Self-reflecting in developmental context: variations in level and patterning during the first 2 university years

Self-reflection, typically operationalized in scales of egocentrism and introspectiveness, is portrayed as problematic in much of the literature on adolescents. Self-reflection has been linked to dysfunctional self-consciousness, symptomatology, and risk behaviors. Yet, self-reflection also is seen as essential for adolescent development, particularly with respect to individuation and identity. In this exploratory study, the authors focused on the process of self-reflecting. From interviews with 10 students conducted over the first 2 university years, the authors longitudinally assessed and then evaluated self-reflecting patterns in relationship to a narrative analysis of developmental change. Students who showed evidence of developmental change or sustained engagement in developmental work over the study period devoted a higher percentage of their interview conversation to self-reflecting content. Differences in self-reflecting patterning over time among the students who showed developmental change further suggest linkages between self-reflecting and development. The authors discuss implications for the conceptualization of self-reflecting in relationship to development and for the reinterpretation of previous studies.     

Separating From the Mothership: A Coordinated Individual and Parent-Based Approach to Severe Agoraphobia in a Young Adult

Families are invested in an older adolescent gradually separating from the family to live independently as an adult, but for many families, adolescent psychopathology makes this transition difficult. Addressing such psychopathology is critical in preventing “failure to launch,” a breakdown in gaining age-appropriate independence from parents. This case study illustrates a promising approach directed at helping an 18-year-old female with agoraphobia and panic disorder who, upon intake, was at risk for long-lasting, prohibitive dependence on her parents. The clinical approach entails the convergence of two psychological treatments conducted in the same treatment center. One provider, working directly with the patient, delivered traditional cognitive-behavioral therapy (CBT) for anxiety. A second provider, working with the parents, delivered Supportive Parenting for Anxious Childhood Emotions (SPACE) a parent-based treatment focused on reducing family accommodation of the patient’s anxiety. Behavioral indices and self-report scores indicated clinically significant improvement following the combined intervention. Attention is drawn to the convergence of those treatments and the utility and special considerations in taking this kind of approach. Overall, the combined treatment may have been more successful than the sum of its parts at preventing failure to launch. This case study, the first to describe the integration of CBT and SPACE, can provide useful guidance for clinicians helping families of adult children to transition to independence.     

Maternity Healthcare Chaplains and Perinatal Post-Mortem Support and Understanding in the United Kingdom and Ireland: An Exploratory Study

Journal of Religion and Health - Perinatal autopsy rates have declined significantly in recent decades. There is a lack of consensus concerning the potential religious influences for bereaved...     

A Qualitative Study Exploring the Causes of Boredom for Men with a Psychosis in a Forensic Setting

Boredom is a problem in forensic mental health settings and is believed to increase levels of violence and be detrimental to health and recovery. There were 8 men in a forensic unit, all diagnosed with a psychotic disorder, that were interviewed regarding their experiences of boredom. A thematic analysis was used to identify emergent themes. These included: Mental health and motivation; Restrictive environment; Responsibilities; and Nothing to do. These findings provide a greater understanding of factors which may contribute to boredom within forensic settings and can guide occupational therapy interventions to address them.     

Development and Content Validity of the Participation and Sensory Environment Questionnaire

Qualitative methodology was used to develop items for a questionnaire designed to examine the perspectives of parents regarding the impact of the sensory environment on participation for children aged 3 to 5 who have autism spectrum disorders. A total of 34 parents/caregivers of children with autism spectrum disorders and 8 experts in autism spectrum disorders and/or measurement completed qualitative interviews for concept, content review, and cognitive interviewing. The result was a pool of 35 items for home/community domains for 3 scales. The outcome of this study was the development and content validation of the Participation and Sensory Environment Questionnaire.     

Cigarette graphic warning labels increase both risk perceptions and smoking myth endorsement

Objective: Cigarette graphic warning labels elicit negative emotion, which increases risk perceptions through multiple processes. We examined whether this emotion simultaneously affects motivated cognitions like smoking myth endorsement (e.g. ‘exercise can undo the negative effects of smoking’) and perceptions of cigarette danger versus other products.

Design: 736 adult and 469 teen smokers/vulnerable smokers viewed one of three warning label types (text-only, low emotion graphic or high emotion graphic) four times over two weeks.

Main outcome measures: Emotional reactions to the warnings were reported during the first and fourth exposures. Participants reported how often they considered the warnings, smoking myth endorsement, risk perceptions and perceptions of cigarette danger relative to smokeless tobacco and electronic cigarettes.

Results: In structural equation models, emotional reactions influenced risk perceptions and smoking myth endorsement through two processes. Emotion acted as information about risk, directly increasing smoking risk perceptions and decreasing smoking myth endorsement. Emotion also acted as a spotlight, motivating consideration of the warning information. Warning consideration increased risk perceptions, but also increased smoking myth endorsement. Emotional reactions to warnings decreased perceptions of cigarette danger relative to other products.

Conclusions: Emotional reactions to cigarette warnings increase smoking risk perceptions, but also smoking myth endorsement and misperceptions that cigarettes are less dangerous than potentially harm-reducing tobacco products.     

Childhood problem behaviours as precursors of drinking to intoxication trajectories – from age 1.5 to 19

Objective: We examined behaviour problem precursors (i.e. internalising and externalising) in childhood (ages 1.5 to 8.5) and early adolescence (age 12.5) and consequences (i.e. harmful alcohol use) in emerging adulthood (age 19), of developmental trajectories of drinking to intoxication across adolescence (ages 14.5–19).

Design and outcome measures: Data from 921 children and their parents followed for 18 years from the population-based Tracking Opportunities and Problems (TOPP) Study were used to examine adolescent trajectories of drinking to intoxication. Logistic regression was used to examine predictors of trajectory group membership.

Results: We identified 3 trajectory classes: low / abstainer (41%), late onset high (31%) and early onset high (28%) using latent class analyses. Logistic regression analyses showed that childhood high externalising characterised early onset of intoxication vs. other classes, while early adolescence externalising discriminated both early and late onset of intoxication. High early childhood internalising characterised those consistently low or abstinent on alcohol intoxication, while early adolescent internalising characterised those having an early onset of intoxication. However, after additional adjustment for co-occurring externalising, there were no evidence for a link between early adolescent internalising and intoxication.

Conclusions: The findings suggest that both child and early adolescent-focused prevention efforts may be warranted.     

Perspectives on Healthcare Provider Well-Being: Looking Back,Moving Forward

Recognizing the impact of healthcare professional (HCP) burnout has led to vigorous interest from organizations and individuals regarding how to most effectively promote HCP well-being. The present paper reviews the literature on HCP well-being and describes factors that impact well-being at various levels (i.e., system, institution, program, interpersonal, and individual). We propose that change must occur at all levels to have the greatest impact. Further, we highlight opportunities to advance research on HCP well-being (e.g., being more inclusive regarding study populations and designing longitudinal intervention studies).     

Religious and non-religious predictors of life satisfaction in a sample of American college students

To promote understanding of young people behavioural mechanisms related to health, we evaluated religious attribution, meaning in life, and emotion regulation strategies as predictors of life satisfaction in the sample of 791 religious and non-religious American college students. Participants completed Religious Attribution Scale, Meaning in Life Questionnaire, Satisfaction with Life Scale, and the Emotion Regulation Questionnaire. A multiple linear regression revealed that the strongest predictor of life satisfaction for both groups was the presence of meaning in life, followed by the use of cognitive reappraisal. We found that participants with high levels of presence of meaning in life, regardless of their religious identity, were able to benefit from the use of cognitive reappraisal. Presence of meaning in life and emotion regulation strategy reside outside of the religious confines, supporting the notion that religiosity is not a singular meaning making system. By identifying constructs related to life satisfaction, we can acquire better understanding of what mechanisms contribute to positive coping strategies that religious and non-religious young adults use to achieve positive life outcomes.