Depression in Primary Care: Comorbid Disorders and Related Problems

Identifying and treating depression has been a major focus in primary care over the last decade. Unfortunately, treatments have not been as successful as originally hoped. The current study investigated factors that may contribute to poor outcomes in a sample of VA primary care patients. Results indicate that 15.5% of the patients in this investigation had significant symptoms of depression. The vast majority (89.6%) of these patients also had significant symptoms of at least one additional comorbid psychiatric condition. Furthermore, an association between depression and unhealthy behaviors (smoking, not exercising) was demonstrated. Finally, sexual dysfunction and chronic pain were more frequently observed in individuals with depressive symptoms. These findings illustrate that depression is only one of many problems for most primary care patients identified with depression. A multidisciplinary team in primary care is recommended to provide a coordinated approach to the treatment of depression and its associated problems.     

Racial Socialization,Private Regard,and Behavior Problems in African American Youth: Global Self-Esteem as a Mediator

Racial socialization messages appear to have varying impacts on the adjustment of African American youth. To further explore this, we examined how two types of racial socialization messages might influence African American youth internalizing and externalizing behavior. The Youth Self Report was used to measure these behavior outcomes. Given that racial socialization messages may not be directly linked to behavior outcomes, we considered private regard, an aspect of racial identity, to serve as a mediator. Additionally, we examined global self-esteem as a mediator of the complex dynamic between racial socialization messages and behavior outcomes. Adolescents in our study completed paper assessments. Majority of the participants were female (56?%) and reside in a metropolitan area in the Mid-Atlantic region. Adolescent’s ages ranged from 14 to 17 years with the average age being 15 years old. Path analysis revealed cultural pride and alertness to discrimination messages varied in their relation to private regard. Results also indicated a strong linkage between private regard, global self-esteem, and internalizing behaviors. Interestingly, the linkage between private regard, global self-esteem and externalizing behaviors was not as robust. Further, private regard appeared to directly and indirectly impact externalizing behaviors. The implications of these findings for racial socialization strategies, identity development (racial and global) as it pertains to behavior problems for African American adolescents are discussed.     

Serial functional communication training: Extending serial DRA to mands and problem behavior

Functional communication training (FCT) is commonly used to eliminate problem behavior. Not surprisingly, the efficacy of the intervention depends on fidelity to programmed procedures. For instance, problem behavior is likely to resurge if caregivers fail to reinforce mands during the maintenance stages of FCT. Despite this, recent translational work on arbitrary human responses suggests that incorporating multiple‐mand instruction into a serial‐training format may increase the probability of a recency effect, and a reversion of response resurgence (both desirable outcomes when mands are the most recently reinforced responses prior to extinction). Although promising, this effect has not been replicated with socially significant human behavior. Thus, we compared the relative effect of traditional FCT with that of serial FCT on the resurgence of the problem behavior, and mands, of 2 children. In contrast to previous research, we observed primacy effects for both subjects (i.e., the magnitude of the resurgence of problem behavior was greater than it was for any subsequently trained mand), and mand resurgence never occurred for one subject. Notwithstanding these limitations, the percentage of total responding allocated toward the resurgence of problem behavior was less in the serial FCT component relative to the traditional FCT component, and we observed a reversion of response resurgence for one subject.     

Abusive supervision and subordinates' organization deviance

The authors developed an integrated model of the relationships among abusive supervision, affective organizational commitment, norms toward organization deviance, and organization deviance and tested the framework in 2 studies: a 2-wave investigation of 243 supervised employees and a cross-sectional study of 247 employees organized into 68 work groups. Path analytic tests of mediated moderation provide support for the prediction that the mediated effect of abusive supervision on organization deviance (through affective commitment) is stronger when employees perceive that their coworkers are more approving of organization deviance (Study 1) and when coworkers perform more acts of organization deviance (Study 2).     

Quality of Life in Male Osteoporosis Decreases as the Number of Fracture Increases

We would like to evaluate quality of life (QL) using validated indexes (QUALEFFO, SF-36) in non-hospitalised osteoporotic men. We have also compared QL in primary or secondary osteoporosis and we have evaluated QL according to the number of fractures. 142 men aged 18 to 80 years (60.3 ± 12.8 years) completed these questionnaires at least 2 months after a fracture. Among them, 81.6% had osteoporosis with fractures and 58% had 2 or more vertebral fractures. Osteoporosis was primary in 52% of cases. The decrease in quality of life due to osteoporotic fractures in men appears comparable to that caused by post menopausal osteoporosis. The impairment of QL concerns all ITEMs ie pain, mobility, social activities, mental functiun, health perception. The primary or secondary nature of the osteoporosis does not influence the decrease in quality of life. Quality of life decreases as the number of fractures increases.     

Psychological inflexibility in childhood and adolescence: development and evaluation of the Avoidance and Fusion Questionnaire for Youth

The authors describe the development and validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y), a child-report measure of psychological inflexibility engendered by high levels of cognitive fusion and experiential avoidance. Consistent with the theory underlying acceptance and commitment therapy (ACT), items converged into a 17-item scale (AFQ-Y) and an 8-item short form (AFQ-Y8). A multimethod psychometric approach provides preliminary support for the reliability and validity of the AFQ-Y and AFQ-Y8. In 5 substudies, 3 samples (total N = 1369) were used to establish (a) item comprehension (n = 181), (b) initial item selection (n = 513), (c) final item reduction and development of a short form for research (n = 346), (d) comprehensive psychometric evaluation of the AFQ-Y and AFQ-Y8 (n = 329), and (e) convergent and construct validity for both versions of the AFQ-Y. Overall, results suggest that the AFQ-Y and AFQ-Y8 may be useful child-report measures of core ACT processes.     

Book Reviews

H annah , B arbara . Jung, his life and work.
K ohut , H einz . The restoration of the self.
F romm , E rich The anatomy of human destructiveness
H aley , A lex . Roots.
S wainson , M ary . The spirit of counsel.