Childhood Emotional Maltreatment as a Robust Predictor of Suicidal Ideation: A 3-Year Multi-Wave,Prospective Investigation

Despite literature suggesting a relationship between child maltreatment and suicidal ideation, few studies have examined the prospective course of this relationship. The current study examined this relationship in a sample of 682 community youth who were followed over the course of 3 years. Repeated measures of suicidal ideation, emotional maltreatment, and depressive symptom severity were examined in multi-wave path analysis models. Overall, results suggest that emotional maltreatment over time contributes uniquely to the prospective prediction of suicidal ideation, even when controlling for age, previous suicidal ideation, biological sex, and depression symptom severity. Unlike previous studies that have only measured emotional maltreatment at one-time point, the current study demonstrates that emotional maltreatment contributes unique risk to suicidal ideation prospectively among youth. Results speak to the importance of examining emotional maltreatment and suicidal ideation within prospective models of risk and suggest that emotional maltreatment is a robust predictor of suicidal ideation, over and above history of suicidal ideation and depression.     

Parenthood Residency Status and Criminal Desistance across Neighborhood Contexts

Research on desistance and parenthood has yielded mixed results bringing into question whether, and for whom, parenthood matters. Scholarship has not fully explored the importance of residency status or patterns of desistance across a full range of neighborhood contexts, nor examined distinctions between temporary and long-term desistance. Our study uses data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to examine the association between parenthood residence and criminal desistance across levels of adolescent neighborhood poverty. Our findings demonstrate that parenthood has different meanings for desistance, depending on its duration, residency status, and neighborhood context.     

From Online Dating to Online Divorce: An Overview of Couple and Family Relationships Shaped Through Digital Media

From the very early stages of initiating relationships to types of post-break-up behaviors, the internet has the potential to play an influential role in all areas of family and particularly couple relationships. This paper examines how ICTs (“information and communication technology”) can shape such relationships. The impact on the various stages of relationships is systematized (relationship development, couple and family formation, separation) with a special focus on intergenerational opportunities and conflicts associated with modern media usage. Against the background of psychological and media communication theories and psychotherapeutic approaches as well as empirical findings the following topics are considered: (1) Initiation of relationships through ICTs (e.g. meet new partners through online dating); (2) Impact of digital media on relationship development and existing partnerships (e.g. new opportunities and internet-related challenges that have to be faced by couples) (3) Influence of ICTs on separations (e.g. online mediation, getting divorced online). In summary, the role of ICTs in new, existing and separated partnerships and families is multifaceted. An outlook on further developments as well as research desiderata is given.     

Decreasing Excessive Bids for Attention in a Simulated Early Education Classroom

Differential-reinforcement-of-low-rate (DRL) schedules can be used to decrease, but not eliminate, excessive bids for teacher attention in a classroom. There are two primary methods of implementing a DRL: full session and spaced responding. Some research suggests that the full-session DRL may eliminate target responding. The purpose of the current study was to compare the effectiveness of and preference for the two DRL methods in a simulated preschool classroom. Three participants completed difficult puzzles in baseline, both DRL, and differential-reinforcement-of-other-behavior (DRO) conditions. In the spaced-responding and full-session DRL conditions, the optimal rate of bids for attention was approximately 75% (two participants) or 50% (one participant) of baseline responding. All participants requested attention near the optimal criterion in both DRL conditions and at a lower rate (near zero) in the DRO condition. Treatment preference of the students was assessed in a concurrent-chain arrangement. All participants preferred both types of DRL conditions to DRO, and two participants showed a preference for the full-session DRL. Results suggest that either DRL procedure may be suitable for a preschool classroom, but a full-session DRL may be ideal.     

PTSD symptoms among tsunami exposed mothers in Sri Lanka: the role of disaster exposure,culturally specific coping strategies,and recovery efforts

Background and objectives: Women in Sri Lanka have been uniquely exposed to a complex and protracted set of stressors stemming from a civil war conflict spanning over 25 years and the tsunami which struck Southeast Asia in 2004. This study investigates coping strategies and their association with trauma-related symptoms of tsunami-exposed mothers in Sri Lanka at two time points.

Design: Data for this study come from surveys administered in two waves of data collection to investigate both mothers’ and adolescent children’s post-tsunami mental health in early 2005, three months after the tsunami struck, and again in 2008, three years later.

Methods: Latent-variable structural equation modeling was used to test the study hypotheses among 160 tsunami-affected mothers in the Polhena village, Matara district, Sri Lanka.

Results: Among the various coping strategies examined, the use of cultural rituals as well as inner psychological strength was associated with lower levels of posttraumatic stress symptoms. In contrast, passive religious beliefs were associated with greater posttraumatic stress levels.

Conclusions: The results of this study reveal the differential associations of various coping strategies including rituals used by mothers exposed to the tsunami in Sri Lanka and their posttraumatic stress symptom levels.     

Psychometric Properties of an Italian Version of the Differentiation of Self Inventory-Revised (It-DSI-R)

The Differentiation of Self (DoS) is a key concept of Bowen’s theory, indicating a process that begins in early infancy and progresses throughout childhood and adolescence, to reach a basic level in early adulthood. This study examined the psychometric properties of an Italian version of the Differentiation of Self Inventory-Revised (DSI-R) Skowron, Schmitt, Journal of Marital and Family Therapy 29:209–222, 2003), a multidimensional measure assessing DoS as conceptualized by Bowen. The sample comprised 671 subjects (age 19–69 year). Exploratory and confirmatory factor analyses showed that the Italian DSI-R possesses good psychometric properties. Internal consistencies were adequate. Correlations with the Dyadic Adjustment Scale, the Symptom Checklist 90-Revised, and the trait form of the State-Trait Anxiety Inventory were consistent with the theoretical relations among the constructs. The findings confirm the use of DSI-R as a psychometrically sound measure of the differentiation of self in the Italian context. Implications for future research and clinical practice are addressed.     

A Case Study of Individually Delivered Mindfulness-Based Cognitive Behavioral Therapy for Severe Health Anxiety

Health anxiety involves persistent worry about one's physical health, despite medical reassurance. Cognitive-behavioral therapy (CBT) is currently the most widely used, evidence-based treatment for health anxiety. Mindfulness-based cognitive therapy (MBCT) is an evidence-based cognitive-behavioral treatment approach that may be useful for health anxiety due to its focus on nonjudgmental awareness and acceptance of physical and emotional events. MBCT has largely been evaluated in a group format; however, the majority of outpatient CBT providers rely also on individual treatments. No research to date has examined the utility of MBCT delivered as an individual therapy for patients with health anxiety. The purpose of the current case study is to describe the delivery, acceptability, and effects of an individually delivered mindfulness-based cognitive-behavioral intervention on health anxiety symptoms for a young woman with severe health anxiety referred to outpatient behavioral medicine by her primary care provider. The treatment was a 16-session, patient-centered intervention largely delivered using MBCT techniques, supplemented by traditional cognitive-behavioral techniques. The patient completed a validated self-report measure of health anxiety symptoms (SHAI) at the beginning of each session. The treatment was found to be acceptable, as evidenced by high treatment attendance and patient feedback. The patient reported significant cognitive, affective, and behavioral improvements, including a 67% reduction in medial visits. Health anxiety scores on the SHAI showed a 52% decrease from the first to last session, reliable change index score of 12.11, and fell below the clinical cutoff at the final session, demonstrating clinical significance. These results suggest that it is feasible to adapt MBCT for the individual treatment of health anxiety, and that controlled trials of individual MBCT are warranted.     

Physician Migration: Experience of International Medical Graduates in the USA

The purpose of this study was to explore the experience of foreign-born international medical graduates (IMGs) in the USA. Few studies describe IMG experiences in attaining medical licensure in the USA at each step of the process. Furthermore, little is known about IMGs who choose not to become a licensed physician or were unsuccessful in doing so. In this study, 20 foreign-born IMGs, 16 practicing IMGs and 4 non-licensed physician IMGs, participated in a 1-h semi-structured face-to-face interview between September 2013 and April 2014. Participants were from North America (Canada), Latin America, South Asia, East Asia, Europe, the Middle East, or Sub-Saharan Africa. Interviews were transcribed. Two of the authors conducted initial analysis of each interview separately. Four primary themes emerged based on the data analysis: (1) barriers to physician careers include the immigration process, years since graduating from medical school, language and culture, and cost and time; (2) positive factors to support physician careers include networking and research experience; (3) factors that positively or negatively affect IMGs seeking physician careers such as the education system in a home country and family; and (4) non-physician careers. In order to develop multiple pathways to utilize IMGs in the US healthcare system, future research examining the following areas is necessary: (1) support systems for IMGs who are taking the US Medical Licensing Exam (USMLE) or applying for a residency position and (2) the experience of IMGs who are not certified physicians in the USA.