Loneliness, depression, social support, and quality of life in older chronically ill Appalachians

This study's purpose was to describe loneliness and to examine the relationships between loneliness, depression, social support, and QOL in chronically ill, older Appalachians. In-person interviews were conducted with a convenience sample of 60 older, chronically ill, community-dwelling, and rural adults. Those with dementia or active grief were excluded. The UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1985), Geriatric Depression Scale (Shiekh & Yesavage, 1986), Katz ADL scale (Katz, Down, & Cash, 1970), MOS Social Support Scale (Sherbourne & Stewart, 1991), and a visual analog scale for Quality of Life (Spitzer et al., 1981) scale were used. Diagnoses were obtained through chart reviews. SPSS was used for data analyses. The majority of the 65% female sample (M age = 75 years) were married and impoverished. Participants' number of chronic illnesses averaged more than 3. Over 88% of participants reported at least 1 area of functional impairment. Loneliness was prevalent with UCLA loneliness scores indicating moderate to high loneliness, ranging from 39 to 62 (possible scores were 20-80). Higher loneliness scores correlated with depression, lower Qol, and lower social support, particularly lower emotional support. This study provides evidence that loneliness is a significant problem for older chronically ill Appalachian adults and that it may be related to low emotional support. Further, it provides evidence that this population may be significantly lonely and may not self-identify as lonely. Screening for loneliness and designing interventions that target the emotional aspects of loneliness could be important in this population.     

Blending Theory with Practice: Implementing Kindergarten Transition Using the Interactive Systems Framework

The Interactive Systems Framework (ISF; Wandersman et al. in Am J Commu Psychol 41(3–4):171–181, 2008) was used to implement a kindergarten transition demonstration project collaboratively developed by elementary and early education providers, community‐based family and housing services, parents, and a University intermediary and technical assistance group. First person accounts from stakeholders at all levels provide a complementary and broad perspective on the project's implementation. The practice model blended existing research on kindergarten transition and parent involvement with feedback from stakeholders to create a community‐specific program designed to help all children make a smooth entry into kindergarten. During implementation, evidence‐based approaches needed to be adjusted to fit the specific needs of each community. Using the ISF as a guide, next steps and lessons learned include increasing leadership through a district‐wide plan that is still flexible within each school community, increasing information and supports to individual schools, and improving data collection for continuous program improvement. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Exploring the Effectiveness of a Mixed-Diagnosis Group Cognitive Behavioral Therapy Intervention Across Diverse Populations

Depression and anxiety are the most common mental health disorders seen in clinical practice and they are highly comorbid. Cognitive behavioral therapy (CBT) has been demonstrated as an effective treatment for both depression and anxiety but is often not available to all individuals who could benefit from it. This paper investigates the effectiveness of a mixed-diagnosis group CBT intervention that incorporates mindfulness meditation for individuals presenting with depression and/or anxiety: CBT Basics II. This intervention was evaluated across two distinct mental health programs to determine both if it can demonstrate positive results and if it is feasible to implement in these types of programs. Sample 1 (n = 42 completers) consisted of higher-functioning individuals in a general mental health program. Sample 2 (n = 53 completers) consisted of individuals with more chronic and severe mental health diagnoses. Overall, intent-to-treat analyses revealed improvements in psychiatric symptoms, and increases in CBT knowledge and mindfulness skill across both programs. This indicates that CBT Basics II is effective across diverse mental health populations and shows promise for improving access to CBT.     

Working in the Metaphor Commentary on Paper by Stephen Seligman

This paper expands on Seligman's ideas about mentalization and the challenges of working with patients who cannot mentalize. Seligman's clinical presentation demonstrates that much valuable analytic work takes place without explicit reference to the transference. Drawing on Britton's notion of the triangular internal space that allows for reflective thought, we propose that analytic interest in an external object, discovered through the relationship and meaningful to both patient and analyst, helps create the same kind of space. The difference-within-sameness of shared contemplation can increase receptivity to divergent perspectives. Likewise, the “third object” can become a therapeutic metaphor, open to various meanings without being limited to any one interpretation. We trace how Seligman and his patient use a series of third objects in their work together. In this process, the patient moves from a transitional relationship of minimal differentiation to an increasingly secure sense of her own separateness, beginning to accept, and even enjoy, having a motivated mind of her own. Finally, we discuss how Ferro's concept of the analytic field offers a theoretical rationale for the effectiveness of this process.     

Priming Effects in Lexical Decisions on Sex-Stereotypical Adjectives

To investigate the semantic memory organization of gender concepts, we used gender words to prime lexical decisions on stereotypically feminine and masculine adjectives (e.g., emotional and aggressive, respectively) in two experiments. Under certain conditions, gender primes facilitated performance on both stereotypically appropriate and inappropriate adjectives. Female subjects were facilitated when either the word woman or man primed stereotypically feminine adjectives. Male subjects were facilitated when the word male primed either stereotypically masculine or feminine adjectives (and they were inhibited when woman primed these adjectives, especially the masculine ones). These results suggest overlap in the memory representations of traits associated with the two genders.     

Sustained Attention and the Type a Behavior Pattern: The Effect of Daydreaming on Performance

The present study examined the ability of Type A and Type B subjects to sustain attention during a 40-min visual vigilance task. It was predicted that Type A subjects would perform better than Type B subjects and that the performance of both groups would be related to the frequency of daydreams during the vigil. Type A subjects outperformed Type B subjects with regard to perceptual sensitivity (A') and number of signal detections. Although both groups reported an increase in the number of their daydreams as the vigil progressed, Type A subjects reported fewer daydreams during each period of watch than did Type B subjects. In addition, an inverse relationship was found between the number of signal detections and the frequency of daydreams.     

Institutional Review Board Issues Related to Special Populations

The present article begins with an introduction to the role of Institutional Review Boards (IRBs) in research activities in general and proceeds to issues IRBs face with relation to special populations, including children and terminally ill individuals, as well as developmentally disabled and cognitively impaired persons. A historical overview of research with these special populations is included, and the report concludes with a real-world example of how IRB-related issues with developmentally disabled and cognitively impaired individuals are discussed and resolved.     

Complicated Grief: An Evolving Theoretical Landscape

The bereavement literature has proliferated in recent decades, generating a shift from conceptualizing grief as a stepwise, uniform process to an idiosyncratic experience that varies among individuals. Among the most notable developments is the empirical exploration of complicated grief—a protracted, debilitating, sometimes life‐threatening response to the death of a loved one—and the testing of novel interventions to treat it. This article provides counselors with recommendations for identifying and treating complicated grief.     

The Observation of Child Behavior During Parent-Child Interaction: The Psychometric Properties of the Crowell Procedure

The observation of child behavior has to be made in ecologically valid contexts. Parent-child interaction was thought to be the most suitable context, since empirical evidence displayed strong associations with children’s behavioral outcomes, psychopathology, social relationships and well-being. Using clinical data from 137 caregiver-child dyads, the main goal of the current study was to test the psychometric properties of an adapted version of the Crowell Procedure among preschoolers. Despite the interest that the Crowell Procedure has aroused, its psychometric properties remain relatively under-documented. This research aimed to study (1) the association between parental and child behavior, (2) the discriminant properties of the Crowell Procedure between preschoolers with a clinical level of externalizing behavior and non-clinical children and (3) the correlation between the Crowell Procedure and a behavioral checklist. The results support the consistency of both tasks and scales, the discriminant properties, external validity and fidelity of the coding system. The Crowell Procedure can therefore be used as an observational paradigm to assess both child and parent behavior in clinical and research contexts. The discriminant analyses revealed that the procedure was effective at differentiating children displaying a clinical level of externalizing behavior from normally developing ones.     

Migration: Vocational perspectives on a complex and diverse transition

This paper outlines the origins of this special issue: a UK Economic and Social Research Council supported seminar series on ‘Careers and Migration’. The series elucidated a number of salient (though under-researched) issues: migration as a diverse and complex process; the loss, recovery and reconstruction of career capital as central in the migration experience; insecurity, security and their dynamic interplay; the salience of relationships with family, compatriots and communities in migrants' career development; and the appropriateness of creative approaches in researching migrants' careers. The seven articles, written by interdisciplinary authorial teams (sometimes working in different occupational sectors) contribute to our understandings of these pressing concerns.