Fabricated Illness: Working within the Family System to Find a Pathway to Health

The term medically unexplained symptoms refers to a clinical presentation where the child's symptoms and impairment cannot be explained by any known organic pathology, and may include conversion disorders, somatoform pain disorders, factitious disorder, and factitious disorder by proxy. In this case study, we present our treatment of a 9‐year‐old girl with a 2‐year history of medically unexplained abdominal cramping and vaginal discharge. During the 9 months that we worked with this family, we were never able to clarify in our own minds the source of the child's symptoms—that is, who was responsible for their induction or who was the instigator or maintainer of the exaggerated symptoms. Nor did we come to fully understand the function of the symptoms in the family system. Our case report does not answer either of these questions. Instead, we describe how we worked with the family despite the ongoing ambiguities as to why the symptoms were occurring and who was inducing them. The functional outcome was disappearance of symptoms, return to full school attendance, and improved parenting behavior.     

Agentic and Communal Personality Traits: Their Associations with Depression and Resilience among Transgender Women

Research reports the perpetuation of communal traits by transgender women, possibly to affirm their core gender identity. Transgender women in the United States are nearly 6 times more likely than the general population to experience significant depressive symptoms. Studies among non-transgender individuals in the United States demonstrate that agentic traits are associated with less depressive symptoms, while studies on communal traits are more inconsistent in their association with indicators of depression. Our study’s central objective was to examine the associations of agency and communion with depression and resilience (i.e., personal competence and acceptance of self and life) among transgender women living part-time and full-time in the female gender role. Participants in the United States were recruited through online and offline purposive sampling. One hundred and twenty-two transgender women (primarily Caucasian; ages ranging from 22 to 75) completed a web-based questionnaire. Results indicated that agentic and communal traits were significantly associated with decreased symptoms of depression and increased levels of resilience. One component of resilience – acceptance of self and life – mediated the relationship between agentic/communal traits and depression, however, for communal traits this pattern was only found for transgender women living in the female role full-time. There were no significant differences on depressive symptoms and one component of resilience - personal competence – among transgender women living full-time compared to transgender women living in the female role part-time. Transgender women living full-time in the female gender role reported higher levels of agentic/communal traits and acceptance of self and life compared to those living part-time in the female gender role. Our findings are discussed in the context of mental health among transgender women.     

Too Sexualized to be Taken Seriously? Perceptions of a Girl in Childlike vs. Sexualizing Clothing

Girls in the United States are increasingly confronted with a sexualized culture, including sexualized clothing made especially for pre-teen girls. Previous research has shown that when adult women are portrayed as sexualized they are seen as less competent. In the present study we depicted a pre-teen girl in sexualized clothing to determine if similar effects would occur as have been found with depictions of adult women. One hundred sixty two male and female students from a small liberal arts college in the Midwestern U.S. looked at one of three images of a fifth-grade girl (obtained from an internet advertisement and manipulated through computer software) who was presented in either childlike clothing, somewhat sexualized clothing, or definitely sexualized clothing. Level of accomplishment was also manipulated so that the girl was described as either average or above average in accomplishment. Participants then rated the girl on ten different traits. The clothing and accomplishment manipulations significantly affected ratings of the girl’s masculine-stereotyped traits such that the girl who was portrayed as more sexualized and less accomplished was seen as the least intelligent, competent, determined, and capable. In addition, the sexualized girl was seen as perhaps “responsible” for her sexualized clothing in that she was rated relatively low in self-respect and morality. Possible implications of the sexualization of girls are discussed.     

Discerning reported suicide attempts within a youthful offender population

With suicide being the third leading cause of death among young people, early identification of risk is critical, particularly for those involved with the juvenile courts. In this study of court-involved youth (N = 433) in two Midwest counties, logistic regression analysis identified some expected and unexpected findings of important demographic, educational, mental health, child welfare, and juvenile court-related variables that were linked to reported suicide attempts. Some of the expected suicide attempt risk factors for these youth included prior psychiatric hospitalization and related mental health services, residential placement, and diagnoses of depression and alcohol dependence. However, the most unexpected finding was that a court disposition to shelter care (group home) was related to a nearly tenfold increased risk in reported suicide attempt. These findings are of importance to families, mental health professionals, and juvenile court personnel to identify those youth who are most at risk and subsequently provide appropriate interventions to prevent such outcomes.     

Stuttering severity and educational attainment

Purpose

This study investigated the relationship between self-reported stuttering severity ratings and educational attainment.

Method

Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering severity on a 9-point scale for a range of speaking situations. These included: (1) talking with a family member, (2) talking with a familiar person, not a family member, (3) talking in a group of people, (4) talking with a stranger, (5) talking with an authority figure such as a work manager or teacher, (6) talking on the telephone, (7) ordering food or drink, and (8) giving their name and address.

Results

There was a significant negative relationship between highest educational achievement and mean self-reported stuttering severity rating for the eight situations.

Conclusions

Future research is needed to investigate how this result should be addressed in educational institutions.Educational objectives: The reader will be able to: (1) describe the negative effects of stuttering through childhood to adulthood; (2) identify some of the negative consequences associated with stuttering on peer and teacher relationships, and academic performance at school; and (3) summarise the relationship between stuttering severity and educational attainment.     

Meaning-making and resilience: case studies of a multifaceted process

Explanations of meaning-making generally prioritise intrapersonal processes. Although making meaning is an intrapersonal process, it is also strongly influenced by person-context interactions and cultural positioning. Nevertheless, the meaning-making literature has paid scant attention to how such interactivity and positioning shape meaning-making. In this article, we highlight the compound character of resilience-promoting meaning-making. To this end, we recount the instrumental cases of Ntando's and Sipho's resilience. The accounts of these black South African students’ positive adjustment to adversity richly illustrate how their lived experiences of a social ecology stimulated multifaceted meaning-making processes. In particular, Ntando's and Sipho's interpersonal experiences and Africentric worldviews gave rise to and/or moderated positive re-appraisal, revisioned goals, purposeful direction, application of spiritual beliefs, identification of benefits, sense-making and reflective problem-solving. Although both their stories drive an understanding of meaning-making as a helix-like process with inter-, intrapersonal and cultural strands, the differences in their accounts of meaning-making stimulate the need for deeper exploration into the complexity of resilience-promoting meaning-making processes.     

Positive affect and learning: exploring the “Eureka Effect” in dogs

Animals may experience positive affective states in response to their own achievements. We investigated emotional responses to problem-solving in dogs, separating these from reactions to rewards per se using a yoked control design. We also questioned whether the intensity of reaction would vary with reward type. We examined the response (behavior and heart rate) of dogs as they learned to gain access to different rewards: (1) food (2) human contact, and (3) dog contact. Twelve beagles were assigned to matched pairs, and each dog served as both an experimental and a control animal during different stages of the experiment. We trained all dogs to perform distinct operant tasks and exposed them to additional devices to which they were not trained. Later, dogs were tested in a new context. When acting as an experimental dog, access to the reward was granted immediately upon completion of trained operant tasks. When acting as a control, access to the reward was independent of the dog’s actions and was instead granted after a delay equal to their matched partner’s latency to complete their task. Thus, differences between the two situations could be attributed to experimental dogs having the opportunity to learn to control access to the reward. Experimental dogs showed signs of excitement (e.g., increased tail wagging and activity) in response to their achievements, whereas controls showed signs of frustration (e.g., chewing of the operant device) in response to the unpredictability of the situation. The intensity of emotional response in experimental dogs was influenced by the reward type, i.e., greatest response to food and least to another dog. Our results suggest that dogs react emotionally to problem-solving opportunities and that tail wagging may be a useful indicator of positive affective states in dogs.