Vitalizing Enactment: A Relational Exploration

Drawing from her extensive work with deeply disturbed children Alvarez (2012) theorized a form of intervention termed “vitalization” in which the analyst actively reaches out to contact and “reclaim” her most inaccessible patients, engaging them in the world of emotions and relationships. In this paper I consider Alvarez’s ideas through the lens of Relational thought, reconceptualizing vitalization as a unique form of enactment that can draw the analytic dyad from deadened impasse into enlivened contact. In vitalizing enactment embryonic affects, hopes, and longings find expression and are potentiated for patient and analyst alike. This is a view of enactment as a progressive and creative lived experience, rather than an unconscious collision to be survived and symbolized. I contextualize vitalizing enactment in relation to Alvarez’s original formulations as well as relevant contemporary theories and present a clinical vignette to illustrate this paper’s themes.     

Extracurricular Participation and Course Performance in the Middle Grades: A Study of Low-Income,Urban Youth

The transition to middle/junior high school is associated with declines in students’ academic performance, especially among low‐income, urban youth. Developmental psychologists posit such declines are due to a poor fit between the needs of early adolescents—industry, identity, and autonomy—and the environment of their new schools. Extracurricular participation during these years may act as a buffer for youth, providing a setting for development outside the classroom. The current study examines participation within and across activity settings among low‐income, urban youth in New York City over this transition. Using the Adolescent Pathways Project data, this study explores how such participation relates to course performance. We find that a large percentage of youth are minimally or uninvolved in extracurricular activities during these years; that participation varies within youth across time; and that the association between participation and course performance varies by activity setting. Youth who participate frequently in community or athletic settings or have high participation in two or more settings are found to have higher GPAs in the year in which they participate and youth who participate frequently in the religious setting are found to have lower GPAs. High participation in more than two settings may be detrimental.     

Longitudinal trajectories of bicultural identity integration in recently immigrated Hispanic adolescents: Links with mental health and family functioning

This study examined, in a sample of recently immigrated Hispanic adolescents in Miami and Los Angeles, the extent to which bicultural identity integration (BII; involving the ability to synthesise one's heritage and receiving cultural streams and to identify as a member of both cultures) is best understood as a developmental construct that changes over time or as an individual‐difference construct that is largely stable over time. We were also interested in the extent to which these trajectories predicted mental health and family functioning. Recent‐immigrant 9th graders (N = 302) were assessed 6 times from 9th to 12th grade. Latent class growth analyses using the first 5 timepoints identified 2 trajectory classes—one with lower BII scores over time and another with higher BII scores over time. Higher heritage and US identity at baseline predicted membership in the higher BII class. At the 6th study timepoint, lower BII adolescents reported significantly poorer self‐esteem, optimism, prosocial behaviour and family relationships compared with their higher BII counterparts. These findings are discussed in terms of further research on the over‐time trajectory of biculturalism, and on the need to develop interventions to promote BII as a way of facilitating well‐being and positive family functioning.     

Popularity, social acceptance, and aggression in adolescent peer groups: links with academic performance and school attendance

This article reports a short-term longitudinal study focusing on popularity and social acceptance as predictors of academic engagement for a sample of 342 adolescents (approximate average age of 14). These youths were followed for 4 consecutive semesters. Popularity, social acceptance, and aggression were assessed with a peer nomination inventory, and data on academic engagement were obtained from school records. For adolescents who were highly aggressive, increases in popularity were associated with increases in unexplained absences and decreases in grade point average. Conversely, changes in social acceptance were not predictive of changes in grade point average or unexplained absences. These results highlight the importance of multidimensional conceptualizations of social standing for research on school adjustment during adolescence and emphasize the potential risks associated with popularity.     

Preschoolers with Asthma: Narratives of Family Functioning Predict Behavior Problems

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low-income preschoolers. The study included parent report of asthma severity and a narrative story-stem method to assess children's representations of both general and disease-specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based-assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.     

Capturing Children's Response to Parental Conflict and Making Use of It

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full-text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ).
The aim of our study is to examine the interface between children's physiological changes and the specificities of parental conflict, and to develop a procedure in which such information can be shared with the family for therapeutic change. Children from 20 families were exposed to parental conflict discussion (CD) while their arousals were measured through skin conductance and heart rate sensors. It was found that regardless of the subject of the argument, 80% of the time they were complaining about each other. Likewise, 80% of the time the children were responding to the parents' own interpersonal tension, including moments of silence. The protocol established for the study, consisting of CD and debriefing, was found to be a powerful tool in moving parents toward conflict resolution.     

The dark side of incremental learning: A model of cumulative semantic interference during lexical access in speech production

Naming a picture of a dog primes the subsequent naming of a picture of a dog (repetition priming) and interferes with the subsequent naming of a picture of a cat (semantic interference). Behavioral studies suggest that these effects derive from persistent changes in the way that words are activated and selected for production, and some have claimed that the findings are only understandable by positing a competitive mechanism for lexical selection. We present a simple model of lexical retrieval in speech production that applies error-driven learning to its lexical activation network. This model naturally produces repetition priming and semantic interference effects. It predicts the major findings from several published experiments, demonstrating that these effects may arise from incremental learning. Furthermore, analysis of the model suggests that competition during lexical selection is not necessary for semantic interference if the learning process is itself competitive.     

A Compelling Practice: Empowering Future Leaders in the Medical Humanities

Medical students and faculty explore the medical humanities for diverse reasons: as a medium for self-reflection, a means to cultivate professionalism and humanism, and a way to gain an appreciation for the broader contexts in which illness and health occur. One important area for development is increasing the exposure of learners and clinicians of various levels of training to the medical humanities and to role models in the field. Student-led programs in the medical humanities at the American Medical Student Association (AMSA) address these needs by offering unique opportunities for learning and sharing experiences. AMSA programs connect physicians-in-training using technology to create virtual communication and learning opportunities. These include monthly book discussion webinars, the Writers' Institute and the Medical Humanities Scholars Program (MHSP).