A Confidant Support and Problem Solving Model of Divorced Fathers’ Parenting

This study tested a hypothesized social interaction learning (SIL) model of confidant support and paternal parenting. The latent growth curve analysis employed 230 recently divorced fathers, of which 177 enrolled support confidants, to test confidant support as a predictor of problem solving outcomes and problem solving outcomes as predictors of change in fathers’ parenting. Fathers’ parenting was hypothesized to predict growth in child behavior. Observational measures of support behaviors and problem solving outcomes were obtained from structured discussions of personal and parenting issues faced by the fathers. Findings replicated and extended prior cross‐sectional studies with divorced mothers and their confidants. Confidant support predicted better problem solving outcomes, problem solving predicted more effective parenting, and parenting in turn predicted growth in children's reduced total problem behavior T scores over 18 months. Supporting a homophily perspective, fathers’ antisociality was associated with confidant antisociality but only fathers’ antisociality influenced the support process model. Intervention implications are discussed regarding SIL parent training and social support.     

Low priority? A cross sectional study of appearance anxiety in 500 consecutive referrals for cosmetic surgery

Low priority treatment guidance is used in the National Health Service to manage requests for cosmetic surgery where there is no associated functional impairment. Provision is made in this guidance to provide surgery on exceptional grounds, and this may include significant psychological distress. However, without a good understanding of the common factors that underpin requests for surgery, ideally in the local population, it is very difficult to define an exception in a clear and consistent way. A prospective study of consecutive referrals for cosmetic surgery in an NHS plastic surgery unit was therefore completed over a five-year period. Five hundred and one men and women aged between 16 and 79 (mean 34.5 years) were assessed using standardised questionnaires and clinical interview carried out by two clinical psychologists specialising in the field. Results indicated very marked impact of appearance-related anxiety with significant withdrawal from social activities particularly intimate behaviour. Coping behaviours ranged from use of concealing clothing and complete social avoidance to ominous high risk strategies such as repeated pregnancy with late termination to maintain breast size. Treatment goals were predominantly psychosocial. High levels of psychological morbidity can be characterised as typical of people requesting cosmetic procedures in the NHS rather than exceptional, making the achievement of equitable access to limited resources impossible. Rather than define this population as 'low-priority', a constructive approach is to examine the utility of psychological interventions in a design which evaluates the comparative benefits of surgical and psychological approaches to management of appearance anxiety.     

Medical Family Therapy in a Primary Care Setting: A Framework for Integration

As the profession of marriage and family therapy (MFT), as well as the emerging sub-specialty of medical family therapy (MedFT), continue to grow and evolve within the current healthcare system, the arena of integrated primary care (IPC) presents an ideal environment for professionals who are relationally and systemically inclined. Although there has been a inundation of literature detailing collaborative systems of healthcare, several gaps still exist: (a) a lack of horizontally integrated models (i.e., models that do not target specific diseases or demographic populations), (b) a lack of model utilization regardless of disease trajectory (i.e., decline, stabilization, improvement), and (c) a lack of IPC models explicitly utilizing MedFT/MFTs as the mental health providers within the system. In lieu of these gaps, the authors present a framework for IPC, utilizing MedFTs/MFTs, that is neither population nor disease specific, as well as a model geared towards implementation regardless of disease trajectory. The framework, which was obtained using ethnography of communication, details MedFTs?? interactions with front line medical providers and patients from initial contact through coordination of a shared treatment plan. Recommendations for future research studies incorporating the use of MedFTs in integrated primary care settings are extended in the context of a three world view framework (Peek in Collaborative medicine case studies: Evidence in practice. Springer, New York, pp 25?C38, 2008; Peek and Heinrich in Family Syst Med 13:327?C342, 1995, Integrated primary care: the future of medical and mental health collaboration. Norton, New York, pp 167?C202, 1998).     

Medical Family Therapy: Charting a Course in Competencies

The skills and training medical family therapists need to be effective in their work is an underdeveloped area in the literature. Training programs in Medical Family Therapy (MedFT) currently vary in duration, intensity, and focus of material and most of this is due to the minimal research done on what core competencies are needed. The results presented in this paper are the product of a larger modified Delphi (Dalkey in Studies in the quality of life, Lexington Books, Lexinton, MA, 1972) study designed to reach consensus regarding the current definition, scope, and practice of MedFT. Thirty-seven experts in MedFT participated in this two-phase investigation. What resulted and will be reported on in this article are the training requirements and recommended core competencies for the practice of MedFT. Participants indicated that 12 academic course content areas and 13 core competencies should be required of those seeking training in MedFT. Recommendations for MedFT core competencies at the master??s, post master??s, and doctoral levels, as well as advancements for future research, are described in detail.     

The impetus theory in judgments about object motion: A new perspective

Several tendencies found in explicit judgments about object motion have been interpreted as evidence that people possess a naive theory of impetus. The theory states that objects that are caused to move by other objects acquire force that determines the kind of motion exhibited by the object, and that this force gradually dissipates over time. I argue that the findings can better be understood as manifestations of a general understanding of externally caused motion based on experiences of acting on objects. Experiences of acting on objects yield the idea that properties of the cause of motion are transmitted to the effect object. This idea functions as a heuristic for explicit predictions of object motion under conditions of uncertainty. This accounts not only for the findings taken as evidence for the impetus theory, but also for several findings that fall outside the scope of the impetus theory. It has also been claimed that judgments about the location at which a moving object disappeared are influenced by the impetus theory. I argue that these judgments are better explained in a different way, as best-guess extrapolations made by the visual system as a practical guide to interactions with the object, such as interception.     

Lesbian Friendships: An Exploration of Lesbian Social Support Networks

Lesbians may face unique challenges when building friendships. The intersection of culturally sanctioned discrimination and familial rejection may intensify the role friendships play for lesbians and the development of social support networks. The author discusses existing research and qualitative findings and provides suggestions for counselors working with their lesbian clients.     

Gut feelings and the reaction to perceived inequity: The interplay between bodily responses, regulation, and perception shapes the rejection of unfair offers on the ultimatum game

It has been robustly demonstrated using the ultimatum game (UG) that individuals frequently reject unfair financial offers even if this results in a personal cost. One influential hypothesis for these rejections is that they reflect an emotional reaction to unfairness that overrides purely economic decision processes. In the present study, we examined whether the interplay between bodily responses, bodily regulation, and bodily perception ("interoception") contributes to emotionally driven rejection behavior on the UG. Offering support for bodily feedback theories, interoceptive accuracy moderated the relationship between changes in electrodermal activity to proposals and the behavioral rejection of such offers. Larger electrodermal responses to rejected relative to accepted offers predicted greater rejection in those with accurate interoception but were unrelated to rejection in those with poor interoception. Although cardiovascular responses during the offer period were unrelated to rejection rates, greater resting heart rate variability (linked to trait emotion regulation capacity) predicted reduced rejection rates of offers. These findings help clarify individual differences in reactions to perceived unfairness, support previous emotion regulation deficit accounts of rejection behavior, and suggest that the perception and regulation of bodily based emotional biasing signals ("gut feelings") partly shape financial decision making on the UG.     

Expanding on cross-price elasticity: Understanding tobacco product demand and substitution from the cross-price purchase task

We examine whether cigarettes serve as substitutes for electronic nicotine delivery systems (ENDS) among ENDS users and demonstrate methodological extensions of data from a cross-price purchase task to inform policies and interventions. During a clinical laboratory study, n = 19 exclusive ENDS users and n = 17 dual cigarette/ENDS users completed a cross-price purchase task with cigarettes available at a fixed price while prices of own-brand ENDS increased. We estimated cross-price elasticity using linear models to examine substitutability. We defined five additional outcomes: nonzero cross-price intensity (purchasing cigarettes if ENDS were free), constant null demand (not purchasing cigarettes at any ENDS price), cross-product crossover point (first price where participants purchased more cigarettes than ENDS), dual-demand score (percentage of prices where both products were purchased), and dual-use break point (minimum relative price to force complete substitution). The cross-price elasticity results indicated that cigarettes could serve as substitutes for ENDS among ENDS users on average, but this average effect masked substantial heterogeneity in profiles of demand (here, a measure of the drug's reinforcement potential). Policies and regulations that increase ENDS prices appear unlikely to steer most exclusive ENDS users toward cigarette use, as most would not purchase cigarettes at any ENDS price, but they could prompt some dual users to substitute cigarettes completely while others remain dual users. This heterogeneity in consumer responses suggests additional indices of cross-product demand are useful to characterize the anticipated and unanticipated effects of tobacco price policies more fully.