James Marsh,Process, Praxis,and Transcendence

Continental Philosophy Review -     

Maternal Emotion Socialization: The Contribution of Inhibited Behaviour and Mothers' Dissatisfaction with the Parent–Child Relationship

In the present study, we examined the associations between children's inhibited behaviour, mothers' dissatisfaction with the parent–child relationship and mothers' self‐reported reactions to children's emotions. Fifty‐three mother–child dyads visited the laboratory, and mothers completed questionnaires about child temperament and emotion socialization. Maternal stress stemming from dissatisfaction with the parent–child relationship was negatively predictive of mothers' supportive reactions to happiness. In addition, the interaction between children's inhibited behaviour and parent–child relationship dissatisfaction significantly predicted mothers' supportive reactions to children's fear; specifically, mothers who reported the highest levels of dissatisfaction in their relationship with their children and had children who exhibited low levels of inhibition reported the lowest levels of supportive responses to their children's fear. Importantly, mothers reported the highest levels of supportive reactions to children's fear when their children were low in inhibition, and they reported low levels of dissatisfaction in their relationship with their child. Copyright © 2015 John Wiley & Sons, Ltd.     

Extreme Values of Maternal Serum Analytes in Second Trimester Screening: Looking Beyond Trisomy and NTD’s

Second trimester maternal serum screening can identify high risk pregnancies and fetuses at risk for birth defects (in addition to those in the standard interpretation). The purpose of this study was to quantify such risks to improve counseling. We compared outcomes of 692 pregnancies that had abnormal levels of at least one analyte with a cohort of 713 pregnancies with normal analytes. Increased risks include: demise with high AFP and low uE3; intrauterine growth restriction with high AFP, high and low hCG, and low uE3; placental abnormalities with high AFP; fetal stress with high AFP and high hCG. Birth defects are increased with high AFP, high hCG, and low hCG. When two or more analytes are abnormal, 46% have a poor outcome. Abnormal levels of maternal serum analytes provide information in addition to the risks for neural tube defects, Down syndrome, and trisomy 18. This information is important for counseling and pregnancy management.     

Patient utilization of cognitive-behavioral therapy for OCD

The current study examined utilization of cognitive-behavioral therapy (CBT) by individuals receiving treatment for obsessive-compulsive disorder (OCD). Participants were 202 adults with primary DSM-IV OCD who enrolled in a longitudinal, observational study of the course of OCD and completed 2 years of annual follow-up interviews using the Longitudinal Interval Follow-Up Evaluation. One hundred twenty participants reported that a mental health professional recommended CBT for their OCD symptoms at some point during the 2-year follow-up period. One quarter (n = 31) of these participants did not initiate CBT despite receiving a treatment recommendation. Thirty-one percent of the 89 participants who entered CBT endorsed dropping out of CBT prematurely and less than one third received an adequate “dose” of CBT sessions. Self-reported CBT drop-out rates were significantly greater than attrition rates reported in clinical trials using intensive schedules of exposure and ritual prevention (EX/RP). Perceived environmental barriers and fears regarding treatment participation were the most frequently endorsed reasons for not participating or dropping out of CBT. Despite its efficacy for OCD, many individuals with clinically significant symptoms fail to initiate CBT when recommended by a mental health professional, receive treatments that are less intensive than those used in clinical trials, or drop out of treatment prematurely. Financial costs of CBT, difficulty attending sessions, and fears regarding treatment are significant barriers to initiating and completing therapy.     

Neurosurgical approaches to intractable obsessive-compulsive disorder

Although significant progress has been made over the last decade in the treatment of obsessive-compulsive disorder (OCD), approximately 20% of OCD patients remain refractory to nonsurgical therapies, including pharmacologic and cognitive-behavioral therapy. Because a number of neural circuits involving the basal ganglia, thalamus, limbic system, and frontal lobes have been implicated in the pathophysiology of OCD, the need for an effective intervention in these patients has brought the focus on surgical approaches, including cingulotomy and capsulotomy procedures. Unlike free-hand surgical approaches used in the past, current neurosurgical interventions have been greatly enhanced by advances in technology, which allow lesioning to an accuracy of 1 mm. Today's neurosurgical approaches have shown significant benefit in as many as 60% of refractory patients, while preserving personality and cognitive functioning and limiting morbidity. A study of gamma knife capsulotomy conducted at Brown University School of Medicine showed that 40% of patients undergoing two lesioning procedures were much or very much improved 2 years postsurgery. The inherent obstacles to conducting placebo-controlled studies in these severely ill patients mean that further study is required to identify optimal candidates for surgical intervention.     

Parental Accommodation Predicts Symptom Severity at Long-Term Follow-Up in Children with Obsessive–Compulsive Disorder: A Preliminary Investigation

Pediatric obsessive–compulsive disorder (OCD) is a chronic condition affecting millions of children. Though well intentioned, accommodation (i.e., a parent’s attempt to assuage their child’s distress and anxiety) is thought to increase OCD symptom severity and may cause greater OCD-related impairment. The present study sought to examine the relative contribution of parental accommodation in predicting OCD symptom severity. Children between the ages of 6 and 18 (and their parents) participated in a prospective, longitudinal study investigating the course of pediatric OCD utilizing a longitudinal design. Data was collected at intake (n = 30) and two-years (n = 22) post-intake controlling for age, anxiety and depression. Parental accommodation (measured at intake) significantly predicted OCD symptom severity and was the strongest predictor at both intake and two-year follow-up. These preliminary findings highlight the importance of further research seeking to delineate factors relevant to the development and maintenance of accommodation as well as parent-level variables that might mediate the relationship between accommodation and OCD symptom severity.     

Trust as an Explanation for Relational Differences in Revenge

We present 4 experiments that explore relational differences in how individuals respond to the harmful behavior of others, finding that revenge is less likely against romantic partners than against various other kinds of offenders (i.e., strangers, coworkers, roommates) both for a laboratory provocation and using hypothetical vignettes. We also implicate trust as a viable explanation for these findings, showing that individuals view the actions of a trusted other (i.e., a romantic partner) as less intentional relative to a less trusted other (i.e., a coworker) and that an experimental manipulation of trust in an offender alters levels of vengeful desires.     

Hoarding in obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study

Hoarding behavior occurs frequently in obsessive-compulsive disorder (OCD). Results from previous studies suggest that individuals with OCD who have hoarding symptoms are clinically different than non-hoarders and may represent a distinct clinical group. In the present study, we compared 235 hoarding to 389 non-hoarding participants, all of whom had OCD, collected in the course of the OCD Collaborative Genetics Study. We found that, compared to non-hoarding individuals, hoarders were more likely to have symmetry obsessions and repeating, counting, and ordering compulsions; poorer insight; more severe illness; difficulty initiating or completing tasks; and indecision. Hoarders had a greater prevalence of social phobia and generalized anxiety disorder. Hoarders also had a greater prevalence of obsessive-compulsive and dependent personality disorders. Five personality traits were independently associated with hoarding: miserliness, preoccupation with details, difficulty making decisions, odd behavior or appearance, and magical thinking. Hoarding and indecision were more prevalent in the relatives of hoarding than of non-hoarding probands. Hoarding in relatives was associated with indecision in probands, independently of proband hoarding status. The findings suggest that hoarding behavior may help differentiate a distinct clinical subgroup of people with OCD and may aggregate in some OCD families. Indecision may be a risk factor for hoarding in these families.     

Boundaries, Exclusion, and Oppression in “The Psychological Basis of Homophobia: Cultural Construction of a Barrier”

This essay takes up Madureira's exploration (Integrative Psychological and Behavioral Science, 2007, doi:10.1007/s12124-007-9024-9) of the relationship between homophobia and sexism, and more broadly, also examines other domains of prejudice, exclusion, and oppression. I identify important questions raised by Madureira, and suggest some additional concepts and frameworks that yield further insights into these issues. I focus primarily upon gender and sexuality theories, but also examine some additional studies of other constructions of difference and variants of prejudice, scapegoating, and boundarism: namely, racism, religious bigotry, and "witch-cleansing," I show how, despite their apparently disparate ideologies, these latter exclusionary practices are on some levels similar to homophobia and sexism, though these phenomena are neither identical nor exactly analogous. I also explore the uses and limitations of psychological, social and cultural analyses of these diverse forms of oppression, with particular emphasis upon homophobia and sexism.