Perceptions of the Limitations of Confidentiality Among Chinese Mental Health Practitioners,Adolescents and Their Parents

The present study aims to (a) survey Chinese mental health professionals’ attitudes toward therapeutic confidentiality with adolescent patients in specific clinical situations, and (b) compare Chinese adolescents’ and parents’ beliefs about when most mental health professionals would breach confidentiality. A sample of 36 mental health practitioners, 152 parents, and 164 adolescents completed a survey to assess their opinions about when confidentiality should be breached in 18 specific clinical situations (e.g., an adolescent tells his or her therapist that he or she smoked a cigarette, had unprotected sex, or attempted suicide). Nearly half of the parents (46%) and adolescents (41%) and 78% of the therapists in our sample selected “yes” in response to the question of whether the principle of confidentiality applies to adolescents. However, 49% of parents indicated “no,” and 53% of adolescents indicated “not sure.” Compared to adolescents, parents were significantly more likely to believe that therapists would breach confidentiality for the high-breach-likelihood items. For the low-breach-likelihood items, adolescents and parents were significantly more likely than therapists to believe confidentiality should be breached. Results from this study provide data to inform the development, refinement, practical implementation, and communication of guidelines and recommendations specific to adolescents receiving psychotherapy in China.     

Minimal Risk of Internalizing Problems in Typically-Developing Siblings of Children with High-Functioning Autism Spectrum Disorder

We examined anxiety and depression clinical symptom levels in 42 typically-developing (TD) siblings of children with high-functioning autism spectrum disorder (HFASD), compared to 42 TD siblings of TD children, matched on age, ethnicity, and gender. Participants were between the ages of 6 and 16. Groups were compared using the parent-report and child self-report versions of the Behavior Assessment System for Children, Second Edition, anxiety and depression clinical scales. Within-group differences were examined for parent versus child ratings. Multivariate procedures did not support clinically elevated levels of internalizing problems in siblings of children with HFASD. Results from both sources were consistent with the overall finding. The findings do not support an increased need for targeted intervention, though clinical and school-based practitioners should attend to clinical warning signs if presented.     

Emotional Responses to the Charlie Hebdo Attacks: Addressing the Authoritarianism Puzzle

The finding that threat boosts the public's preferences for authoritarian policies has been well established in the research literature. Why this shift occurs remains open as the extant literature reports contradictory findings regarding the interaction of dispositions, such as conservatism and authoritarianism, with threat. One line of research argues that threat increases authoritarian preferences among those who are more prone to authoritarianism. Another argues that it is those with a nonauthoritarian ideology who switch in response to threat. By using a two‐wave panel study of the French population taken before and after the January 2015 twin attacks in Paris, we find that both trends occur simultaneously. Our results show that the factors that drive the impact of ideological dispositions on support for authoritarian policies are emotional reactions. On the one hand, anxiety led left‐wing respondents to move towards adopting authoritarian policy preferences following the attacks, yet produced no such change among right‐wing respondents. On the other hand, anger did not turn left‐wing voters more authoritarian but strengthened authoritarian policy preferences among right‐wing respondents.     

Weight suppression as a predictor of weight gain and response to intensive behavioral treatment in patients with anorexia nervosa

Previous studies have documented that weight suppression (a person's highest adult weight minus current weight) predicts weight gain and disordered eating symptoms during treatment of bulimia spectrum disorders, but no research has examined weight suppression in individuals with anorexia nervosa (AN). Thus, this study sought to characterize weight suppression in a large sample of patients with AN (N = 185), and to evaluate whether weight suppression at admission for intensive behavioral treatment predicts weight gain and clinical outcomes at discharge. Weight suppression varied from 0 kg to 78 kg (M [SD] = 17.1 [10.8] kg) in AN patients. Higher levels of weight suppression predicted greater total weight gain, a faster rate of weight gain, and bulimic symptoms during intensive treatment even after controlling for body mass index on admission, length and type of intensive treatment received, restricting versus binge-eating/purging AN subtype, and other predictors of study outcomes. These findings converge with previous research documenting the clinical significance of weight suppression in the treatment of eating disorders. Future work is needed to replicate the current findings, and examine whether weight suppression predicts the course of AN following discharge from intensive treatment.     

Emotional appraisal is influenced by cardiac afferent information

Influential models highlight the central integration of bodily arousal with emotion. Some emotions, notably disgust, are more closely coupled to visceral state than others. Cardiac baroreceptors, activated at systole within each cardiac cycle, provide short-term visceral feedback. Here we explored how phasic baroreceptor activation may alter the appraisal of brief emotional stimuli and consequent cardiovascular reactions. We used functional MRI (fMRI) to measure brain responses to emotional face stimuli presented before and during cardiac systole. We observed that the processing of emotional stimuli was altered by concurrent natural baroreceptor activation. Specifically, facial expressions of disgust were judged as more intense when presented at systole, and rebound heart rate increases were attenuated after expressions of disgust and happiness. Neural activity within prefrontal cortex correlated with emotionality ratings. Activity within periaqueductal gray matter reflected both emotional ratings and their interaction with cardiac timing. Activity within regions including prefrontal and visual cortices correlated with increases in heart rate evoked by the face stimuli, while orbitofrontal activity reflected both evoked heart rate change and its interaction with cardiac timing. Our findings demonstrate that momentary physiological fluctuations in cardiovascular afferent information (1) influence specific emotional judgments, mediated through regions including the periaqueductal gray matter, and (2) shape evoked autonomic responses through engagement of orbitofrontal cortex. Together these findings highlight the close coupling of visceral and emotional processes and identify neural regions mediating bodily state influences on affective judgment.     

Female Passion and the Matrix of Mother,Daughter, and Body: Vicissitudes of the Maternal Transference in the Working Through of Sexual Inhibitions

The maternal object is rarely seen as a girl's source of identification as a vibrant, sexually desirous woman. In this paper, I propose that the mother's capacity both to convey her own pride and pleasure in her female body, its sexual and procreative capacities, and to confer the privilege of passion on her daughter is requisite for a girl's full, pleasurable possession of her body and sexuality. Using observations from two analyses, I explore ways in which transformations of the negative transference manifestations of thwarted maternal sexuality and its pernicious expressions within the mother–daughter relationship paralleled recovery of a fuller capacity for sexual pleasure and agency. To offer clinical pathways toward development of female analysands' capacities for feminine pride and sexual passion, theories must allow for adaptive resolution of oedipal-period conflicts—resolution that can lead to a mature mutuality between mother and daughter.     

‘I'm beyond caring’, a response to the Francis Report: the failure of social systems in health care to adequately support nurses and nursing in the clinical care of their patients

Lord Francis was commissioned to look at why the serious problems (between January 2005 and March 2009) at Mid Staffs Foundation Trust were not identified sooner and the appropriate action taken. Lord Francis was also asked to outline what lessons could be learned to enhance patient care. The report was delivered on 5 February 2013 and contained 290 recommendations. The key message was that the National Health Service needed to put the patient first and everything else should flow from that principle. Poor standards of care should not be tolerated and staff would be expected to speak out when they felt patient care was being compromised. Lord Francis also recommended that there should be one regulatory body and that the role of the Care Quality Commission was to be reviewed.     

Development and implementation of a spiritual coping group intervention for adults living with HIV/AIDS: A pilot study

The aims of the current study were to (1) describe a spirituality-oriented, group pilot intervention for HIV-positive adults, and (2) examine the preliminary impact of the intervention among a sample (N?=?13) of adults living with HIV in an urban city in northeast United States. The 8-session intervention, based on the cognitive theory of stress and coping and the framework of spiritual coping, addressed stressors unique to HIV disease. Changes in spiritual coping and mental health were evaluated using a within group pretest-posttest design. Results revealed that, at post-intervention, participants reported higher self-rated religiosity, more use of positive spiritual coping, lower use of negative spiritual coping, and lower depression. Studies using a randomized, controlled design with larger samples of individuals with HIV are needed to determine the efficacy of a spiritual intervention when compared to a secular one.     

The Foundations of Capability Theory: Comparing Nussbaum and Gewirth

This paper is written from a perspective that is sympathetic to the basic idea of the capability approach. Our aim is to compare Martha Nussbaum’s capability theory of justice with Alan Gewirth’s moral theory, on two points: the selection and the justification of a list of central capabilities. On both counts, we contend that Nussbaum’s theory suffers from flaws that Gewirth’s theory may help to remedy. First, we argue that her notion of a (dignified) human life cannot fulfill the role of a normative criterion that Nussbaum wants it to play in selecting capabilities for her list. Second, we question whether Nussbaum’s method of justification is adequate, discussing both her earlier self-validating argumentative strategy and her more recent adherence to the device of an overlapping consensus. We conclude that both strategies fail to provide the capabilities theory with the firm foundation it requires. Next, we turn to Gewirth’s normative theory and discuss how it can repair these flaws. We show how his theory starts from a fundamental moral principle according to which all agents have rights to the protection of the necessary preconditions of their agency. Gewirth’s justification of this principle is then presented, using a version of a transcendental argument. Finally, we explicitly compare Nussbaum and Gewirth and briefly demonstrate what it would mean for Nussbaum to incorporate Gewirthian elements into her capabilities theory of justice.