Lending a Hand One Child at a Time: The Children's Rights Council's Child Access and Transfer Centers

This paper summarizes characteristics of Children's Rights Council child access and transfer centers and presents findings from a pilot survey of parents in a subset of centers. The legislative history of Federal government support for child access projects is presented. The importance of parent-child access following divorce is noted, and existing research findings on outcomes associated with child access programs are reviewed. The differences between the CRC model of child access centers, and those operated by other providers, are discussed in detail. Add-on services, such as parenting education, counseling, and marriage and family therapy, receive due attention.     

Poorer sleep quality is associated with lower emotion-regulation ability in a laboratory paradigm

Theoretical models suggest a positive relationship between sleep quality and individuals' ability to regulate emotion. However, few studies have empirically tested this hypothesised link using standardised laboratory measures of emotion-regulation ability. The present research examined the relationship between sleep quality and the ability to implement a type of emotion regulation that has particularly important implications for psychological health: cognitive reappraisal (cognitively reframing an emotional event so as to dampen its impact). To do so, 156 participants (86 male) reported on their past week's sleep quality. Their ability to implement cognitive reappraisal (CRA) was then measured with a standardised laboratory challenge. Participants with poorer self-reported sleep quality exhibited lower CRA, even after controlling for fourteen potential key confounds (e.g., age, negative affect, mood disorder symptoms, stress). This finding is consistent with the idea that poorer sleep quality impairs individuals' ability to engage in the crucial task of regulating negative emotions.     

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.     

Commentary: “A Fundamental Polarity in Psychoanalysis: Implications for Personality Development,Psychopathology, and the Therapeutic Process” by Sidney J. Blatt

A commentary on Dr. Sidney J. Blatt's article, “A Fundamental Polarity in Psychoanalysis: Implications for Personality Development, Psycho-pathology, and the Therapeutic Process” is presented by articulating Dr. Blatt's significant contribution to psychoanalysis, developmental and attachment theory, and therapeutic process research. According to Blatt's theory, normal maturation involves a complex reciprocal transaction between two developmental lines throughout the life cycle: (a) the establishment of stable, enduring, mutually satisfying interpersonal relationships and (b) the achievement of a differentiated, stable, and cohesive identity. He has applied this theory to understand both normal and pathological psychological phenomena, the latter resulting from disruptions in these developmental lines, resulting in an overemphasis on relational (anaclitic) or self-definitional (introjective) issues. Further, Dr. Blatt has evaluated his theoretical model through empirical study and demonstrated that relationally oriented and self-definitionally oriented persons have differential responses to psychotherapy. Finally, areas of question and potential for future research are outlined. Specifically, it is argued that although anaclitic and introjective configurations are easy to discuss as distinct types, relevant evidence from attachment theory raises the issue of whether these types may be better conceptualized as dimensions, with different configurations located within two-dimensional space. Further, findings of a group evidencing mixed anaclitic and introjective features raise additional questions about how these configurations relate to one another, and evidence from the attachment literature is used to shed light on this issue.     

Attachment Theory,Psychoanalysis, Personality Development,and Psychopathology

Blatt and Levy place attachment theory and research in a broad theoretical matrix by considering the relationship of attachment patterns to personality development and to different types of psychopathology in adults. Thus Blatt and Levy construct conceptual bridges between the two configurations of personality development and psychopathology that Blatt and colleagues have developed over the past quarter century (e.g., Behrends and Blatt, 1985; Blatt, 1974, 1995; Blatt and Behrends, 1987; Blatt and Blass, 1990, 1996; Blatt and Shichman, 1983) and attachment theory and research. Blatt and Levy identify a polarity that is central to attachment theory and research, the polarity of attachment and separation, and they note that this polarity has also been central in much of classic psychoanalytic theory (e.g., Freud, 1930; Loewald, 1962). This polarity is expressed in attachment theory and research in the differences between avoidant and anxious-preoccupied insecure attachment patterns as well in the distinction between two types of disorganized attachment, helpless-withdrawn and negative intrusive, identified by Lyons-Ruth (1999, 2001).

This polarity of attachment and separation, or relatedness and self-definition is also fundamental to personality development that occurs in the hierarchical dialectic transaction of two basic developmental lines—interpersonal relatedness and self-definition (Blatt and Blass, 1990, 1996). This polarity is also inherent in the conception of two fundamental configurations of psychopathology—anaclitic psychopathology, the dependent (or infantile) and hysterical personality disorders—that are preoccupied with issues of interpersonal relatedness, and introjective psychopathology, the paranoid, obsessive-compulsive and depressive personality disorders, in which issues of self-definition and self-worth are dominant (Blatt, 1974, 1995; Blatt and Shichman, 1983). Thus, the identification of this fundamental polarity provides the basis for establishing links between attachment patterns, personality development, and adult psychopathology. Blatt and Levy also attempt to integrate psychoanalytic concepts of the representational world (e.g., Sandler and Rosenblatt, 1965)—the development of concepts of self and significant others—with the internal working models (IWMs) of attachment relationships. This integration enabled Blatt and Levy to bring a fuller developmental perspective to the IWMs of attachment theory and to note that, based on differences in the content and structural organization of the IWMs or mental representation of self and significant others, several developmental levels can be identified in both avoidant and anxious preoccupied attachment. These developmental levels within each attachment style also identifies less and more adaptive forms of both types of insecure attachment. Thus, the integration of the psychoanalytic concepts of mental representation with concepts of the IWM of attachment theory and research enables Blatt and Levy to create a fuller developmental perspective in the study of insecure attachment patterns.     

Executive functions and social skills in survivors of pediatric brain tumor

Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper-and-pencil measures of social skills and real-world executive skills. Social functioning was related to a specific aspect of executive functions, that is, the survivors' variability in response time, such that inconsistent responding was associated with better parent-reported and survivor-reported social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed.     

A Framework of Statistical Tests For Comparing Mean and Covariance Structure Models

Temporal patterning in blood glucose (BG) consistent with fractals—how BG follows a repetitive pattern through resolutions of time—was used to examine 2 different samples of adolescents with Type 1 diabetes (10–14 years). Sample 1 contained 10 adolescents with longtime series for accurate estimations of long-term dependencies associated with fractals. The second contained 94 adolescents measured multiple times daily over a 2-week period corresponding to psychosocial measures. In both samples, temporal dependencies in BG showed patterns consistent with fractals. In the second sample, temporal dependencies were associated with indicators of vigilant regulation including adolescents' higher anxiety, mothers' higher monitoring, and intrusive support. The existence of temporal dependencies in BG moderated the relationship between glycosylated hemoglobin (Hb_A1c) and indicators of low BG risk but not the relationship between Hb_A1c and high BG risk. These results show how a biomedical indicator may be susceptible to metric issues associated with fractals.     

‘Be careful,or you'll act corruptly and make a carved image for yourselves,in the form of a figure,the likeness male or female’ (Deut. 4:16): A commentary on Norenzayan's Big Gods: How Religion Transformed Cooperation and Conflict (2013)

Norenzayan's book is an ambitious attempt to integrate recent research from behavioral economics and social psychology, particularly priming studies, into a book about religion. If the account is meant as an explanation of religion or big religion, it does not succeed. If it has more modest aims, namely to describe how surveillance institutions, of which big religion is one important class, can sometimes lead to cooperation and conflict, then it is quite successful in doing so.     

Men’s strategies for preserving emotional well-being in advanced prostate cancer: An interpretative phenomenological analysis

Objective: This study explores men with advanced prostate cancers’ own practices for promoting and maintaining emotional well-being using Interpretative Phenomenological Analysis.

Design: Five men with advanced prostate cancer participated in face-to-face, semi-structured, in-depth interviews.

Results: Within rich narratives of lost and regained well-being, two super-ordinate themes emerged – ‘living with an imminent and uncertain death’ and ‘holding on to life.’ Well-being was threatened by reduced sense of the future, isolation and uncertainty. Yet, the men pursued well-being by managing their emotions, striving for the future whilst enjoying life in the present, taking care of their families and renegotiating purpose. Running through participant’s accounts was a preference for taking action and problem-solving. Sense of purpose, social connectedness, and life engagement were revealed as concepts central to improving well-being, indicating areas which practitioners could explore with men to help them re-establish personal goals and life purpose.

Conclusions: The findings also add weight to the evidence base for the potential value of psychological interventions such as cognitive behaviour therapy and mindfulness in men with prostate cancer.     

What,and Where,Luck is: A Response to Jennifer Lackey

In ‘What Luck Is Not’, Lackey presents counterexamples to the two most prominent accounts of luck: the absence of control account and the modal account. I offer an account of luck that conjoins absence of control to a modal condition. I then show that Lackey's counterexamples mislocate the luck: the agents in her cases are lucky, but the luck precedes the event upon which Lackey focuses, and that event is itself only fortunate, not lucky. Finally I offer an account of fortune. Fortune is luck-involving, and therefore easily confused with luck, but it is not itself lucky.