Building Collaborative Mental Health Teams in Schools Through MFT School Certification: Initial Findings

Building collaborative multidisciplinary mental health teams to boost student achievement has been a growing initiative in American schools since the 1970s. Marriage and Family Therapists (MFTs)joined those teams in 2008, when Connecticut became the first state to certify MFTs for schoolbased practice. This article chronicles the history of that collaboration and reports initial research into MFT school-based participation on those teams.     

The neural substrates associated with inattentional blindness

Inattentional blindness is the failure to perceive salient stimuli presented at unattended locations. Whereas the behavioral manifestation of inattentional blindness has been investigated, the neural basis of this phenomenon has remained elusive. In the current study, event-related fMRI was used to identify the neural substrates associated with inattentional blindness. During central fixation, participants named colored digits presented at a peripheral location. On a subset of trials, an unexpected checkerboard circle (the critical stimulus) was presented at the same eccentricity along with the colored digits (a post-scan questionnaire assessed participants’ awareness of the critical stimulus). Neural activity during inattentional blindness was observed in the prefrontal cortex. Together with previous findings, these results call into question the widespread view that activity in the prefrontal cortex reflects conscious processing.     

The abject self: self-states of relentless despair

Early childhood deprivation, attachment chaos, repeated medical traumata, and abuse set up neural networks of dread, shame, worthlessness, and hopelessness: the phenomenology of abject experience that resides in implicit memory. Abject interactions with others condense yearning and despair into complex enactments of abject suffering. Working in abject subgroups dilutes the intensity of abject material as ownership of toxic affects is broadened. Affective engagement and a relational perspective facilitate the management and transformation of self-abjection into more optimal relatedness in combined group and individual treatment.     

Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity

Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.g., alcohol use dependence and borderline personality disorder) are reflective of more pervasive or general personality pathology or whether the comorbidity is specific to individual PDs. Face-to-face interview data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Participants included 34,653 adults living in households in the United States. We used hierarchical factor models to statistically partition general and specific personality disorder dimensions while simultaneously testing for specific PD-substance dependence relations. Results indicated that substance dependence-Axis II comorbidity is characterized by general (pervasive) pathology and by Cluster B PD pathology over and above the relationship to the general PD factor. Further, these relations between PD factors and substance dependence diagnoses appeared to largely account for the comorbidity among substance dependence diagnoses in the younger but not older participants. Our findings suggest that a failure to consider the general PD factor, which we interpret as reflecting interpersonal dysfunction, can lead to potential mischaracterizations of the nature of certain PD and SUD comorbidities.     

Clarifying boundaries of binge eating disorder and psychiatric comorbidity: a latent structure analysis

Binge eating disorder (BED) presents with substantial psychiatric comorbidity. This latent structure analysis sought to delineate boundaries of BED given its comorbidity with affective and anxiety disorders. A population-based sample of 151 women with BED, 102 women with affective or anxiety disorders, and 259 women without psychiatric disorders was assessed with clinical interviews and self-report-questionnaires. Taxometric analyses were conducted using DSM-IV criteria of BED and of affective and anxiety disorders. The results showed a taxonic structure of BED and of affective and anxiety disorders. Both taxa co-occurred at an above-chance level, but also presented independently with twice-as-large probabilities. Within the BED taxon, diagnostic co-occurrence indicated greater general psychopathology, lower social adaptation, and greater premorbid exposure to parental mood and substance disorder, but not greater eating disorder psychopathology. Eating disorder psychopathology discriminated individuals in the BED taxon from individuals in the affective and anxiety disorders taxon. Diagnostic criteria of BED were more indicative of the BED taxon than were criteria of affective and anxiety disorders. The results show that at the latent level, BED was co-occurring with, yet distinct from, affective and anxiety disorders and was not characterized by an underlying affective or anxiety disorder.     

Pulling the finger off disrupts agency, embodiment and peripersonal space

For this experiment a visual illusion was created in which the participant's finger looked and felt as though it was being stretched to twice its normal length until it snapped and the tip came off. It was then stabbed with virtual weapons while skin conductance was measured. Sometimes the fingertip moved under the participant's own control and sometimes it moved independently. Curiously, detaching the tip of the finger destroyed the underlying ownership for the remaining stump as well as for the tip itself, even when the tip was under participants' control. These results have implications for theories of agency, embodiment, and tool-use.     

Ambivalence toward mothers who kill: an examination of 45 U.S. cases of maternal neonaticide

Public opinion about neonaticide (the killing of a newborn within the first 24 hours of life) has varied across time and cultures. Some nations have passed legislation on behalf of maternal offenders with the assumption that childbirth, a time of unique biological change, may lead to mental disturbance. The United States, however, makes no such distinction; offenders are prosecuted under general homicide laws. Nevertheless, U.S. courts often consider a mother's emotional and physical condition prior to and during delivery. This study includes 44 female offenders and 45 infant deaths and highlights society's ambivalence toward neonaticide offenders. The authors suggest that this ambivalence may be attributed to: (1) the perception that an offender's emotional and physical turmoil during the birth and homicide reduces her culpability; (2) the sentiment that neonaticide offenders are more "redeemable" than other offenders; and (3) the uncertainty about the personhood of a fetus or newborn.     

When disagreement gets ugly: perceptions of bias and the escalation of conflict

It is almost a truism that disagreement produces conflict. This article suggests that perceptions of bias can drive this relationship. First, these studies show that people perceive those who disagree with them as biased. Second, they show that the conflict-escalating approaches that people take toward those who disagree with them are mediated by people's tendency to perceive those who disagree with them as biased. Third, these studies manipulate the mediator and show that experimental manipulations that prompt people to perceive adversaries as biased lead them to respond more conflictually-and that such responding causes those who engage in it to be viewed as more biased and less worthy of cooperative gestures. In summary, this article provides evidence for a "bias-perception conflict spiral," whereby people who disagree perceive each other as biased, and those perceptions in turn lead them to take conflict-escalating actions against each other (which in turn engender further perceptions of bias, continuing the spiral).