The Role of Gender in Worry and Efforts to Cope during Stressful Waiting Periods

Sex Roles - Waiting for personally significant news is a near-universal experience, but people differ in how they cope with these acute moments of uncertainty. The present study examined whether...     

Bread and Roses: Empathy and Recognition

Empathy and Recognition represent two closely intertwined, crucial elements of human relatedness, and thus of the analytic relationship. Each ushers in a different quality of relatedness in the dyad: Empathy is a response to a basic human need, crucial to psychic safety and coherence, and may be imagined ahead of time as the need for someone to understand one’s experience, to get one’s pain. By contrast, recognition as a longing may be only partially formulated before it is emergent, because it is in the moments when it is realized that the desire for its inherent mutuality may be most keenly felt. It is in such moments, often arising through collision and unpacking between two distinct and suddenly more fully knowable subjectivities, that the experience of desire may be both held and renewed. Recent relational writing has made clear how deeply intersubjective empathy may be, in its fullest realization; however, with recognition, the desire for the other as other, who may now be known as such, arises anew out of the experience of being met in intersubjective encounter. Like bread and roses, both are vital as felt experience, and in potentiating transformation.     

Effects of a handwashing intervention package on handwashing in preschool children

Young children who attend out‐of‐home care (e.g., preschool) are more susceptible to infections than children who do not attend out‐of‐home care. Previous research suggests handwashing is effective in reducing risk of infection and illness. However, research suggests that individuals do not routinely wash their hands using methods that healthcare agencies, such as the Centers for Disease Control and Prevention, have determined best practice. We evaluated the effects of a multicomponent handwashing intervention package on correct handwashing across groups of preschool children. Furthermore, we measured the degree to which their hands were clean using premeasures and postmeasures. Results suggest the intervention package was effective at increasing both correct handwashing and cleanliness of participants' hands.     

Using Multiple Contexts and Retrieval Cues in Exposure-Based Therapy to Prevent Relapse in Anxiety Disorders

The benefits of exposure-based interventions for anxiety disorders are substantial but not stable for everyone, given that these interventions are often followed by relapse of symptoms. A body of research provides a background on how to add certain strategies in exposure-based therapy to prevent relapse in anxiety disorders. This review summarizes some of these strategies and provides clear-cut clinical implications. Studies that provide support for two types of strategies to prevent relapse have been reviewed—the use of multiple contexts and the use of retrieval cues. The use of multiple contexts reduces context and stimulus specificity of extinction learning during exposure, while the use of retrieval cues enhances memory (re)consolidation and retrieval after exposure. The described strategies to enhance the accessibility and therefore the retrievability of exposure-based learning to prevent relapse in anxiety disorders can be summarized as advice to conduct exposure under variable conditions. This way, the generalizability of what is learned during exposure to the patients’ daily life after treatment improves. Therefore, adding these strategies in the course of exposure-based treatment of anxiety disorders seems beneficial. However, future replications and translational studies are needed to verify ecological validity.     

Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population

Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ² test, Fisher’s exact test and multivariate logistic regression were used for statistical analysis to determine independent predictors of depression, anxiety, stress and severe impairment of quality of life. Unadjusted analysis revealed that depression was associated with Indian ethnicity (p = .041) and severe impairment of quality of life was associated with Indian ethnicity (p = .032), higher education (p = .013), higher income (p = .042), and employment status (p = .014). Multivariate analysis revealed that Indian ethnicity was a predictor of depression (p = .024). For stress, tertiary level of education (p = .020) was an independent risk factor while a higher monthly income was a protective factor (p = .042). The ethnic Indians and Malays were significantly more likely than the ethnic Chinese to suffer reduced quality of life (p = .001 and p = .006 respectively) and subjects with tertiary education were more likely to have severe impairment of quality of life (p = .002). Our study was unique in determining sociocultural influences on psychological complications of psoriasis in a South East Asian population. This has provided invaluable insight into factors predictive of adverse effects of psoriasis on psychological distress and quality of life in our patient population. Future studies should devise interventions to specifically target at risk groups in the development of strategies to reduce morbidity associated with psoriasis.     

Do Marital Conflict Behaviors in Response to a Novel Stressor Uniquely Predict Adolescent Outcomes?

The goal of this study was to examine whether mothers’ and fathers’ marital conflict behaviors in response to a novel stressor are uniquely predictive of adolescent outcomes. Previous research establishing the detrimental consequences of marital conflict for child outcomes has relied exclusively on assessments of conflict that measure reoccurring or past conflict. From 153 adolescents and/or both of their parents, reports were gathered on marital conflict, adolescent conflict appraisals, parent-adolescent relationship quality, and adolescent adjustment. Couples engaged in two marital problem-solving interaction tasks—one that elicited conflict behaviors by requiring discussion of salient, reoccurring topics of disagreement and one that prompted conflict behaviors by requiring that couples worked together to solve an unfamiliar problem. Results indicated that compared to behaviors during the marital conflict discussion as well as parent-reports of the frequency, intensity, and resolution of typical conflict, conflict behaviors in response to a novel stressor, particularly those displayed by mothers, were uniquely associated with adolescents’ conflict appraisals and dimensions of the parent-adolescent relationship but not adolescent adjustment. Specifically more-negative (relative to positive) conflict behaviors in response to the novel stressor was associated with more-negative adolescent conflict appraisals; mothers’ more-negative conflict behaviors in response to a novel stressor were also linked to adolescents reporting less parental monitoring. In contrast, parent reports of typical marital conflict uniquely predicted conflict property appraisals, the affective quality of mother-adolescent relationships, and adolescent adjustment. Implications for future research elucidating associations between conflict behaviors in response to a novel stressor on children and families are discussed.     

Promoting Mental Health Equity: The Role of Integrated Care

People suffering from mental illness experience poor physical health outcomes, including an average life expectancy of 25 years less than the rest of the population. Stigma is a frequent barrier to accessing behavioral health services. Health equity refers to the opportunity for all people to experience optimal health; the social determinants of health can enable or impede health equity. Recommendations from the U.S. government and the World Health Organization support mental health promotion while recognizing barriers that preclude health equity. The United States Preventive Services Task Force recently recommended screening all adults for depression. The Satcher Health Leadership Institute at the Morehouse School of Medicine (SHLI/MSM) is committed to developing leaders who will help to reduce health disparities as the nation moves toward health equity. The SHLI/MSM Integrated Care Leadership Program (ICLP) provides clinical and administrative healthcare professionals with knowledge and training to develop culturally-sensitive integrated care practices. Integrating behavioral health and primary care improves quality of life and lowers health system costs.     

Appraisals of Interparental Conflict and Change in Attention to Emotion after Exposure to Marital Conflict

The goal of this study was to investigate whether exposure to marital conflict changes patterns of attention to anger and happiness, as well as whether those patterns vary based on appraisals of the history of interparental conflict in the home. Emerging adults viewed photo pairs with one emotionally-neutral photo and another photo depicting a happy/angry emotional interaction (while a high-speed camera tracked gaze), were randomly assigned to view a neutral or marital conflict recording, viewed neutral-emotional photo pairs again, and then reported their appraisals of their parents’ conflict. Results indicated that feeling threatened by and to blame for parental conflict predicted avoidance of happy emotions at baseline. Although there were no significant changes in attention to emotion overall based on condition, self-blame for interparental conflict predicted greater increases in time spent looking at anger after watching marital conflict (but not after watching the neutral recording). These results indicate that differences in attention to emotion may be one mechanism linking parental conflict to anxiety that could be the focus of prevention/intervention efforts to reduce anxiety symptoms in those from high-conflict homes.