Effect of Problem‐Solving Therapy on Depressed Low‐Income Homebound Older Adults' Death/Suicidal Ideation and Hopelessness

Previous study findings of psychotherapy's effect on suicide prevention have been inconsistent. This study reports the results of secondary analyses of outcome data from a short‐term depression treatment on reducing death/suicidal ideation among 158 low‐income homebound adults aged 50+. The treatment, in‐person or telehealth problem‐solving therapy (PST), compared with telephone support call, has been found effective in reducing depressive symptoms and disability among participants. Compared with support call participants, tele‐PST participants, but not in‐person PST participants, exhibited lower ideation ratings across the follow‐up period. Effect sizes at 36 weeks were 0.31 for tele‐PST and 0.17 for in‐person PST. Hopelessness mediated the effect of tele‐PST but not in‐person PST; however, in‐person PST also alleviated hopelessness, which led to lower ideation. Clinical implications of the findings are discussed.     

Conceptualizing Self-determination from a Behavioral Perspective: The Role of Choice,Self-control,and Self-management

The goal of education can be defined in many ways; but in searching the literature, we found that in most cases, people consider the goal of education to be developing a self-determined individual. Self-determination is an abstract term. Behavior analysts may find this term difficult to define. Therefore, it may be difficult to observe and measure whether “self-determined behaviors” have developed. Many other service providers use this term frequently; thus, behavior analysts working with these service providers must come to terms with this concept in order to better collaborate. We argue that self-determination can be operationally defined with the concepts of choice, self-control, and self-management. By using the measurable behaviors included in these concepts, we believe that services can be developed to teach self-determination skills. This paper explores these concepts and how they can contribute to an operational definition of self-determination, and ultimately, help behavior analysts work with other providers to effectively teach self-determination to individuals with developmental disabilities.

     

Inhibitory control and set shifting describe different pathways from behavioral inhibition to socially anxious behavior

Individuals with a behaviorally inhibited (BI) temperament are more likely to develop social anxiety. However, the mechanisms by which socially anxious behavior emerges from BI are unclear. Variation in different forms of top‐down control, specifically executive functions (EF), may play distinct roles and characterize differential pathways to social anxiety. Here 291 children were assessed for BI in toddlerhood (ages 2 and 3), parent‐reported inhibitory control and set shifting during middle childhood (age 7), and multidimensional assessment of socially anxious behavior completed during late childhood and early adolescence (ages 9 and 12). Structural equation modeling revealed that early variation in BI predicted the development of socially anxious behavior through either higher levels of parent‐reported inhibitory control or lower levels of parent‐reported set shifting. These data reinforce the notion that top‐down control does not uniformly influence relations between temperament and socially anxious behavior. These data suggest novel approaches to thinking about the role of EFs and social anxiety outcomes as children approach adolescence.     

The relationship of perinatal birth status to handedness: A prospective study

As part of a longitudinal study of the consequences of high risk birth, 66 infants born to right-handed parents were given two unimanual tasks at 24 months of age to assess their hand preference. The 66 infants had been assigned to one of four diagnostic categories at birth: Premature with no postnatal medical complications; premature and having experienced respiratory distress; term and having experienced birth asphyxia during labor and delivery; term with normal delivery and postnatal course. Results of the handedness tasks revealed an increased incidence of use of the left hand among the term infants who underwent birth asphyxia and among the healthy preterm infants. The data indicate that timing of birth stress may play an important role in the ontogeny of pathological left-handedness.     

Face-to-face interaction in term and preterm infants

Previous research has found that mothers of preterm infants work harder in a face-to-face situation with their infants than mothers of term infants. Data have also revealed that preterm infants are less responsive than term infants in a social interaction. To date, there have been few studies that have attempted to determine the range of facial expressive cues that preterms may be emitting or the possible physiological basis for this behavior. In an attempt to investigate these questions, preterm and term infants were observed in a face-to-face situation. Prior to the session, three minutes of resting EKG was recorded. The infant's facial behavior was coded with a discrete facial action coding system. Maternal behavior was also coded. Measures of heart rate as well as short and long term variability were computed. Results revealed no differences in facial lability or in facial expressiveness between term and preterm infant. In addition, there were no differences in maternal behavior to either term or preterm. There were, however, reliable contingent relationships between facial expression of the infant and maternal behavior. In addition, there was a significant association between short term variability (vagal tone) and infant facial behavior.     

The Infant mental health specialist in newborn pediatric rounds: A systems approach

This article describes a special program wherein infant mental health specialists participate in hospital rounds with pediatric residents. The purpose of the program is described in terms of medical awareness of psycho-social needs of the family and improved clinical services. Examples are given of the way in which “rounding” contributes to the meeting of infants' and families' medical and psychological needs. Note is made of the multilevel impact of this collaboration.