Parental Opioid Abuse: A Review of Child Outcomes,Parenting, and Parenting Interventions

Opioid abuse is now considered an epidemic, and many of the adults using this substance are parents. The purpose of the current paper is twofold: (1) to review rigorously conducted studies (e.g., included a comparison group; utilized inferential statistics) examining the association of opioid abuse with parenting and child outcomes, and (2) to review parenting intervention programs with these caregivers. Findings indicate that there are very few rigorously conducted studies examining children and parenting when parents abuse opioids. Furthermore, only four intervention programs have been conducted using randomized control trials and inferential statistics. We conclude that there is limited research that can be labeled as a rigorous science currently addressing this aspect of the opioid epidemic. Recommendations for further research are delineated.     

Follow-up evaluation of 55 child guidance cases

Parents coming to a child guidance clinic reported behaviour in their children which they (parents) viewed as problems or symptoms. The first 55 families coming to a new clinic were selected as part of a programme to evaluate the effects of the clinic's services on its total caseload. A follow-up inquiry was made about the presenting symptoms six months after the family ceased attending the Center. The parental reports of improvement in the child's symptoms appeared to be related to the extent to which both parents participated in coming to the clinic: the child's age also had some relationship to reported improvement. The kind of service provided, and the number of contacts with the Center appeared to be unrelated to reported improvement.     

Cellular and molecular mechanisms underlying learning and memory impairments produced by cannabinoids

Why does smoking marijuana impair learning and memory? Behavioral studies suggest that a disruption of normal hippocampal function contributes to these deficits. In vitro experiments find that cannabinoid receptor activation reduces neurotransmitter release below the levels required to trigger long-term changes in synaptic strength in the hippocampus. Cannabinoids reduce glutamate release through a G-protein-mediated inhibition of the calcium channels responsible for neurotransmitter release from hippocampal neurons. These mechanisms likely play a role in the learning and memory impairments produced by cannabinoids and by endogenous cannabinoid receptor ligands.     

Newborn Screening for Cystic Fibrosis: Parents’ Preferences Regarding Counseling At the Time of Infants’ Sweat Test

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents’ preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents’ preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents’ distress while mismatched counseling tended to increase parents’ worry about their infant.     

How does clients' method of payment influence psychologists' diagnostic decisions?

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues.     

Therapeutic reactance in a depressed client sample: a comparison of two measures

The impact of client variables on psychotherapy is of both theoretical and practical importance. Reactance--the premise that individuals seek to maintain control over personal freedoms when threatened by a perceived loss thereof--has been shown to have an impact on the effectiveness of therapeutic interventions. Developing an effective means of quantitatively assessing this characteristic prior to treatment could facilitate treatment planning and maximize treatment outcome. The present study compared two paper-and-pencil measures of reactance: the Therapeutic Reactance Scale (TRS) and Resistance Potential (RP). Ninety-eight men and women diagnosed with depression completed both measures. The TRS and RP failed to correlate despite their presumed ability to measure the same construct. The RP exhibited extremely poor internal consistency, calling into question results that have been based on this measure. The TRS results provided evidence of convergent, divergent, and construct validity for this instrument.     

“Paging Dr. Lauben! Dr. Gustav Lauben!”: Some Questions about Individualism and Competence

In several works, Frege argues that content is objective (i.e., thethoughts we entertain and communicate, and the senses of which theyare composed, are public, not private, property). There are, however,some remarks in the Fregean corpus that are in tension with this view.This paper is centered on an investigation of the most notorious andextreme such passage: the `Dr. Lauben example, from Frege (1918). Aprincipal aim is to attain more clarity on the evident tension withinFreges views on content, between this dominant objectivism and someelements that seem to run counter to it, via developing an understandingof the `Dr. Lauben example. Then I will argue that this interpretation goes some way toward undermining some prevalent contemporary viewsabout language. Based on the advice of Dr. Lauben, I will argue againsta certain understanding of the causal-historical theory of reference –more specifically, of the phenomenon of deferential uses of linguisticexpressions – upon which these views are premised, and I will drawout some morals that pertain to individualism and competence.     

The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.