Paradoxical intervention using a polarization model of cotherapy in the treatment of elective mutism: A case study

A case history is presented of a four and-a-half year-old electively mute child who was successfully treated by the authors. The treatment approach involved paradoxical interventions in the context of a polarization model of cotherapy in combination with behavioral techniques in a family therapy framework.     

The Relation Between Maternal ADHD Symptoms &; Improvement in Child Behavior Following Brief Behavioral Parent Training is Mediated by Change in Negative Parenting

This study examined the extent to which maternal attention-deficit/hyperactivity disorder (ADHD) symptoms predict improvement in child behavior following brief behavioral parent training. Change in parenting was examined as a potential mediator of the negative relationship between maternal ADHD symptoms and improvement in child behavior. Seventy mothers of 6–10 year old children with ADHD underwent a comprehensive assessment of adult ADHD prior to participating in an abbreviated parent training program. Before and after treatment, parenting was assessed via maternal reports and observations and child disruptive behavior was measured via maternal report. Controlling for pre-treatment levels, maternal ADHD symptomatology predicted post-treatment child disruptive behavior problems. The relation between maternal ADHD symptomatology and improvement in child behavior was mediated by change in observed maternal negative parenting. This study replicated findings linking maternal ADHD symptoms with attenuated child improvement following parent training, and is the first to demonstrate that negative parenting at least partially explains this relationship. Innovative approaches combining evidence-based treatment for adult ADHD with parent training may therefore be necessary for families in which both the mother and child have ADHD. Larger-scale studies using a full evidence-based parent training program are needed to replicate these findings.     

Attenuated response to methamphetamine sensitization and deficits in motor learning and memory after selective deletion of β-catenin in dopamine neurons

In the present study, we analyzed mice with a targeted deletion of β-catenin in DA neurons (DA-βcat KO mice) to address the functional significance of this molecule in the shaping of synaptic responses associated with motor learning and following exposure to drugs of abuse. Relative to controls, DA-βcat KO mice showed significant deficits in their ability to form long-term memories and displayed reduced expression of methamphetamine-induced behavioral sensitization after subsequent challenge doses with this drug, suggesting that motor learning and drug-induced learning plasticity are altered in these mice. Morphological analyses showed no changes in the number or distribution of tyrosine hydroxylase-labeled neurons in the ventral midbrain. While electrochemical measurements in the striatum determined no changes in acute DA release and uptake, a small but significant decrease in DA release was detected in mutant animals after prolonged repetitive stimulation, suggesting a possible deficit in the DA neurotransmitter vesicle reserve pool. However, electron microscopy analyses did not reveal significant differences in the content of synaptic vesicles per terminal, and striatal DA levels were unchanged in DA-βcat KO animals. In contrast, striatal mRNA levels for several markers known to regulate synaptic plasticity and DA neurotransmission were altered in DA-βcat KO mice. This study demonstrates that ablation of β-catenin in DA neurons leads to alterations of motor and reward-associated memories and to adaptations of the DA neurotransmitter system and suggests that β-catenin signaling in DA neurons is required to facilitate the synaptic remodeling underlying the consolidation of long-term memories.     

Parental burden associated with borderline personality disorder in female offspring

To identify aspects of parental burden associated with borderline personality disorder (BPD), an anonymous internet survey linked to BPD support websites was developed for parents to complete on their BPD offspring and unaffected siblings. The questions cover aspects of the child's life from pregnancy through young adulthood, and query about the impact of the child's BPD on six domains of the parent's life, including physical and emotional health, marriage, job, standard of living, social life, and career trajectory. Additionally, financial burden was assessed with questions pertaining to insurance and out-of pocket costs associated with the BPD disorder. BPD offspring were identified by meeting diagnostic criteria embedded within the survey and having been given a diagnosis of BPD by a professional at some point in their life. We report on 233 female offspring meeting strict criteria for BPD. Parents of daughters with BPD endorsed varying levels of impact on the six domains comprising burden with the largest impact on emotional health which was impacted in over 88% of the respondents. Over 50% of parents endorsed four or greater of the six burden items. Particular aspects of the offspring's BPD symptom profile correlated with intensity of parental burden included including problems in adolescence with acting out behavior (p < .000), property destruction (.003), delusional symptoms (.007), and hallucinatory symptoms (.008). A subgroup of respondents provided data on specific financial expenses. The average and median out-of-pocket expense was $60,087, and $10,000. Insurance costs totaled an average of $108,251 with a mean of $20,000. The average cost per year after diagnosis was $14,606 out-of-pocket and $45,573 billed to insurance. The median cost per year after diagnosis was $3,667 out-of-pocket, and $12,500 billed to insurance. After adjusting for household income, a female proband who had been raped incurred roughly $40,000 more in BPD-related costs, while a diagnosis of conduct disorder led to about $50,000 in additional costs. Parents of female offspring with BPD experience burden in multiple domains of their life and many have incurred substantial financial expense. Increasing awareness of co-morbid conditions in the BPD proband that significantly increase parental burden may be indicators for the provision of increased family support.     

Adrenocortical influences on free-operant avoidance behavior

Rats were conditioned to avoid shock on a free-operant avoidance schedule in which no exteroceptive stimulus signaled impending shock. Injections of adrenocorticotropic hormone (ACTH) or dexamethasone raised blood levels of glucocorticoids. These increases were accompanied by changes in avoidance performance: there was a higher frequency of long-duration interresponse times, a greater stability among them, and fewer short interresponse times, total responses, and shocks.     

Individual differences in the emergence of depressive symptoms in children and adolescents: a longitudinal investigation of parent and child reports

The authors address questions about the rate that depressive symptoms emerge, developmental and gender differences in this rate, and differences between parent and child estimates of this rate. In a 12-wave, cohort-sequential, longitudinal design, 1,570 children (Grades 4-11) and parents completed reports about children's depression. Cross-domain latent growth curve analysis revealed that (a) the rate of symptom growth varied with developmental level. (b) gender differences symptom growth preceded emergence of mean level gender differences, (c) the rate of symptom development varied with age, and (d) parent-child agreement about rate of symptom change was stronger than agreement about time-specific symptoms. The authors suggest that predictability of depressive symptoms varies with age and the dimension under investigation.     

From Enemy Combatant to Strange Bedfellow The Role of Religious Narratives in the Work of W. R. D. Fairbairn and D. W. Winnicott

Psychoanalysis has a well-documented history of antipathy toward religion. As a consequence of the postmodern shift in philosophy, however, there are those who, albeit cautiously, are attempting to approach religion with a renewed spirit of dialogue and inquiry as a narrative among many narratives that has informed and even enriched the development of psychoanalysis.

In this spirit of dialogue, the author traces the influence of early religious affiliations on two object relations theorists, W. R. D. Fairbairn and D. W. Winnicott. Fairbairn's early imbibing of Calvinist theology in Scotland and Winnicott's involvement in the Wesleyan church are detailed. The theological differences between these Protestant perspectives (which form counterpoints to one another) are clarified and the perspectives are positioned within the framework of British culture. These religious themes are then identified within the works of Fairbairn and Winnicott.

As a final consideration, the relational nature of the Judeo-Christian God, and the subsequent view of human life that flows from that theology, are posited as influential in the development of the relational shift in psychoanalysis. The author details the association between this shift and the seminal work of Fairbairn and Winnicott.     

Structural differences in parent and child reports of children's symptoms of depression and anxiety

Two cohorts of public elementary school children and their parents (assessed 3 years apart) completed child and parent forms of the Children's Depression Inventory (CDI) and the Revised Children's Manifest Anxiety Scale (RCMAS). Assessments were conducted twice, once during the fall (N = 562) and again during the spring (N = 630) of the 6th grade. Factor analyses revealed 3 factors for each measure. Two of the 3 parent CDI factors manifested some degree of congruence with their counterparts from the child CDI. Similarly, 2 of the 3 RCMAS factors were somewhat congruent across informant types. Differences between parent and child factor structures suggest that parents' and children's reports focus on somewhat different aspects of child psychopathology, and they can make qualitatively different contributions to the multiaxial assessment of children.     

Suicide and the contemporary woman: Are male and female suicide rates converging?

Nationwide statistics on White suicide rates for the years 1960–1978 are examined to assess whether the suicide rates of women are increasing relative to those of men. This is accomplished by calculating for the total population and for several age groupings the sex differential (SD), which is defined as the percentage of suicides which are female after adjustments are made for the sex distribution in the population. The data reveal that the SD narrowed from 1960–1967, held steady from 1968–1972, and then widened slightly from 1973–1978. The most important aspects of these trends are that (a) the narrowing of the SD is due more to declining suicide rates among older (over-40) males than to increasing female suicide rates, and (b) the narrowing of the SD and the small increases in female suicide rates occurred prior to 1970 and thus were earlier than would be expected on the basis of changing sex-role expectations. Post hoc explanations of these patterns refer to methodological factors and to changes in social integration resulting from a variety of sociohistorical factors.