Avoiders vs. Amenders: Implications for the investigation of guilt and shame during Toddlerhood?

Abstract

Recent research and theory highlights the distinctive features of shame vs. guilt, as well as the important implications of that distinction for typical and atypical behaviour regulation. Briefly, shame is characterised by withdrawal and hiding from judgemental others, and guilt by making amends–repairing and confessing. The present study was aimed at determining whether a shame-relevant and a guilt-relevant pattern of responses to a standard violation could be distinguished in toddlers.

Two-year-old children participated in a play session, during which a mishap occurred that the children appeared to have caused. Based upon whether or not children avoided the experimenter (E) after the mishap, they were dichotomised into a shame-relevant group of subjects (Avoiders) who avoid E after the mishap, are slow to make reparation, and are slow to tell E about the mishap; and a guilt-relevant group (Amenders) showing the opposite pattern. All guilt-relevant behaviours were greater for Amenders than Avoiders, and all but one shame-relevant behaviour was greater for Avoiders than for Amenders, suggesting coherence in the organisation of responses. Moreover, convergent evidence from a maternal report questionnaire indicated that in non-laboratory settings as well, Amenders manifested greater guilt relative to shame than did Avoiders. Further research is needed to determine developmental antecedents and consequences of the Avoider/Amender dichotomy.     

Treating PTSD in active duty service members using cognitive processing therapy or prolonged exposure therapy: Examining everyday practice at a military outpatient clinic

The Institute of Medicine has stressed the need for evaluations of evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) among active duty service members (AD) using a variety of evaluation approaches (Institute of Medicine, 2012). The current study examined the clinical files of 134 service members who completed treatment for PTSD using either prolonged exposure (PE) or cognitive processing therapy at an outpatient clinic. At the completion of each session, therapists made a clinical rating as to whether or not the session was protocol adherent. The total number of treatment sessions and the proportion of sessions rated as being protocol adherent were calculated. Multi-level models estimated the change in patient PTSD and other psychological symptoms over time as a function of clinician-rated protocol adherence and total number of sessions. Approximately 65% of clinic encounters were rated by therapists as being protocol adherent. Significant reductions in PTSD and psychological symptoms were associated with protocol adherence, and this was particularly true for patients who began treatment above clinical thresholds for both PTSD and other psychological symptoms. However, as the number of sessions increased, the impact of protocol adherence was attenuated. Patient characteristics, including gender, ethnicity, and co-morbidity for other psychiatric disorders were not related to symptom change trajectories over time. These findings suggest that protocol adherence and efficiency in delivery of EBTs for the treatment of PTSD with AD is critical.     

Skin cancer: Assessing perceived risk and behavioural attitudes

Abstract

Measures of attitude concerning exposure to the sun, and judgements of risk and other beliefs concerning skin cancer and four other problems (stomach cancer, deafness, AIDS and sunstroke) were obtained from a questionnaire completed by 176 university students. Subjects also estimated the incidence of each problem using one of three response formats. The highest incidence estimates were obtained when subjects were asked to guess at an absolute number, and the lowest when they used a scale which differentiated between lower frequencies, while grouping higher frequencies into a single response category. The effect of the response scale format, however, did not generalize to other ratings of personal risk. Subjects' ratings of their personal risk, compared with their peers, showed an optimistic bias over the five problems as a whole, particularly for AIDS, but not reliably so in the case of skin cancer. Optimism was inversely related to the amount of thought given to each problem. Men and women did not differ overall in their optimism regarding their own risk of skin cancer. However, differences as a function of gender and optimism were found on various behavioural attitudes. The results are discussed in relation to a tendency of disregard base-rates in subjective risk judgements, unrealistic optimism, and implications for health education.     

Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

Personal Construction of Family Relationships: The Relation of Commonality and Sociality to Family Satisfaction for Parents and Adolescents

This study tested the hypothesis that family members showing greater commonality (similarity) and sociality (predictive accuracy) in their construing of family relationships would display greater satisfaction with those relationships than would individuals in families whose relational construing was more discrepant and unpredictable. Forty-seven family triads participated in the study, including a mother, father, and adolescent from each family. Measures of commonality and sociality in the construction of family relationships derived from a family relationships grid were compared to measures of family structure, including the Family Cohesion and Adaptability Evaluation Scale (FACES-II) (Olson, Portner, & Bell, 1982) and the Parent-Adolescent Communication Scale (PACS) (Barnes & Olson, 1982). The findings suggest that members' perceptions of the family as emotionally close, flexible, and communicative may not represent independent aspects of the family structure, at least within the present nonclinical sample. Comparison of the family relationship grids with the FACES-H and PACS demonstrated that commonality and sociality among family members was highly related to mothers' and adolescents' family satisfaction, but was much less predictive of that of the father.     

Counselling asylum seekers and refugees: a study of Kurds in early and later stages of exile

This study explores the experience of asylum seekers and refugees in early and later phases of exile. Twenty-five Kurds (mainly asylum seekers) were interviewed in Greece in early phases of exile and twenty Kurds (mainly refugees) in later phases of exile in the UK. Refugee camps in Greece and community centres in London were the main locations for these interviews. Representatives from eight support organizations were also interviewed in each country. The multidimensional aspects of being a refugee are discussed, including models of formulating the experience, PTSD and the cross-cultural context. Key findings of the study include the desperate need among the asylum seekers and refugees, in the early phases, to have the story of their traumatic journey to Greece witnessed and validated by an outsider; the differing experiences of men and women; a change in identity over time; and considerable fear, which was evident in early and later phases. Moreover, all the support organizations expressed pronounced frustration but responded to it in different ways. Those organizations with supervision and support groups in place demonstrated more insight into their interactions with asylum seekers and refugees. Counselling approaches are evaluated with reference to the asylum seekers' and refugees' needs, and the desirability of adequate support for those with a counselling role is highlighted.     

Pushing the limits of task difficulty for the right and left hands in manual aiming

The effects of task difficulty on the performance of the two hands in right-handers were examined in a manual-aiming paradigm. In order to examine both simple and complex tasks, movement amplitude, cursor size, and target size were manipulated, resulting in eight different indices of difficulty (as defined by Fitts' Law). Kinematic parameters examined included reaction time, movement time, time to and time after peak velocity, peak velocity, and resultant accuracy. Analysis revealed no differential effects of task difficulty on the overall movement times of the two hands. These results are discussed in light of current theories of manual asymmetries.     

Visual agnosia and prosopagnosia in childhood: a prospective case study.

Selective impairments in visual processing are well documented in adults but rarely reported in children. The few childhood cases reported are mostly retrospective accounts with little attention paid to developmental, assessment or management issues. We report a prospective case study of a boy with prosopagnosia and visual processing deficits of presumed developmental origin. At the age of 4 years, AL presented with a range of cognitive and visual recognition deficits. Subsequent assessments revealed an evolving pattern in visual recognition and dissociations between developing skills. At the age of 7 AL has impairments in early perceptual analysis, visual organisation and in complex visual processing. Although he can identify facial features and match faces he is unable to recognise familiar faces. His reading and spelling are developing normally. The nature of his deficits and his progress are discussed within a cognitive neuropsychological framework.     

Psychoeducational Interventions with Pediatric Cancer Patients: Part II. Effects of Information and Skills Training on Health-Related Outcomes

In Part I of this paper, we described a model that was used as a framework for reviewing studies of psychoeducational interventions intended to influence illness- and treatment-related behaviors and attitudes in pediatric cancer patients. In Part II, we distinguish between interventions that attempt to influence patients' behaviors just by providing information and interventions that specifically teach skills related to the behaviors they are trying to change. Many types of psychoeducational interventions appear to be effective and those that are training-based generally appear more effective than those that are information-based. Training-based interventions may face a barrier to wide adoption because they are resource-costly, but the development of digital-based training interventions may potentially overcome this barrier.