A Pilot Study of Emotion Regulation Therapy for Generalized Anxiety and Depression: Findings From a Diverse Sample of Young Adults

Emotion regulation therapy (ERT) for generalized anxiety disorder (GAD) and accompanying major depressive disorder (MDD) is a theoretically derived, evidence-based treatment that integrates principles from traditional and contemporary cognitive-behavioral and experiential approaches with basic and translational findings from affect science to offer a blueprint for improving intervention by focusing on the motivational responses and corresponding self-referential regulatory characteristics. Preliminary evidence supports the efficacy of a 20-session version of ERT. However, previous trials of ERT and other traditional and contemporary cognitive-behavioral therapies have often utilized relatively homogeneous samples. Various contextual and demographic factors may be associated with challenges that increase risk for negative mental and social outcomes for young adults ages 18–29, particularly for individuals from diverse backgrounds. The aim of this pilot study was to examine the effectiveness of a briefer 16-session version of ERT in a racially and ethnically diverse sample of young adults. Participants (N = 31) were enrolled at an urban-based, commuter college who consented to treatment for anxiety, worry, or depression at an on-campus counseling center. Open-trial results demonstrate strong ameliorative changes in worry, rumination, self-reported and clinician-rated GAD and MDD severity, social disability, quality of life, attentional flexibility, decentering/distancing, reappraisal, trait mindfulness, and negative emotionality from pre- to posttreatment. These gains were maintained throughout a 3- and 9-month follow-up. These findings provide preliminary evidence for the efficacy of ERT in treating a racially and ethnically heterogeneous population. Further, this study highlights comparable effectiveness of a briefer 16-session version of ERT.     

Genetic Counselors’ Perspectives About Cell-Free DNA: Experiences,Challenges, and Expectations for Obstetricians

The expansion of cell-free fetal DNA (cfDNA) screening for a larger and diverse set of genetic variants, in addition for use among the low-risk obstetric population, presents important clinical challenges for all healthcare providers involved in the delivery of prenatal care. It is unclear how to leverage the different members of the healthcare team to respond to these challenges. We conducted interviews with 25 prenatal genetic counselors to understand their experience with the continued expansion of cfDNA screening. Participants supported the use of cfDNA screening for the common autosomal aneuploidies, but noted some reservations for its use to identify fetal sex and microdeletions. Participants reported several barriers to ensuring that patients have the information and support to make informed decisions about using cfDNA to screen for these different conditions. This was seen as a dual-sided problem, and necessitated additional education interventions that addressed patients seeking cfDNA screening, and obstetricians who introduce the concepts of genetic risk and cfDNA to patients. In addition, participants noted that they have a professional responsibility to educate obstetricians about cfDNA so they can be prepared to be gatekeepers of counseling and education about this screening option for use among the general obstetric population.     

Associations between Stress,Psychosomatic Complaints,and Parental Criticism among Affluent Adolescent Girls

A growing body of research has shown that adolescent girls in the context of affluence face a series of unique pressures that may increase social-emotional problems. Little research, however, has examined associations between perceived stress and psychosomatic complaints among privileged youth. In the present study, we investigated the relationships between stress, psychosomatic complaints, and parental criticism in a sample of preadolescent and adolescent girls (n?=?218) from selective, private schools. Using OLS regression analyses, cross-sectional and longitudinal associations were evident between perceived stress and psychosomatic complaints, with increases in stress associated with increases in psychosomatic problems. Parental criticism was also examined as a predictor of girls’ psychosomatic complaints and stress levels. Results indicated that parental criticism was significantly and positively associated with psychosomatic problems in cross-sectional models and that perceived stress levels mediated this association. Additional analyses demonstrated that the relationship between psychosomatic complaints and stress may be bidirectional. Taken together, results from this exploratory study suggest that girls in the context of affluence may also experience psychosomatic complaints, in addition to social-emotional problems.     

From Treatment to Empowerment: New Approaches to Youth Mentoring

Traditional approaches to formal youth mentoring have focused primarily on improving the lives of “at‐risk” youth through the assignment of individual mentors who are typically disconnected from youth's communities. Similarly, research in the field of formal mentoring has emphasized the dyadic relationship between the mentor and the mentee, with less attention paid to the broader relational contexts in which such relationships unfold. The current paper proposes a new framework that expands the scope of mentoring interventions to include approaches that build on and cultivate informal supports and empower youth to identify and reach out to networks of potential supportive adults, thus increasing the reach of youth mentoring.     

Prior exposure to extreme pain alters neural response to pain in others

In the extant literature examining the brain mechanisms implicated in pain perception, researchers have theorized that the overlapping responses to pain in the self and in others mark the human capacity for empathy. Here we investigated how prior exposure to extreme pain affects pain perception, by assessing the dynamics of pain processing in veterans who were previously exposed to severe injury. Forty-three participants (28 pain-exposed and 15 controls) underwent whole-head magnetoencephalography (MEG) while viewing photographs of limbs in painful and nonpainful (neutral) conditions. Among controls, an early (0–220 ms) “pain effect” in the posterior cingulate and sensorimotor cortices, and a later (760–900 ms) “pain effect” in the posterior cingulate cortex, superior temporal gyrus/insula, and fusiform gyrus were found, indicated by enhanced alpha suppression to the pain versus nonpain conditions. Importantly, pain-exposed participants exhibited an atypical pain response in the posterior cingulate cortex, indicated by a normative response to pain, but no pain-to-no-pain differentiation. This may suggest that individuals exposed to extreme pain may perceive neutral stimuli as potentially threatening. Our findings demonstrate alterations in pain perception following extreme pain exposure, chart the sequence from automatic to evaluative pain processing, and emphasize the importance of considering past experiences in studying the neural response to others’ states.     

DEPLOYMENT STATUS: A DIRECT OR INDIRECT EFFECT ON MOTHER–CHILD ATTACHMENT WITHIN A CANADIAN MILITARY CONTEXT?

Research has suggested that military spouses experience increased depressive symptoms and parenting stress during a military member's deployment. A relationship between maternal depressive symptoms, parenting stress, and child attachment security has been found in the general population, as has an indication that social support may provide a buffering effect. While there appears to be an association between the emotional well‐being of military spouses and child emotional well‐being during deployment, data are limited regarding the association between maternal emotional well‐being and child attachment security. The current study explores the association between deployment status and child attachment to the nonmilitary parent (i.e., the mother in this study) in a sample of 68 Canadian military families. Results revealed a significant impact of deployment status on maternal depressive symptoms and on quality of child attachment. The impact of deployment status on attachment was not mediated through the maternal variables, and despite a main effect of social support on the maternal variables, there was no moderating effect. Thus, our results suggest that deployment may affect child attachment independently of maternal well‐being.     

Early development program: Collaborative structures and processes

The Early Development Program (EDP) provides and coordinates interdisciplinary mental health and developmental assessment/intervention for children ages zero through 3 years and their families. EDP's interdisciplinary team includes faculty in child and adolescent psychiatry, developmental pediatrics, pediatrics, psychology, developmental psychology, education, nursing, social service, speech and language, and occupational and physical therapy plus trainees in psychiatry, pediatrics, psychology, and education. Children are referred largely by pediatrics; two-thirds are insured by Medicaid and one-third by HMOs and private insurance. Local foundations help support ongoing assessment/intervention. Disruptive behavior is the most frequent referral problem; almost half of those presenting with disruptive behavior also have delays. Using the Diagnostic Classification: 0-3 (DC: 0-3), Disorders of affect, regulatory disorders, traumatic stress disorder, and relationship disorders are most often diagnosed; comorbid diagnoses are common. Family-centered intervention includes family-psychodynamic and interactional approaches and facilitated use and development of community resources. © 1997 Michigan Association for Infant Mental Health