Affects, agency, and self-regulation: complexity theory in the treatment of children with anxiety and disruptive behavior disorders

In an increasingly unsettled and violent world, with swelling numbers of children who are abused, abandoned, or neglected, emotionally if not physically, and an increasing population of aggressive preschool children with anxiety and disruptive behavior disorders who cannot be contained in ordinary settings, psychoanalysts can make a contribution. Early intervention is essential. In very early childhood, new procedural memories for interacting with others and for regulating affects can be formed more easily than they can ever be again. Intervention should aim toward helping the child develop a sense of agency, establish moral standards, assume self-responsibility, and attain the capacity for emotional regulation. The principles of complex dynamic systems can inform psychoanalytic treatment strategies, as demonstrated with five children whose cases are presented.     

The structure of goal contents across 15 cultures

The authors investigated the structure of goal contents in a group of 1,854 undergraduates from 15 cultures around the world. Results suggested that the 11 types of goals the authors assessed were consistently organized in a circumplex fashion across the 15 cultures. The circumplex was well described by positioning 2 primary dimensions underlying the goals: intrinsic (e.g., self-acceptance, affiliation) versus extrinsic (e.g., financial success, image) and self-transcendent (e.g., spirituality) versus physical (e.g., hedonism). The circumplex model of goal contents was also quite similar in both wealthier and poorer nations, although there were some slight cross-cultural variations. The relevance of these results for several theories of motivation and personality are discussed.     

Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes

This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field.     

Heart Follows Head: Influencing Violence-related Attitudes in the Classroom

We examined whether an undergraduate course on violence would influence students’ violence-related attitudes and beliefs. Students (N=145) completed the Violence-Related Attitudes and Beliefs Scale (V-RABS) at the beginning (Time 1) and end (Time 2) of the semester-long course. As expected, support for the death penalty, punishment, and catharsis decreased significantly, as did belief in an association between mental illness and violence. Acceptance of environmental influences on violent behavior increased significantly, although belief in biological influences did not change. Support for violence prevention efforts was high at both Times 1 and 2, and did not change significantly. Consistent with previous research, the results of this study confirm that college curricula may influence students’ attitudes and beliefs in addition to imparting knowledge.     

Communication strategies to promote spiritual well-being among people with dementia

Declining communication skills in dementia threaten a person's sense of self. Building on enduring capabilities, pastoral visitors can significantly enhance spiritual well-being through the use of individualized, person-centered strategies. This article outlines the primary spiritual needs of older adults with dementia and some general strategies to improve communication based on enduring abilities. Detailed examples illustrate how these personhood-centered strategies can meet spiritual needs by connecting with individuals with dementia through life stories and through helping them to participate in religious life.     

A fairy tale with a twist: pastoral counseling with adoptive families

Adoption counseling often focuses primarily on the enigmatic issues faced by adoptees. Very little attention, however, is pointed in the direction of the adoptive parents and their unique struggles. This article begins by providing some current information on adoption in the United States and ensuing implications for pastoral caregiving. Some of the unique challenges associated with the adoption experience are delineated, primarily focusing on systemic and personal issues faced by many adoptive families. Several practical interventions are suggested for pastoral caregivers working with adoptive families. Finally, the entire adoption experience is framed within a theological perspective offering hope to adoptive parents and adoptees.     

Analyzing the Process and Content of Genetic Counseling in Familial Breast Cancer Consultations

A detailed examination of the process of genetic counseling has been identified as a priority area for research by previous authors. This multicenter longitudinal study examined the process and content of genetic counseling in initial consultations with women from high-risk breast cancer families. One hundred and fifty-eight consultations with women unaffected and affected with breast cancer were audio taped and transcribed verbatim. A detailed coding system was developed. Clinical geneticists and genetic counselors demonstrated consistently good practice in giving detailed information on essential aspects related to familial breast cancer such as screening and management, genetic testing, breast cancer genetics, and prophylactic surgery. Eliciting emotional concerns and facilitating communication were found to be inconsistently present. As clinical practice guidelines and the general communication literature emphasize the importance of these factors, this is an area where training in or self-monitoring of such behaviors may assist consultants to further develop these skills.     

Intra-basolateral amygdala infusions of AP-5 impair or enhance retention of inhibitory avoidance depending on training conditions

Previous evidence has suggested that N-methyl-D-aspartate receptors (NMDARs) in the basolateral amygdala (BLA) are critically involved in the acquisition of aversively based learning tasks. However, the role of NMDARs in the BLA in the consolidation of memory of aversive training has not been well elucidated. In the present study, the NMDAR antagonist AP-5 (1 or 3 microg) was infused into the BLA of male Sprague-Dawley rats immediately before, immediately after, or 6h after training on an inhibitory avoidance task with either a high footshock (HFS; only high dose of AP-5 given) or a low footshock (LFS; both doses of AP-5 given). The 48 h retention of animals given AP-5 (3 microg) immediately before or after HFS training was significantly impaired compared to that of vehicle-controls. In contrast, the retention of rats given AP-5 (3 microg) immediately after LFS training was significantly enhanced compared to that of vehicle-controls. AP-5 (3 microg) infusions administered 6h after training with either an HFS or LFS did not affect retention. These findings suggest that the NMDARs in the BLA are involved in both the acquisition and consolidation of aversive memory. In addition, the AP-5-induced enhancement of memory obtained with LFS training suggests that NMDARs in the BLA are involved in other mechanisms influencing synaptic transmission, in addition to their well-established role in neuroplasticity.     

A counterintuitive hypothesis about employment interview validity and some supporting evidence

This study found mixed support for the hypothesis that the difference in criterion-related validity between unstructured and structured employment interviews is due solely to the greater reliability of structured interviews. Using data from prior meta-analyses, this hypothesis was tested in 4 data sets by using standard psychometric procedures to remove the effects of measurement error in interview scores from correlations with rated job performance and training performance. In the 1st data set. support was found for this hypothesis. However, in a 2nd data set structured interviews had higher true score correlations with performance ratings, and in 2 other data sets unstructured interviews had higher true score correlations. We also found that averaging across 3 to 4 independent unstructured interviews provides the same level of validity for predicting job performance as a structured interview administered by a single interviewer. Practical and theoretical implications are discussed.     

Conditions affecting the revelation effect for autobiographical memory

In four experiments involving 184 participants, people rated their confidence that particular events had happened in their childhood (e.g., "Broke a window playing ball"). If participants had to unscramble a key word in a phrase just before rating it (e.g., "Broke a nwidwo [window] playing ball"), confidence ratings increased-the revelation effect. However, the pattern of revelation effects depended on the particular way in which participants processed key words (e.g., visualizing vs. counting vowels in the word window) approximately 10 min prior to rating life events that contained those words. Prior exposure to key words never in itself directly affected confidence ratings. These results demonstrate that one can manipulate the revelation effect by altering the processing that participants perform on words prior to unscrambling them. These results also pose difficulties for many accounts of the revelation effect. The major puzzle posed by our present findings is that unscrambling key words increases confidence that an event has happened in childhood, whereas prior exposure to these words does not.