An experimental study of the relationship between thoughts and eating behaviour in bulimia nervosa

This study tested the hypothesis that cognitive disturbance has a causal role in the maintenance of disturbed eating in bulimia nervosa. Thoughts about eating, weight and shape were activated in one group of patients with bulimia nervosa (the experimental group) but not in another (the control group). There was an increase in negative self-statements in the experimental group following the experimental manipulation. Food consumption was then measured in a taste test. As predicted, the experimental group ate less in the short term than the control group. Contrary to expectations, they did not subsequently report more objective bulimic episodes as a consequence of this decreased food intake. They did, however, report significantly fewer subjective bulimic episodes.     

Implementing Housing First Across Sites and Over Time: Later Fidelity and Implementation Evaluation of a Pan-Canadian Multi-site Housing First Program for Homeless People with Mental Illness

This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and leadership facilitated implementation, while staff turnover, rehousing participants, participant isolation, and limited vocational/educational supports impeded implementation. The findings shed light on important implementation “drivers” at the staff, program, and community levels.     

Understanding the Mental Health Travails of Custodial Grandparents

Grandcarers are at-risk of poor mental health outcomes. Current knowledge of the support needs of grandcarers is fragmented. To help fill this knowledge gap qualitative analysis was undertaken on 49 interviews conducted with custodial grandparents. The findings reveal that conflicted occupational roles coupled with the complexity of the stressors facing grandcarers both contribute to their social isolation and to their self-doubts about their ability to adequately attend to their grandchildren’s needs. Greater awareness among occupational therapists (OTs) of custodial grandparents’ mental health travails and an increased understanding of key occupational therapy (OT) practice initiatives are central to addressing grandcarers’ mental health travails.     

Multimethod Assessment of Depression in Sexually Abused Girls

This study measured depression in sexually abused Black girls using the Children's Depression Inventory (Kovacs & A. T. Beck, 1977), the Internalization scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and the Rorschach Depression Index (Exner, 1986). There were no significant correlations between these self-report, behavior observation (by parental report), and projective measures. The abused subjects had high scores on the behavior observation and Rorschach scales. Consistent with past research, negative results were obtained with the self-report instrument. We suggest that the low scores on self-report measures of distress produced by sexually abused children may be the result of guardedness or defensiveness rather than a genuinely low level of dysphoria in this population. There were no significant relations between abuse characteristics and scores on the depression measures. Scores on Rorschach measures of organizational activity (Zf) and available coping resources (EA) were generally positively related to depression within the abuse group and negatively related to depression within the control group.     

The Family Sanctum: The Promise of Love’s Continuing Enlargement Across the Lifespan

Humanistic psychology acknowledges that spirituality is woven into the very fabric of human existence; however, this article furthers the position that the human striving for love and connection is the very definition of human spirituality. By suggesting that the original human intention to connect re-emerges in each subsequent developmental stage, merely reconfiguring to fit the requirements of current developmental tasks, it argues that the early family is an important arbiter of human spirituality across the lifespan. Finally, this article posits that the experience and expression of spirituality in older age reflects either an unbroken link to the original affectionate connection to (biological or surrogate) family members, or the intentional vitalization of weakly formed early family ties.     

Design and Evaluation of a Decision Aid for Inviting Parents to Participate in a Fragile X Newborn Screening Pilot Study

The major objectives of this project were to develop and evaluate a brochure to help parents make an informed decision about participation in a fragile X newborn screening study. We used an iterative development process that drew on principles of Informed Decision Making (IDM), stakeholder input, design expertise, and expert evaluation. A simulation study with 118 women examined response to the brochure. An independent review rated the brochure high on informational content, guidance, and values. Mothers took an average of 6.5 min to read it and scored an average of 91.1 % correct on a knowledge test. Most women rated the brochure as high quality and trustworthy. When asked to make a hypothetical decision about study participation, 61.9 % would agree to screening. Structural equation modeling showed that agreement to screening and decisional confidence were associated with perceived quality and trust in the brochure. Minority and white mothers did not differ in perceptions of quality or trust. We demonstrate the application of IDM in developing a study brochure. The brochure was highly rated by experts and consumers, met high standards for IDM, and achieved stated goals in a simulation study. The IDM provides a model for consent in research disclosing complicated genetic information of uncertain value.     

The drawing effect: Evidence for reliable and robust memory benefits in free recall

In 7 free-recall experiments, the benefit of creating drawings of to-be-remembered information relative to writing was examined as a mnemonic strategy. In Experiments 1 and 2, participants were presented with a list of words and were asked to either draw or write out each. Drawn words were better recalled than written. Experiments 3–5 showed that the memory boost provided by drawing could not be explained by elaborative encoding (deep level of processing, LoP), visual imagery, or picture superiority, respectively. In Experiment 6, we explored potential limitations of the drawing effect, by reducing encoding time and increasing list length. Drawing, relative to writing, still benefited memory despite these constraints. In Experiment 7, the drawing effect was significant even when encoding trial types were compared in pure lists between participants, inconsistent with a distinctiveness account. Together these experiments indicate that drawing enhances memory relative to writing, across settings, instructions, and alternate encoding strategies, both within- and between-participants, and that a deep LoP, visual imagery, or picture superiority, alone or collectively, are not sufficient to explain the observed effect. We propose that drawing improves memory by encouraging a seamless integration of semantic, visual, and motor aspects of a memory trace.     

"Show me" bioethics and politics

Missouri, the "Show Me State," has become the epicenter of several important national public policy debates, including abortion rights, the right to choose and refuse medical treatment, and, most recently, early stem cell research. In this environment, the Center for Practical Bioethics (formerly, Midwest Bioethics Center) emerged and grew. The Center's role in these "cultural wars" is not to advocate for a particular position but to provide well researched and objective information, perspective, and advocacy for the ethical justification of policy positions; and to serve as a neutral convener and provider of a public forum for discussion. In this article, the Center's work on early stem cell research is a case study through which to argue that not only the Center, but also the field of bioethics has a critical role in the politics of public health policy.     

The use of multitreatment modalities in early intervention: A quantitative case study

A quantitative single case study is presented to illustrate how an early intervention program used two therapeutic modalities to treat a depressed mother and her 2-month-old son. Drawing upon an ecological, transactional model of development, the case study utilized a multimethod, longitudinal approach to assess the infant's developmental competence and attachment status, the mother's history and current psychosocial functioning, patterns of mother-infant interaction, and components of the family's social ecology. Measures were administered during a baseline period to assess pre-intervention functioning and were systematically repeated throughout the 2-year period of intervention. The treatment modalities included psychodynamically oriented individual therapy and Parent-Infant Relationship Treatment (PIRT) in which the dyad was also seen by a second therapist to foster more adaptive mother-infant transactional patterns. The findings indicated increased infant developmental competence and a shift from an insecure to a secure attachment classification, improved maternal psychosocial functioning, and a decline in the dyadic interactional pattern of maternal intrusiveness and infant withdrawal. The advantages of using two treatment modalities and a single case approach to evaluation are discussed.