Exploring Mindfulness With Occupational Therapists Practicing in Mental Health Contexts

Mindfulness, defined as “a purposeful, non-anxious, reflective presence,” (Epstein, 2003a Epstein, R. M., 2003a. Mindful practice in action (I): Technical competence, evidence-based medicine, and relationship-centered care, Families, Systems, &; Health 21 (1) (2003a), pp. 1–9.[Crossref] , [Google Scholar], p. 1) has been identified as a potentially key practice skill of effective health care practitioners working in mental-health settings. The purpose of this mixed-methods study was to explore the cultivation and use of mindfulness in the clinical practice and everyday lives of occupational therapists who practice in mental health. Results revealed that mindfulness is perceived as being an important clinical quality, which enhances therapist well-being and effectiveness, and contributes to improved client outcomes. Relevance to occupational therapy practice philosophies and directions for future research are discussed.     

Exploring Emotion-Regulation and Autonomic Physiology in Metastatic Breast Cancer Patients: Repression, Suppression, and Restraint of Hostility

We examined relationships between three emotion-regulation constructs and autonomic physiology in metastatic breast cancer patients (N = 31). Autonomic measures are not often studied in breast cancer patients and may provide evidence of an increase in allostatic load. Patients included participated as part of a larger clinical trial of supportive-expressive group therapy. Systolic and diastolic blood pressure and heart rate were assessed at a semi-annual follow-up. We averaged 3 resting assessments and used measures of Repression, Suppression, Restraint of Hostility, and Body Mass Index as predictors of autonomic response. We found that higher repression was significantly associated with higher diastolic blood pressure, while higher restraint of hostility was significantly associated with higher systolic blood pressure. A repressive emotion regulation style may be a risk factor for higher sympathetic activation possibly increasing allostatic load, while restraint of hostility may be a protective factor for women with metastatic breast cancer.     

Relationship between patient characteristics and treatment allocation for patients with personality disorders

Within a large multi-center study in patients with personality disorders, we investigated the relationship between patient characteristics and treatment allocation. Personality pathology, symptom distress, treatment history, motivational factors, and sociodemographics were measured at intake in 923 patients, who subsequently enrolled in short-term or long-term outpatient, day hospital, or inpatient psychotherapy for personality pathology. Logistic regressions were used to examine the predictors of allocation decisions. We found a moderate relationship (R(2) = 0.36) between patient characteristics and treatment setting, and a weak relationship (R(2) = 0.18) between patient characteristics and treatment duration. The most prominent predictors for setting were: symptom distress, cluster C personality pathology, level of identity integration, treatment history, motivation, and parental responsibility. For duration the most prominent predictor was age. We conclude from this study that, in addition to pathology and motivation factors, sociodemographics and treatment history are related to treatment allocation in clinical practice.     

Neurobiological and memory models of risky decision making in adolescents versus young adults

Predictions of fuzzy-trace theory and neurobiological approaches are examined regarding risk taking in a classic decision-making task--the framing task--as well as in the context of real-life risk taking. We report the 1st study of framing effects in adolescents versus adults, varying risk and reward, and relate choices to individual differences, sexual behavior, and behavioral intentions. As predicted by fuzzy-trace theory, adolescents modulated risk taking according to risk and reward. Adults showed standard framing, reflecting greater emphasis on gist-based (qualitative) reasoning, but adolescents displayed reverse framing when potential gains for risk taking were high, reflecting greater emphasis on verbatim-based (quantitative) reasoning. Reverse framing signals a different way of thinking compared with standard framing (reverse framing also differs from simply choosing the risky option). Measures of verbatim- and gist-based reasoning about risk, sensation seeking, behavioral activation, and inhibition were used to extract dimensions of risk proneness: Sensation seeking increased and then decreased, whereas inhibition increased from early adolescence to young adulthood, predicted by neurobiological theories. Two additional dimensions, verbatim- and gist-based reasoning about risk, loaded separately and predicted unique variance in risk taking. Importantly, framing responses predicted real-life risk taking. Reasoning was the most consistent predictor of real-life risk taking: (a) Intentions to have sex, sexual behavior, and number of partners decreased when gist-based reasoning was triggered by retrieval cues in questions about perceived risk, whereas (b) intentions to have sex and number of partners increased when verbatim-based reasoning was triggered by different retrieval cues in questions about perceived risk.     

Gender Bias in Leader Selection? Evidence from a Hiring Simulation Study

The present research investigated factors that might affect gender discrimination in a hiring simulation context from the perspectives of social role theory and the shifting standards model. Specifically, the experimental study investigated whether gender biases are evident in the screening and hiring stage of the personnel selection process depending on the applicants?? social role and evaluators?? gender. A sample of German undergraduate business students (54 women, 53 men) was asked to make a personnel selection decision (short-listing or hiring) about a fictitious applicant (man or woman) in a specific role (leader or non-leader) for a managerial position. Consistent with social role theory??s assumption that social role information is more influential than gender information, participants selected applicants described as leaders over applicants described as non-leaders, regardless of applicant gender. In addition, in the presence of role information, female applicants portrayed as leaders were similarly short-listed and hired as male applicants with the same credentials. In the absence of role information, female applicants were similarly short-listed as male applicants; however, male applicants were hired over female applicants, albeit by male participants only. This is consistent with the shifting standards model??s assumption that group members are held to a higher standard to confirm traits on which they are perceived to be deficient: Male participants hired female applicants portrayed as non-leaders with less certainty than their male counterparts possibly due to higher confirmatory standards for leadership ability in women than men. The research and practice implications of these results are discussed.     

Physical activity and cognitive function in a cross-section of younger and older community-dwelling individuals.

Previous reports have indicated a small, positive relationship between physical activity and cognition. However, the majority of research has focused on older adults, with few studies examining this relationship during earlier periods of the life span. This study examined the relationship of physical activity to cognition in a cross-section of 241 community-dwelling individuals 15-71 years of age with a task requiring variable amounts of executive control. Data were analyzed with multiple regression, which controlled for age, sex, and IQ. Participants reported their physical activity behavior and were tested for reaction time (RT) and response accuracy on congruent and incongruent conditions of a flanker task, which manipulates interference control. After controlling for confounding variables, an age-related slowing of RT was observed during both congruent and incongruent flanker conditions. However, physical activity was associated with faster RT during these conditions, regardless of age. Response accuracy findings indicated that increased physical activity was associated with better performance only during the incongruent condition for the older cohort. Findings suggest that physical activity may be beneficial to both general and selective aspects of cognition, particularly among older adults.     

Boundary Considerations Between Doctoral Students and Master's Students

Counselor educators have a responsibility to teach students about boundary issues and multiple relationships. In addition to counselor–client concerns, there has been increased attention to faculty–student multiple relationships. Like faculty, doctoral students in counselor education programs often engage in roles with master's‐level students in which they hold a position of authority. This article reviews the professional literature on multiple relationships and boundary issues within counselor preparation programs and applies the research to boundary considerations between graduate students. Potentially fruitful areas for research are also suggested.     

Distance-Delivered Parent Training for Childhood Disruptive Behavior (Strongest Families™): a Randomized Controlled Trial and Economic Analysis

Disruptive behavior disorders are prevalent in youth, yet most children with disruptive behavior do not have access to timely, effective treatment. Distance-delivered service (e.g., via telephone, Internet) can overcome several barriers to care. This study tested the effectiveness of a 12-week parent training program, Strongest Families? Parenting the Active Child, delivered via written material, skill-based videos, and telephone coaching sessions, as compared to usual care in reducing child externalizing behavior. Participants were 172 primary caregivers of a 6- to 12-year-old (29% girls; M age?=?8.5 years) recruited from community children’s mental health clinics. Participants were randomized to either Strongest Families? or usual care and completed measures of child externalizing behavior, parenting practices, parent distress, and intervention services consumed at baseline and 5-, 10-, 16-, and 22-months post-baseline. Growth curve analysis showed significant reductions in externalizing behavior in both conditions over time. Improvements were significantly greater at 10 months in the Strongest Families? condition (d =?0.43). At 22 months, however, the differences were not significant and small in magnitude (d =??0.05). The intervention decreased inconsistent discipline significantly more than usual care. Parents in both conditions showed significant reductions in distress. We also conducted a cost-effectiveness analysis to assess the value for money of the Strongest Families? program versus usual care. Distance parent training is a promising way to increase access to, and reduce costs associated with, mental health care for families with a child with disruptive behavior.     

Strukturniveau,Abwehr und Merkmale von Träumen

Attempts were made early on to associate certain human characteristics with dreams. The psychoanalytical notion of structure encompasses a fully differentiated construct, which in particular is characterized by basic mental capabilities. The structural level of a person derived from this reflects their ability for communicative exchange and dealing with themselves as well as with social partners.Within the framework of the project “Affectivity, relationship and mental disorder” operationalized psychodynamic diagnostic (OPD) interviews were carried out, from which the reports of dreams were evaluated for this investigation using the dream generation model of Moser and von Zeppelin. The aim was to investigate associations between features of dreams and the structural level. A total of four different indicators of structure were investigated, e.g. number of personality disorders, OPD-2 structural level, inventory of personality organization (IPO) and the defence maturity quotient, with reference to the association with dream characteristics according to Moser and von Zeppelin.In this investigation only a few associations between dream characteristics and structural level could be identified. The clearest was the association between the degree of maturity of defence and the dream characteristics. Dreams from persons with a more mature defence appeared more complex and livelier. Dreams from persons with a good structural integration according to OPD-2 are also characterized by more “animation” than dreams from less structured persons. The dreams from persons with a moderate structural level do not show any significant differences to those with low structural integration.The results are first and foremost critically discussed with reference to the methods.