Professional values and their development among trainees in psychoanalytic psychotherapy1

Forty-six psychotherapy students in three groups at one training institute for psychoanalytic psychotherapy in Sweden were asked to fill out a questionnaire about important influences on their professional development during their three-year training and afterwards. The questionnaire was distributed on three occasions during the training program and on one later occasion. Twenty-one students responded to the questionnaire on all four occasions. Working with patients in therapy, getting supervision, and participating in personal psychotherapy were viewed as the three most important influences on the students. The importance attributed to specialist literature and technical skills seemed to increase over time during the training, while the influences of experiences in personal life and personal qualities decreased. These changes in reported views were reversed in the initial years after graduation. Concerning assets, the students valued the ability to be containing and emphatic as the most important, but in their first years as licensed psychotherapists assigned more importance to the ability to create contact. The training program led to a change over time in a higher rating for the importance of technical and methodological attributes and less emphasis on personal characteristics and experiences. Most of the changes reported during training tended to be reversed afterwards.     

Type D Personality as a Prognostic Factor in Heart Disease: Assessment and Mediating Mechanisms

Type D personality, a synergy between negative affectivity and social inhibition, has established itself as a serious risk factor for morbidity and mortality in patients suffering from cardiovascular disease. In this review, we summarize studies on the validity of the assessment methods of Type D, emphasizing its role as an independent vulnerability factor in the progression of cardiovascular disease. We further present evidence on the physiological characteristics that accompany the 2 psychological traits negative affectivity and social inhibition and may mediate the relation between personality and prognosis in heart disease. Further research needs to determine the mechanisms by which Type D affects the course and outcome of cardiovascular disease as well as how Type D patients may benefit from psychosocial intervention.     

Exploring the personal and social context of female youth sex offenders

This study explored the personal and social context of young female sex offenders, probing their risk profiles for prospective treatment interventions. A convenience sample of eight young South African female sexual offenders participated in the study (black = 88%, Indian = 12%, age range = 14–20 years). They completed semi-structured interviews on their perceptions of the influences to commit a sexual offence. The data were thematically analysed. Emergent themes on factors associated with sexual offending included: peer influence, poor child monitoring, parental neglect, unproductive sexual health education, as well as insight into the participants’ maladaptive beliefs and distorted thinking.     

Building on Wachtel’s Points About Implications of Mitchell’s Ideas: Suggestions Based on the Participatory Philosophical Perspective for Locating the Person in the World of Practical Activities

In his paper “The Relationality of Everyday Life,” Wachtel (this issue) successfully moves us further along the path of the “unfinished journey” (p. 509) of Mitchell’s work. I begin my comments by pointing out how Wachtel identifies the importance for both theory and practice of focusing on everyday life in addition to early parent–child interactions and what transpires in psychoanalytic/psychotherapy sessions. His points about everyday life include rejecting one-person notions of internal processes that are “frozen” in time and offering a way to understand the vicious circles that are a prominent part of most clinical problems. My comments also include suggestions about how we can take another step along the path Wachtel has encouraged us to pursue—which he aptly describes as treating the person as a “self-in-context” (p. 507)—if we approach basic issues about the person’s relationship to others and the world at large along the lines of the participatory philosophical perspective (e.g., Westerman, 2005, 2013, 2014; Westerman & Steen, 2007). That perspective takes as its cornerstone idea the view that from the outset the person is a participant in practical activities. Guided by the participatory perspective, I add to Wachtel’s suggestions about how a focus on everyday life can enter into therapeutic work; present a different view of what are typically called “inner” processes and discuss some of the implications of that view for clinical work; and, most important, put forward an alternative account of vicious circles.     

How can you resist? Executive control helps romantically involved individuals to stay faithful

In the present research, we examined why some people have more difficulty than others in staying faithful to their romantic partners. Three studies supported our main prediction that executive control is associated with romantically involved individuals' ability to stay faithful. Study 1 showed that participants with a higher level of executive control reported less difficulty in staying faithful to their partners than did those with lower levels of executive control. In Study 2, romantically involved male participants were placed in a waiting room together with an attractive female confederate. Results showed that participants with a higher level of executive control showed less flirting behavior with the confederate than did those with lower levels of executive control. Study 3 demonstrated that a higher level of executive control was related to a lower expressed desire to meet an attractive other, but only for romantically involved participants. Together, these studies showed that executive control helps romantically involved individuals to deal with the lure of attractive alternatives.     

Adolescent Family Adversity and Mental Health Problems: The Role of Adaptive Self-regulation Capacities. The TRAILS Study

Adolescent family adversity is a considerable adaptive challenge in an increasingly turbulent developmental period. Using data from a prospective population cohort of 2230 Dutch adolescents, we tested risk-buffering interactions between adolescent family adversity and self-regulation capacities on mental health. We used two adaptive self-regulation capacities that could allow adolescents to manage relatively well with family adversity: (1) parent-reported effortful control, and (2) an attentional flexibility (in this case, set-shifting) task. Adolescent family adversity was associated with internalizing problems and externalizing problems. The risk-buffering effects of effortful control were found for externalizing problems but not for internalizing problems. There were no risk-buffering effects of attentional flexibility on both types of mental health problems. Effortful control is likely to benefit adolescents’ ability to channel their frustrations in adaptive ways in the presence of family adversity. Additionally, (attentional) set-shifting tasks might have a limited predictive value for risk-buffering research.     

The Dimensional Nature of Externalizing Behaviors in Adolescence: Evidence from a Direct Comparison of Categorical,Dimensional, and Hybrid Models

Researchers have recognized the importance of developing an accurate classification system for externalizing disorders, though much of this work has been framed by a priori preferences for categorical vs. dimensional constructs. Newer statistical technologies now allow categorical and dimensional models of psychopathology to be compared empirically. In this study, we directly compared the fit of categorical and dimensional models of externalizing behaviors in a large and representative community sample of adolescents at two time points separated by nearly 2.5 years (N = 2027; mean age at Time 1 = 11.09 years; 50.8% female). Delinquent and aggressive behaviors were assessed with child and parent Child Behavior Checklist reports. Latent trait, latent class, and factor mixture models were fit to the data, and at both time points, the latent trait model provided the best fit to the data. The item parameters were inspected and interpreted, and it was determined that the items were differentially sensitive across all regions of the dimension. We conclude that classification models can be based on empirical evidence rather than a priori preferences, and while current classification systems conceptualize externalizing problems in terms of discrete groups, they can be better conceptualized as dimensions.     

Symptoms of depression in Swedish fathers in the postnatal period and development of a screening tool

Methods for detecting depression in fathers after the birth of their child are scarce. The Edinburgh Postnatal Depression Scale (EPDS), used to screen mothers for postpartum depression (PPD), lacks somatization and externalizing items. This potentially decreases its sensitivity in detecting depression in fathers, as many men actually express depression with somatization or externalizing symptoms. The present study assessed depressive symptoms in fathers of children 0–18 months old, and evaluated whether addressing both typical depression and externalizing, so‐called “depressive equivalent” symptoms, might be more suitable for such assessment. The Beck Depression Inventory‐II (BDI‐II), EPDS, and Gotland Male Depression Scale (GMDS) were responded to by 447 Swedish fathers online. Among participants, 27% reported depressive symptoms above the BDI‐II cut‐off suggestive of depression. Most fathers reported both traditional and depressive equivalent symptoms and a subgroup expressed exclusively depressive equivalent symptoms. Consistently, a scale combining items from the EPDS and GMDS showed higher sensitivity than the EPDS alone in identifying fathers with elevated depressive symptoms, at equal levels of specificity. Our findings suggest that a combination of EPDS and depressive equivalent symptom items results in a more suitable instrument for screening for depression in fathers during the postnatal period.