Family Cohesion and Adaptation in Pediatric Chronic Conditions: The Missing Link of the Family’s Condition Management

The quality of family functioning has been considered an important predictor of adaptation in children with chronic conditions and their parents. Previous research suggests that beyond general family functioning, the specific experience of the family’s condition management is paramount for understanding family members’ adaptation. This study’s first goal was to compare family functioning and parents’ and children’s adaptation outcomes across four chronic conditions: asthma, diabetes, epilepsy, and obesity. Secondly, we explored the mediating role of family life difficulties and parental mutuality, as two potential paths through which family cohesion is linked to family members’ adaptation. A total of 263 parents of children (3–19 years old) with asthma (n = 77), obesity (n = 79), epilepsy (n = 52) and diabetes (n = 55) completed self-report measures of family cohesion, family life difficulty, parental mutuality, anxiety and depressive symptoms, and their children’s health-related quality of life (HrQoL). The results showed that families of children with diabetes, obesity, and epilepsy were at higher risk of experiencing family difficulties and children’s deteriorated HrQoL when compared to families of children with asthma. With regard to the links among study variables, although family cohesion had both a direct and indirect relationship with parental depressive symptoms, its links with parental anxiety symptoms and children’s HrQoL were only indirect, through family life difficulty. These associations were consistent across the four clinical groups. These findings emphasize the relevance of family-centered interventions aimed at promoting family cohesion, parents’ mutuality, and effective coping with the demands of pediatric chronic conditions.     

Does Theory of Mind in Pre-kindergarten Predict the Ability to Think About a Reader’s Mind in Elementary School Compositions? A Longitudinal Study

A critical skill in emergent writing is the developing ability to take the perspective of different readers; however, the precursors of this skill have not yet been identified. In this longitudinal study, 105 children (90 after attrition) were tested at 3 time points: pre-kindergarten (3–4 years old, n = 105), kindergarten (5 years old, n = 97), and Grade 1 (6–7 years old, n = 90). Theory of mind (ToM) in pre-kindergarten significantly predicted children’s awareness of a reader’s epistemic state when they dictated letters in both kindergarten and Grade 1 even after controlling for language (Peabody Picture Vocabulary Task [PPVT]) and inhibitory control. In addition, ToM in pre-kindergarten remained a significant predictor of reader awareness in Grade 1 after further controlling for reader awareness in kindergarten. There was little relationship between higher-order ToM tasks in kindergarten and reader awareness, but higher-order ToM in Grade 1 concurrently predicted reader awareness. Receptive vocabulary (PPVT) was significantly related to reader awareness at all time points, longitudinally and concurrently. This study has both theoretical implications for the relationship between ToM and emergent literacy and practical implications for the early identification and remediation of children at risk for later writing difficulties.     

Frequency and impact of trauma in older women: A military and nonmilitary sample

Understanding the impact of trauma on late-life functioning in older females is needed in order to provide best care. We explored the impact of trauma on late-life psychological and physical health and functioning among older women (n = 48) who served in the military, or participated in a military lifestyle. Eleven of these women were not veterans, but married to military personnel. Number of traumatic exposures and types of events experienced was associated with increased trauma symptom severity. Trauma symptom severity was associated with decreased physical functioning and increased pain. Increased numbing and avoidance was significantly associated with poorer physical functioning and increased pain. Older women in this study remained at risk of experiencing negative consequences of trauma in terms of increased quantity and severity of trauma symptoms and physical decline and pain. Clinical and research implications are discussed.     

Cultural differences in distraction processing: influence of context at retrieval

Cultural differences in information processing affect perceptual judgment, attention, and memory. We investigated whether cultural differences in processing patterns, specifically East Asian participants’ tendency to encode holistically, compared to Western tendencies to process analytically, affect performance on an implicit memory test. First, participants completed a 1-back task on pictures with superimposed distracting words. After a delay filled with a computerised Corsi block task, they performed a word fragment task in which some fragments could be completed with the distracting words from the 1-back task. Critically, fragments were presented with the same pictures as previously seen (matched condition), with no pictures (control condition), or with pictures from other trials on the 1-back task (mismatched condition). Non-Asian Canadian participants showed virtually no priming for distraction, independent of the reinstatement of encoding context. East Asian Canadian participants showed superior priming for fragments that had been paired with their original pictures. They did not show evidence of a detriment for the mismatched, relative to control, condition.     

THE INTERPLAY OF THE TWO HEMISPHERES OF THE BRAIN IN PSYCHOANALYSIS

Several authors have written intriguingly about the right and left hemispheres of the brain. Each hemisphere perceives the world differently, impacting that which it looks upon and reinforcing our particular world view. Notably, the left hemisphere, has always been assumed to be the dominant hemisphere, but only because it has language and is so adept at formulating arguments. The detached mode of the left hemisphere, while useful and necessary to get distance, is no more real than the engaged, imaginative approach of the right hemisphere. Having written about self-sufficiency as a defense against feeling alone and helpless, I now consider these rational, problem solving, answer generating, and planning activities as products of the left hemisphere. The approach that I am suggesting is of calling our patients’ attention to how their left hemisphere overpowers the new, more uncertain voice of the right hemisphere just after it speaks in a session.     

Supervising Psychoanalytic Psychotherapy: Present Knowledge,Pressing Needs,Future Possibilities

Existing research from the fields of education, cognitive science, neuroscience, and psychoanalytic psychotherapy points us toward possibilities for the future of psychoanalytic supervision. This research suggests that we need to go beyond communicating abstract knowledge and make our supervisory relationships more experiential, participatory, relationship-focused, and personal in order to teach usable knowledge, develop complex psychotherapeutic skills, and facilitate emotional and relational development in our supervisees. The author concludes that a relational model of supervision fits this pedagogical profile. After grappling with our resistances to change, the author hopes that more psychoanalytic supervisors will make use of a relational model of supervision, as well as drawing upon new technologies and neuroscience-based teaching techniques.     

Social Discounting and Cigarette Smoking During Pregnancy

In this study, we examined the association between social discounting and smoking status in a cohort of pregnant cigarette smokers (n = 91), quitters (n = 27), or never‐smokers (n = 30). The smokers and quitters were participants in clinical trials on smoking cessation and relapse prevention, whereas the never‐smokers were controls in a study on nicotine withdrawal during pregnancy. Social discounting was assessed using a paper‐and‐pencil task that assesses the amount of hypothetical money a person is willing to forgo in order to share with individuals in their social network ranging from the person who is emotionally closest to them to a mere acquaintance. The amount that women were willing to forgo in order to share decreased hyperbolically as a function of social distance, with smokers exhibiting steeper discounting functions (i.e., less generosity) than quitters or never‐smokers; discounting functions of quitters and never‐smokers did not differ significantly. In multivariate analyses controlling for potential sociodemographic and other confounds, social discounting remained a significant predictor of smoking status among smokers versus quitters. Overall, these results suggest that individual differences in social discounting may be a factor influencing the choices that women make about quitting smoking upon learning of a pregnancy. Copyright © 2011 John Wiley & Sons, Ltd.     

Generalizability of WISC-IV index and subtest score profiles in children with traumatic brain injury

The Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) is often used to assess children with traumatic brain injury (TBI); although limited information is available regarding its psychometric properties in these children. Two recent reports suggest that the Perceptual Reasoning Index is not uniquely sensitive to TBI, which differs from the Perceptual Organization Index of the WISC-III. The current study examined WISC-IV profiles in two independently gathered samples of children with TBI. Examination of profiles indicated similarities between the current findings and those reported in other studies, in that the greatest deficits were present on the Processing Speed Index and its component subtests of Coding and Symbol Search, while the Perceptual Reasoning index score was comparable to the Verbal Comprehension Index. Also, no significant index or subtest score differences were present when the current sample was compared to the children with TBI reported by Allen, Thaler, Donohue and Mayfield (2010 ). The present findings are consistent with two prior studies of the WISC-IV in children with TBI, providing additional evidence for profile differences between the WISC-III and WISC-IV. The results also suggest that WISC-IV profiles reported in prior studies are generalizable across TBI samples and study sites.     

Risky Business: Risk Perception and the Use of Medical Services among Customers of DTC Personal Genetic Testing

Direct-to-consumer genetic testing has generated speculation about how customers will interpret results and how these interpretations will influence healthcare use and behavior; however, few empirical data on these topics exist. We conducted an online survey of DTC customers of 23andMe, deCODEme, and Navigenics to begin to address these questions. Random samples of U.S. DTC customers were invited to participate. Survey topics included demographics, perceptions of two sample DTC results, and health behaviors following DTC testing. Of 3,167 DTC customers invited, 33% (n?=?1,048) completed the survey. Forty-three percent of respondents had sought additional information about a health condition tested; 28% had discussed their results with a healthcare professional; and 9% had followed up with additional lab tests. Sixteen percent of respondents had changed a medication or supplement regimen, and one-third said they were being more careful about their diet. Many of these health-related behaviors were significantly associated with responses to a question that asked how participants would perceive their colon cancer risk (as low, moderate, or high) if they received a test result showing an 11% lifetime risk, as compared to 5% risk in the general population. Respondents who would consider themselves to be at high risk for colon cancer were significantly more likely to have sought information about a disease (p?=?0.03), discussed results with a physician (p?=?0.05), changed their diet (p?=?0.02), and started exercising more (p?=?0.01). Participants’ personal health contexts—including personal and family history of disease and quality of self-perceived health—were also associated with health-related behaviors after testing. Subjective interpretations of genetic risk data and personal context appear to be related to health behaviors among DTC customers. Sharing DTC test results with healthcare professionals may add perceived utility to the tests.     

Changing the general factor of personality and the c-fos gene expression with methylphenidate and self-regulation therapy

A deepening in the biological nature of the general factor of personality (GFP) is suggested: the activation level of the stress system is here represented by the gene expression of c-fos. The results of a single case experimental design are reported. A model of four coupled differential equations that explains the human personality dynamics as a consequence of a single stimulant drug intake has been fitted to psychological and biological experimental data. The stimulant-drug conditioning and its adaptation to the considered mathematical model is also studied for both kinds of measures. The dynamics of the c-fos expression presents a similar pattern to the dynamics of the psychological measures of personality assessed by the GFP-FAS (Five-Adjective Scale of the General Factor of Personality) as a consequence of a single dose of stimulant drug (methylphenidate). The model predicts similar dynamic patterns for both psychological and biological measures. This study proves that describing mathematically the dynamics of the effects of a stimulant drug as well as the effects of a conditioning method on psychological or subjective variables and on gene expression is possible. It verifies the existence of biological mechanisms underlying the dynamics of the General Factor of Personality (GFP).