Distress,wellbeing, and growth amidst COVID-19: Considering the dynamic interplay between positive and negative anticipatory emotions

Although negative anticipatory emotions are typically seen as risk factors for poorer psychological outcomes over COVID-19, emotion theorists suggest that this risk may be attenuated if balanced by the experience of positive emotion. Thus, the current study examined whether interactions between positive and negative anticipatory emotions were concurrently associated with psychological distress and greater personal wellbeing/posttraumatic growth (PTG) at three distinct periods (i.e., pre-lockdown, during lockdown, post-lockdown), and whether associations varied by these three COVID-19 time periods. The study utilizes two large longitudinal Australian samples, surveyed in 2020 prior to, during, and after a strict 4-month lockdown that occurred in Australia. Overall, positive emotions attenuated the adverse psychological outcomes arising from higher levels of negative emotion (i.e., higher psychological distress and lower personal wellbeing). Observed effects varied according to COVID-19 threat exposure. Specifically, the interaction was significantly associated with psychological distress prior to the lockdown for Sample 2, and during the lockdown for both samples. The interaction was significantly associated with wellbeing (Sample 2) prior to, and during, the lockdown but only marginally associated post-lockdown. The interaction, however, was not significantly associated with PTG (Sample 1). The results suggest that it is valuable for future research to consider greater emotional complexity (i.e., mixed emotions) over COVID-19, and other stressors more generally, to encompass a more nuanced understanding of resilience.     

Development of knowledge bases and the reliability of a decision support system for behavioral treatment consultation for persons with mental retardation: The Mental Retardation-Expert

The development of expert and decision support systems requires the collection, organization, codification, and storage of a body of specialized knowledge. The development, using reconstructive methods, of two such knowledge bases, the first containing the current scientific literature and the second containing an expert’s knowledge, is described for an automated decision support system, the Mental Retardation-Expert. This system provides practitioners with assistance in the treatment of aggressive, self-injurious, and destructive behaviors displayed by individuals with mental retardation or developmental disabilities. The average interobserver reliability of the expert knowledge base ranged from 92.5% to 95.0% when calculated across four clinicians’ assessments of 31 abstracted cases.     

Short-term psychodynamic intervention in an urban health clinic: A case report

This paper describes the application of short-term dynamic therapeutic techniques to treat both symptom disturbance and character pathology in an urban mental health clinic. Short-Term dynamic psychotherapy focuses extensively on the subjectivity and inner life of the patient with emphasis on repressed anger, sadness and desire. Methods to overcome patient ambivalence and resistance to psychotherapy are presented. The clinical psychodynamics associated with early life trauma are illustrated with a case of an African-American patient.Acknowledgments for support & critical feedback are expressed to Christine Baker, Ph.D., John Swanson, ACSW, Duncan Walton, Ph.D., and Isabelle Beveridge (Graphics).     

Harming future people

Hanser examines Derek Parfit's contention in his treatise on rationalism, Reasons and Persons (Oxford University Press; 1984) that acts that are not reproductive in nature can nonetheless predictably affect the identities of future people, and that this fact has unexpected and important consequences for ethical theory. Hanser argues tht this fact is not as significant as Parfit believes it to be. The arguments of both scholars concern the morality of choices that, while causing future persons to be badly off, do not make them worse off than they would have been if the choices had not been made. Hanser concludes his essay with a discussion of responsibility for acts that will affect the health of future offspring.     

Do substance abuse and mental health clients prefer automated assessments?

In both psychiatric and substance-abuse services, clinicians have been concerned with the introduction of automated assessments and with their clients’ reactions toward those assessments. The positive reactions of psychiatric clients have been well documented, but little has been known about substance-abusing clients’ impressions of automated assessments. The impact of automated assessment on clients seeking substance-abuse services was evaluated and compared with a previously analyzed sample of clients seeking mental health services. On the whole, both groups responded similarly and positively to automated assessments. Factor analyses revealed three underlying dimensions in client attitudes toward automated assessment,Completeness and satisfaction,Ease of use and enjoyment, andNegative attitudes. In addition, statistically, though not clinically, significant differences in attitudes were found between various demographic groups. Overall, the results support the use of automated assessments with individuals seeking either substance-abuse or mental-health services.     

Clinical pragmatism: a method of moral problem solving

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Antecedents and Consequences of Victimization of Lesbian, Gay, and Bisexual Young People: A Structural Model Comparing Rural University and Urban Samples

Research indicates that antigay victimization is widespread and that lesbian, gay, and bisexual young people may be very vulnerable to such victimization. The current study builds upon previous work by Hershberger and D'Augelli (1995), who studied the consequences of sexual orientation-based victimization in 194 urban lesbian, gay, and bisexual youths. Using structural equation modeling, the present study models both antecedents and consequences (including psychological distress, self-esteem, and suicidality) of victimization via a secondary analysis of their data set. In addition, a second sample of 54 lesbian, gay, and bisexual youths from a rural university setting was examined to cross-validate and generalize the relationships found in urban settings. Results indicated that a revised model of victimization exhibited sufficient fit to the urban sample data and provided preliminary support for the generalizability of the model beyond the initial sample. Additional similarities were found between the urban and rural university community samples, including a high prevalence of reported suicide attempts: 42% of the urban sample and 32% of the rural university sample had attempted suicide at least once. Results indicated that victimization based on sexual orientation has similar correlates for young people in different community settings.     

TRAINING PARENTS IN BEHAVIORAL SELF-MANAGEMENT: AN ANALYSIS OF GENERALIZATION AND MAINTENANCE

This study examined the generalization and maintenance effects of three phases of parent training (Instructions plus Feedback and two Self-management Training phases) on levels of disruptive child behavior and the accuracy with which parents implemented programs. Data were collected from five families in three main settings: the initial training setting (the home), a variety of generalization settings in the community, and the family breakfast. A multiple baseline across subjects design was used. Instructions plus Feedback comprised instructing parents to use a range of behavior management procedures and provided home-based differential feedback concerning accuracy of program implementation. Self-management Training phases involved training parents in goal setting, self-monitoring, and planning skills, specific to their performance of appropriate parenting skills in generalization settings. Results indicated that the Instructions plus Feedback phase was sufficient to produce reduced levels of problem behavior at home and high levels of accurate implementation, but generalization effects out of home were equivocal. Self-management maintained reduced levels of problem behavior at home but, in addition, resulted in generalization effects in community settings for both children and parents. Maintenance probes 3 months following the program revealed the effects had been maintained.