The Role of BIS Sensitivity in the Relationship Between Family Enmeshment and Child Anxiety

Previous work has demonstrated that three overarching vulnerabilities–genetic, environmental, and temperamental–contribute to the development of child anxiety. The purpose of our study was to assess: (a) the relationship between an environmental vulnerability, family enmeshment, and child anxiety; (b) whether parental anxiety accounts for this relationship; and (c) whether this relationship is mediated by levels of child Behavioral Inhibition System sensitivity, a highly persistent temperamental variable demonstrating positive associations with child anxiety. Our study included 38 Canadian parent–child dyads from an urban area, of which 33 children were Caucasian and 18 were girls. Children were aged 9 or 11 years (M = 10.21, SD = 1.07). Children completed measures of anxiety and sensitivity towards threat and parents completed measures of family enmeshment. The results supported a significant positive relationship between family enmeshment and child anxiety; parental anxiety did not account for this relationship; and the relationship was partially mediated by Behavioral Inhibition System sensitivity. Specifically, when the effect of Behavioral Inhibition System sensitivity was controlled for, the association between family enmeshment and child anxiety became non-significant. The results suggest that family enmeshment is associated with levels of child anxiety largely through the function of children’s sensitivity to threat. Enmeshed families may increase children’s susceptibility to anxiety through their effect on child temperament, specifically sensitivity to threat.     

An Intriguing Third Way: Mapping Contextual Education for Curricular Integration

This article emerges from the experience of incorporating doctoral students into our Contextual Education (CXE) Program at Emmanuel College (Toronto). This change, I argue, helped us to distinguish more clearly among and thus distinctly orient the different kinds of relationships and theological practices that make up our program towards the often‐elusive goal of curricular integration. After outlining a definition of integration, I contextualize that definition in our particular practices at Emmanuel College using Kathryn Tanner's (1997) understanding of theology as a cultural practice as my guide. I then offer a brief overview of our CXE Programs to demonstrate how nurturing strategic partnerships within them has made certain forms of integration possible for our students. I close with some activities for practical application in other CXE contexts.     

Olfactory Reference Syndrome: A Case Report and Screening Tool

Journal of Clinical Psychology in Medical Settings - Olfactory reference syndrome (ORS) is a lesser known disorder that is related to obsessive–compulsive disorder. ORS is the obsessional and...     

Pilot Trial of Acceptance-Based Behavioral Weight Loss and Neurocognition Among American Indians

Acceptance-based behavioral therapies (ABTs) for obesity may be superior to standard behavioral therapies but have not been adequately tested with American Indians (AIs). Neurocognitive function is also unexamined in relation to behavioral weight loss among AIs despite findings that neurocognition predicts outcomes in general samples, may help explain some of the benefits of ABTs, and may be relevant to marginalized groups. The primary objective of this pilot was to examine the feasibility/acceptability of ABT in an AI sample. Exploratory analyses examined the relationship between neurocognition and weight loss. Forty-eight AI adults with overweight/obesity (ages 43.3 ± 10.3 years, 85% female; baseline body mass index = 36.8 ± 4.4 kg/m²) enrolled in a 6-month open ABT weight loss trial. Feasibility indices, including screening/enrollment, session attendance, retention rates for posttreatment assessments, and program acceptability were examined. Percent weight loss (%WL) was assessed as well as fluid and crystalized neurocognition (National Institutes of Health Toolbox Cognition Battery [NIHTB-CB]). We enrolled 79% of the eligible sample and retained 75% (N = 36) at posttreatment assessments. Program completers lost an average of 5.2 ± 4.9% of initial body weight (d_z = 1.14), whereas intent-to-treat analyses show a mean loss of 4.1 ± 4.7%. Participants reported high satisfaction, effectiveness, and cultural appropriateness. Exploratory analyses of neurocognitive domains suggested that crystalized cognition was higher among completers, and higher baseline cognitive flexibility predicted greater %WL (β = .34, p = .05). ABT resulted in clinically significant weight loss in an AI sample. A controlled trial of ABT in a larger, more diverse sample is warranted to determine whether (a) the findings are robust, generalizable, and/or superior to other treatments and (b) neurocognitive factors moderate outcomes.     

Antisocial Process Screening Device Subscales Predict Recidivism in an Australian Juvenile Offender Sample

The present study is the first to examine the psychometric properties of the self-report Antisocial Process Screening Device (APSD-SR), and the predictive utility of its subscales for reoffending, among Australian juvenile offenders (N?= 308, M age = 17.00, SD?=?1.49). Exploratory factor analysis supported a modified three-factor structure in which four items loaded differently to prior studies. Total APSD-SR and modified subscale scores were positively associated with criminal history and mental health problems (e.g., internalizing and externalizing problems, alcohol and substance abuse/dependence). Survival analyses indicated that youth scoring high on the APSD-SR total score were faster to reoffend nonviolently (Hazard Ratio [HR]?= 1.31, p?=?.0003) and violently (HR?=?1.42, p?=?.0003) than those scoring low. Whereas the modified grandiose-manipulative subscale predicted faster time to nonviolent recidivism (HR?=?1.18, p?=?.026) as a single predictor, when all subscales were simultaneously entered into the model only callous-unemotional (CU) traits and impulsivity predicted nonviolent recidivism (HR?=?1.19, p?=?.026 and 1.22, p?=?.015, respectively), and only impulsivity predicted violent recidivism (HR?=?1.26, p?=?.014). Findings inform current understanding of the relative contribution of adolescent psychopathy dimensions to designating a particularly high-risk group of Australian youth in custody.     

What is the Role of the Arts in Medical Education and Patient Care? A Survey-based Qualitative Study

To inform medical education reform efforts, we systematically collected information on the level of arts and humanities engagement in our medical school community. Attitudes regarding incorporating arts and humanities-based teaching methods into medical education and patient care were also assessed. An IRB-approved survey was electronically distributed to all faculty, residents, fellows, and students at our medical school. Questions focused on personal practice of the arts and/or humanities, as well as perceptions of, and experience with formally incorporating these into medical teaching. Of 13,512 community members surveyed, 2,775 responded (21% overall response rate). A majority of respondents agreed or strongly agreed that medical education and patient care could be "enhanced" by the integration of the arts (67% and 74% respectively). There was enthusiastic support for the creation of a formal program in the arts at our medical school (72 %). Integration of the arts into medical education may have a role in improving the quality of medical training and would likely be well received by teachers and learners.