Can Cognitive‐Behavioral Therapy Be Optimized With Parent Psychoeducation? A Randomized Effectiveness Trial of Adolescents With Major Depression in Puerto Rico

This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive‐behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre‐ to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1‐year follow‐up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT‐alone showed an increase. The implication of these findings is discussed.     

Achievement and social goals, persistence-effort, and intentions of sport practice in physical education students

The present study examined the relationship between achievement and social goals, and explored how both types of goals can affect secondary school students' persistence/effort in Physical Education classes, as well as their intention to participate in sport activities after finishing secondary school. A sample of 350 students (aged 15-17) from two high schools in Asturias participated in the study. Multiple regression analysis showed: a) persistence/effort in physical education classes was better explained by social responsibility goals, followed by mastery-approach goals and mastery-avoidance goals; b) achievement goals are the only predictors of young people's intention of practicing sport in the future. Differences were found in these results according to gender and course. These findings help us better understand the processes involved in Physical Education. Finally, implications to improve classes and to achieve young people's more active and higher level of implication in sports are discussed.     

Effects of the iodine deficiency on intellectual variables among children

An association between severe iodine deficiency and poor mental development has been found in many studies. We examined the relationship between moderate or mild iodine deficiency and intellectual capacity in order to determine whether problems common to severe iodine deficiency (including mental retardation) also emerge in a more subtle form. We also wished to know whether the classic methodology (comparing iodine-deficient zones with nondeficient zones) is the most adequate, and propose to combine this grouping by zones with urinary iodine presented by individuals in each zone. We measured IQ, manipulative and verbal capacity, attention, visual motor ability and disruptive behaviour, variables that have barely been studied in this kind of investigations. The sample comprised 760 schoolchildren from the province of Jaén (southern Spain). Our results show that children with low levels of iodine intake and with urinary iodine concentration lower than 100 microg/litre had a lower IQ and displayed more disruptive behaviour than children with high levels of the criteria. The other variables were not associated with iodine deficiency.     

Successive negative contrast after partial reinforcement in the consummatory behavior of rats

Rats given access to a 32% sucrose solution later reject a 4% solution significantly more than controls that have only received the 4% solution. In Experiment 1, this consummatory successive negative contrast (cSNC) effect was attenuated by previous exposure to 50% partial reinforcement. Furthermore, recovery from cSNC was also facilitated by partial reinforcement. In Experiment 2, the attenuating effects of partial reinforcement on cSNC were eliminated by administration of the benzodiazepine anxiolytic chlordiazepoxide (5 mg/kg) before nonreinforced trials. In Experiment 3, the attenuating effect of partial reinforcement was greater after a shift from 32 to 6% solution, than after a shift from 32 to 2% solution. The parallels between the effects of partial reinforcement on consummatory and instrumental behavior are discussed.     

What can we learn from psychoanalysis and prospective studies about chemically dependent patients?

Despite the common occurrence of drug abusers in the psychoanalytic clinic, contemporary literature on the subject, particularly among publications in the IJP, is sparse. This paper aims to review the most important psychoanalytic contributions on drug dependency in the past 100 years, then attempts to compare their postulations to the findings ofpertinent prospective studies. In these patients, a persistent symbiotic object relationship is found, which ties them to narcissistic functioning, where drug use is viewed in the light of both pleasure without object and omnipotently controlled need. The author also discusses the possible contribution of the mother and father in the genesis of this condition, focusing on the compromise of the paternal function as the deciding factor. The theoretical and technical implications of this approach are illustrated by clinical material.     

Antidepressant discontinuation in the context of cognitive behavioral treatment for panic disorder.

Cognitive behavioral treatment (CBT) has been shown to reduce risk for adverse reactions (e.g., rebound panic) following benzodiazepine taper for patients with panic disorder (PD). This study evaluated the effects of antidepressant discontinuation for patients with PD in the context of CBT. Patients with PD (n=21) on a stable dose of antidepressants completed a 12-week group CBT treatment and were randomly assigned to discontinue antidepressants during week 8 of the treatment. There were no statistically significant differences between groups at posttreatment or 6-month follow-up. Data indicate no apparent immediate or long-term adverse effects for antidepressant discontinuation for patients with PD receiving CBT.     

Youth Exposed to Violence: Stability, Co-occurrence, and Context

With considerable literature establishing how separate types of violence disrupt the lives of children, there is emerging interest in examining violence across multiple interpersonal domains. This article examines four commonly occurring and frequently researched domains of violence exposure: marital physical aggression, mother-to-youth aggression, father-to-youth aggression, and community violence. A community-based sample of 103 parents and youth provided three waves of data at annual intervals beginning when the youth were aged 9–10. We explored stability of exposure, co-occurrence across different types of violence exposure, and associations with co-occurring risk factors. Approximately 30–45% of youth reported intermittent exposure over the 3 years. In addition to overlap among types of violence exposure within the family, we found overlap between parent-to-youth aggression and community violence, an association that was exacerbated in families where fathers reported high levels of global distress symptoms. Mother-to-youth, father-to-youth, and community violence related to youth behavior problems beyond the contextual risk factors of low income, stressful life events, and parents’ global distress symptoms. These results highlight the importance of examining violence longitudinally, across multiple types, and with attention to contextual factors.     

Brightness contrast: a reinterpretation of compound cue and combined cue experiments with pigeons.

A group of three pigeons was trained on a 4-ply multiple schedule: a green color and a vertical line superimposed upon an achromatic background as positive stimuli, and a red color and a horizontal line on an achromatic background as negative stimuli. The pigeons were tested with the vertical line superimposed upon different achromatic background intensities, then with the vertical line superimposed upon different green background intensities, and finally with the vertical line and its training achromatic backgfound attenuated (and unattenuated) by a neutral density filter. The gradients peaked at the luminance of the achromatic background used during training and at the equivalent luminance for the green background when it was substituted for the achromatic background. The brightness contrast, not the background luminance, was the critical variable as the neutral density filter attenuated both the line and the background equally, leaving brightness contrast unchanged; there was no response decrement to this attenuated stimulus. Two other groups of three pigeons showed that they attended to line orientation as well as to brightness contrast. The brightness contrast hypothesis was extended to explain results of attention experiments and combined cue experiments which have used line stimuli in combinations with different backgrounds.     

Alpha2A-adrenoceptor stimulation improves prefrontal cortical regulation of behavior through inhibition of cAMP signaling in aging animals

The working-memory functions of the prefrontal cortex (PFC) are improved by stimulation of postsynaptic, alpha2A-adrenoceptors, especially in aged animals with PFC cognitive deficits. Thus, the alpha2A-adrenoceptor agonist, guanfacine, greatly improves working-memory performance in monkeys and rats following systemic administration or intra-PFC infusion. Alpha2A-adrenoceptors are generally coupled to Gi, which can inhibit adenylyl cyclases and reduce the production of cAMP. However, no study has directly examined whether the working-memory enhancement observed with guanfacine or other alpha2A-adrenoceptor agonists results from cAMP inhibition. The current study confirmed this hypothesis in both rats and monkeys, showing that treatments that increase cAMP-mediated signaling block guanfacine's beneficial effects. In aged rats, guanfacine was infused directly into the prelimbic PFC and was challenged with co-infusions of the cAMP analog, Sp-cAMPS. In aging monkeys, systemically administered guanfacine was challenged with the phosphodiesterase 4 inhibitor, rolipram, using intramuscular doses known to have no effect on their own. In both studies, agents that mimicked the actions of cAMP (rats) or increased endogenous cAMP (monkeys) completely blocked the enhancing effects of guanfacine on working-memory performance. These results are consistent with alpha2A-adrenoceptor stimulation enhancing PFC working-memory function via inhibition of cAMP-mediated signaling.