Predictors of Health Care Use Among Individuals Seeking Therapy for Marital and Family Problems: An Exploratory Study

A number of studies have examined variables associated with health care use. However, no study is known to have considered health care use among people seeking services for marital and family problems. In this study, health care use of persons (N = 110) seeking these services was investigated to determine the strongest psychosocial correlates of health care use. The goal was to identify potential “targets” of clinical intervention that may be driving excessive health care use. “Informational support” and “somatization” were the strongest correlates for the complete sample, with the model explaining 24% of the variance in health care use. For “high users” of health care, “hostility” was the strongest correlate, accounting for more than 36% of the variance in health care use.     

Gender Stereotyping and Under-representation of Female Characters in 200 Popular Children’s Picture Books: A Twenty-first Century Update

Gender stereotyping and under-representation of girls and women have been documented in children’s picture books in the past, in the hope that improvements would follow. Most researchers have analyzed award-winning books. We explored sexism in top selling books from 2001 and a 7-year sample of Caldecott award-winning books, for a total of 200 books. There were nearly twice as many male as female title and main characters. Male characters appeared 53% more times in illustrations. Female main characters nurtured more than male main characters did, and they were seen in more indoor than outdoor scenes. Occupations were gender stereotyped, and more women than men appeared to have no paid occupation. Few differences were found between Caldecott award books and other books. A comparison of our book sample to 1980s and 1990s books did not reveal reduced sexism. The persistence of sexism in picture books and implications for children and parents are discussed.     

Converted patients and clinic patients as control cases: a comparison with implications for psychoanalytic training

All twenty-eight respondents to a recent poll of the thirty institutes affiliated with the American Psychoanalytic Association reported that they now accept cases converted from psychotherapy to psychoanalysis as control cases. This study was designed to compare converted cases to clinic cases systematically with respect to patient characteristics, treatment, and the educational experience of the treating candidate. The study followed twenty-four candidates entering analytic training between 1992 and 1995, who treated thirty-four clinic cases and forty-three converted cases between February 1993 and July 2000. Clinic and converted patients were comparable with regard to demographics, prior treatment histories, structural diagnoses, and Axis I diagnoses. In addition, the two groups of cases were indistinguishable with respect to the rate at which candidates received credit toward graduation requirements. Candidates treating converted cases earned approximately dollars 7,600 per patient per year, compared to candidates treating clinic cases, who earned nothing. Eighty-four percent of converted patients diagnosed with a mood disorder by the treating candidate were on medication, in contrast to only 20% of clinic patients with the same diagnosis. Similar differences were seen in the case of anxiety disorders. Given the prevalence of affective and anxiety disorders in control cases and the availability of a variety of medications and psychotherapies with documented efficacy in treating these disorders, candidates should be trained to discuss treatment options with patients who present with Axis I disorders.     

Crossover of marital dissatisfaction during military downsizing among Russian army officers and their spouses

This study examined mechanisms of strain crossover within couples and the moderating role of gender. Data were collected at a time of military downsizing from a sample of 1,250 Russian army officers and their spouses. The authors tested a model that incorporated 3 mechanisms for the crossover of marital dissatisfaction among dual-earner couples. The model provided support for 2 suggested crossover mechanisms: direct reactions of crossover and indirect mediated effects through social undermining. Strong evidence was also provided for gender asymmetry in the crossover process. Marital dissatisfaction crossed over from husbands to wives but not vice versa, and social undermining behavior played a role in the process of crossover of marital dissatisfaction for husbands but not for wives.     

The PANDAS subgroup: recognition and treatment

A subgroup of patients with childhood-onset obsessive-compulsive disorder (OCD) has been identified who share a common clinical course characterized by dramatic symptom exacerbations following Group A beta-hemolytic streptococcal (GABHS) infections. The term PANDAS has been applied to the subgroup, to indicate the postulated etiology of their symptoms: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Five clinical characteristics define the PANDAS subgroup: presence of OCD and/or tic disorder, prepubertal symptom onset, sudden onset or abrupt exacerbations (sawtooth course), association with neurological abnormalities (presence of adventitious movements or motoric hyperactivity during exacerbations), and temporal association between symptom exacerbations and GABHS infections. Post-streptococcal symptom exacerbations are typically quite dramatic, with patients reporting that their symptoms "...came on overnight" or "...appeared all of a sudden a few days after I had a sore throat." The post-streptococcal inflammatory nature of the neuropsychiatric symptoms provides novel opportunities for treatment and prevention, including immunomodulatory therapies such as therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIG). A recently completed placebo-controlled trial revealed that both IVIG and TPE were effective in reducing neuropsychiatric symptom severity (40% to 55% reductions, respectively) for a group of severely ill children with OCD and/or tic disorders. Further research is required to determine why the treatments are helpful, as well as to ascertain whether or not antibiotic prophylaxis can help prevent post-streptococcal symptom exacerbations.     

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress

Background and Objectives: Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together.

Design: The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations.

Methods: Undergraduate students (N?=?243; M?=?20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks.

Results: Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness.

Conclusions: It may be important to more strongly consider interpersonal stress generation in models of social anxiety.     

Comparison of choose-a-movie and approach–avoidance paradigms to measure social motivation

Social motivation is a subjective state which is rather difficult to quantify. It has sometimes been conceptualised as “behavioural effort” to seek social contact. Two paradigms: approach–avoidance (AA) and choose a movie (CAM), based on the same conceptualisation, have been used to measure social motivation in people with and without autism. However, in absence of a direct comparison, it is hard to know which of these paradigms has higher sensitivity in estimating preference for social over non-social stimuli. Here we compare these two tasks for their utility in (1) evaluating social seeking in typical people and (2) identifying the influence of autistic traits on social motivation. Our results suggest that CAM reveals a clear preference for social stimuli over non-social in typical adults but AA fails to do so. Also, social seeking measured with CAM but not AA has a negative relationship between autistic traits.     

The Development and Validation of the Rational and Intuitive Decision Styles Scale

Decision styles reflect the typical manner by which individuals make decisions. The purpose of this research was to develop and validate a decision style scale that addresses conceptual and psychometric problems with current measures. The resulting 10-item scale captures a broad range of the rational and intuitive styles construct domain. Results from 5 independent samples provide initial support for the dimensionality and reliability of the new scale, as demonstrated by a clear factor structure and high internal consistency. In addition, our results show evidence of convergent and discriminant validity through expected patterns of correlations across decision-making individual differences and the International Personality Item Pool (IPIP) Big Five traits. Research domains that would benefit from incorporating the concept of decision styles are discussed.