Maternal Avoidant Coping Mediates the Effect of Parenting Stress on Depressive Symptoms during Early Adolescence

We examined maternal avoidant coping as a mediator between maternal parenting stress and maternal depressive symptoms during early adolescence. Three years of self-report data were collected from 173 mothers, beginning when mothers’ adolescents were in 6th grade and aged 11–13 years. Utilizing longitudinal path analysis, results indicated that avoidant coping at time two mediated the association between parenting stress at time one and depressive symptoms at time three. Additionally, the reverse direction of effects was examined, revealing that the relation between parenting stress and avoidant coping was unidirectional, while the relation between avoidant coping and depressive symptoms was bidirectional. Our results suggest that during early adolescence, mothers who experience more stress in the parenting role are more likely to engage in higher levels of avoidant coping when faced with parenting problems. In turn, a mother’s long-term avoidant reactions to parenting problems may predict increases in depressive symptoms. Moreover, our findings of a bidirectional relation between avoidant coping and depressive symptoms suggest that prior levels of depression might serve as a barrier to efficient and effective coping. The present study may inform preventive intervention efforts aimed at decreasing the use of avoidance in response to parenting stressors by increasing adaptive parental coping with stressors, and providing appropriate support and resources for parents.     

Enduring deficits in contextual and auditory fear conditioning after adolescent, not adult, social instability stress in male rats

Adolescence is a time of developmental changes and reorganization in the brain and stress systems, thus, adolescents may be more vulnerable than adults to the effects of chronic mild stressors. Most studies, however, have not directly compared stress experienced in adolescence to the same stress experience in adulthood. In the present study, adolescent (n=46) and adult (n=48) male rats underwent 16 days of social instability stress (daily 1h isolation and change of cage partners) or were non-stress controls. Rats were then tested on the strength of acquired contextual and cued fear conditioning, as well as extinction learning, beginning either the day after the stress procedure or 3 weeks later. No difference was found among the groups during the Training Phase of conditioning. Irrespective of the time between the social stress experience and fear conditioning, rats stressed in adolescence had decreased context and cue memory, and cue generalization compared to control rats, as measured by the percentage of time spent freezing in tests. Social instability stress in adulthood had no effect on any measure of fear conditioning. The results support the hypothesis that adolescence is a time of heightened vulnerability to stressors.     

Component analysis of simple span vs. complex span adaptive working memory exercises: A randomized,controlled trial

There has been growing interest in using adaptive training interventions such as Cogmed-RM to increase the capacity of working memory (WM), but this intervention may not be optimally designed. For instance, Cogmed-RM can target the primary memory (PM) component of WM capacity, but not the secondary memory (SM) component. The present study hypothesized that Cogmed-RM does not target SM capacity because the simple span exercises it uses may not cause a sufficient amount of information to be lost from PM during training. To investigate, we randomly assigned participants to either a standard (simple span; N = 31) or a modified (complex span; N = 30) training condition. The main findings showed that SM capacity did not improve, even in the modified training condition. Hence, the potency of span-based WM interventions cannot be increased simply by converting simple span exercises into complex span exercises.     

Parallel process in supervision

This paper addresses the concept of parallel process and its application in clinical supervision. Parallels between therapy and supervision are examined as well as some of the key issues surrounding the use of parallel process as a supervisory intervention. Although there is a need for more investigation to explain and support this concept further, the authors would argue that parallel process interventions in supervision can enhance the supervisory process and the task of teaching and learning for both the supervisee and supervisor. A case example is provided to demonstrate the parallel process in supervision and its potential as a facilitative intervention.     

Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial

This study examined the individual and combined effects of two nonpharmacological treatments for attention deficit/hyperactivity disorder (ADHD): Cogmed working memory training (CWMT) for adolescents and behavioral parent training (BPT) for mothers. Ninety-one adolescents (ages 11–15) and their mothers were randomized to one of four CWMT and BPT treatment and active control (placebo) group combinations of 5-week interventions. At pre- and posttest, mothers and teachers completed rating forms, and adolescents completed neuropsychological measures of working memory (WM). Individual intervention effects showed that treatment CWMT significantly improved WM spans, whereas there were no significant differences for treatment or control BPT on reports of parent-related outcomes. Combined treatment effects indicated an overall pattern of greatest improvements for the control CWMT/treatment BPT group, as compared to the other three groups, on adolescent WM deficit, behavioral regulation problems, and global executive deficit. Most significant effects for outcomes were main effects of improvements over time. A combination of CWMT and BPT did not result in increased treatment gains. However, potential effects of combined treatment may have been masked by greater perceived benefits arising from lack of struggle in the nonadaptive, CWMT active control condition. Future combined intervention research should focus on specific, theoretically driven WM deficits among individuals with ADHD, should include possible adaptations to the standard CWMT program, should examine effectiveness of cognitive treatments combined with contextual interventions and should utilize appropriate control groups to fully understand the unique and combined effects of interventions.     

The value of dignity in and for bioethics: rethinking the terms of the debate

The discussion of the nature and value of dignity in and for bioethics concerns not only the importance of the concept but also the aims of bioethics itself. Here, I challenge the claim that the concept of dignity is useless by challenging the implicit conception of usefulness involved. I argue that the conception of usefulness that both opponents and proponents of dignity in bioethics adopt is rooted in a narrow understanding of the role of normative theory in practical ethical thinking. I then offer an alternate understanding of the nature and value of dignity. I begin by recognizing that claims that one’s dignity has been violated point to an important difference between “respect for autonomy” and “respect for persons.” I then suggest three different conceptions of how dignity can be normatively guiding for bioethics, and conclude that, ultimately, understanding dignity as the cornerstone of a reflective perspective that frames moral reflection and deliberation is valuable for doing bioethics well.     

Beyond stigma: Understanding the “inclined abstainers” in military behavioral health-care utilization

ABSTRACT

Low treatment utilization in Soldiers with combat-related Posttraumatic Stress Disorder (PTSD) is an ongoing issue. The critical concern is to better understand factors which prohibit a Soldier with PTSD who wants help from seeking treatment (an “inclined abstainer”). A total of 537 Active Duty Soldiers on a US Army post completed a brief survey comprising psychometrically validated measures of stigma, behavioral health treatment beliefs, resilience, PTSD symptoms, and treatment intentions. Health-care records were prospectively tracked for 12 months to determine the relation between survey answers and treatment utilization. Sixty-three percent of those who acknowledged having a mental health-related problem did not seek help within a one-year period. Greater severity of PTSD symptoms was associated with an increased likelihood of behavioral health engagement. Soldiers that were classified as “inclined abstainers” were also more likely to endorse negative beliefs about psychotherapy and report higher levels of resilience as compared to “inclined actors.” These results suggest that a treatment model of PTSD emphasizing self-efficacy and self-reliance, while addressing negative beliefs about psychotherapy, may help promote engagement of behavioral health services among Active Duty Soldiers.