Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Mothers and fathers and mothers and babies: Interrelationship among relationships

The relationship between perceived marital satisfaction and early mother-infant interaction was investigated. Seventeen mothers and their three-day-old infants served as subjects. Dyads were observed via a modified time-sampling technique during a hospital feeding session. Then mothers completed a questionnaire concerning their perceptions of the marital relationship. Correlational analyses revealed a significant covariance of positive perceptions of the expressive aspects of the marital relationship and heightened social interaction for mother and infant. An interrelationship was observed between mother-neonate social-visual communication and maternal reports of planned pregnancies, time spent talking with spouse, general ratings of “getting along with spouse,” and positive overall evaluations of the material relationship. Also observed was the interrelationship of mother holding infant away from close bodily contact with reports of decreased love felt toward spouse, less optimal perceptions of ease of emotional expression and spousal interest in maternal daily activities, and less optimal overall ratings of the relationship. Implications of the results and the need for further research are discussed.     

Hostile masculinity,sexual aggresion,and gender-biased domineeringness in conversations

This study assessed the ability of certain variables to predict which men would be more domineering in conversations with a woman and/or with a man. The variables included men's self-reported sexually aggressive behavior and several components comprising a personality profile labeled “Hostile Masculinity.” As expected, these variables successfully predicted domineering behavior toward the female but not toward the male. These findings supported theories hypothesizing that men's desire to control women and men's antisocial behavior toward them are due to specific rather than to general factors (i. e., evolutionary and feminist theorizing). © 1994 Wiley-Liss, Inc.     

Sex and genes,part 2: A biopsychosocial approach to assess and treat challenging sexual behavior in persons with intellectual disabilities including fragile X syndrome and 22q11.2 deletion syndrome

Individuals with intellectual disabilities (IDs) – and specifically those with genetic disorders – are more prone to medical and psychological challenges that affect their sexual development, experiences, and fertility. In this review paper we first provide an overview of the biopsychosocial (BPS) model and then explain how the model can guide and improve the assessment and treatment of challenging sexual behaviors by persons with IDs. We discuss two genetic conditions – fragile X syndrome and 22q11.2 deletion syndrome – in case studies, showing how the BPS model can be used to assess and treat the sexual problems of individuals with various types of ID. We conclude with BPS-formulated treatment considerations in three key domains: biomedical treatment (e.g., medication side effects; stopping or changing medications), psychological treatment (e.g., providing psychological therapies), and socio-environmental interventions (e.g., providing socio-sexual education and staff training). Together, these treatment interventions can aid clinicians to prevent and/or treat problematic sexual behaviors of people with IDs.     

An update on the study of playfulness in adolescents: its relationship with academic performance,well-being,anxiety, and roles in bullying-type-situations

Playfulness is an individual differences variable at the trait-level. It describes the ability to experience or (re)frame everyday situations as stimulating, interesting, and/or entertaining. Playfulness in adolescents is understudied. We collected self-report data on four facets of playfulness (other-directed, lighthearted, intellectual, and whimsical) in two German-speaking samples of adolescents (N1 = 210, N2 = 270; age range 13–18 years). The facets correlated positively, but to varying degrees with life satisfaction (social life, self, friends) and intrinsic goals. There was no relationship with self-reported school grades and achievement goals (Sample 1). Playfulness in girls was associated with peer-nominated (classmates) bullying behaviors and victimization status (Sample 2). Overall, the findings show that playfulness has an impact on various domains of the life of adolescents. We discuss directions for further research in the field.     

Effects of manual versus voice-activated dialing during simulated driving

We measured driving performance (lane-keeping errors, driving times, and glances away from the road scene) in a video driving simulator for 24 volunteers who each drove alone on a 10.6-km multicurved course while simultaneously placing calls on a mobile phone subscribed to a voice-activated dialing system. Driving performance also was measured for the same distance while participants manually dialed phone numbers and while they drove without dialing. There were 22% fewer lane-keeping errors (p<.01) and 56% fewer glances away from the road scene (p<.01) when they used voice-activated dialing as compared to manual dialing. Significantly longer driving times in both of the dialing conditions as compared to the No Dialing condition are discussed in terms of the hypothesis that drivers decrease driving speed to compensate for the demands of the secondary phone tasks.     

Teaching cultural sensitivity in psychological assessment: a modular approach used in a distance education program

In this article, I describe the teaching and evaluation of 8 multicultural assessment competencies in an American Psychological Association accredited, distance education, clinical psychology doctoral program. This modular approach consists of 15 hr of face-to-face, didactic and experiential multicultural assessment training designed to (a) augment personal awareness, (b) develop a conceptual base, (c) provide exposure to available assessment technologies, (d) ensure an understanding of an integrative model of culturally sensitive assessment, and (e) offer opportunities to apply this material to assessment cases. In addition to completing this training, students are evaluated on these competencies as part of their preinternship clinical comprehensive. I present preliminary evaluative outcome data as well as a critique of this approach.     

Mother-infant interactions in western Lowland Gorillas (Gorilla gorilla gorilla): spatial relationships,communication, and opportunities for social learning

This study investigated mother-infant interactions in lowland gorillas (Gorilla gorilla gorilla) with particular focus on the relative role of mothers and infants in creating situations that are potentially conducive to infant social learning. Eleven gorilla mother-infant dyads were focally observed in weekly 1-hr sessions for 12 months. Spatial relationships were affected by age as well as by ambient temperature. Although the youngest infant was encouraged by its mother to walk and climb, mothers showed little or no encouragement in other contexts. In contrast, infants were quite interested in their mothers' activities, on some occasions repeated their mother's behavior, and actively encouraged their mothers to share food, play, or follow them. These findings suggest that gorilla infants are more active than their mothers in creating situations that are potentially conducive to the acquisition of knowledge or skills.