Teenagers' attitudes about seeking help from telephone crisis services (hotlines)

The purpose of this study was to examine the attitudes toward the use of telephone crisis services (hotlines) among 519 adolescents in 9th through 12th grade mandatory health courses in six high schools in New York State. Few adolescents (2.1%) used hotlines and negative attitudes were stronger toward hotlines than they were toward other formal sources of help. The most common reasons for hotline nonuse related to feelings of self-reliance and shame. Objections to hotlines were strongest among students most in need of help by virtue of impaired functioning or feelings of hopelessness. The results underscore needed outreach efforts to youth.     

Imitation from 12 to 24 months in autism and typical development: a longitudinal Rasch analysis

The development of imitation during the second year of life plays an important role in domains of sociocognitive development such as language and social learning. Deficits in imitation ability in persons with autism spectrum disorder (ASD) from toddlerhood into adulthood have also been repeatedly documented, raising the possibility that early disruptions in imitation contribute to the onset of ASD and the deficits in language and social interaction that define the disorder. This study prospectively examined the development of imitation between 12 and 24 months of age in 154 infants at familial risk for ASD and 78 typically developing infants who were all later assessed at 36 months for ASD or other developmental delays. The study established a developmental measure of imitation ability and examined group differences over time, using an analytic Rasch measurement model. Results revealed a unidimensional latent construct of imitation and verified a reliable sequence of imitation skills that was invariant over time for all outcome groups. Results also showed that all groups displayed similar significant linear increases in imitation ability between 12 and 24 months and that these increases were related to individual growth in both expressive language and ratings of social engagement but not in fine motor development. The group of children who developed ASD by age 3 years exhibited delayed imitation development compared with the low-risk typical outcome group across all time-points, but were indistinguishable from other high-risk infants who showed other cognitive delays not related to ASD.     

Whatever does not kill us: cumulative lifetime adversity, vulnerability, and resilience

Exposure to adverse life events typically predicts subsequent negative effects on mental health and well-being, such that more adversity predicts worse outcomes. However, adverse experiences may also foster subsequent resilience, with resulting advantages for mental health and well-being. In a multiyear longitudinal study of a national sample, people with a history of some lifetime adversity reported better mental health and well-being outcomes than not only people with a high history of adversity but also than people with no history of adversity. Specifically, U-shaped quadratic relationships indicated that a history of some but nonzero lifetime adversity predicted relatively lower global distress, lower self-rated functional impairment, fewer posttraumatic stress symptoms, and higher life satisfaction over time. Furthermore, people with some prior lifetime adversity were the least affected by recent adverse events. These results suggest that, in moderation, whatever does not kill us may indeed make us stronger.     

Musings on the “Seasoned Therapist”

This is a brief essay offering the personal reflections and musings of a therapist in her ninth decade.     

Genetic and environmental contributions to the co-occurrence of depressive personality disorder and DSM-IV personality disorders

One of the main controversies with regard to depressive personality disorder (DPD) concerns the co-occurrence with the established DSM-IV personality disorders (PDs). The main aim of this study was to examine to what extent DPD and the DSM-IV PDs share genetic and environmental risk factors, using multivariate twin modeling. The DSM-IV Structured Interview for Personality was applied to 2,794 young adult twins. Paranoid PD from Cluster A, borderline PD from Cluster B, and all three PDs from Cluster C were independently and significantly associated with DPD in multiple regression analysis. The genetic correlations between DPD and the other PDs were strong (.53-.83), while the environmental correlations were moderate (.36-.40). Close to 50% of the total variance in DPD was disorder specific. However, only 5% was due to disorder-specific genetic factors, indicating that a substantial part of the genetic vulnerability to DPD also increases the vulnerability to other PDs.     

Eye of the beholder: the individual and dyadic contributions of empathic accuracy and perceived empathic effort to relationship satisfaction

This study examined links between two distinct facets of empathy-empathic accuracy and perceived empathic effort-and one's own and one's partner's relationship satisfaction. Using a video recall procedure, participants (n = 156 couples in committed relationships) reported on their own emotions and their perceptions of partners' emotions and partners' empathic intentions during moments of high affect in laboratory-based discussions of upsetting events. Partners' data were correlated as a measure of how accurately they were able to read what the other was feeling and to what degree they felt the other was trying to be empathic at those moments. The perception of empathic effort by one's partner was more strongly linked with both men's and women's relationship satisfaction than empathic accuracy. Men's relationship satisfaction was related to the ability to read their partners' positive emotions accurately, whereas women's relationship satisfaction was related to their partners' ability to read women's negative emotions accurately. Women's ability to read their husbands' negative emotions was positively linked to both men's and women's relationship satisfaction. Findings suggest that the perception of a partner's empathic effort-as distinct from empathic accuracy-is uniquely informative in understanding how partners may derive relationship satisfaction from empathic processes. When working with couples in treatment, heightening partners' perceptions of each other's empathic effort, and helping partners learn to demonstrate effort, may represent particularly powerful opportunities for improving satisfaction in relationships.