Developmentally Adapted Cognitive Processing Therapy for Adolescents Suffering from Posttraumatic Stress Disorder after Childhood Sexual or Physical Abuse: A Pilot Study

Although childhood sexual abuse and childhood physical abuse (CSA and CPA) have severe psychopathological consequences, there is little evidence supporting psychotherapeutic interventions for adolescents who have experienced CSA or CPA. To provide a treatment tailored to the specific needs of adolescents suffering from abuse-related posttraumatic stress disorder (PTSD), we modified Cognitive Processing Therapy (CPT) by adding new treatment modules and changing the therapy setting. To evaluate the feasibility and efficacy of Developmentally Adapted CPT (D-CPT), we treated 12 adolescents suffering from PTSD secondary to CSA or CPA. Patients were assessed prior to treatment (t0), post-treatment (t1), and 6 weeks after treatment (t2). Assessments included the Clinician-Administered PTSD Scale (CAPS), the UCLA PTSD Index (UCLA), the Children’s Depression Inventory (CDI), the Adolescent Dissociative Experiences Scale (A-DES), and the Borderline Symptom List (BSL-23). MANOVAs revealed that posttraumatic stress measurements and associated symptom measurements significantly differed across time points. When comparing t0 with t2, Cohen’s d was large with respect to the CAPS scores (d = 1.45, p < .001) and the UCLA scores (d = 1.91, p < .001). Cohen’s d had a medium magnitude with respect to the CDI scores (d = .78, p < .001), the A-DES scores (d = 0.64, p < .05), and the BSL-23 scores (d = 0.74, p < .01). D-CPT has the potential to reduce PTSD symptoms and comorbid psychopathology in adolescents with histories of CSA or CPA.     

A Qualitative Study on Children’s Digital Media Use and Parents’ Self-interest

Journal of Child and Family Studies - This qualitative study provides insight into the role of parents’ self-interest in digital media use of children in different age groups. We conducted 31...     

Filial Piety,Generativity and Older Adults’ Wellbeing and Loneliness in Denmark and China

The article considers the potential of intergenerational encounters and family and social ties for alleviating loneliness and promoting older adults’ wellbeing. Loneliness has been widely recognized as one of the factors that are most deeply and pervasively detrimental to older adults’ wellbeing. We combine theoretical reflections with a comparative study of older adults in Denmark and China. Both countries have to deal with an aging population and growing number of cases of isolation and loneliness in an increasingly individualized society. They differ, however, with regard to how far they have developed a system of institutionalized care, as well as with regard to their culture-specific views of family life and parent-child relationships. We apply the notions of filial piety, known from Confucian philosophy but often misinterpreted as conservative and conformist, and generativity, to qualitative studies of older adults in Denmark and China. The great potential of intergenerational ties is confirmed. Our study also shows that filial piety is still highly valued, in both China and Denmark, and can be maintained even in a highly individualized society. There is, however, considerable uncertainty among both older adults and their younger relatives as to what is required and what can be expected; realism, and an emphasis on the quality, rather than the quantity of interaction, may be sensible coping strategies, but can also lead to unnecessary acquiescence and self-abnegation. Our study also serves to distinguish different aspects and effects on wellbeing of intergenerational relationships.

     

Enculturation and narrative practices

Recent work on enculturation suggests that our cognitive capacities are significantly transformed in the course of the scaffolded acquisition of cognitive practices such as reading and writing. Phylogenetically, enculturation is the result of the co-evolution of human organisms and their socio-culturally structured cognitive niche. It is rendered possible by evolved cerebral and extra-cerebral bodily learning mechanisms that make human organisms apt to acquire culturally inherited cognitive practices. In addition, cultural learning allows for the intergenerational transmission of relevant knowledge and skills. Ontogenetically, enculturation is associated with neural plasticity and the development of new motor routines and action schemas. It relies on scaffolded learning that structures novice-teacher interactions. The acquisition of reading and writing are paradigm examples of enculturation. Based on an empirically informed analysis of the components of enculturation, I will apply the emerging account of enculturated cognition to narrative practices. To date, research on the impact of narratives on the constitution of the self and our understanding of folk psychology has not paid much attention to the question how narratives are influenced by cumulative cultural evolution and our capacity to acquire reading and writing during ontogeny. I will argue that textual narratives, above and beyond oral narratives, provide genuinely new ways of narration. Therefore, the enculturated interaction with textual narratives has the potential to contribute to a better understanding of ourselves and other cognitive agents.     

Brief Counseling for Alcohol Misuse Among Trauma Patients: Two Interventions and Influence of Baseline Use

This study examined whether baseline trauma patient characteristics and randomized participation in 1 of 2 brief interventions predicted changes in alcohol use at 6 months postintervention. Higher total Alcohol Use Disorders Identification Test (AUDIT) scores predicted greater changes, and specific AUDIT items were significant predictors.     

Development switch in neural circuitry underlying odor-malaise learning

Fetal and infant rats can learn to avoid odors paired with illness before development of brain areas supporting this learning in adults, suggesting an alternate learning circuit. Here we begin to document the transition from the infant to adult neural circuit underlying odor-malaise avoidance learning using LiCl (0.3 M; 1% of body weight, ip) and a 30-min peppermint-odor exposure. Conditioning groups included: Paired odor-LiCl, Paired odor-LiCl-Nursing, LiCl, and odor-saline. Results showed that Paired LiCl-odor conditioning induced a learned odor aversion in postnatal day (PN) 7, 12, and 23 pups. Odor-LiCl Paired Nursing induced a learned odor preference in PN7 and PN12 pups but blocked learning in PN23 pups. 14C 2-deoxyglucose (2-DG) autoradiography indicated enhanced olfactory bulb activity in PN7 and PN12 pups with odor preference and avoidance learning. The odor aversion in weanling aged (PN23) pups resulted in enhanced amygdala activity in Paired odor-LiCl pups, but not if they were nursing. Thus, the neural circuit supporting malaise-induced aversions changes over development, indicating that similar infant and adult-learned behaviors may have distinct neural circuits.     

The concept of risk and responsible conduct of research

Assessment of risk is one of the key issues in the field of responsible conduct of research which covers discourses of research ethics and research integrity. The principle of minimizing risks and balancing of risks and benefits is one of the main requirements of research ethics. In addition, the content of informed consent that is another fundamental principle of research ethics derives from the assessment of risks and benefits related to a particular research project. Risk assessment also plays a crucial role in methodological design of the research project. This is an important point where research ethics and research integrity discourses overlap. Firstly, because the choice of a control group (e.g., placebo control) is a key ethical issue related to the protection of the research subjects' interests. Secondly, because the quality of the research data, that is one of the key elements of research integrity, is closely connected to the choice of research methodology as well. The problem of biased interpretation or manipulation of risk related features of biomedical research should also be taken into account. Despite the importance of the concept of risk to the field of biomedical research, its relevance has not yet attracted a sufficient attention in the responsible conduct of research debate.     

The protection of patients’ rights in clinical trials

The Helsinki Declaration is a very important document regarding the protection of patients’ rights in clinical trials and one of the fundamental sources of operational principles for every ethics committee. Although they have been updated, the international guidelines for ethics committees continually fail to address certain issues pertaining to the protection of patients’ rights in clinical trials. These issues include, most significantly, the method of electing ethics committees (a free, secret ballot should be preferred to direct appointment), the avoidance of conflict of interest during the election of ethics committee members, and the necessary insurance coverage for the participants of clinical trials. Polish law should, on the other hand, be developed in such way as to not limit the effectiveness of ethics committees in protecting patients’ rights in clinical trials. The ideal solution would be to draft a uniform law concerning not only clinical trials, but all medical experiments. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. This paper was presented at the 6th International Bioethics Conference on the subject of ‘The Responsible Conduct of Basic and Clinical Research’, held in Warsaw, Poland, 3–4 June 2005. The author is Chairman, Bioethics Committee of the Warsaw Regional Chamber of Physicians and Dentists.