Internet-Delivered Exposure-Based Cognitive-Behavioral Therapy for Adolescents With Functional Abdominal Pain or Functional Dyspepsia: A Feasibility Study

Functional abdominal pain (FAP) and functional dyspepsia (FD) are common in adolescents and associated with low quality of life. Exposure-based cognitive-behavioral therapy (CBT) is efficient for adult and adolescent irritable bowel syndrome (IBS), but has never been evaluated for adolescent FAP/FD. The aim of this study was to evaluate the feasibility and potential efficacy of a novel disorder-specific Internet-delivered CBT (Internet-CBT) for adolescents with FAP or FD, using an uncontrolled open pilot including 31 adolescents. The Internet-CBT consisted of 10 weekly online modules, which focused mainly on exposure to abdominal symptoms. Parents received modules to help them reduce unhelpful parental behaviors. Participants reported the treatment to be credible, and an overall satisfaction with the treatment. Data attrition rate was low (7%) and adherence to treatment was acceptable. We saw a significant and large effect on the primary outcome, pain intensity, at posttreatment (d = 1.20, p < .001) that was further improved after 6 months (d = 1.69, p < .001). Participants also made significant and large improvements on gastrointestinal symptoms (d = 0.84, p < .001) and quality of life (d = 0.84, p < .001) that were sustained or further improved at follow-up 6 months after treatment. This study demonstrated that exposure-based Internet-CBT, tailored for adolescents with FAP or FD, is a feasible treatment that potentially improves pain intensity, gastrointestinal symptoms, and quality of life.     

Profiles of competence and adaptation in preschoolers as related to the quality of parent–child interaction

In a sample of 107 five-year-olds, cluster analysis was used to identify groups of children with similar profiles of competence and adaptation. A comprehensive set of child characteristics was included in the analysis, together covering the most important aspects of five-year-olds’ development and functioning. Three groups of children emerged, which were labeled Well-adapted/Competent, Underachieving/Internalizing, and Maladapted/Externalizing. Well-adapted/Competent children (59%) were competent and well-adjusted in all domains. The Maladapted/Externalizing children (22%) scored low in almost all domains of competence and functioning, and the Underachieving/Internalizing children (22%) showed a mixed profile of competence and adaptation. The differences in the quality of parent–child interaction that were observed between the groups provide clues as to how the different profiles of competence and adaptation are shaped and maintained in the interactions with parents.     

Are women always more interpersonally sensitive than men? Impact of goals and content domain

Two studies examined motivation and content domain as possible influences on sex differences in interpersonal sensitivity. Although much research has found women to excel on tasks measuring interpersonal sensitivity, most of the tasks have measured accuracy in female-relevant domains such as emotion. The present studies measured interpersonal sensitivity, defined as accurate recall of another person, for both female-relevant and male-relevant content domains and also included motivational manipulations intended to influence men and women differently. Study 1 measured accuracy of recalling information in a written vignette about a person, and Study 2 measured accuracy of recalling details about an interaction partner. Both studies supported hypotheses about domain specificity and gender-relevant motivation. However, even for male-stereotypic content and for tasks framed to favor men's motivation to perform well, men's accuracy never exceeded women's.     

Gender differences in facial imitation and verbally reported emotional contagion from spontaneous to emotionally regulated processing levels

Previous studies on gender differences in facial imitation and verbally reported emotional contagion have investigated emotional responses to pictures of facial expressions at supraliminal exposure times. The aim of the present study was to investigate how gender differences are related to different exposure times, representing information processing levels from subliminal (spontaneous) to supraliminal (emotionally regulated). Further, the study aimed at exploring correlations between verbally reported emotional contagion and facial responses for men and women. Masked pictures of angry, happy and sad facial expressions were presented to 102 participants (51 men) at exposure times from subliminal (23 ms) to clearly supraliminal (2500 ms). Myoelectric activity (EMG) from the corrugator and the zygomaticus was measured and the participants reported their hedonic tone (verbally reported emotional contagion) after stimulus exposures. The results showed an effect of exposure time on gender differences in facial responses as well as in verbally reported emotional contagion. Women amplified imitative responses towards happy vs. angry faces and verbally reported emotional contagion with prolonged exposure times, whereas men did not. No gender differences were detected at the subliminal or borderliminal exposure times, but at the supraliminal exposure gender differences were found in imitation as well as in verbally reported emotional contagion. Women showed correspondence between their facial responses and their verbally reported emotional contagion to a greater extent than men. The results were interpreted in terms of gender differences in emotion regulation, rather than as differences in biologically prepared emotional reactivity.     

Body Objectification and “Fat Talk”: Effects on Emotion,Motivation, and Cognitive Performance

To evaluate the effects of self-objectification on mood, motivation, and cognitive performance, 80 women either tried on a swimsuit (high objectification) or a sweater (low objectification). In addition, in order to investigate whether “fat talk” exacerbates the negative effects of self-objectification, half of each group overheard a confederate make self-disparaging body comments or neutral comments. Self-objectification, either as an individual difference disposition (trait) or as a situationally induced state, was associated with increased negative feelings, decreased intrinsic motivation, lower self-efficacy, and diminished cognitive functioning. The “fat talk” prime had mixed effects; potential reasons are discussed in detail. Exposure to fat talk was associated with an increase in negative emotion for women in sweaters, but a decrease in negative emotion for women in swimsuits. Fat talk was also associated with improved motivation and cognitive functioning for women low in trait self-objectification but diminished motivation and performance for women high in trait self-objectification.     

Die Psychotherapeutenausbildung aus Sicht der Teilnehmer

Background

A survey was performed to assess the current situation in education and to identify critical issues 10 years after the inception of the German law regulating the education of psychological psychotherapists and child and adolescent psychotherapists. The study reports the results of a nationwide survey of German psychological psychotherapists and child and adolescent psychotherapists currently in training. The aim of the survey was to evaluate the individual sections of training, desired alterations and structural and financial conditions.

Methods

All trainees were contacted via the training institutes and the umbrella organizations. A total of 3,223 trainees participated and answered questions mainly using an online questionnaire.

Results

Most respondents practiced their training part-time and in most cases the trainees thought that the training would last longer than initially expected. The practical training was rated most poorly, whereas practical education and individual supervision were rated as most useful. The survey revealed deficits concerning the evaluation of the quality of several components of the training.

Conclusions

From the perspective of the trainees there is a necessity to modify the financial conditions of the training. This result has been considered in the recommendations of a research expertise on psychotherapy training and should stimulate further research.     

Motor and cognitive control in a normative sample of 7‐year‐olds

The aim of the present study was to explore the relationship between cognitive and motor control by correlating individual performance on a variety of complex tasks in a normative sample of over 100 7‐year‐olds. While there are a few studies including children with specific developmental disorders (i.e. ADHD and DCD) showing that they share similar comorbid deficits, it is still unclear whether control processes share variance in normative samples. Results presented here reveal on the one hand that some aspects of cognitive and motor control are significantly interrelated, even when controlling for age. On the other hand, individuals’ ability to efficiently respond to the speed and accuracy demands of any of the included tasks appeared to constitute an important aspect of executive functioning.     

The predictive value of different infant attachment measures for socioemotional development at age 5 years

The predictive value of different infant attachment measures was examined in a community‐based sample of 111 healthy children (59 boys, 52 girls). Two procedures to assess infant attachment, the Attachment Q‐Set (applied on a relatively short observation period) and a shortened version of the Strange Situation Procedure (SSSP), were applied to the children at age 15 months and related to a comprehensive set of indicators of the children's socioemotional development at age 5 years. Three attachment measures were used as predictors: AQS security, SSSP security, and SSSP attachment disorganization. AQS security and SSSP security jointly predicted the security of the children's attachment representation at age 5. Apart from that, SSSP attachment disorganization was a better predictor of the children's later socioemotional development than were the other two early attachment measures. First, attachment disorganization was the only attachment measure to predict the children's later ego‐resiliency, school adjustment, and dissociation. Second, as for the socioemotional measures at age 5 that also were related to AQS or SSSP security (i.e., peer social competence and externalizing problems), the attachment security measures did not explain any extra variance beyond what was explained by attachment disorganization.     

Reflections

The American Journal of Psychoanalysis -