Transforming mental health care for children and their families

In April 2002, the President's New Freedom Commission on Mental Health was created by executive order to study the mental health care delivery system in our nation and to make recommendations for improvements so that individuals with serious mental disorders can live, work, learn, and fully participate in their homes and communities. In its report, "Achieving the Promise: Transforming Mental Health Care in America," the commission provided strategies to address critical infrastructure, practice, and research issues. This article focuses on the work of the commission's Subcommittee on Children and Families, describing its vision for mental health service delivery for children and providing suggestions for strengthening community-based care for youths with or at risk of behavioral health disorders. Training, research, practice, and policy implications for psychologists are discussed.     

Divergent trajectories in the aging mind: changes in working memory for affective versus visual information with age

Working memory mediates the short-term maintenance of information. Virtually all empirical research on working memory involves investigations of working memory for verbal and visual information. Whereas aging is typically associated with a deficit in working memory for these types of information, recent findings suggestive of relatively well-preserved long-term memory for emotional information in older adults raise questions about working memory for emotional material. This study examined age differences in working memory for emotional versus visual information. Findings demonstrate that, despite an age-related deficit for the latter, working memory for emotion was unimpaired. Further, older adults exhibited superior performance on positive relative to negative emotion trials, whereas their younger counterparts exhibited the opposite pattern.     

Power and Type I errors for pairwise comparisons of means in the unequal variances case

A Monte Carlo simulation was conducted to compare pairwise multiple comparison procedures. The number of means varied from 4 to 8 and the sample sizes varied from 2 to 500. Procedures were evaluated on the basis of Type I errors, any‐pair power and all‐pairs power. Two modifications of the Games and Howell procedure were shown to make it conservative. No procedure was found to be uniformly most powerful. For any pair power the Games and Howell procedure was found to be generally most powerful even when applied at more stringent levels to control Type I errors. For all pairs power the Peritz procedure applied with modified Brown–Forsythe tests was found to be most powerful in most conditions.     

Desire to change one’s multimodality and its relationship to the use of different transport means

Using data collected from French employees of a transportation institute and residents of the US San Francisco Bay Area, we operationalize a segmentation of mobility patterns based on objective, subjective, and desired amounts of mobility by various modes and overall. We especially focus on the degree of multimodality in an individual’s current modal mix and desired changes to that mix through the use of a “multimodality index”. The clusters that result showed some similarities and some differences across countries, where the latter are likely due to disparities in the sampling strategies and in the land use/transportation/cultural milieux. In both cases, however, the clusters have useful policy implications, enabling us, for example, to distinguish car users who might be inclined to reduce car use and increase transit use from those who are largely content with their current modal baskets.     

Temperament and Risk for Depressive Symptoms in Adolescence: Mediation by Rumination and Moderation by Effortful Control

The present study examined the relations between temperament, ruminative response style and depressive symptoms both cross-sectionally and prospectively (1 year follow-up) in a community sample of 304 seventh- through tenth-graders. First, higher levels of negative affectivity (NA), lower levels of positive affectivity (PA) and lower levels of effortful control (EC) were found to be associated with higher levels of depressive symptoms. Second, the association between NA and PA on the one hand and depressive symptoms on the other was significantly moderated by level of EC (low PA and high NA are associated with depressive symptoms only if EC is low) and these relations were moderated by sex in the cross-sectional data. In the prospective data, T1 depressive symptoms and PA predicted T2 depressive symptoms; with EC approaching significance. Third, rumination also predicted T1 as well as T2 depressive symptoms. Finally, support was found for a model of moderated mediation: higher levels of NA were associated with higher levels of ruminative response style, which was in turn related to more depressive symptoms but only in individuals with low EC and this was true for the cross-sectional as well as the prospective data albeit with noteworthy differences in pattern. These findings confirm and extend previous findings on the associations between temperament, response styles and depression in adolescence and, as such, add to the growing body of research providing support for the applicability of cognitive vulnerability theories to depression in younger populations.

Moral Imagination, Trading Zones, and the Role of the Ethicist in Nanotechnology

The societal and ethical impacts of emerging technological and business systems cannot entirely be foreseen; therefore, management of these innovations will require at least some ethicists to work closely with researchers. This is particularly critical in the development of new systems because the maximum degrees of freedom for changing technological direction occurs at or just after the point of breakthrough; that is also the point where the long-term implications are hardest to visualize. Recent work on shared expertise in Science & Technology Studies (STS) can help create productive collaborations among scientists, engineers, ethicists and other stakeholders as these new systems are designed and implemented. But collaboration across these disciplines will be successful only if scientists, engineers, and ethicists can communicate meaningfully with each other. The establishment of a trading zone coupled with moral imagination present one method for such collaborative communication.     

Lonely Adolescents and Their Best Friend: An Examination of Loneliness and Friendship Quality in Best Friendship Dyads

Friendship experiences have been shown to be important predictors of adolescents’ loneliness. The current study examined selection and socialization effects of loneliness within reciprocal best friendships, while controlling for friendship quality. Analyses were conducted on a sample of 884 adolescents (42.08% boys), making up 442 dyads, who were on average 13.51 years old (SD?=?1.37). Adolescents completed the peer-related loneliness subscale of the Loneliness and Aloneness Scale for Children and Adolescents as well as the Friendship Qualities Scale. A longitudinal actor-partner interdependence model, which accounts for the interdependencies in the data of best friends, suggested the presence of a selection effect for loneliness but no socialization effect. This finding within best friendships contrasts with studies on friendship networks where both selection and socialization were established.     

The central nucleus of the amygdala is essential for acquiring and expressing conditional fear after overtraining

The basolateral complex of the amygdala (BLA) is critical for the acquisition and expression of Pavlovian fear conditioning in rats. Nonetheless, rats with neurotoxic BLA lesions can acquire conditional fear after overtraining (75 trials). The capacity of rats with BLA lesions to acquire fear memory may be mediated by the central nucleus of the amygdala (CEA). To examine this issue, we examined the influence of neurotoxic CEA lesions or reversible inactivation of the CEA on the acquisition and expression of conditional freezing after overtraining in rats. Rats with pretraining CEA lesions (whether alone or in combination with BLA lesions) did not acquire conditional freezing to either the conditioning context or an auditory conditional stimulus after extensive overtraining. Similarly, post-training lesions of the CEA or BLA prevented the expression of overtrained fear. Lastly, muscimol infusions into the CEA prevented both the acquisition and the expression of overtrained fear, demonstrating that the effects of CEA lesions are not likely due to the destruction of en passant axons. These results suggest that the CEA is essential for conditional freezing after Pavlovian fear conditioning. Moreover, overtraining may engage a compensatory fear conditioning circuit involving the CEA in animals with damage to the BLA.     

Clinical Characterization and Risk Profile of Individuals Seeking Genetic Counseling for Hereditary Breast Cancer in Brazil

Hereditary breast cancer (HBC) accounts for 5–10% of breast cancer cases and it significantly increases the lifetime risk of cancer. Our objective was to evaluate the sociodemographic variables, family history of cancer, breast cancer (BC) screening practices and the risk profile of cancer affected or asymptomatic at-risk women that undergo genetic counseling for hereditary breast cancer in public Brazilian cancer genetics services. Estimated lifetime risk of BC was calculated for asymptomatic women using the Gail and Claus models. The majority of women showed a moderate lifetime risk of developing BC, with an average risk of 19.7% and 19.9% by the Gail and Claus models, respectively. The average prior probability of carrying a BRCA1/2 gene mutation was 16.7% and overall only 32% fulfilled criteria for a hereditary breast cancer syndrome as assessed by family history. We conclude that a significant number of individuals at high-risk for HBC syndromes may not have access to the benefits of cancer genetic counseling in these centers. Contributing factors may include insufficient training of healthcare professionals, disinformation of cancer patients; difficult access to genetic testing and/or resistance in seeking such services. The identification and understanding of these barriers is essential to develop specific strategies to effectively achieve cancer risk reduction in this and other countries were clinical cancer genetics is not yet fully established.     

Testing the Effectiveness of Brief Behavioral Activation Treatment for Depression—Revised: Changes in Depression,Anxiety, Dysfunctional Attitudes,and Mindfulness

We tested the effectiveness of Brief Behavioral Activation Treatment for Depression-Revised (BATD-R), and its impact on secondary outcomes: anxiety, dysfunctional attitudes, and mindfulness. It was expected that individuals who completed BATD-R would exhibit decreased depression, anxiety, and dysfunctional attitudes, as well as increased mindfulness. A sample of adults with depression (n?=?42) was recruited to complete the 10-week treatment. A healthy control group (n?=?38) was included for comparison. Outcomes (depression, anxiety, dysfunctional attitudes, and mindfulness) were assessed at pre-treatment, post-treatment or 10 weeks for the healthy control group, and three-month follow-up. At pre-treatment, the clinical group reported greater depression, anxiety, and dysfunctional attitudes, and less mindfulness than the healthy control group. At post-treatment, the clinical group reported decreased depressive symptoms, trait anxiety, and dysfunctional attitudes, and increased mindfulness, compared to pre-treatment. The control group did not exhibit changes across the 10 weeks. Clinical and healthy control group post-treatment scores did not differ. At three-month follow-up, the clinical group reported a slight increase in depressive symptoms from post-treatment, but still maintained lower depressive symptoms than pre-treatment. The clinical group maintained treatment gains in dysfunctional attitudes, and mindfulness. Results support the effectiveness of BATD-R and suggest BATD-R may influence dysfunctional attitudes and mindfulness.