(Emotion-centered) problem-solving therapy: An update

Problem-solving therapy (PST) is a psychosocial intervention, typically considered to be a member of the cognitive and behaviour therapies family, and is based on a biopsychosocial, diathesis-stress model of psychopathology. The overarching goal of this approach is to promote the successful adoption of adaptive problem-solving attitudes and the effective implementation of certain behaviours as a means of coping with life stressors in order to attenuate the negative effects of such events on physical and mental well-being. Over the past several decades, in addition to accumulating strong support for its efficacy as a clinical intervention, similar to many other forms of psychotherapy, PST has undergone various evolutionary changes. Developed primarily as a more cognitive-based approach, due to the large body of literature in the field of affective neuroscience that underscores the importance of the impact of affect on problem solving, PST has evolved into emotion-centered problem-solving therapy (EC-PST). This article provides for a brief excursion into the historical roots of PST and why it has evolved into EC-PST, as well as providing support for its characterisation as a transdiagnostic approach. In addition, several meta-analyses that underscore its efficacy are described, as well as the most recent clinical guidelines that comprise EC-PST.     

The morality of creating and eliminating duties

Philosophical Studies - We often act in ways that create duties for ourselves: we adopt a child and become obligated to raise and educate her. We also sometimes act in ways that eliminate duties:...     

Mathematics ability and related skills in preschoolers born very preterm

Children born very preterm (VPT) are at risk for academic, behavioral, and/or emotional problems. Mathematics is a particular weakness and better understanding of the relationship between preterm birth and early mathematics ability is needed, particularly as early as possible to aid in early intervention. Preschoolers born VPT (n = 58) and those born full term (FT; n = 29) were administered a large battery of measures within 6 months of beginning kindergarten. A multiple-mediation model was utilized to characterize the difference in skills underlying mathematics ability between groups. Children born VPT performed significantly worse than FT-born children on a measure of mathematics ability as well as full-scale IQ, verbal skills, visual–motor integration, phonological awareness, phonological working memory, motor skills, and executive functioning. Mathematics was significantly correlated with verbal skills, visual–motor integration, phonological processing, and motor skills across both groups. When entered into the mediation model, verbal skills, visual–motor integration, and phonological awareness were significant mediators of the group differences. This analysis provides insights into the pre-academic skills that are weak in preschoolers born VPT and their relationship to mathematics. It is important to identify children who will have difficulties as early as possible, particularly for VPT children who are at higher risk for academic difficulties. Therefore, this model may be used in evaluating VPT children for emerging difficulties as well as an indicator that if other weaknesses are found, an assessment of mathematics should be conducted.     

A Comparison of Sexual Relationships Among Hispanic Men by Sexual Orientation: Implications for HIV/STI Prevention

Hispanic men experience high rates of HIV infection and other sexually transmitted infections (STIs) when compared to non-Hispanic whites. Many factors contribute to HIV/STI risk among Hispanic men. Some researchers have suggested that primary relationships may be a source of HIV/STIs because some men engage in sexual relationships outside of the primary relationship. However, little is known about this among Hispanic men, and less is known about how sexual relationships differ by sexual orientation. The purpose of this study was twofold: (1) to determine if Hispanic men engage in sexual relationships outside of primary relationships; and (2) to compare sex outside of primary relationships by sexual orientation. Data for this study were obtained from a larger study that investigated health risks of Hispanic men residing in the U.S.–Mexico border community. Participants were recruited from agencies that provided services to Hispanic men. Participants completed a structured interview that included questions about primary relationships and sex outside of primary relationships. The sample consisted of 103 Hispanic men (50 heterosexual, 43 gay, and 10 bisexual Hispanic men), but two participants refused to answer relationship questions, resulting in a sample of 101 Hispanic men. About one-third of the participants (n = 29) reported sex outside of the primary relationship, but no differences were found between the gay/bisexual and heterosexual men, X ² (2, N = 101) = 9.91, p = .128. More gay/bisexual men reported sex with the primary partner and another person at the same time than heterosexual men, X ² (2, N = 101) = 13.32, p = .010. More gay/bisexual men reported open relationships when compared to heterosexual men, X ² (2, N = 101) = 17.23, p = .008, and more gay/bisexual men reported sex outside the primary relationship without the primary partner’s knowledge, X ² (2, N = 101) = 15.09. p = .020. However, more heterosexual men reported that condoms were not used for sex outside the primary relationship when compared to gay/bisexual men, X ² (2, N = 101) = 14.01, p = .029. Sex outside of primary relationships presents some implications for HIV/STI prevention among Hispanic men. Because gay/bisexual men experience higher rates of HIV/STI, more attention needs to be focused on all forms of relationships to prevent acquisition of HIV/STIs. Among heterosexual Hispanic men more attention needs to be given to reinforcement of safer sex practices both outside the primary relationship, and within the primary relationship if high risk sex is occurring outside the primary relationship. More research is needed on the reasons for sex outside the primary relationship among Hispanic men, as well as research to promote safer sex practices when sex occurs outside of the primary relationship.     

Clergy Burnout: A Comparison Study with Other Helping Professions

Clergy experience a large number of stressors in their work, including role overload and emotional labor. Although studies have found high rates of depression in clergy, the degree of work-related burnout in clergy compared to other occupations is unknown. The widely used Maslach Burnout Inventory (MBI) measures three aspects of burnout: emotional exhaustion, depersonalization, and personal accomplishment. We sought studies using comparable versions of the MBI for clergy; for social workers, counselors, and teachers because of those occupations’ emotional intensity and labor; and for police and emergency personnel because of the unpredictability and stress-related physiological arousal in those occupations. We found a total of 84 studies and compared the ranges of burnout scores between the studies of clergy, each additional occupation, and MBI published mean norms. Compared to U.S. norms, clergy exhibited moderate rates of burnout. Across the three kinds of burnout, clergy scores were relatively better than those of police and emergency personnel, similar to those of social workers and teachers, and worse than those of counselors. Clergy may benefit from burnout prevention strategies used by counselors. The moderate levels of burnout found for clergy, despite the numerous stressors associated with their occupation, suggest that clergy generally cope well and may be models to study. Overall, there is room for improvement in burnout for all professions, especially police and emergency personnel. It is important to remember the variation within any profession, including clergy, and prevent and address burnout for those in need.     

Emotion dysregulation and threat-related attention bias variability

Although theory suggests that a bias for attending to threat information (ABT) may be a biobehavioral process underlying the transdiagnostic vulnerability factor of emotion dysregulation, there is a paucity of empirical evidence showing direct associations between emotion dysregulation and ABT. The purpose of the present study was to examine the relation between ABT and emotion dysregulation. Participants (N?=?200) completed a battery of self-report questionnaires and a modified dot-probe task with both neutral and threat stimuli and four stimulus presentation durations. Task response times were used to examine traditionally calculated ABT scores, as well as attention bias variability (ABV). As predicted, those with greater emotion dysregulation exhibited greater ABV. Importantly, emotion dysregulation was not associated with response time variability on trials for which only neutral stimuli were presented, thus increasing confidence that emotion dysregulation-related ABV is specific to the presence of threat stimuli and not merely a function of general variability in response times. Results suggest that those with greater emotion dysregulation exhibit attentional dyscontrol in the presence of perceived threat that is characterized by dynamic shifts between vigilance and avoidance.     

The effect of the order in which episodic autobiographical memories versus autobiographical knowledge are shared on feelings of closeness

Autobiographical memories (AMs) can be used to create and maintain closeness with others [Alea, N., &; Bluck, S. (2003). Why are you telling me that? A conceptual model of the social function of autobiographical memory. Memory, 11(2), 165–178]. However, the differential effects of memory specificity are not well established. Two studies with 148 participants tested whether the order in which autobiographical knowledge (AK) and specific episodic AM (EAM) are shared affects feelings of closeness. Participants read two memories hypothetically shared by each of four strangers. The strangers first shared either AK or an EAM, and then shared either AK or an EAM. Participants were randomly assigned to read either positive or negative AMs from the strangers. Findings suggest that people feel closer to those who share positive AMs in the same way they construct memories: starting with general and moving to specific.     

Bad Mothers and Monstrous Sons: Autistic Adults,Lifelong Dependency,and Sensationalized Narratives of Care

Sensationalized representations of autistic families in film and other media frequently feature violent encounters between mothers and sons. This essay analyzes two media stories and three films that suggest how limited—and therefore misleading—popular representations of the autism family are. Except for one of the films, these representations blame the problem of adult autistic dependency on either monstrous autism or bad mothering. Doing so elides collective social responsibility for autism care and denies the reality that autistic adults continue to have complex dependency needs that families cannot always meet. Narratives that sensationalize youth and adults with autism or scapegoat their maternal caregivers also diminish opportunities for social inclusion and for autistic people to live fully and dependently.     

Elevated suicide rates at high altitude: sociodemographic and health issues may be to blame

Suicide rates are higher at high altitudes; some hypothesize that hypoxia is the cause. We examined 8,871 suicides recorded in 2006 in 15 states by the National Violent Death Reporting System, with the victim's home county altitude determined from the National Elevation Dataset through FIPS code matching. We grouped cases by altitude (low<1000m; middle=1000-1999m; high≥2000m). Of reported suicides, 5% were at high and 83% at low altitude, but unadjusted suicide rates per 100,000 population were higher at high (17.7) than at low (5.7) altitude. High and low altitude victims differed with respect to race, ethnicity, rural residence, intoxication, depressed mood preceding the suicide, firearm use and recent financial, job, legal, or interpersonal problems. Even after multivariate adjustment, there were significant differences in personal, mental health, and suicide characteristics among altitude groups. Compared to low altitude victims, high altitude victims had higher odds of having family or friends report of a depressed mood preceding the suicide (OR 1.78; 95%CI:1.46-2.17) and having a crisis within 2weeks before death (OR 2.00; 95%CI:1.63-1.46). Suicide victims at high and low altitudes differ significantly by multiple demographic, psychiatric, and suicide characteristics; these factors, rather than hypoxia or altitude itself, may explain increased suicide rates at high altitude.