Clinical features of major depressive disorder in adolescents and their relatives: impact on familial aggregation, implications for phenotype definition, and specificity of transmission

Three questions were addressed using family study data from a community sample: (a) Which clinical features of major depressive disorder (MDD) in adolescents are associated with elevated rates of MDD in relatives? (b) Which features of MDD in relatives distinguish family members of depressed adolescents from relatives of adolescents without mood disorders (NMD)? and (c) Do depressed adolescents with particular features have higher proportions of depressed relatives with the same features? Participants included 268 MDD adolescents, 401 NMD adolescents, and their 2,202 first-degree relatives. Rates of MDD were highest among relatives of depressed adolescents with recurrent episodes and greater impairment. Depression severity best distinguished the relatives of depressed adolescents from relatives of controls. Specific clinical features did not aggregate in families.     

RECONSIDERING RESEARCH ON DIVORCE, FAMILY LIFE CYCLE, AND THE MEANING OF FAMILY

This article analyzes functionalist and normative assumptions about marriage, divorce, family, and gender in developmental models of family life cycle. An interdisciplinary review of the literature in family development, family sociology, and family therapy reveals how a deficit comparison model implicitly informs the discourse in the study of single-parent families, women who are alone, and the adjustment of women and children to divorce. A feminist critique of family life cycle as the prevailing conceptual model in family development and therapy is presented, and postmodern definitions that deconstruct the concept of family are discussed. Future perspectives for research on family life and form are considered in terms of new action theory that considers divorce as a mode of resistance and change for women and families.     

Preliminary evidence for impaired rapid verb generation in schizophrenia

It has been hypothesized that nouns and verbs are processed within relatively separable semantic memory networks. Although abnormal semantic processing is a common feature of schizophrenia-spectrum disorders, no prior studies have specifically examined the comparability of noun and verb generation deficits in schizophrenia. In the current study, verb (action), noun (animal), and letter (f) fluency performance was evaluated in 22 inpatients with schizophrenia and 27 healthy comparison subjects. On average, individuals with schizophrenia performed approximately one standard deviation below the healthy comparison subjects on action, animal, and letter fluency. Action fluency-but not letter or animal fluency-was moderately correlated with tests of working memory, response inhibition, semantic memory, and cognitive flexibility. Findings suggest that verb- and noun-based fluency deficits are of comparable severity in schizophrenia, but that the impairment in verb generation may be driven by different underlying cognitive mechanisms. Further, hypothesis-driven research on the nature and extent of verb network disruption in schizophrenia appears warranted.     

Shared and separate systems in bilingual language processing: converging evidence from eyetracking and brain imaging

The neurological and cognitive aspects of bilingual language processing were examined in late Russian-English bilinguals using headband-mounted eyetracking and functional neuroimaging. A series of three eyetracking studies suggested that, at early stages of word recognition, bilinguals can activate both languages in parallel, even when direct linguistic input is in one language only. A functional neuroimaging study suggested that, although the same general structures are active for both languages, differences within these general structures are present across languages and across levels of processing. For example, different centers of activation were associated with first versus second language processing within the left Inferior Frontal Gyrus, but not within the Superior Temporal Gyrus. We suggest that parallel activation (as found with eyetracking) and shared cortical structures (as found with fMRI) may be characteristic of early stages of language processing (such as phonetic processing), but the two languages may be using separate structures at later stages of processing (such as lexical processing).     

Children Exposed to the Arrest of a Family Member: Associations with Mental Health

The arrest of a parent or other family member can be detrimental to children’s health. To study the impact of exposure to the arrest of a family member on children’s mental health and how said association may change across developmental periods, we examined baseline data for children (birth through 11 years) entering family-based systems of care (SOC). Children exposed to the arrest of a family member had experienced significantly more 5.38 (SD = 2.59) different types of potentially traumatic events (PTE) than children not exposed to arrest 2.84 (SD = 2.56). Multiple regression model results showed that arrest exposure was significantly associated with greater behavioral and emotional challenges after controlling for children’s age, gender, race/ethnicity, household income, caregiver’s education, parenting factors, and other PTE exposure. Further analyses revealed differences in internalizing and externalizing behaviors associated with arrest exposure across developmental levels. This study highlights some of the mental health challenges for children exposed to the arrest of a family member, while adding to our knowledge of how such an event affects children across different developmental periods. More trauma-informed, developmentally appropriate systems need to be in place at all levels to assist children and families experiencing arrest.     

Object‐based visual processing in children with spina bifida and hydrocephalus: A cognitive neuropsychological analysis

The aim of the study was to use cognitive neuropsychological analysis to investigate object‐based visual processing skills in children with spina bifida myelomeningocele and hydrocephalus (SBH). Fourteen children with SBH (aged 8–12) and 21 age‐, socio‐economic status‐, and Verbal IQ‐matched healthy controls were assessed using the Birmingham Object Recognition Battery. Overall, the performance of the children with SBH on the object‐processing tasks was intact, indicating normal development of the ventral visual processing pathway. While the initial results indicated that the children with SBH performed statistically significantly less accurately on some tasks, these group differences no longer met significance criteria after capacity for sustained attention was statistically controlled.     

Differential Attention as a Mechanism of Change in Parent–Child Interaction Therapy: Support from Time-Series Analysis

Although many interventions address children’s externalizing behavior problems, negative treatment outcomes remain common. Reasons for success or failure are frequently unclear, due in part to a lack of research identifying treatment change mechanisms. The current study evaluated differential attention as a mechanism of change in Parent–Child Interaction Therapy (PCIT), a treatment for children with externalizing problems. Using sequential coding and time-series analysis, we examined parent–child interactions across treatment for three families. Contrary to hypotheses, child prosocial behaviors and parent skill use held steady or decreased across coaching periods, with the exception of one family, where the parent’s skill use increased during coaching. Partial support was found for the hypothesis that parent differential attention would predict child prosocial behavior in the next minute. These results provide support for differential attention as a mechanism of change, but also demonstrate that this factor is not the only such mechanism.     

Art, dreams and active imagination: a post-Jungian approach to transference and the image

The term active imagination is sometimes applied rather uncritically to describe all forms of creative activity that take place in depth psychology. Whilst there are many forms of expression that evoke or are evoked by active imagination, they cannot automatically be classed as active imagination. In this article investigation of visualized mental imagery, dreams and art reveals three distinct forms of image-based psychological activity. Integrated and mediated within the transference and countertransference dynamic, it is proposed that the engagement in active imagination reflects and is influenced by the transference. Distinctions between sign and symbol, simple and big dreams as well as diagrammatic and embodied imagery clarify the differences. Examples from clinical practice demonstrate each mode in action within the analytic frame.