Exploring Relationships Between Negative Cognitions and Anxiety Symptoms in Youth With Autism Spectrum Disorder

Although cognitions are central to the conceptualization and treatment of anxiety in typically developing (TD) youth, there is scant research investigating automatic thoughts and their relationship with anxiety in youth with autism spectrum disorder (ASD). We sought to examine the types of automatic thoughts experienced by youth with ASD and co-occurring anxiety as well as the predictive relationship of anxiety to different types of automatic thoughts in 97 children, ages 8-14 years. We also explored the relationship of automatic thoughts and intolerance of uncertainty. Consistent with prior data, there was a strong relationship between anxiety and automatic thoughts pertaining to social and physical threat. Anxiety and IU were independently associated with thoughts pertaining to personal failure which raises the hypothesis that personal failure may serve as a common pathway between anxiety, IU, and depression in ASD youth. These findings highlight the importance of assessing and treating negative cognitions in youth with ASD and anxiety.     

How Many People Are Exposed to Suicide? Not Six

It has long been stated that six people are left behind following every suicide. Despite a lack of empirical evidence, this has been extensively cited for over 30 years. Using data from a random‐digit dial survey, a more accurate number of people exposed to each suicide is calculated. A sample of 1,736 adults included 812 lifetime suicide‐exposed respondents who reported age and number of exposures. Each suicide resulted in 135 people exposed (knew the person). Each suicide affects a large circle of people, who may be in need of clinician services or support following exposure.     

A Model Psychosocial Support Training and Workshop during a Medical Mission for Syrian Refugee Children in Jordan: Techniques,Lessons Learned and Recommendations

ABSTRACT

This article describes a model training and workshop for volunteers that was implemented with child refugees in Jordan, to build empowerment, resilience, and connection with others. The importance of such services for this population is emphasized. The present model, with elements of arts activities and play similar to those used in the Child Friendly Spaces, is based on my extensive experience working with diverse populations under various conditions of crisis, natural disaster, and infectious diseases, mainly in low resource settings. I review activities from my toolbox, their purpose, methods, and processing. The clinical value of such psychosocial support is presented, as has been shown by pilot research in several settings, despite limitations of conducting empirical assessments, which are discussed. Lessons learned and recommended are given. The intervention for refugee children is presented in the context of international policy agreements that provide an important foundation for such projects that clinicians and researchers can use to support their work for this population and others, in efforts to heal children from the traumas of refugeeism and other similar extreme stresses.     

Increasing Utilization of Cancer Genetic Counseling Services Using a Patient Navigator Model

Rarely has utilization of genetic counseling for Hereditary Breast and Ovarian Cancer (HBOC) been studied separately from utilization of testing. At Kaiser Permanente Colorado, consistently only 30% of all members referred for HBOC attend genetic counseling. To increase the volume of genetic counseling appointments, a patient navigator approach was pilot tested in a randomized-controlled trial over 3 months. A total of 125 members were referred for HBOC genetic counseling (55 randomized to PN, 70 randomized to usual care). Utilization of referrals for Navigator-assisted members was 44%, compared to 31% in the usual care arm (p=0.16). The patient navigator significantly decreased time to appointment, with over 80% of Navigator-assisted members seen for genetic counseling less than three months from referral date, compared to 32% in usual care (p=0.002). patient navigator assistance shortens time from referral to appointment for HBOC genetic counseling, and may increase utilization of such services.     

Equality: A Continuing Dialogue

We reply to discussions of Equality: From Theory to Action by Harry Brighouse, Joanne Conaghan, Cillian McBride and Stuart White. We find many of their points helpful and treat them as a useful contribution to a continuing dialogue on egalitarianism.     

Parents’ Autobiographical Narratives: Setting Events for Their Contemplation of Mindful Changes

The ability to tell a coherent and rich story about one’s personal life is an important marker of an individual’s capacity and willingness to contemplate personal change. We review research on correlations between the coherence of parents’ narrative accounts of life experiences and their responsiveness during interactions with their children. Based on this review, we explore ideas about the nature of narrative coherence, how parents might be taught to improve this structural feature when telling their stories, and why a well constructed story might enhance the parents’ objective study of the here and now. We discuss how the effects of narrative restructuring may enable parents to be more cognitively mindful of their interactions with their children. We present our speculations in the spirit of promoting discussion of new clinical strategies for parents and new research strategies aimed at experimental analyses of observed connections between parent narratives and their willingness to contemplate personal change.