The Role of Depression, Shame-Proneness, and Guilt-Proneness in Predicting Criticism of Relatives Towards People With Bipolar Disorder

Expressed emotion (EE) has been associated with poor patient outcomes in many different psychiatric disorders. Given its robust association with relapse, EE has become a major target of family psychoeducational interventions. Most psychoeducational interventions to date have failed to change EE levels among families of those with bipolar disorder. Better intervention strategies, then, may depend on an increased understanding of the predictors of EE. Although EE has traditionally included many facets, criticism appears to be the most robust predictor of outcome within bipolar disorder. The present study tested three primary predictors of criticism among family members of people with bipolar disorder: shame-proneness, guilt-proneness, and depression. Depressive symptoms were significantly associated with EE. Discussion focuses on limitations and implications of the study and suggestions for future research.     

Loneliness,Interpersonal Distrust,and Alexithymia in University Students1

Loneliness has been linked to emotional knowledge and interpersonal distrust, but it is unknown whether it is mediated or moderated by these variables. Using self‐report measures, the relationship between loneliness, interpersonal distrust, and alexithymia was investigated in undergraduate students (N = 224). Analyses showed a direct relationship between alexithymia and social, family, and romantic loneliness. We also found that interpersonal distrust partly mediates this relationship, and that alexithymia and interpersonal distrust interacted to predict social and family loneliness. These findings suggest that links between the different facets of alexithymia, interpersonal distrust, and loneliness are complex and multifaceted, and they are discussed with regard to interventions for young adults.     

Early-Onset Bipolar Spectrum Disorders: Diagnostic Issues

Since the mid 1990s, early-onset bipolar spectrum disorders (BPSDs) have received increased attention in both the popular press and scholarly press. Rates of diagnosis of BPSD in children and adolescents have increased in inpatient, outpatient, and primary care settings. BPSDs remain difficult to diagnose, particularly in youth. The current diagnostic system makes few modifications to accommodate children and adolescents. Researchers in this area have developed specific BPSD definitions that affect the generalizability of their findings to all youth with BPSD. Despite knowledge gains from the research, BPSDs are still difficult to diagnose because clinicians must: (1) consider the impact of the child’s developmental level on symptom presentation (e.g., normative behavior prevalence, environmental limitations on youth behavior, pubertal status, irritability, symptom duration); (2) weigh associated impairment and course of illness (e.g., neurocognitive functioning, failing to meet full DSM criteria, future impairment); and (3) make decisions about appropriate assessment (differentiating BPSD from medical illnesses, medications, drug use, or other psychiatric diagnoses that might better account for symptoms; comorbid disorders; informant characteristics and assessment measures to use). Research findings concerning these challenges and relevant recommendations are offered. Areas for further research to guide clinicians’ assessment of children with early-onset BPSD are highlighted. Principal Investigators and Coinvestigators of Longitudinal Assessment of Manic Symptoms (LAMS) Group are listed in Appendix.     

The role of emotion in bridging the intention–behaviour gap: The case of sports participation

ProblemPsychological models of sports participation frequently draw on the Theory of Planned Behaviour (TPB) in order to predict health-behaviour-related intentions. While these models commonly show high predictive power with respect to intention, they often fall short in the prediction of behaviour (the ‘intention–behaviour gap’). The present study contends that integrating emotional processes into TPB can substantially improve the model's predictive power over and above traditional cognitive predictors.MethodIn a longitudinal study structural equation modelling was employed to test a traditional model (based on TPB) and an extended model including emotion associated with the intention to exercise as a mediator variable. A community sample (N = 237) completed a questionnaire measuring the components of a traditional TPB model. Prior to each of 16 expected exercise sessions (over 8 weeks) intention to exercise and emotion associated with the intention were measured.ResultsResults confirmed a substantial increase of 17% in explained variance of exercise frequency and 20% in exercise duration for the extended model. Emotional appraisal of the intention to exercise thus appears to mediate the traditional intention–behaviour relationship, suggesting that emotionally based interventions aimed at increasing sports participation may be helpful.ConclusionIt is concluded that emotion variables should be added to traditional TPB models in order to predict health behaviour more fully.     

An examination of self-compassion in relation to positive psychological functioning and personality traits

This study examined the relation of self-compassion to positive psychological health and the five factor model of personality. Self-compassion entails being kind toward oneself in instances of pain or failure; perceiving one’s experiences as part of the larger human experience; and holding painful thoughts and feelings in balanced awareness. Participants were 177 undergraduates (68% female, 32% male). Using a correlational design, the study found that self-compassion had a significant positive association with self-reported measures of happiness, optimism, positive affect, wisdom, personal initiative, curiosity and exploration, agreeableness, extroversion, and conscientiousness. It also had a significant negative association with negative affect and neuroticism. Self-compassion predicted significant variance in positive psychological health beyond that attributable to personality.     

Is Expressed Emotion a Specific Risk Factor for Depression or a Nonspecific Correlate of Psychopathology?

Five Minute Speech Sample Expressed Emotion (FMSS-EE) was examined in families of youth with depressive disorders, nondepressed youth with attention deficit/hyperactivity disorder (ADHD), and community controls screened for the absence of depression and ADHD. Consistent with the hypothesis that FMSS-EE shows some specificity as a risk factor for depression, rates of critical EE were significantly higher among mothers of youth with depression as compared to mothers of nondepressed youth with ADHD, or mothers of controls. When both mothers' and fathers' scores were used to generate family EE ratings, rates of overall EE and critical EE were significantly higher for the depressed group than the control group, but the nondepressed ADHD group did not differ significantly from the other groups. Results support the hypothesis that critical EE in mothers shows some specificity as a risk factor or correlate of depression in youth.     

Building Collaborative Capacity in Community Coalitions: A Review and Integrative Framework

This article presents the results of a qualitative analysis of 80 articles, chapters, and practitioners' guides focused on collaboration and coalition functioning. The purpose of this review was to develop an integrative framework that captures the core competencies and processes needed within collaborative bodies to facilitate their success. The resulting framework for building collaborative capacity is presented. Four critical levels of collaborative capacity—member capacity, relational capacity, organizational capacity, and programmatic capacity—are described and strategies for building each type are provided. The implications of this model for practitioners and scholars are discussed.     

Research and Theory Religion and Spirituality in Coping With Stress

Relations among and between religion, spirituality, and the ability to cope with stress were examined using a sample of 115 graduate students in counseling. Religion and spirituality positively correlated with coping with stress. Counseling students who expressed spirituality through religious beliefs had greater spiritual health and immunity to stressful situations than counseling students who identified themselves as spiritual but not religious. Counseling students with a religious/spiritual affiliation indicated more discomfort counseling clients hostile to religion compared with counseling students with a spiritual‐only affiliation. The results have implications for preparing counseling students to work with clients with religious/spiritual issues.     

Prospective Study of Major Loss Life Events and Risk for Suicidal Thoughts and Behaviors Among Adolescents and Young Adults

This prospective, naturalistic study examined the association between major loss life experiences, other psychiatric risk factors (depression, hopelessness, and anxiety), and suicidal thoughts and behaviors (STBs) among adolescents followed through young adulthood for up to 14 years. Major loss life events were related to subsequent increases in STBs. Major loss life events were primarily related to increases in suicide ideation in the presence of lower levels of other risk factors. There was a bidirectional relationship between major losses and other risk factors. Implications for the association between loss experiences, other risk factors, and future STBs are discussed.     

A Community of Psychotherapists

Services for chronic mental patients in this era of deinstitutionalization present a major challenge to clinicians and planners alike. The complexity of these patients' clinical and other programmatic needs requires that an array of viable comprehensive services be made available to them. Following certain established principles of service planning will help facilitate patients' longitudinal, psychological, financial, and geographical access to care.