Family Support in Children’s Mental Health: A Review and Synthesis

A comprehensive review of structured family support programs in children’s mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented (n = 33, 66%), followed by family-led (n = 11, 22%), and team-delivered (n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodology, and outcomes. However, the content of the components was similar across all three program types. There are both important differences in emphasis across typologies of family support provided by clinicians, family members, or teams as well as important similarities in content. Family-delivered support may be an important adjunct to existing services for parents, although the research base remains thin. A research agenda to promote more rigorous evaluations of these services especially those delivered by peer family members is critical.     

Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial

The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n?=?47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d?=?0.68) than the control condition (d?=?0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r?=?0.62) and barriers self-efficacy (r?=?0.63) and decreases in depression (r?=?-0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.     

A Divine Connection

This article outlines the development of a scholarship programme geared toward African American laypeople in the Archdiocese of Chicago as a partnership between the archdiocese and the Catholic Theological Union.     

Trajectories of Change in a Group Behavioral Activation Treatment for Severe,Recurrent Depression

Depression is a common and costly problem. Behavioral Activation (BA) is an effective treatment for depression when delivered 1:1, but group treatments often do not perform as well as 1:1 treatments. One way to begin to understand how group treatments perform is to assess the process of change during treatment. This study examined trajectories of change across 10-session group BA for individuals with severe, chronic, or recurrent forms of depression. We also tested whether individuals who had associated sudden gains or depression spikes had better outcomes than those who did not have these change patterns. We examined psychological and sociodemographic predictors of the patterns of change. Participants were 104 individuals who met diagnostic criteria for major depressive disorder and participated in one of 10 BA groups, provided over a 2-year period. A linear, but not quadratic or cubic, rate of change fit the data and the effect size for the change in mood symptoms from baseline to posttreatment was large, Cohen’s d = 1.25. Although 34% (26 of the 77 who provided outcome data) of individuals had a sudden gain and 10% (7/77) had a depression spike, neither sudden gains nor depression spikes predicted posttreatment outcomes. None of the demographic or psychological factors (rumination, behavioral activation) predicted the pattern of change. These results suggest that although group BA may help to reduce depressive symptoms in individuals with severe, recurrent, and/or chronic forms of depression, the overall linear pattern of change is different from quadratic patterns of change reported for 1:1 BA.     

Sleep deprivation in Air National Guard medical personnel responding to simulated disaster-training exercises

National Guard personnel remain largely unstudied within the sleep research community, despite their unique and important role. In response, the purpose of this study was to investigate the extent of sleep deprivation in National Guard medical personnel from two separate Air Force Bases (AFBs) responding to simulated disaster-training exercises. National Guard medical personnel (N = 77) were fitted with wrist activity monitors (actigraphy) to objectively measure their sleep for 4 days of their civilian time (baseline), followed by a 4-day transition period from civilian to military duty, and a 3–5-day disaster-training exercise. Differences in sleep quantity, quality, and “cognitive effectiveness” were analyzed using generalized linear mixed models. Participants’ sleep quantity was significantly reduced from civilian to disaster-training periods, and their cognitive effectiveness also dropped significantly. National Guard medical personnel were sleep-deprived during a simulated disaster-training exercise, which, although a valid proxy for real-world disasters, is likely to be a conservative approximation of the stress and fatigue National Guard personnel experience during crisis response. As such, the need for targeted fatigue-related interventions to safeguard our service members during these critical times is clear.     

School psychology: a public health perspective : I. Prevention, populations, and systems change

Concerns regarding American schools and mental health services for children abound, including inadequate educational achievement, school violence, over-referral to special education and disproportionate placement of minorities into special education, under-utilization of mental health services for children, and a poorly coordinated system of child mental health services. All of the above concerns share two common attributes: (a) they are statements regarding populations, rather than specific individuals; and (b) they are best addressed by changing system-wide elements of psychological service delivery. We argue that, although conceptualizing school psychology as primarily an indirect service specialty (e.g., J. Sch. Psychol. 28 (1990) 203) has advanced our thinking about effective service delivery, conceptualizing school psychological services from a public health perspective will provide an even broader framework that can increase both the efficacy and efficiency of school psychologists' work.     

Criticism or praise? The impact of verbal versus text-only computer feedback on social presence, intrinsic motivation, and recall.

The Computers Are Social Actors (CASA) paradigm asserts that human computer users interact socially with computers, and has provided extensive evidence that this is the case. In this experiment (n = 134), participants received either praise or criticism from a computer. Independent variables were the direction feedback (praise or criticism), and voice channel (verbal or text-only). Dependent variables measured via a computer-based questionnaire were recall, perceived ability, intrinsic motivation, and perceptions of the computer as a social entity. Results demonstrate that participants had similar reactions to computers as predicted by interpersonal communication research with participants who received text-only criticism reporting higher levels of intrinsic motivation, perceived ability, and recall. Additionally, the computer was seen as more intelligent. Implications for theory and application are discussed.     

Exploring the utility of functional analysis methodology to assess and treat problematic verbal behavior in persons with acquired brain injury

Functional analyses were conducted on four adults with acquired brain injuries who regularly displayed instances of inappropriate verbal behavior including depressive, aggressive, suicidal, profane, and sexually inappropriate utterances. After the functional analysis yielded a maintaining variable for each participant, a function‐based intervention consisting of differential reinforcement of alternative verbal behavior was implemented. Results of the behavioral interventions show that instances of vocal behavior can be assessed and subsequently treated using the functional analysis methodology often reserved for nonverbal forms of behavior. The utility of functional analysis for assessing complex human behavior is discussed. Copyright © 2004 John Wiley & Sons, Ltd.     

Subjective and Objective Risks of Carrying a BRCA1/2 Mutation in Individuals of Ashkenazi Jewish Descent

This repeated measures study examines (1) the change in subjective risk of mutations pre- to postcounseling, (2) the accuracy of BRCAPRO estimates of mutations, and (3) the discrepancy between subjective risk and BRCAPRO estimates of mutations before and after genetic counseling. Ninety-nine Ashkenazi Jewish individuals pursued testing for BRCA1/2 mutations. Most had a personal cancer history (N = 51; family only: N = 48); and received uninformative negative results (N = 66; positives: N = 23; informative negative: N = 10). The coping strategy of defensive pessimism predicts that individuals will believe the worst case scenario to better cope with a potential negative outcome. Consistent with this, most felt they would have a mutation, if not mutations in both genes. The BRCAPRO model appeared to overestimate risk of having a mutation in this sample (p < .001). BRCAPRO overestimates notwithstanding, genetic counseling increased accuracy of subjective risk (p < .01). Individuals with a family-only cancer history had the least accurate estimates of risk (p < .05) and may need further intervention to either manage anxiety or improve knowledge.     

Do You See What I See? Effects of Group Consciousness on African American Women's Attributions to Prejudice

This study examined the effects of three types of group consciousness among African American women ( ethnic , feminist , and womanist ) on prejudice attributions and appraised personal significance ( centrality ) of a negative intergroup event. African American female college students  ( N = 123)  imagined themselves in an audiotaped scenario in which they overheard two European American male classmates make negative evaluations of them. The scenario provided no cause for the negative evaluations and no references to race or gender. Multiple regression analyses revealed that higher ethnic and womanist consciousness were related to increased prejudice attributions and greater centrality appraisals  ( p  <.05)  , while feminism had no effect. Results suggest that womanist consciousness may be more relevant than traditional feminist consciousness in predicting African American women's perceptions of prejudice.