Predicting maternal sensitivity: The roles of postnatal depressive symptoms and parasympathetic dysregulation

Previous research has established that maternal depression is a risk factor for a variety of negative developmental outcomes among infants and children. Although low levels of maternal sensitivity have been hypothesized to explain this risk, the biological mechanisms underlying the association between maternal depressive symptoms and low levels of maternal sensitivity have been largely underexplored. This study examined the roles of postnatal depressive symptoms and parasympathetic nervous system functioning as predictors of low levels of maternal sensitivity, during a stressful mother–infant interaction—the reunion phase of the Still‐Face Paradigm. Depressive symptoms and traitlike predispositions toward parasympathetic dysregulation, as indexed by low resting levels of respiratory sinus arrhythmia, were associated independently with less sensitive parenting. Discussion considers that during stressful mother–infant interactions, both mothers with depressive symptoms and mothers predisposed to parasympathetic dysregulation may have fewer emotional, physiological, and psychological resources with which to respond sensitively to their infants' cues.     

Early childhood trichotillomania: Initial considerations on phenomenology,treatment, and future directions

Historically, trichotillomania (TTM) in young children (0–3 years old) generally has been considered to be a benign habit that is clinically distinct from the TTM seen in older children and adults. However, early childhood TTM can be an impairing pathological disorder that merits formal intervention. The present article reviews the extant literature on TTM in young children, highlighting the limited available phenomenological data. We discuss a behavioral approach to conceptualization and treatment, highlighting core intervention strategies in three early childhood TTM cases seen in our clinic. We conclude by discussing areas in need of further empirical attention.     

Mothers' voices: Coping with their children's initial disability diagnosis

For parents of infants and toddlers receiving a diagnosis of disability, a variety of responses may result. Yet, little is known about the specific ways families cope with the initial diagnosis. This qualitative study investigated 6 mothers' memories of their children's diagnoses. Mothers described their use of both palliative strategies (denying, questioning, and wishful thinking) and problem‐solving strategies (searching for information, seeking social support, reframing, and seeking spiritual support) to cope with their children's initial diagnoses. The results of this study may improve professionals' understanding of parents' need for information and support at the time of initial diagnosis.     

Spiritual Issues in Counseling: What Do Students Perceive They Are Being Taught?

Client religious and spiritual practices have recently emerged as beneficial to both mental and physical health. However, graduates of counseling programs indicate that they have not been adequately trained to address religious and spiritual issues with clients. This exploratory study focused on the perceptions of counselors‐in‐training regarding what messages they received about these issues during their training programs, as well as their potential behaviors when working with clients. Results indicated that potential behaviors are not always consistent with what they are taught. Implications for training and future research are discussed.     

Neural activation underlying cognitive control in the context of neutral and affectively charged pictures in children

The neural correlates of cognitive control for typically developing 9-year-old children were examined using dense-array ERPs and estimates of cortical activation (LORETA) during a go/no-go task with two conditions: a neutral picture condition and an affectively charged picture condition. Activation was estimated for the entire cortex after which data were exported for four regions of interests (ROIs): ventrolateral prefrontal cortex (VLPFC), dorsal anterior cingulate cortex (dACC), dorsolateral prefrontal cortex (DLPFC), and orbitofrontal/ventromedial prefrontal cortex (OFC/VMPFC). Results revealed faster reaction times, greater N2 activation, and greater prefrontal activation for the affectively charged picture condition than the neutral picture condition. The findings are discussed in reference to the impact of affective stimuli on recruitment of specific brain regions involved in cognitive control.     

The perceptual span during foveally-demanding visual target localization

Foveally-induced processing load deteriorates target localization performance in vision-guided tasks. Here, participants searched for a target embedded among coded distractors. High processing load was effected by instructing some participants to use the coded distractors to guide their search for the target. Other participants (in the low processing load condition) were not apprised of the code. The experiment examined whether increased processing load alters the span of effective processing (i.e. perceptual span) by (a) reducing its size, (b) altering its shape, or (c) reducing its size and altering its shape. The results demonstrated a reduction in the size of the perceptual span, with no significant change to its shape. It is argued that when distractors are processed beyond simply rejecting them as non targets, the perceptual span shrinks with increasing processing load. The findings are discussed in contrast to a general interference theory that predicts a change in vision-guided performance without a shrinking of the perceptual span.     

Introduction: babies in the consulting room: what happens when analyst, mother, and infant meet?

Analytic work with a pregnant woman may foster the psychological gestation of the self-as-mother. For the mother--as for the infant--the developmental process continues well beyond delivery. It should not surprise us, then, that many mothers continue to bring their babies to sessions after birth. Analytic work in this context can affect a patient's sense of herself, and perhaps her competence, as a mother. Yet the presence of babies in the consulting room is an underacknowledged feature of contemporary practice. For this section of JAPA, we have collected three papers that explore some of the unique challenges and opportunities that arise when a patient brings her baby to treatment. Earlier versions of each paper were first presented at a panel, "Babies in the Consulting Room," at the June 2011 meeting of the American Psychoanalytic Association in San Francisco.     

The compensation and capitalization models: A test of two approaches to individualizing the treatment of depression

Despite long-standing calls for the individualization of treatments for depression, modest progress has been made in this effort. The primary objective of this study was to test two competing approaches to personalizing cognitive-behavioral treatment of depression (viz., capitalization and compensation). Thirty-four adults meeting criteria for Major Depressive Disorder (59% female, 85% Caucasian) were randomized to 16-weeks of cognitive-behavioral treatment in which strategies used were selected based on either the capitalization approach (treatment matched to relative strengths) or the compensation approach (treatment matched to relative deficits). Outcome was assessed with a composite measure of both self-report (i.e., Beck Depression Inventory) and observer-rated (i.e., Hamilton Rating Scale for Depression) depressive symptoms. Hierarchical linear modeling revealed a significant treatment approach by time interaction indicating a faster rate of symptom change for the capitalization approach compared to the compensation approach (d = .69, p = .03). Personalizing treatment to patients' relative strengths led to better outcome than treatment personalized to patients' relative deficits. If replicated, these findings would suggest a significant change in thinking about how therapists might best adapt cognitive-behavioral interventions for depression for particular patients.     

Taking stress response out of the box: stability, discontinuity, and temperament effects on HPA and SNS across social stressors in mother-infant dyads

This study investigated continuity and stability of hypothalamic-pituitary-adrenal (HPA) and sympathetic nervous system (SNS) response measures in mother-infant dyads across 2 different types of social stress sessions. Synchrony of response trajectories across systems (SNS-HPA coordination) and partners (mother-infant attunement) was addressed, as were associations with infant temperament. Primiparous mothers and their 18-month-old infants (n = 86 dyads) completed an attachment stressor--Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978)--at Session 1 and challenge stressors--cleanup task and emotion task battery--at Session 2. Mother and infant saliva samples collected to index pre-stress, stress, and post-stress response during each session were assayed for cortisol (HPA marker) and salivary alpha-amylase (sAA; SNS marker). Multilevel modeling of cortisol/sAA trajectories across sessions revealed rank-order stability in mother/infant stress measures but discontinuity in absolute levels; cortisol trajectories were higher during attachment stress, and sAA trajectories were higher during challenge stress. Varying degrees of mother-infant attunement were found across sessions/systems. Infant surgency predicted higher stress measures, and negative affect and effortful control predicted lower stress measures, though associations depended on session/system. Findings are discussed in terms of advancing a multisystemic, contextual definition of developing stress responsiveness.     

A factor analytic investigation of the BASC-2 Behavioral and Emotional Screening System Parent Form: psychometric properties, practical implications, and future directions

The Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Parent Form (BESS Parent; Kamphaus & Reynolds, 2007) is a recently developed instrument designed to identify behavioral and emotional risk in students. To describe the underlying factor structure for this instrument, exploratory (EFA) and confirmatory factor analyses (CFA) were conducted utilizing two subsets of a large, nationally-representative sample. The results of the EFA suggested that the BESS Parent contained a four-factor latent structure (i.e., Externalizing, Internalizing, Adaptive Skills, and Inattention), which was supported by CFA. Results support further investigation into utilizing four subscales in addition to an overall risk score; distributional and reliability information for the BESS Parent subscales is provided. Practical implications for school psychologists interested in early identification and directions for future research are discussed.