that dopamine plays an important role not only in WM function but also for improving WM capacity. For example, pharmacological interventions acting on the dopaminergic system, such as methylphenidate, improve WM performance. In addition, behavioral interventions for improving WM performance in the form of intensive computerized training have recently been associated with changes in dopamine receptor density. These two different means of improving WM performance--pharmacological and behavioral--are thus associated with similar biological mechanisms in the brain involving dopaminergic systems. This article reviews some of the evidence for the role of dopamine in WM functioning, in particular concerning the link to WM development and cognitive plasticity. Novel data are presented showing that variation in the dopamine transporter gene (DAT1) influences improvements in WM and fluid intelligence in preschool-age children following cognitive training. Our results emphasize the importance of the role of dopamine in determining cognitive plasticity.     

The Role of Personality in Relation to Gender Differences in School Subject Choices in Pre-University Education

Boys and girls to some extent differ in personality characteristics while they also prefer different school subjects in secondary education. This study has attempted to unravel the relations among gender, personality, and students?? subject choices. The study was based on a sample of 1,740 9th grade pre-university students throughout the Netherlands (average age 15?years). We used the Five-Factor Personality Inventory (FFPI) of Hendriks, Hofstee, and De Raad (1999a) to measure the students?? personalities. The research questions were: (1) To what extent are students?? personality characteristics related to their subject choices in secondary education? (2) Do students?? personality characteristics mediate the gender ?C subject choice relation? And if yes, which personality characteristics are responsible for this? (3) Is the relation between personality characteristics and subject choices different for boys and girls? We found several associations between personality characteristics and students?? subject choices. Although the relationship between gender and students?? subject choices was slightly attenuated after the inclusion of the personality characteristics in the multinomial logistic regression analyses, gender remained an important predictor of the students?? choices. The personality factor Extraversion partially mediated the relation between gender and students?? choice of advanced mathematics, chemistry, and physics versus a more language and culturally-oriented set of school subjects. Furthermore, gender was found to moderate the relation between the personality factor Autonomy and students?? choice of advanced mathematics, chemistry, and physics versus a more language and culturally-oriented set of school courses.     

The Coronary Health Improvement Project (CHIP) for lowering weight and improving psychosocial health

This study extends previous research evaluating the association between the CHIP intervention, change in body weight, and change in psychological health. A randomized controlled health intervention study lasting 4 wk. was used with 348 participants from metropolitan Rockford, Illinois; ages ranged from 24 to 81 yr. Participants were assessed at baseline, 6 wk., and 6 mo. The Beck Depression Inventory (BDI) and three selected psychosocial measures from the SF-36 Health Survey were used. Significantly greater decreases in Body Mass Index (BMI) occurred after 6 wk. and 6 mo. follow-up for the intervention group compared with the control group, with greater decreases for participants in the overweight and obese categories. Significantly greater improvements were observed in BDI scores, role-emotional and social functioning, and mental health throughout follow-up for the intervention group. The greater the decrease in BMI through 6 wk., the better the chance of improved BDI score, role-emotional score, social functioning score, and mental health score, with odds ratios of 1.3 to 1.9. Similar results occurred through 6 mo., except the mental health variable became nonsignificant. These results indicate that the CHIP intervention significantly improved psychological health for at least six months afterwards, in part through its influence on lowering BMI.     

Emotional Dynamics in the Development of Early Adolescent Psychopathology: A One-Year Longitudinal Study

This study examined the role of the level and variability of happiness, anger, anxiety, and sadness in the development of adolescent-reported anxiety disorder symptoms, depressive symptoms, and aggressive behavior in 452 adolescents (250 male) followed from age 13 to 14. Level and between-day variability of emotions were assessed through adolescent report at 3-month intervals across a 1 year period. Level and variability of the four emotions contributed to changes in anxiety disorder and depressive symptoms more consistently than to changes in aggressive behavior. All four emotions were predictive of changes in internalizing problems, while anger played the most prominent role in the development of aggressive behavior. Variability of emotions contributed to changes in anxiety disorder symptoms, while heightened levels of negative emotions and diminished happiness contributed to changes in depression. Results suggested somewhat stronger effects of negative affect on aggressive behavior for females than for males. Results underscore the role of emotion dysregulation in the development of psychopathology.     

ICAT: a computational model for the adaptive control of fixation durations

Eye movements depend on cognitive processes related to visual information processing. Much has been learned about the spatial selection of fixation locations, while the principles governing the temporal control (fixation durations) are less clear. Here, we review current theories for the control of fixation durations in tasks like visual search, scanning, scene perception, and reading and propose a new model for the control of fixation durations. We distinguish two local principles from one global principle of control. First, an autonomous saccade timer initiates saccades after random time intervals (local-I). Second, foveal inhibition permits immediate prolongation of fixation durations by ongoing processing (local-II). Third, saccade timing is adaptive, so that the mean timer value depends on task requirements and fixation history (Global). We demonstrate by numerical simulations that our model qualitatively reproduces patterns of mean fixation durations and fixation duration distributions observed in typical experiments. When combined with assumptions of saccade target selection and oculomotor control, the model accounts for both temporal and spatial aspects of eye movement control in two versions of a visual search task. We conclude that the model provides a promising framework for the control of fixation durations in saccadic tasks.     

Heterogeneity of treatment changes after psychodynamic therapy within a one year follow‐up: A replication study

Naturalistic psychotherapy effect studies commonly report effect sizes for the total sample. However, a previous study of SCL‐90 Global Severity Index (GSI) improvement in a large outpatient sample used a cluster analytic strategy and reported clinical relevant outcome trajectories that could be grouped into early within‐treatment improvement, late improvement in the follow‐up period, and deteriorating patients with slight improvement that was lost at follow‐up. We explore GSI outcome trajectories and clinical significant change in a sample of 320 patients at a public psychiatric outpatient psychodynamic group therapy unit, the majority with anxiety, personality, and mood disorders. The study revealed large discharge and follow‐up effect sizes but more than one third of the patients were without measurable improvement. The major clusters described above were confirmed, and revealed unique clinical and socio‐demographic characteristics. Late improvers, as compared with early improvers, were characterized by anxiety symptoms and lack of network support after controlling for GSI at admission. Similarly, deteriorating patients had longer duration of illness and less favourable social characteristics compared with the other two groups. Early improving patients were less likely to have participated in short‐term groups, and only one third participated in additional treatment compared with more than 69% of the other patients. Severe and socially affected psychiatric patients, and patients with anxiety and agoraphobic symptoms may be less optimally treated in short‐term time limited psychodynamic groups. There is an obvious need for diversity of treatment offers, better integration of psycho‐social treatment components, and long‐term open ended treatment.     

Reward-driven modulation of adaptive control: How prospective monetary gains interact with unpredictable control demands

Shifting attention is an effortful control process and incurs a cost on the cognitive system. Previous research suggests that rewards, such as monetary gains, will selectively enhance the ability to shift attention when this demand for control is explicitly cued. Here, we hypothesized that prospective monetary gains will selectively enhance the ability to shift attention even when control demand is unpredictable and not cued beforehand in a modality shift paradigm. In two experiments we found that target detection was indeed facilitated by reward signals when an unpredictable shift of attention was required. In these crossmodal trials the target stimulus was preceded by an unpredictive stimulus directing attention to the opposite modality (i.e., visual–auditory or auditory–visual). Importantly, there was no reward effect in ipsimodal trials (i.e., visual–visual or auditory–auditory). Furthermore, the absence of the latter effect could not be explained in terms of physical limits in speed of responding. Potential motivation of monetary rewards thus selectively translates into motivational intensity when control (i.e., switching) is demanded in unpredictable ways.