A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema

Objective: Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL.

Design: Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions.

Main Outcome Measures: Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy–Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis.

Results: There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis.

Conclusion: These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.     

Investigating the Potentially Protective Effects of Neighborhood Processes in Intimate Partner Violence

Women who experience intimate partner violence (IPV) are often mothers. This study seeks to further the understanding of IPV in families, as well as social factors that can prevent violence from occurring. Based on existing literature and theory, we hypothesize that social cohesion and informal social control are associated with lower rates of IPV. To test this theory, we use a total sample of 2,344 mothers with partners surveyed in the Families and Child Wellbeing study and analyze the effects of neighborhood social cohesion and informal social control on reported IPV experiences. This was done by using a negative binomial regression. Findings show that informal social control is associated with lower levels of IPV experiences among mothers with partners.     

Building seven bridges with young asylum seekers living in exile in the UK (Part 1)

This first paper focuses on the key themes that emerge in work with young asylum seekers and refugees and on our assessment of the needs of individual young asylum seekers, alongside the ways in which we meet the needs of these young people given the holistic, integrated and developmental approach of the Baobab Centre. The fact that psychotherapeutic methods are useful in this context and the need to have flexible approach to psychotherapy in our context are two ideas explored here. This paper will explore how we can slowly build sturdy and protective connections during and after the developmental years following experiences of sequential violence. This means building bridges and links within the internal worlds of these young people between: (1) different aspects of themselves that emerge after violence and loss; (2) themselves and their peers; (3) listening adults; (4) various social influences; (5) cultural influences; (6) their past, present and future lives; (7) links with local, national and international communities all of which are addressed via a ‘Transitional Non-Residential Therapeutic Community’. A case example will illustrate how this work may take place.     

Building seven bridges with young asylum seekers living in exile in the UK (Part 2)

This paper is derived from a talk given in November 2016 as the Birkbeck Counselling Association Autumn Talk in collaboration with Psychodynamic Practice. The original talk has been divided into two related papers of which this is the second, concentrating on the effects on young asylum seekers of the political and social situation in which they find themselves when they reach the UK. Both papers explore how, working with young asylum seekers, we can slowly build sturdy and protective connections during and after the developmental years following experiences of sequential violence. This means building links within the internal worlds of these young people between themselves and: (i) different aspects of themselves that emerge after violence and loss; (ii) their peers; (iii) listening adults; (iv) various social influences; (v) cultural influences; (vi) their past, present and future lives; (vii) links with local, national and international communities. Describing further the work that takes place at the Baobab Centre, a ‘transitional therapeutic community’, and using case material to illustrate this, the author raises the challenge of how we might best address the needs of this group of children, adolescents and young adults who objectively have to live for several years of their lives in a situation of ongoing uncertainty that is in fact much more than a young person can bear. As Jo Goldstein a legal specialist, Anna Freud a child psychoanalyst and Al Solnit a paediatrician write, in their trilogy of works, States and State Agencies cannot parent children, and children need involved parenting, (i.e. involved relationships with individual caring adults). Often for children separated from their original families, the parenting role is split between large bureaucracies and foster carers who work with agencies outsourced from the Social Services Departments. Yet this country makes Social Services Departments and the Home Office responsible for decisions about whether or not child asylum seekers might remain in the UK, in fact often without a very deep assessment and hence little knowledge and understanding of their experiences and their developmental needs. Asylum seeking minors usually have to wait for decisions about their safety and protection, and about permanence and continuity, for a much longer period of time than a child can bear.     

Parent–Child Interaction Therapy and Chronic Illness: A Case Study

We examined the outcome of parent–child interaction therapy (PCIT) for a child diagnosed with Oppositional Defiant Disorder (ODD) and cancer. Robert, a 4-year-old Caucasian male, showed significant and meaningful changes in his behavior over the course of 13 weeks of PCIT, and Robert no longer met diagnostic criteria for ODD following treatment. His scores on the Eyberg Child Behavior Inventory and the Achenbach Child Behavior Checklist were in the clinical range before treatment and in the normal range at the conclusion of treatment. His mother also reported dramatic improvements in Robert's behavior during medical visits. Physician and social worker reports were consistent with her report. Such anecdotal data may have implications for the generalization of compliance to the medical setting for children with chronic illnesses. The results of this case study should prompt further investigation of parent-training interventions for children with chronic illnesses and disruptive behavior.     

A secreted form of the beta-amyloid precursor protein (sAPP695) improves spatial recognition memory in OF1 mice

The beta-amyloid precursor protein (APP) plays a central role in Alzheimer's disease (AD) and appears to be a multifunctional protein. Secreted forms of APP (sAPP) have memory-enhancing effects in certain behavioral paradigms. To investigate sAPP's role in spatial memory processes, we adapted a spatial recognition task and evaluated (1) the performance of OF1 mice after massed training (single 15-min acquisition session) and distributed training (three 5-min acquisition sessions), (2) the decline of spatial recognition performance by introducing different delays (5min, 1, 3, and 24h) between the acquisition and retention phases, and (3) the effects of sAPP(695) on spatial recognition memory. In the present study, mice selectively reacted to a change in the spatial configuration of five objects. Indeed, 3min post-acquisition, mice performed similarly in the massed and distributed versions of the task, by re-exploring the two displaced objects only, whereas mice exposed to the same spatial configuration did not. Additionally, all mice did react to a novel object in a subsequent object recognition phase. Mice detected object displacements 5min, 1h, or 3h post-acquisition, but no more at a 24h-delay. Finally, mice treated with sAPP(695) intracerebroventricularly at a dose of 0.5pg/4microL/mouse, 20-min pre-acquisition or 5-min post-acquisition, still reacted to a spatial change in objects position 24h post-acquisition, in marked contrast to NaCl-treated mice. Our data demonstrate that sAPP(695) significantly improves a form of spatial memory, and confirms the hypothesis of an action of this protein on early memory processes.     

Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children

Numerous studies have revealed autonomic underarousal in conduct-disordered adolescents and antisocial adults. It is unknown, however, whether similar autonomic markers are present in at-risk preschoolers. In this study, the authors compared autonomic profiles of 4- to 6-year-old children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD; n = 18) with those of age-matched controls (n = 20). Children with ADHD and ODD exhibited fewer electrodermal responses and lengthened cardiac preejection periods at baseline and during reward. Although group differences were not found in baseline respiratory sinus arrhythmia, heart rate changes among ADHD and ODD participants were mediated exclusively by parasympathetic withdrawal, with no independent sympathetic contribution. Heart rate changes among controls were mediated by both autonomic branches. These results suggest that at-risk preschoolers are autonomically similar to older externalizing children.     

Playing on the typewriter, typing on the piano: manipulation knowledge of objects

Two experiments investigated sensory/motor-based functional knowledge of man-made objects: manipulation features associated with the actual usage of objects. In Experiment 1, a series of prime-target pairs was presented auditorily, and participants were asked to make a lexical decision on the target word. Participants made a significantly faster decision about the target word (e.g. ‘typewriter’) following a related prime that shared manipulation features with the target (e.g. ‘piano’) than an unrelated prime (e.g. ‘blanket’). In Experiment 2, participants' eye movements were monitored when they viewed a visual display on a computer screen while listening to a concurrent auditory input. Participants were instructed to simply identify the auditory input and touch the corresponding object on the computer display. Participants fixated an object picture (e.g. “typewriter”) related to a target word (e.g. ‘piano’) significantly more often than an unrelated object picture (e.g. “bucket”) as well as a visually matched control (e.g. “couch”). Results of the two experiments suggest that manipulation knowledge of words is retrieved without conscious effort and that manipulation knowledge constitutes a part of the lexical-semantic representation of objects.     

Child-Directed Interaction: Prediction of Change in Impaired Mother–Child Functioning

The first phase of parent–child interaction therapy (PCIT), called child-directed interaction, teaches parents to use positive and differential social attention to improve the parent–child relationship. This study examined predictors of change in mother and child functioning during the child-directed interaction for 100 mother–child dyads. The children were 3–6-years-old and diagnosed with oppositional defiant disorder. After establishing that significant improvements occurred in mother report of child disruptive behavior, parenting stress, and parenting practices, these three variables were combined to form a latent impaired mother–child functioning construct. Structural equation models were examined using maternal demographic and psychosocial variables as predictors of impaired mother–child functioning before and after the child-directed interaction. Mothers’ self-reported daily hassles and depressive symptomatology predicted 74% of variance in impaired mother–child functioning before treatment. Mothers’ report of social support predicted impaired mother–child functioning after the child-directed interaction, with 57% of the variance accounted for in this longitudinal model. These findings suggest the importance of improving maternal social support during the initial phase of PCIT.

Auditory abilities of speakers who persisted, or recovered, from stuttering

OBJECTIVE: The purpose of this study was to see whether participants who persist in their stutter have poorer sensitivity in a backward masking task compared to those participants who recover from their stutter. DESIGN: The auditory sensitivity of 30 children who stutter was tested on absolute threshold, simultaneous masking, backward masking with a broadband and with a notched noise masker. The participants had been seen and diagnosed as stuttering at least 1 year before their 12th birthday. The participants were assessed again at age 12 plus to establish whether their stutter had persisted or recovered. Persistence or recovery was based on participant's, parent's and researcher's assessment and Riley's [Riley, G. D. (1994). Stuttering severity instrument for children and adults (3rd ed.). Austin, TX: Pro-Ed.] Stuttering Severity Instrument-3. Based on this assessment, 12 speakers had persisted and 18 had recovered from stuttering. RESULTS: Thresholds differed significantly between persistent and recovered groups for the broadband backward-masked stimulus (thresholds being higher for the persistent group). CONCLUSIONS: Backward masking performance at teenage is one factor that distinguishes speakers who persist in their stutter from those who recover. Education objectives: Readers of this article should: (1) explain why auditory factors have been implicated in stuttering; (2) summarise the work that has examined whether peripheral, and/or central, hearing are problems in stuttering; (3) explain how the hearing ability of persistent and recovered stutterers may differ; (4) discuss how hearing disorders have been implicated in other language disorders.