Television Viewing and Attentional Abilities in Fourth and Fifth Grade Children

To evaluate the common assumption that television viewing is related to attentional difficulties in school, 70 fourth and fifth grade students recorded a “television diary” for one week and reported their preferred television shows. Parents estimated their child's television viewing time and reported their child's preferred shows. Assessment of attentional difficulties included teacher ratings, parent ratings, standardized tests, and classroom observations. It was found that the amount of television a child viewed was significantly related to teacher ratings of attentional difficulties, but not to parent ratings, classroom observations or a standardized test. Type of shows viewed did not relate to any attentional outcome variable. There was a clear relationship between fourth and fifth grade children's ability to pay attention in school, as assessed by their teacher, and the amount of time they spent watching television.     

Cognitive-Behavior Therapy for Low Self-Esteem: A Case Example

Low self-esteem is a common, disabling, and distressing problem that has been shown to be involved in the etiology and maintenance of a range of Axis I disorders. Hence, it is a priority to develop effective treatments for low self-esteem. A cognitive-behavioral conceptualization of low self-esteem has been proposed and a cognitive-behavioral treatment (CBT) program described (Fennell, 1997, 1999). As yet there has been no systematic evaluation of this treatment with routine clinical populations. The current case report describes the assessment, formulation, and treatment of a patient with low self-esteem, depression, and anxiety symptoms. At the end of treatment (12 sessions over 6 months), and at 1-year follow-up, the treatment showed large effect sizes on measures of depression, anxiety, and self-esteem. The patient no longer met diagnostic criteria for any psychiatric disorder, and showed reliable and clinically significant change on all measures. As far as we are aware, there are no other published case studies of CBT for low self-esteem that report pre- and posttreatment evaluations, or follow-up data. Hence, this case provides an initial contribution to the evidence base for the efficacy of CBT for low self-esteem. However, further research is needed to confirm the efficacy of CBT for low self-esteem and to compare its efficacy and effectiveness to alternative treatments, including diagnosis-specific CBT protocols.     

Loneliness as a specific risk factor for depressive symptoms: cross-sectional and longitudinal analyses

The extent to which loneliness is a unique risk factor for depressive symptoms was determined in 2 population-based studies of middle-aged to older adults, and the possible causal influences between loneliness and depressive symptoms were examined longitudinally in the 2nd study. In Study 1, a nationally representative sample of persons aged 54 and older completed a telephone interview as part of a study of health and aging. Higher levels of loneliness were associated with more depressive symptoms, net of the effects of age, gender, ethnicity, education, income, marital status, social support, and perceived stress. In Study 2, detailed measures of loneliness, social support, perceived stress, hostility, and demographic characteristics were collected over a 3-year period from a population-based sample of adults ages 50-67 years from Cook County, Illinois. Loneliness was again associated with more depressive symptoms, net of demographic covariates, marital status, social support, hostility, and perceived stress. Latent variable growth models revealed reciprocal influences over time between loneliness and depressive symptomatology. These data suggest that loneliness and depressive symptomatology can act in a synergistic effect to diminish well-being in middle-aged and older adults.     

Adverse Childhood Experiences and Diabetes in Adulthood: Support for a Collaborative Approach to Primary Care

Prior studies have demonstrated an association between retrospective reports of experiencing trauma in childhood and the current incidence of type 2 diabetes in adulthood. Much less is known about this association among low-income minority patients in primary care settings. We replicated the adverse childhood experiences (ACEs) Centers for disease control and prevention (CDC) study with a low-income minority sample of primary care patients (N = 801) at a community-based healthcare center. We conducted a cross-sectional retrospective quantitative survey study to examine the association between participants’ reports of past childhood trauma and their current health care outcomes. Data were analyzed using binary logistic regression to evaluate the hypothesis that low income minority patients who reported more childhood trauma (abuse, neglect, household dysfunction, cumulative adverse childhood experiences [ACEs]) would more likely be diagnosed with type 2 diabetes. Results suggest that the number of ACEs in our sample were considerably higher than the original CDC ACEs study, as almost 50 % of patients surveyed at our clinic reported 4 or more ACEs, confirming that trauma is central in our urban primary care setting. The results of the cumulative ACEs score was in the expected direction and was significant, suggesting that participants who cumulatively reported experiencing more childhood trauma were more likely to be diagnosed with type 2 diabetes in adulthood. These findings have implications for family therapists, primary care providers, researchers, and policy makers to develop more collaborative approaches to primary care that better target the negative sequelae of ACEs.