Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury

Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature—namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved.     

Neonatal Intensive-Care Unit Graduates Show Persistent Difficulties in an Intradimensional Shift Card Sort

Neonatal intensive-care unit (NICU) graduates, a group at risk for attention problems and attention-deficit hyperactivity disorder, performed an intradimensional shift card sort at 34, 42, 51, and 60 months to assess executive function and to examine effects of individual risk factors. In the “silly” game, children sorted cards (airplanes and dogs) so they were not the same as targets. In the “same” game, they did the opposite. Performance on the “silly” game was poor, especially when it was presented first. Success in following “silly” game rules improved with age and was significantly linked to maternal education and birth weight for gestational age, a measure of intrauterine stress. Degree of central nervous system injury differentiated children who completed the task from children who did not, and it also affected the need to repeat instructions in the “same” game. These results confirm an increased likelihood of impairments in executive function during preschool years in NICU graduates.     

Understanding the utility of emotional approach coping: evidence from a laboratory stressor and daily life

Background: Dispositional emotional approach coping (EAC) marks an adaptive tendency to process and express emotions. EAC's association with cognitions, affect, and intra- and interindividual characteristics that may account for its utility was examined in response to an acute stressor and in daily life. Design: This study included a laboratory stress task and ecological momentary assessment. Methods: Healthy undergraduate students (n = 124; mean age: 20; women: 56%) completed a laboratory component (baseline survey, speech stress task, pre- and posttask measures) and five subsequent days of surveys via palm pilot (six surveys/day). Results: Controlling for sex, neuroticism, and social support, greater EAC was associated with more positive cognitive appraisals, personal resources, and positive affect and less-negative affect during the lab stressor, and with more perceived control and positive affect in daily life. Significant EAC × sex interactions were found for poststressor affect: men with high EAC reported more positive affect and women with high EAC reported less negative affect. Conclusions: Findings provide support that EAC's utility may be independent of intra- and interindividual characteristics, and that men and women may benefit from EAC in different ways in regards to affect. The proclivity to use EAC may come with a resiliency that protects against stress and promotes general well-being.     

Relative Efficacy of Cognitive-Behavioral Therapy Administered by Videoconference for Posttraumatic Stress Disorder: A Six-Month Follow-Up

Until recently, only one study was published on cognitive-behavioral therapy (CBT) of posttraumatic stress disorder (PTSD) in individual therapy via videoconference (Germain, Marchand, Bouchard, Drouin, & Guay, 2009 Germain, V., Marchand, A., Bouchard, S., Drouin, M. S. and Guay, S. 2009. Effectiveness of cognitive behavioural therapy administered by videoconference for posttraumatic stress disorder. Cognitive Behaviour Therapy, 38: 42–53. [Taylor & Francis Online] , [Google Scholar]); however, it only assessed the posttreatment effect. This study presents the follow-up of Germain et al.'s (2009 Germain, V., Marchand, A., Bouchard, S., Drouin, M. S. and Guay, S. 2009. Effectiveness of cognitive behavioural therapy administered by videoconference for posttraumatic stress disorder. Cognitive Behaviour Therapy, 38: 42–53. [Taylor & Francis Online] , [Google Scholar]) study. The main goal was to compare the effectiveness after six months of CBT for PTSD either face-to-face (n = 24) or by videoconference (n = 12). Each participant received CBT for 16 to 25 weeks and completed various questionnaires before and after treatment and at a six-month follow-up. The two treatments had equivalent levels of symptom reduction (Modified PTSD Symptom Scale: η² < 0.01, p > .05) and proportion of patients with a clinically significant change in symptoms (42% for face-to-face vs. 38% for videoconferencing, p > .05). Thus, CBT for PTSD via videoconference seems to be a viable alternative when adequate face-to-face treatments are less available.     

Characterization of facial emotion recognition in bipolar disorder: Focus on emotion mislabelling and neutral expressions

Increasing evidence suggests that facial emotion recognition is impaired in bipolar disorder (BD). However, patient–control differences are small owing to ceiling effects on the tasks used to assess them. The extant literature is also limited by a relative absence of attention towards identifying patterns of emotion misattribution or understanding whether neutral faces are mislabelled in the same way as ones displaying emotion. We addressed these limitations by comparing facial emotion recognition performance in BD patients and healthy controls on a novel and challenging task. Thirty-four outpatients with BD I and 32 demographically matched healthy controls completed a facial emotion recognition task requiring the labelling of neutral and emotive faces displayed at low emotional intensities. Results indicated that BD patients were significantly less accurate at labelling faces than healthy controls, particularly if they displayed fear or neutral expressions. There were no between-group differences in response times or patterns of emotion mislabelling, with both groups confusing sad and neutral faces, although BD patients also mislabelled sad faces as angry. Task performance did not significantly correlate with mood symptom severity in the BD group. These findings suggest that facial emotion recognition impairments in BD extend to neutral face recognition. Emotion misattribution occurs in a similar, albeit exaggerated manner in patients with BD compared to healthy controls. Future behavioural and neuroimaging research should reconsider the use of neutral faces as baseline stimuli in their task designs.     

Persistent career indecision over time: Links with personality,barriers, self-efficacy,and life satisfaction

Taking control over one's career requires the ability to make career decisions; thus, remaining in a state of career indecision is problematic. However, the stability of career indecision has not yet been investigated using advanced statistical modeling approaches. We present two studies of German university students applying three-wave, longitudinal designs. Study 1 investigated the stability of career indecision by means of latent state-trait analysis within two samples with different time lags (Sample 1: N = 363, 7 weeks; Sample 2: N = 591, 6 months). The results indicated that career indecision was determined by a stable component (i.e., trait career indecisiveness) that was associated with lower core self-evaluations, lower occupational self-efficacy, and higher perceived career barriers. Study 2 (N = 469) examined career indecision over one year. We found that the stable career indecision component explained 5% of the variance in student life satisfaction beyond self-evaluated generalized indecisiveness.     

Parents' Emotion‐Related Beliefs,Behaviours, and Skills Predict Children's Recognition of Emotion

Children who are able to recognize others' emotions are successful in a variety of socioemotional domains, yet we know little about how school‐aged children's abilities develop, particularly in the family context. We hypothesized that children develop emotion recognition skill as a function of parents' own emotion‐related beliefs, behaviours, and skills. We examined parents' beliefs about the value of emotion and guidance of children's emotion, parents' emotion labelling and teaching behaviours, and parents' skill in recognizing children's emotions in relation to their school‐aged children's emotion recognition skills. Sixty‐nine parent–child dyads completed questionnaires, participated in dyadic laboratory tasks, and identified their own emotions and emotions felt by the other participant from videotaped segments. Regression analyses indicate that parents' beliefs, behaviours, and skills together account for 37% of the variance in child emotion recognition ability, even after controlling for parent and child expressive clarity. The findings suggest the importance of the family milieu in the development of children's emotion recognition skill in middle childhood and add to accumulating evidence suggesting important age‐related shifts in the relation between parental emotion socialization and child emotional development. Copyright © 2014 John Wiley & Sons, Ltd.     

The Promise and Pitfalls of Facebook Advertising: a Genetic Counselor’s Perspective

Facebook advertising is a powerful tool for increasing the outreach and recruitment of research participants. We describe our experience as genetic counselors within the context of an internet-based research study, recruiting subjects for a Parkinson disease (PD) biomarker study.     

Linking Formal Child Care Characteristics to Children’s Socioemotional Well-Being: A Comparative Perspective

Most research on formal child care and children’s outcomes has focused on single countries. We, however, contend that policy context may moderate the association between formal child care characteristics and children’s socioemotional well-being. We examined this by comparing the Netherlands, Finland and the UK; three countries that differ regarding family policies. Of these three countries, Finland was recently ranked highest (ranked 1st) with regards to quality of child care in a recent analysis by the Economist, followed by the UK (ranked 3rd) and then the Netherlands (ranked 7th). We hypothesized that children who attend child-care settings in countries with higher-quality formal child-care provision would generally show better socioemotional outcomes. Data from the comparative ‘Families 24/7’ survey were used, including 990 parents with children aged 0–12. We distinguished between two age groups in our analysis. Results indicated that, compared to the UK, longer hours in formal care were less beneficial in the Netherlands. Furthermore, spending time in formal care during nonstandard hours was more harmful for children in Finland compared to the UK. Lastly, receiving care from multiple caregivers was more disruptive for British children than for Dutch children. No differences were found between Finland and the Netherlands.