Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction.

OBJECTIVE: To compare the impact of network support and different types of perceived functional support on all-cause mortality or nonfatal reinfarction for patients with a recent acute myocardial infarction (AMI). DESIGN: Participants were recruited from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) trial; 2,481 AMI patients with depression or low social support were randomized to a cognitive-behavioral intervention or to a usual care control group. Data collection for certain measures of social support was limited: 2,466 participants completed the ENRICHD Social Support Inventory; 2,457 completed the Perceived Social Support Scale; 1,296 completed the Social Network Questionnaire; and 707 completed the Interpersonal Support and Evaluation List, Tangible Support subscale. Patients also completed the Beck Depression Inventory and were followed for up to 4.5 years. MAIN OUTCOME MEASURE: Time to death or nonfatal reinfarction. RESULTS: Over the follow-up period, 599 patients (24%) died or had a nonfatal AMI. Survival models controlling age, sex, race, socioeconomic status, smoking, antidepressant use, and a composite measure of increased risk revealed that higher levels of perceived social support were associated with improved outcome for patients without elevated depression but not for patients with high levels of depression. Neither perceived tangible support nor network support were associated with more frequent adverse events. CONCLUSION: AMI patients should be assessed for multiple dimensions of perceived functional support and depression to identify those at increased psychosocial risk who may benefit from treatment.     

Risk for separation anxiety disorder among girls: paternal absence, socioeconomic disadvantage, and genetic vulnerability

The authors examined genetic and environmental influences, including the contributions of 2 measured aspects of the shared environment of twins (paternal absence, socioeconomic disadvantage) on the development of mother-reported separation anxiety disorder (SAD) history in a sample of 1,887 female twin pairs. Four different symptom categories of SAD were considered. Results revealed that all 4 SAD symptom categories were significantly heritable, whereas the contribution of shared environmental influences to the variation in risk was significant for only 2 of the 4 SAD categories. Paternal absence was found to have an important influence in vulnerability for SAD, whereas the effect of socioeconomic disadvantage was less robust. Evidence for race differences in the etiology of SAD was not found.     

Adolescents React to the Events of September 11, 2001: Focused Versus Ambient Impact

This study examined the perceived impact of the events of September 11, 2001, on adolescents distant from the disaster sites and compared these perceptions with changes in everyday moods. A survey of reactions to September 11 was completed 2-5 months after the events by 171 adolescents participating in a longitudinal study of stress and health. Electronic diary ratings of contemporaneous moods before and after the attacks were also compared. Many adolescents distant from the disaster sites reported changes in everyday activities and signs of distress along with some positive outcomes. Elevated levels of negative affect emerged when adolescents were asked directly about the event (focused impact), but no changes were detected in their ongoing, momentary mood reports before and after September 11 (ambient impact). Trait and electronic diary measures of anxiety independently predicted posttraumatic distress. Refined assessments are needed to evaluate the degree to which self-reported traumatic symptoms reflect significant clinical distress versus an attentional focus generated by the question-asking process.     

A genetically informed study of the processes underlying the association between parental marital instability and offspring adjustment

Parental divorce is associated with problematic offspring adjustment, but the relation may be due to shared genetic or environmental factors. One way to test for these confounds is to study offspring of twins discordant for divorce. The current analyses used this design to separate the mechanisms responsible for the association between parental divorce, experienced either before or after the age of 16, and offspring well-being. The results were consistent with a causal role of divorce in earlier initiation of sexual intercourse and emotional difficulties, in addition to a greater probability of educational problems, depressed mood, and suicidal ideation. In contrast, the increased risk for cohabitation and earlier initiation of drug use was explained by selection factors, including genetic confounds. ((c) 2006 APA, all rights reserved).     

Peer influence on bulimic symptoms in college students

This longitudinal study examined the influence of peer selection and socialization on bulimic symptoms in college students. Ninety-eight participants completed measures of bulimic symptoms, self-esteem, perfectionism, and impulsivity in the spring and fall of 2003. Peer influence was assessed by examining similarity among selected peers, unselected peers, and nonpeers over time. Among selected peers, bulimic symptoms demonstrated patterns of socialization, self-esteem and perfectionism demonstrated patterns of selection, and these personality traits longitudinally predicted changes in bulimic symptoms. Unselected peers demonstrated no similarity for bulimia, self-esteem, or perfectionism, but they did evidence socialization for impulsivity. The findings support an etiological model that integrates social and individual risk factors in creating environments that influence disordered eating among college students.     

A preliminary evaluation of two behavioral skills training procedures for teaching abduction-prevention skills to schoolchildren

Although child abduction is a low-rate event, it presents a serious threat to the safety of children. The victims of child abduction face the threat of physical and emotional injury, sexual abuse, and death. Previous research has shown that behavioral skills training (BST) is effective in teaching children abduction-prevention skills, although not all children learn the skills. This study compared BST only to BST with an added in situ training component to teach abduction-prevention skills in a small-group format to schoolchildren. Results showed that both programs were effective in teaching abduction-prevention skills. In addition, the scores for the group that received in situ training were significantly higher than scores for the group that received BST alone at the 3-month follow-up assessment.     

Is who you are who you're talking to? Interpersonal style and complementarity in mixed-sex interactions

To investigate interpersonal theory, the authors examined the social behavior of 112 previously unacquainted male-female pairs collaborating on a joint task. Structural equation modeling analyses provided clear evidence of complementarity: In addition to trait affiliation and dominance both predicting situational behavior, each interaction partner's behavior influenced the other's in accordance with the theory, eliciting similar levels of affiliation and opposite levels of dominance. There were also clear biases related to participants' interpersonal traits: When behavior, as indexed by observers, was held constant, more trait affiliative participants tended to view themselves and their partner as warmer during the interaction; likewise, more trait dominant participants perceived themselves to act more dominantly than they actually did. Throughout, there were no sex differences.     

Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology

The authors explore the extent to which eating disorders, specifically anorexia nervosa (AN) and bulimia nervosa (BN), represent culture-bound syndromes and discuss implications for conceptualizing the role genes play in their etiology. The examination is divided into 3 sections: a quantitative meta-analysis of changes in incidence rates since the formal recognition of AN and BN, a qualitative summary of historical evidence of eating disorders before their formal recognition, and an evaluation of the presence of these disorders in non-Western cultures. Findings suggest that BN is a culture-bound syndrome and AN is not. Thus, heritability estimates for BN may show greater variability cross-culturally than heritability estimates for AN, and the genetic bases of these disorders may be associated with differential pathoplasticity.     

A hypothetical clinical vignette of delusional disorder: how potential legal issues could be addressed in the United Kingdom and the United States

One of the major difficulties in presenting an international perspective on delusional disorders and their impact on offending or violent behaviour is that no two legal systems are quite the same, and there are substantial differences between some of them; in addition, there is international variation in relevant service provision or use. We therefore invited several experts practising in forensic mental health services or the law to consider the following case and to use relevant literature, statute and case law to draw out similarities and differences in process and management of the following case. Annie Smith is not a real person; the things that happened really occurred.