Mentalization in children and mothers in the context of trauma: An initial study of the validity of the Child Reflective Functioning Scale

This study examined the validity of the Child Reflective Functioning Scale (CRFS: Ensink, Target, & Oandason, 2013, Child reflective functioning scale scoring manual: for application to the Child Attachment Interview. London, UK: Anna Freud Centre – University College London), a measure designed to assess reflective functioning (RF) or mentalization during middle childhood. Participants were 94 mother–child dyads divided into two subgroups; 46 dyads where children had histories of intrafamilial (n = 22 dyads) or extrafamilial (n = 24 dyads) sexual abuse, and a community control group composed of 48 mother–child dyads. RF of children and their mothers was assessed using videotaped and transcribed data gathered using the Child Attachment Interview and the Parent Development Interview (PDI: Slade, Aber, Bresi, Berger, & Kaplan, 2004, The parent development interview‐Revised. New York, NY: The City University of New York). The findings indicate that the CRFS proved reliable, with excellent intraclass correlation coefficients for general RF, as well as RF regarding self and others. Significant differences in RF were found between sexually abused children and the control group, and also between children who had experienced intrafamilial and extrafamilial sexual abuse. This provides support for the discriminant validity of the CRFS. Furthermore, maternal RF was associated with child RF. Both abuse and maternal RF made significant contributions to predicting children's RF regarding themselves, but child sexual abuse was the only variable that made a significant contribution to explaining variance in children's RF regarding others.     

Patient Perceptions of Telephone vs. In-Person <Emphasis Type="Italic">BRCA1/BRCA2</Emphasis> Genetic Counseling

Telephone genetic counseling (TC) for hereditary breast/ovarian cancer risk has been associated with positive outcomes in high risk women. However, little is known about how patients perceive TC. As part of a randomized trial of TC versus usual care (UC; in-person genetic counseling), we compared high risk women’s perceptions of: (1) overall satisfaction with genetic counseling; (2) convenience; (3) attentiveness during the session; (4) counselor effectiveness in providing support; and (5) counselor ability to recognize emotional responses during the session. Among the 554 participants (TC, N?=?272; UC, N?=?282), delivery mode was not associated with self-reported satisfaction. However, TC participants found counseling significantly more convenient than UC participants (OR?=?4.78, 95 % CI?=?3.32, 6.89) while also perceiving lower levels of support (OR?=?0.56, 95 % CI?=?0.40–0.80) and emotional recognition (OR?=?0.53, 95 % CI?=?0.37–0.76). In exploratory analyses, we found that non-Hispanic white participants reported higher counselor support in UC than in TC (69.4 % vs. 52.8 %; OR?=?3.06, 95 % CI?=?1.39–6.74), while minority women perceived less support in UC vs. TC (58.3 % vs. 38.7 %; OR?=?0.80, 95 % CI?=?0.39–1.65). We discuss potential research and practice implications of these findings which may further improve the effectiveness and utilization of TC.     

错误信息持续影响效应的神经基础

本研究通过分析任务态fMRI下相关脑区激活及功能连接的条件间差异以揭示CIEM神经基础并为心理模型更新及记忆提取失败假说提供更多证据。结果发现, 更正条件的推理分显著高于控制条件, 存在CIEM。编码阶段左颞中回在更正条件下的激活显著弱于控制条件, 提取阶段更正条件下额中回及前扣带回激活更弱、额中回与中央前回的功能连接更强。结果提示上述脑区可能参与了CIEM的形成, 并从神经层面提供了心理模型更新和记忆提取失败假说可能解释了CIEM形成的不同阶段的证据。     

Sociocultural Influences on Body Image Concerns and Body Change Strategies Among Indigenous and Non-Indigenous Australian Adolescent Girls and Boys

Sociocultural messages about the ideal body build have been studied predominantlyamong White adolescent girls. In the current study we examined the relationships between perceived sociocultural influences, body image concerns, and body change strategies among 47 (22 boys and 25 girls) Indigenous Australian adolescents. These relationships were compared to those from 47 non-Indigenous adolescents (predominantly from an Anglo-Saxon background), who were matched on gender, age, and school grade. Overall, the sociocultural influences were found to be associated with body image concerns and body change strategies among both cultural groups. The only exception was that the sociocultural influences were not associated with the Indigenous girls’ levels of body dissatisfaction or body image importance. These findings are discussed in relation to past studies of White and Black girls.     

Body Image and Self-Esteem Across Age and Gender: A Short-Term Longitudinal Study

This study examined the relationship between body image and self-esteem across time and age for men and women. Participants were 150 men and 239 women aged between 20 and 86 years (M?=?59.73), recruited from the general population in Australia. They completed a questionnaire assessing self-esteem, body dissatisfaction, body importance, and a range of other domains of life satisfaction at baseline and 2 years later. Cross-sectionally, we found that higher self-esteem was associated with lower body dissatisfaction, but there was no consistent relationship between these variables across time for age and gender. Women were more dissatisfied with their bodies than men; yet, men placed greater importance on their appearance than women, and also reported high levels of body dissatisfaction.     

Interest and Beliefs About BRCA Genetic Counseling Among At-Risk Latinas in New York City

Background: Latinas are less likely to use genetic services (counseling and testing) for hereditary breast and/or ovarian cancer risk compared to other ethnic groups. Meanwhile, little is known about barriers to genetic counseling among Latinas at increased risk of inherited breast cancer. Methods: A two-phase pilot study was conducted to examine interest, barriers and beliefs about BRCA genetic counseling among at-risk Latinas in New York City and explore the potential for developing a culturally-tailored narrative educational tool for use in future studies. Phase 1 included quantitative telephone interviews (N = 15) with bilingual participants with a personal diagnosis at a young age and/or family history of breast and/or ovarian cancer. Quantitative results informed development of a narrative prototype educational presentation viewed by a subset of participants (N = 10) in Phase 2 focus groups. Results: Despite barriers, including lack of awareness/knowledge, concerns related to learning cancer risks of family members, and concerns about cost/health insurance, participants reported positive attitudes, beliefs and interest in learning about BRCA genetic counseling. Further, significant increases in knowledge were demonstrated from pre-post presentation (p = 0.04). Conclusion: There is an unmet need to educate at-risk Latinas about BRCA genetic counseling. Culturally-tailored educational materials including narratives may increase knowledge about BRCA genetic counseling among this underserved group. The effectiveness of these approaches should be tested in future research with larger samples.     

Literature and the revolution.

Studies in East European Thought -     

Development of an Interactive Decision Aid for Female BRCA1/BRCA2 Carriers

Shared decision making between patients and providers is becoming increasingly common, particularly when there is no clear preferred course of action. As a result, decision aids are being adopted with growing frequency and have been applied to many medical decision-making issues. One such issue where there is uncertainty is breast cancer risk management among BRCA1/BRCA2 carriers. We present the development of a CD-ROM decision aid to facilitate risk management decision making in this population. Our decision aid was developed with the intention of providing it through a randomized clinical trial. The CD-ROM is a multimedia, interactive intervention which provides information about breast cancer, risks associated with BRCA1 and BRCA2 mutations, risk management options for hereditary breast cancer, and a breast cancer risk management decision aid. The goal of this CD-ROM, offered as an adjunctive intervention, is to reduce decisional conflict and psychological distress and improve comprehension of risk information, decisional satisfaction, medical adherence, and quality of life for this population of women at increased risk for breast cancer.