Working with Low-income Families: Lessons Learned from Basic and Applied Research on Coping with Poverty-related Stress

Poverty and low socioeconomic status create tremendous amounts of physical and psychosocial stress that compromise health and well-being. This paper explores how the stressors created, exacerbated, and maintained by living in poverty lead to compromised mental health, and at the same time present significant challenges to participating in and benefitting from traditional psychotherapy. This paper summarizes the strong research evidence supporting the causal role of poverty-related stress in contributing to mental (and physical) health problems, discusses the physiology that underlies this process and how it affects clients’ ability to make use of psychotherapy, and presents recommendations for incorporating a multi-faceted approach to coping in clinical work with low-income clients and families. Addressing the pernicious effects of economic stress with a multi-step approach to effective coping can serve to prepare low-income clients to better engage in and get the most out of psychotherapy.     

Disagreement and causal learning: Others' hypotheses affect children's evaluations of evidence

When children evaluate evidence and make causal inferences, they are sensitive to the social context in which data are generated. This study investigated whether children learn more from evidence generated by an agent who agrees with them or from one who disagrees with them. Children in two age groups (5- and 6-year-olds and 9- and 10-year-olds) observed the functioning of a machine that lit up and played music in the presence of certain objects. After endorsing one of two plausible causal hypotheses, children observed a puppet either agree or disagree with their own hypotheses. The puppet then generated a further piece of evidence that confirmed, disconfirmed, or was neutral with respect to the children's hypotheses. When they were later asked to make causal inferences about objects they did not directly observe, children in both age groups responded differentially to identical evidence depending on whether the agent agreed or disagreed, and they often drew stronger inferences in response to disagreement. In addition, older children were particularly sensitive to disagreement when the evidence was ambiguous. Our results suggest that children consider the relationship between their own and others' hypotheses when evaluating evidence that others generate. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Loneliness and eating disorders

This article examines the link between loneliness and eating disorders. This concept is evaluated through a systematic review of the literature that links loneliness and eating disorders and through a survey of themes connecting the 2 conditions. Eating disorders-including anorexia nervosa, bulimia nervosa, and eating disorders that are not otherwise specified, which include binge eating disorder-are challenging health issues. Each of these diagnoses specifically relates to loneliness. This negative emotion contributes to and fuels eating disorder symptoms. Negative interpersonal relationships, both real experiences and individuals' skewed perceptions, exacerbate eating disorders and feelings of loneliness. Characteristics that have been associated with loneliness clearly relate to eating disorders. Understanding this relationship is vital, so that we can appreciate our patients' struggles and work to target these intense emotions within the treatment setting. We need to be aware of the power of loneliness as it applies to individuals in general and specifically to those struggling with disordered eating.     

Prolonged exposure therapy for combat-related posttraumatic stress disorder: comparing outcomes for veterans of different wars

There is significant support for exposure therapy as an effective treatment for posttraumatic stress disorder (PTSD) across a variety of populations, including veterans; however, there is little empirical information regarding how veterans of different war theaters respond to exposure therapy. Accordingly, questions remain regarding therapy effectiveness for treatment of PTSD for veterans of different eras. Such questions have important implications for the dissemination of evidence based treatments, treatment development, and policy. The current study compared treatment outcomes across 112 veterans of the Vietnam War, the first Persian Gulf War, and the wars in Afghanistan and Iraq. All subjects were diagnosed with PTSD and enrolled in prolonged exposure (PE) treatment. Veterans from all three groups showed significant improvement in PTSD symptoms, with veterans from Vietnam and Afghanistan/Iraq responding similarly to treatment. Persian Gulf veterans did not respond to treatment at the same rate or to the same degree as veterans from the other two eras. Questions and issues regarding the effectiveness of evidence based treatment for veterans from different eras are discussed.     

The manifestation of transference during early psychotherapy sessions: Exploring an alternate data source for therapist narratives in transference research

Introduction: Previous transference studies have compared in‐session client narratives about significant others to in‐session client narratives about the therapist, limiting data to the information that clients are willing to share with the therapist. Method: The first three sessions of 30 therapies with high‐functioning individuals were examined using the Core Conflictual Relationship Theme (CCRT) method. Client narratives about others were drawn from the psychotherapy sessions and client narratives about the therapist were drawn from a Participant Critical Event (PCE) interview conducted after the third session of therapy. Results: Factor analyses of the CCRT components indicated several relational patterns: a complementary pattern of relating characterised by a devaluation of the therapist and idealisation of others; a concordant relational transfer where clients feel bad with both the therapist and others; and as clients experience control issues with significant others, they wish to adopt a submissive stance toward the therapist. The results suggest that the source of therapist narratives may influence the results of transference research.