Parents’ Experiences of Receiving the Initial Positive Newborn Screening (NBS) Result for Cystic Fibrosis and Sickle Cell Disease

The clinical advantages of the newborn screening programme (NBS) in the UK are well described in the literature. However, there has been little exploration of the psychosocial impact on the family. This study followed the principles of grounded theory to explore parents’ experiences of receiving the initial positive NBS result for their child with cystic fibrosis (CF) or sickle cell disease (SCD). Semi-structured, qualitative interviews were conducted with 22 parents (12 mothers and 10 fathers) whose children had been diagnosed with CF or SCD via NBS and were under the age of 1 year at the time of interview. The main themes that arose from the data were; parents previous knowledge of the condition and the NBS programme, the method of delivery and parental reactions to the result, sharing the results with others, the impact on parental relationships and support strategies. Study conclusions indicate that most parents thought initial positive NBS results should be delivered by a health professional with condition specific knowledge, preferably with both parents present. Genetic counselling needs to include a focus on the impact of NBS results on parental relationships. Careful consideration needs to be given to strategies to support parents of babies who have positive NBS results both in terms of the psychological health and to assist them in sharing the diagnosis.     

The Role of BIS Sensitivity in the Relationship Between Family Enmeshment and Child Anxiety

Previous work has demonstrated that three overarching vulnerabilities–genetic, environmental, and temperamental–contribute to the development of child anxiety. The purpose of our study was to assess: (a) the relationship between an environmental vulnerability, family enmeshment, and child anxiety; (b) whether parental anxiety accounts for this relationship; and (c) whether this relationship is mediated by levels of child Behavioral Inhibition System sensitivity, a highly persistent temperamental variable demonstrating positive associations with child anxiety. Our study included 38 Canadian parent–child dyads from an urban area, of which 33 children were Caucasian and 18 were girls. Children were aged 9 or 11 years (M = 10.21, SD = 1.07). Children completed measures of anxiety and sensitivity towards threat and parents completed measures of family enmeshment. The results supported a significant positive relationship between family enmeshment and child anxiety; parental anxiety did not account for this relationship; and the relationship was partially mediated by Behavioral Inhibition System sensitivity. Specifically, when the effect of Behavioral Inhibition System sensitivity was controlled for, the association between family enmeshment and child anxiety became non-significant. The results suggest that family enmeshment is associated with levels of child anxiety largely through the function of children’s sensitivity to threat. Enmeshed families may increase children’s susceptibility to anxiety through their effect on child temperament, specifically sensitivity to threat.     

Impact of Caregiver Factors on Youth Service Utilization of Trauma-Focused Cognitive Behavioral Therapy in a Community Setting

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an increasingly available evidence-based therapy that targets the mental health symptoms of youth who have experienced trauma. Limited research has examined how to engage and retain families in TF-CBT services in community settings. Using a mixed-methods approach, the goal of this exploratory study was to identify caregiver factors that impact youth enrollment and completion of community-delivered TF-CBT. The study included 41 caretakers of youth referred to therapy at a local child advocacy center following a forensic assessment substantiating youth trauma exposure. Caregiver factors examined include caregiver demographics, trauma exposure, and mental health symptomology. Results from multivariate logistic regressions indicate that caregivers reporting more children residing in the household were significantly more likely to enroll youth in therapy (OR 2.27; 95 % CI 1.02, 5.03). Qualitative analyses further explicate that parents with personal trauma or therapy experiences expressed positive opinions regarding therapy services for youth, and were more likely to enroll in or complete services. Findings suggest that caregivers with personal traumatic experience and related symptomatology view therapy as important and are more committed to their child receiving therapy. Future research on service utilization is warranted and should explore offering parental psychoeducation or engagement strategies discussing therapy benefits to parents who have not experienced trauma and related mental health symptomatology.     

Staff Intervention and Youth Behaviors in a Child Welfare Residence

The aim of this study was to explore the bidirectional relationship between youth behaviours, more specifically opposition and aggression, and the types of interventions used by staff within a child welfare residential setting. Intervention forms were completed by staff after their interventions with youth. A total of 278 micro-interactions between staff and youth were coded from 84 forms. Generalised estimating equations were conducted controlling for past aggression during the intervention. Reminding youth of rules and using constraining methods were the interventions used with greater frequency when youth were oppositional or aggressive. These two interventions were also found to increase the odds of opposition and aggression among youth.     

Improving Treatment Response for Paediatric Anxiety Disorders: An Information-Processing Perspective

Cognitive behavioural therapy (CBT) is considered the treatment of choice for paediatric anxiety disorders, yet there remains substantial room for improvement in treatment outcomes. This paper examines whether theory and research into the role of information-processing in the underlying psychopathology of paediatric anxiety disorders indicate possibilities for improving treatment response. Using a critical review of recent theoretical, empirical and academic literature, the paper examines the role of information-processing biases in paediatric anxiety disorders, the extent to which CBT targets information-processing biases, and possibilities for improving treatment response. The literature reviewed indicates a role for attentional and interpretational biases in anxious psychopathology. While there is theoretical grounding and limited empirical evidence to indicate that CBT ameliorates interpretational biases, evidence regarding the effects of CBT on attentional biases is mixed. Novel treatment methods including attention bias modification training, attention feedback awareness and control training, and mindfulness-based therapy may hold potential in targeting attentional biases, and thereby in improving treatment response. The integration of novel interventions into an existing evidence-based protocol is a complex issue and faces important challenges with regard to determining the optimal treatment package. Novel interventions targeting information-processing biases may hold potential in improving response to CBT for paediatric anxiety disorders. Many important questions remain to be answered.     

Examining the Intensity and Frequency of Experience of Discrete Positive Emotions

Research into positive emotions has grown significantly over the last decade. This has focused typically on aggregate positive emotions, despite increasing evidence for differential outcomes from discrete positive emotions. We examined the intensity and frequency of experience of 50 discrete positive emotions in a sample of 500 participants. Results showed that the most frequently experienced positive emotions were Interested, Curious, Friendly, Amused and Positive. The most intensely experienced positive emotions were Happy, Optimistic, Friendly, Interested and Determined. Women scored higher than men on the frequency of experience of 12 positive emotions; men scored higher for Ecstatic only. Women scored higher than men on the intensity of experience of 6 positive emotions, whereas men scored higher on the intensity of experience of three positive emotions. Analyses with age showed findings broadly consistent with the U-curve of life satisfaction across the life span. The discussion focuses on how these data can inform and support future positive emotions research, and the importance of considering discrete positive emotions.     

The right to preventive health care

The right to health care is a right to care that (a) is not too costly to the provider, considering the benefits it conveys, and (b) is effective in bringing about the level of health needed for a good human life, not necessarily the best health possible. These considerations suggest that, where possible, society has an obligation to provide preventive health care, which is both low cost and effective, and that health care regulations should promote citizens’ engagement in reasonable preventive health care practices.     

Comparing species decisions in a dichotomous choice task: adjusting task parameters improves performance in monkeys

In comparative psychology, both similarities and differences among species are studied to better understand the evolution of their behavior. To do so, we first test species in tasks using similar procedures, but if differences are found, it is important to determine their underlying cause(s) (e.g., are they due to ecology, cognitive ability, an artifact of the study, and/or some other factor?). In our previous work, primates performed unexpectedly poorly on an apparently simple two-choice discrimination task based on the natural behavior of cleaner fish, while the fish did quite well. In this task, if the subjects first chose one of the options (ephemeral) they received both food items, but if they chose the other (permanent) option first, the ephemeral option disappeared. Here, we test several proposed explanations for primates’ relatively poorer performance. In Study 1, we used a computerized paradigm that differed from the previous test by removing interaction with human experimenters, which may be distracting, and providing a more standardized testing environment. In Study 2, we adapted the computerized paradigm from Study 1 to be more relevant to primate ecology. Monkeys’ overall performance in these adapted tasks matched the performance of the fish in the original study, showing that with the appropriate modifications they can solve the task. We discuss these results in light of comparative research, which requires balancing procedural similarity with considerations of how the details of the task or the context may influence how different species perceive and solve tasks differently.     

An electrophysiological dissociation of craving and stimulus-dependent attentional capture in smokers

It has been suggested that over the course of an addiction, addiction-related stimuli become highly salient in the environment, thereby capturing an addict’s attention. To assess these effects neurally in smokers, and how they interact with craving, we recorded electroencephalography (EEG) in two sessions: one in which participants had just smoked (non-craving), and one in which they had abstained from smoking for 3 h (craving). In both sessions, participants performed a visual-search task in which two colored squares were presented to the left and right of fixation, with one color being the target to which they should shift attention and discriminate the locations of two missing corners. Task-irrelevant images, both smoking-related and non-smoking-related, were embedded in both squares, enabling the shift of spatial attention to the target to be examined as a function of the addiction-related image being present or absent in the target, the distractor, or both. Behaviorally, participants were slower to respond to targets containing a smoking-related image. Furthermore, when the target contained a smoking-related image, the neural responses indicated that attention had been shifted less strongly to the target; when the distractor contained a smoking-related image, the shift of attention to the contralateral target was stronger. These effects occurred independently of craving and suggest that participants were actively avoiding the smoking-related images. Together, these results provide an electrophysiological dissociation between addiction-related visual-stimulus processing and the neural activity associated with craving.