Training Pediatric Psychologists for Perinatal Behavioral Health Services in a Pediatric Hospital

Although pediatric hospitals specialize in providing care to children and adolescents, at The Children’s Hospital of Philadelphia (CHOP), our team has been providing behavioral health services for two unique parent populations—parents with a child in the Newborn Infant Intensive Care Unit and pregnant women carrying fetuses with specific birth defects and receiving prenatal care in the Center for Fetal Diagnosis and Treatment. A new training program was developed to expand the scope of pediatric psychologists’ practice to include perinatal behavioral health services, specifically for these two unique parent populations served at CHOP. The program includes direct service provision for adult mental health concerns, as well as education and support to help families cope with the existing medical conditions. This article describes the training program and its implementation as a model of training for other pediatric hospitals. The roles of psychologists embedded in these units and hospital privileges are discussed.     

A Meta-analysis of Wilderness Therapy Outcomes for Private Pay Clients

Wilderness therapy is becoming a more widely used intervention for adolescents, but there have not been any meta-analyses focused solely on its clinical effectiveness for private pay clients. This study’s objective was to conduct outcome-based meta-analyses of private-pay wilderness therapy programs, benchmark primary features of this approach, and educate the clinical community as to its effectiveness. The authors conducted a review of all available databases, as well as manual searches. Searches resulted in a meta-analysis based on 36 studies, totaling 2399 participants receiving wilderness therapy. Our meta-analyses found medium effect sizes for all six constructs assessed: self-esteem (g = 0.49), locus of control (g = 0.55), behavioral observations (g = 0.75), personal effectiveness (g = 0.46), clinical measures (g = 0.50) and interpersonal measures (g = 0.54). Subgroup analyses included age of participants, duration of program, open or closed model, presence of a mental health practitioner, and publication year.     

The role of social support in women’s health and recovery processes

The aim of this study was to assess the psychological state of women who have undergone surgery for breast cancer or cardiac surgery, including examination of the role of social support in both groups. The study included 48 women (mean age: 66.04?±?8.3 years). They were divided into two groups according to diagnosis: 23 women (mean age: 69.2?±?8.6 years) who underwent heart surgery (cardiac group, CG) and 25 women (mean age: 63.2?±?7.0 years) treated for breast cancer and associated with the Women After Mastectomy Club (oncology group, OG). In addition to the assessment of socio-demographic variables, the following self-report questionnaires were administered: Satisfaction with Life Scale, Acceptance of Illness Scale, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory as well as Berlin Social Support Scale. In the CG, the severity of depressive symptoms was two times higher than in OG (p?=?.003). In both groups, there was a high percentage (80%) of women with severe symptoms of anxiety (p?=?.37). In both groups, the level of life satisfaction was similar (p?=?.58), but OG was characterized by a higher level of acceptance of the disease (p?=?.003). The correlation analysis showed that in both groups, social support was related differently to the parameters of emotional state. Women treated for breast cancer were in a better mental condition than women treated for heart disease. The support coming from other women in similar circumstances (Women After Mastectomy Club) seems to be more effective than the support coming from the patient’s immediate environment. The results for social support ought to be interpreted not only through the prism of mean values of received support, but also with regard to the information on the sources of support.     

Helpful processes in psychological therapy for patients with primary cancers: A qualitative interview study

Aims: The purpose of this study was to identify what patients with primary cancers found helpful in therapy. Method: In‐depth qualitative interviews were conducted with eight patients who had completed a course of psychological therapy within an NHS psychology service for cancer patients. Data were analysed using thematic analysis. Results: The participants identified a range of helpful processes in therapy: talking and expressing their feelings to someone outside of the family; forming a relationship with their therapist; normalisation through the therapists' expert knowledge; problem‐solving and CBT. Limitations: As with all qualitative studies, the small sample and size and dependence on participant recall limits generalisability of the findings. Implications: The findings of this study are consistent with a pluralistic perspective: that multiple therapeutic processes ‐ aligned to a range of different orientations ‐ can be of value to patients with primary cancers. This supports the provision of a range of therapeutic interventions and strategies for this patient group.     

Representational Pseudoneglect: A Review

Pseudoneglect, the tendency to be biased towards the left-hand side of space, is a robust and consistent behavioural observation best demonstrated on the task of visuospatial line bisection, where participants are asked to centrally bisect visually presented horizontal lines at the perceived centre. A number of studies have revealed that a representational form of pseudoneglect exists, occurring when participants are asked to either mentally represent a stimulus or explore a stimulus using touch in the complete absence of direct visuospatial processing. Despite the growing number of studies that have demonstrated representational pseudoneglect there exists no current and comprehensive review of these findings and no discussion of a theoretical framework into which these findings may fall. An important gap in the current representational pseudoneglect literature is a discussion of the developmental trajectory of the bias. The focus of the current review is to outline studies that have observed representational pseudoneglect in healthy participants, consider a theoretical framework for these observations, and address the impact of lifespan factors such as cognitive ageing on the phenomenon.     

The Sound of Silence: Can Imagining Music Improve Spatial Rotation Performance?

We report two experiments exploring whether imagining music improves spatial rotation via increases in arousal and mood levels (Schellenberg 2005). To aid their imagination, participants were given instructions (none, basic or detailed) and lyrics (present or absent). Experiment 1 showed no effect of instructions or lyrics on performance although participants felt that the presence of the lyrics helped. Experiment 2 was identical to Experiment 1 except that the participants were musicians (as evidenced by musical experience and/or qualification). This time there was a significant effect of instructions in that those who received the detailed instructions performed significantly better than the no instruction condition although the presence of lyrics did not help. Further research is required to establish the similarity of the imagination to the traditional arousal and mood effect but the phenomenon may be useful for short-term boosts in spatial rotation activities.     

Pain Sensitivity: An Unnatural History from 1800 to 1965

Who was truly capable of experiencing pain? In this article, I explore ideas about the distribution of bodily sensitivity in patients from the early nineteenth century to 1965 in Anglo-American societies. While certain patients were regarded as “truly hurting,” other patients’ distress could be disparaged or not even registered as being “real pain.” Such judgments had major effects on regimes of pain-alleviation. Indeed, it took until the late twentieth century for the routine underestimation of the sufferings of certain groups of people to be deemed scandalous. Often the categorizations were contradictory. For instance, the humble status of workers and immigrants meant that they were said to be insensitive to noxious stimuli; the profound inferiority of these same patients meant that they were especially likely to respond with “exaggerated” sensitivity. How did physicians hold such positions simultaneously? Pain-assignation claimed to be based on natural hierarchical schemas, but the great Chain of Feeling was more fluid than it seemed.     

The role of activation charge in an emotional categorisation task for words: insight from the perspective of a dual process theory of the activation mechanisms

The role of activation (arousal and subjective significance) was investigated for word processing in an explicit emotional judgement task using a 3?×?3 manipulation. We expected to find dissociative effects for both factors. The behavioural results showed that the fraction of words perceived as emotional increases with increasing arousal or subjective significance. The electrophysiological (EEG) results showed that both factors influence ERP amplitudes. General effects of subjective significance were found for early (60–120?ms and 120–250?ms, low subjective significant stimuli evoked higher amplitude than other conditions) and late (350–490?ms, high subjective significant stimuli evoked higher amplitude than other conditions) time ranges. Localised arousal effects were found in 250–350?ms and 350–490?ms time ranges at posterior (amplitude for high arousing stimuli was less positive than for other conditions) and left frontal ROIs (diverse pattern). Localised subjective significance effects were found for the 350–490?ms time range at the posterior ROIs (amplitude for high subjective significant stimuli was more positive than for other conditions). The results of this study suggest that the effects of arousal reported in earlier studies might account for a more complex form of activation that was recently postulated, namely subjective significance.