Loneliness predicts suicidal ideation and anxiety symptoms in long-term childhood cancer survivors

Background/ObjectiveLong-term childhood cancer survivors (CCS) are at risk for adverse late effects. However, not all of them are well understood. The present study addressed loneliness, a previously under-researched mental health risk in cancer survivor populations. We assessed the prevalence of loneliness and its impact on psychological symptoms over time. Method: A registry-based sample of N = 633 adult long-term CCS underwent medical and psychological assessments and took part in a follow-up survey 2.5 years later. Psychological symptoms (somatic, anxiety, depression symptoms, and suicidal ideation) were measured using the Patient Health Questionnaire. We calculated linear regression models of symptoms at follow-up to investigate the impact of loneliness over time (controlling for symptoms at baseline and relevant confounders). Results: Loneliness was reported by 17.70% of CCS. In multivariate linear regression analyses, loneliness was still predictive of more severe anxiety symptoms and suicidal ideation over two years later. Loneliness did not predict somatic and depression symptoms at follow-up (which increased with age). Conclusions: Loneliness affected a significant number of CCS and was a risk factor for persistent anxiety symptoms and suicidal ideation. The extent to which young cancer patients’ re-integration into society is successful could thus have important implications for well-being in adulthood.     

Development and psychometric evaluation of the Interactive Test of Interpersonal Behavior (ITIB): a pilot study examining interpersonal deficits in chronic depression

Chronic depression is assumed to be caused and maintained by interpersonal deficits. We describe the development and psychometric evaluation of the Interactive Test of Interpersonal Behavior (ITIB) that we developed for self‐assessment of these deficits. Participants with chronic depression (CD, N = 15), episodic depression (ED, N = 15) and healthy controls (HC, N = 15) participated in this pilot study. They completed the ITIB and a number of pen and paper questionnaires including the Lübeck Questionnaire of Preoperational Thinking (LQPT) and the inventory of interpersonal problems (IIP). The ITIB was highly acceptable for use in these participants. Internal consistency for the ITIB was adequate for group comparisons (Cronbach's alpha = 0.649). Item‐total correlations indicated adequate discriminatory power of five of the six items. The ITIB correlated moderately with the LQPT (r = 0.524) and the IIP (r = –0.568). The ITIB score differed significantly between the diagnostic groups (ANOVA F(2,42) = 6.22, p = 0.004). It was the only measure that – albeit at a trend level – was associated with diagnostic group (CD vs. ED) on multinomial logistic regression analysis (B = 0.049 ± 0.029; OR 1.051; p = 0.088). We found preliminary evidence that the ITIB is an acceptable and psychometrically adequate measure of interpersonal behavior that distinguishes between patients with CD and patients with ED. If replicated with an improved version of the test, our results could support the hypothesis that having interpersonal problems is a core deficit in patients with CD.     

A Mixed Methods Study of the Stages of Implementation for an Evidence-Based Trauma Intervention in Schools

A mixed methods study was conducted to examine the implementation process of 26 urban school-based mental health clinics that took part in a training and implementation support program for an evidence-based school trauma intervention. Implementation process was observed using the Stages of Implementation Completion (SIC) measure. Qualitative interviews were conducted with clinic leaders in order to gain insight into clinic processes related to the SIC. Results showed that almost all of the clinics engaged in some activities related to pre-implementation (engagement, feasibility, and readiness), but only 31% of the sites formally started delivering the program to youth. Completing more pre-implementation activities, particularly those related to readiness, predicted program start-up. Qualitative analysis comparing those that implemented the program to those that did not revealed critical differences in decision-making processes, leadership strategies, and the presence of local champions for the program. This study documented the patterns of clinic behavior that occurs as part of large-scale training efforts, suggests some unique challenges that occur in schools, and highlights the importance of engaging in particular implementation activities (i.e., readiness planning, stakeholder consensus and planning meetings) as part of program start-up. Findings indicate that pre-implementation and readiness-related consultation should be employed as part of broad-scale implementation and training efforts.     

Classroom ethnic diversity,teacher support,and peer victimization: Evidence from four European countries

We investigated how classroom ethnic diversity is associated with peer victimization, effects of ethnic minority/majority status, and if individual teacher support can buffer potentially negative effects of ethnic diversity. Using two theoretical perspectives (balance of power, ethnic competition), we hypothesized that (1) victimization is more prevalent at intermediate ethnic diversity and less prevalent at lower and higher ethnic diversity, (2) this curvilinear link is stronger for ethnic majority than minority students, and (3) peer victimization at intermediate levels of ethnic diversity is lower when teacher support is high. We conducted multilevel analyses based on the first wave of the Children of Immigrants Longitudinal Survey in Four European Countries (CILS4EU). The analytical sample included 17,882 students, nested in 882 classrooms. Although our hypotheses received no support, the findings showed that diversity was linked to less victimization for ethnic minority student. Teacher support was linked to less victimization for ethnic minority students at every level of classroom diversity but especially when diversity was low and to less victimization for ethnic majority students in classrooms with intermediate to high ethnic diversity. We discuss our findings in light the theoretical approaches and underscore the role of teachers as a protective resource.     

Color opponency in synaesthetic experiences

Grapheme-color synaesthesia is a rare condition in which perception of a letter or a digit is associated with concurrent perception of a color. Synaesthetes report that these color experiences are vivid and realistic. We used a Stroop task to show that synaesthetically induced color, like real color, is processed in color-opponent channels (red-green or blue-yellow). Synaesthetic color produced maximal interference with the perception and naming of the real color of a grapheme if the real color was opponent to the synaesthetic color. Interference was reduced considerably if the synaesthetic and real colors engaged different color channels (e.g., synaesthetic blue and real red). No dependence on color opponency was found for semantic conflicts between shape and color (e.g., a blue lemon). Thus, the neural representation of synaesthetic colors closely resembles that of real colors. This suggests involvement of early stages of visual processing in color synaesthesia and explains the vivid and realistic nature of synaesthetic experiences.     

Inter‐ and intrapersonal processes underlying authoritarianism: The role of social conformity and personal need for structure

Several personality constructs have been theorised to underlie right‐wing authoritarianism (RWA). In samples from New Zealand and Germany (Ns = 218, 259), we tested whether these constructs can account for specific variance in RWA. In both samples, social conformity and personal need for structure were independent predictors of RWA. In Sample 2, where also openness to experience was measured, social conformity and personal need for structure fully mediated the impact of the higher‐order factor of openness on RWA. Our results contribute to the integration of current approaches to the personality basis of authoritarianism and suggest that two distinct personality processes contribute to RWA: An interpersonal process related to social conformity and an intrapersonal process related to rigid cognitive style. Copyright © 2009 John Wiley & Sons, Ltd.     

Young infants' triangular communication with their parents in the context of maternal postpartum psychosis: Four case studies

With increasing data on the dynamics of normative couples as they transition to parenthood and become a triad, the need for greater understanding of the impact of parental psychopathology on this transition has become clear. The goal of the current article is to begin exploring this area that has received little attention to date, by describing case examples from a study of clinical families as they transitioned to parenthood. Four representative cases were selected from a pool of 13 mother–father–baby triads, for whom the mother had been hospitalized conjointly with her infant due to a psychotic episode during the postpartum period. The families were observed as part of a clinical consultation that included a semistructured play paradigm known as the Lausanne Trilogue Play (LTP; E. Fivaz‐Depeursinge, & A. Corboz‐Warnery, 1999). Interactions were scored using standardized measures as well as clinical impressions. All families from the clinical sample were noted to struggle and frequently failed to achieve the goals of play. The impact on the infants in terms of their developing sense of self as well as their defensive strategies in this context are discussed, with clinical implications explored.     

Revisiting dispersion in count data item response theory models: The Conway–Maxwell–Poisson counts model

Count data naturally arise in several areas of cognitive ability testing, such as processing speed, memory, verbal fluency, and divergent thinking. Contemporary count data item response theory models, however, are not flexible enough, especially to account for over- and underdispersion at the same time. For example, the Rasch Poisson counts model (RPCM) assumes equidispersion (conditional mean and variance coincide) which is often violated in empirical data. This work introduces the Conway–Maxwell–Poisson counts model (CMPCM) that can handle underdispersion (variance lower than the mean), equidispersion, and overdispersion (variance larger than the mean) in general and specifically at the item level. A simulation study revealed satisfactory parameter recovery at moderate sample sizes and mostly unbiased standard errors for the proposed estimation approach. In addition, plausible empirical reliability estimates resulted, while those based on the RPCM were biased downwards (underdispersion) and biased upwards (overdispersion) when the simulation model deviated from equidispersion. Finally, verbal fluency data were analysed and the CMPCM with item-specific dispersion parameters fitted the data best. Dispersion parameter estimates indicated underdispersion for three out of four items. Overall, these findings indicate the feasibility and importance of the suggested flexible count data modelling approach.     

Only the right noise? Effects of phonetic and visual input variability on 14‐month‐olds' minimal pair word learning

Seminal work by Werker and colleagues (Stager & Werker [1997] Nature, 388, 381–382) has found that 14‐month‐old infants do not show evidence for learning minimal pairs in the habituation‐switch paradigm. However, when multiple speakers produce the minimal pair in acoustically variable ways, infants' performance improves in comparison to a single speaker condition (Rost & McMurray [2009] Developmental Science, 12, 339–349). The current study further extends these results and assesses how different kinds of input variability affect 14‐month‐olds' minimal pair learning in the habituation‐switch paradigm testing German learning infants. The first two experiments investigated word learning when the labels were spoken by a single speaker versus when the labels were spoken by multiple speakers. In the third experiment we studied whether non‐acoustic variability, implemented by visual variability of the objects presented together with the labels, would also affect minimal pair learning. We found enhanced learning in the multiple speakers compared to the single speaker condition, confirming previous findings with English‐learning infants. In contrast, visual variability of the presented objects did not support learning. These findings both confirm and better delimit the beneficial role of speech‐specific variability in minimal pair learning. Finally, we review different proposals on the mechanisms via which variability confers benefits to learning and outline what may be likely principles that underlie this benefit. We highlight among these the multiplicity of acoustic cues signalling phonemic contrasts and the presence of relations among these cues. It is in these relations where we trace part of the source for the apparent paradoxical benefit of variability in learning.