Age of avatar modulates the altercentric bias in a visual perspective-taking task: ERP and behavioral evidence

Despite being able to rapidly and accurately infer their own and other peoples’ visual perspectives, healthy adults experience difficulty ignoring the irrelevant perspective when the two perspectives are in conflict; they experience egocentric and altercentric interference. We examine for the first time how the age of an observed person (adult vs. child avatar) influences adults’ visual perspective-taking, particularly the degree to which they experience interference from their own or the other person’s perspective. Participants completed the avatar visual perspective-taking task, in which they verified the number of discs in a visual scene according to either their own or an on-screen avatar’s perspective (Experiments 1 and 2) or only from their own perspective (Experiment 3), where the two perspectives could be consistent or in conflict. Age of avatar was manipulated between (Experiment 1) or within (Experiments 2 and 3) participants, and interference was assessed using behavioral (Experiments 1–3) and ERP (Experiment 1) measures. Results revealed that altercentric interference is reduced or eliminated when a child avatar was present, suggesting that adults do not automatically compute a child avatar’s perspective. We attribute this pattern to either enhanced visual processing for own-age others or an inference on reduced mental awareness in younger children. The findings argue against a purely attentional basis for the altercentric effect, and instead support an account where both mentalising and directional processes modulate automatic visual perspective-taking, and perspective-taking effects are strongly influenced by experimental context.     

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding,Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS?, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS? report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS? reports were released to 14 families (N?=?28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N?=?24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS? reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS? report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).     

Utilization of the Tablet Application Proband in Pedigree Construction and Assessment

Many medical institutions have converted to a digital model for record keeping due to the Health Information Technology for Economic and Clinical Health Act. This Act provides incentives to health care systems to accelerate and encourage the adoption of electronic health record (EHR) systems. The pedigree as a tool in medicine provides an efficient method to assess and represent an individual’s health and family health risks that may otherwise not be apparent in the medical record in a clearly identifiable way (Schuette, J. L., & Bennett 2009). Many clinicians continue to construct pedigrees using pen and paper method despite findings of improved identification of at risk patients with similar electronic intake tools (Arar et al. in Personalized Medicine 2011 8:523–32). The goal of this study was to explore the patient and practitioner experience with electronic pedigree programs using Proband, an application developed at The Children’s Hospital of Philadelphia for genetic counselors to construct pedigrees during genetic counseling sessions directly on iPads. The first part of this study looked at the patient experience and assessed time to take the pedigree and the impact of using an electronic pedigree tool on the relationship between participant and genetic counselor. This involved 50 participants and was compared with the traditional paper method of taking a pedigree. There was no statistical significance found between the two different mediums in accuracy, speed, and rapport with provider. The second part of the study assessed the usability of Proband by ten genetic counselors. Overall, the application received a system usability score of 90/100 with a majority (7/10) of counselors agreeing that they would use this application in their clinic. The positive outcome of this study encourages future work to assess the impact and usability of programs on a larger scale as they continue to integrate into current electronic health records.     

The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.     

From Application to Approach: A Systematic Review of 50 Years of Psychoanalytic Couple Therapy

ABSTRACT

This systematic review of contributions to peer-reviewed journals in the area of couple interventions aims to provide a comprehensive and intensive overview of this evolving field, within psychoanalysis. Using a pan theoretical systematic review methodology, 113 peer-reviewed journal articles were reviewed, dated between 1963 and 2014, addressing the topic of couple therapy and psychoanalysis. This article addresses a number of specific questions including, where authors have published their work, what methodologies they have used, with which couples psychoanalysts have been working, how writers from within different theoretical orientations talk about their work with couples, and how the field has changed over time. It also explores emerging themes of the relationship between couple and individual therapy, sex, and co-therapy. This review of writing over the past 50 years suggests that although Classical contributions have waned over time, couple psychoanalysts from within Object Relations, Self Psychology, Intersubjectivity, and Relational orientations have evolved in their discourse about couple distress, from an application of psychoanalytic concepts to full-bodied, well-articulated, clear, and concise approaches to diagnosis and treatment. The first 50 years of writing in the field of couple psychoanalysis has brought us distinct treatment models, which have opened the door for greater communication and sharing within and between orientations.     

Cognitive reappraisal reduces perceived exertion during endurance exercise

Emotion regulation may influence psychological responses to exercise. We examined whether the emotion regulation strategies, cognitive reappraisal and distraction, influenced psychological state and prefrontal cortex oxygenation during endurance exercise. Twenty-four endurance runners ran for 90 min at 75–85% maximum heart rate in three separate sessions with no instruction or with instructions to use cognitive reappraisal or distraction. Participants rated their emotional arousal, emotional valence, and perceived exertion before, every 30 min during, and after exercise. Functional near-infrared spectroscopy quantified changes in prefrontal cortex oxygenation. Participants felt lower emotional arousal and physical exertion when instructed to utilize cognitive reappraisal than when given no emotion regulation instruction. Such responses to distraction did not differ from the other conditions. Emotion regulation strategies did not influence emotional valence or prefrontal cortex oxygenation. Participants’ analytical interpretation of the cognitive reappraisal instruction could contribute to small effect sizes and limited effects. Further research should determine contexts under which emotion regulation strategies most benefit endurance exercise experience.     

Measuring Anhedonia in Adolescents: A Psychometric Analysis

Anhedonia—the reduced capacity to experience pleasure—is a trait implicated in mental and physical health. Yet, psychometric data on anhedonia measures in adolescents are absent. We conducted an in-depth psychometric analysis of the Snaith–Hamilton Pleasure Scale (SHAPS; Snaith et al., 1995 Snaith, R. P., Hamilton, M., Morley, S., Humayan, A., Hargreaves, D., & Trigwell, P. (1995). A scale for the assessment of hedonic tone: The Snaith–Hamilton Pleasure Scale. British Journal of Psychiatry, 167, 99–103. doi:10.1192/bjp.167.1.99[Crossref], [PubMed], [Web of Science ®] , [Google Scholar])—a self-report measure of anticipated pleasure response to 14 pleasant experiences—in adolescents. Adolescents (N = 585, M age = 14.5) completed the SHAPS and other paper-and-pencil surveys. Item response theory models were used to evaluate the psychometric performance of each SHAPS item. Correlations of the SHAPS with other personality and psychopathology measures were calculated to evaluate construct validity. Results showed that (a) certain items (e.g., reported pleasure from basic experiences like “seeing smiling faces” or “smelling flowers”) provided more information about latent anhedonia than others; and (b) SHAPS scales exhibited construct-consistent convergent and discriminant validity (i.e., stronger correlations with low positive affect constructs, weaker correlations with negative affect). Reporting diminished pleasure from basic pleasant experiences accurately indicates adolescent anhedonia, which is important for future scale development and understanding the phenomenology of anhedonia in teens. These data support using the SHAPS for assessing anhedonia in epidemiological research and school-based universal prevention programming in general adolescent populations.     

Mental Health Utilization Among Diverse Parenting Young Couples

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social–personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor–Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow‐up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse’s influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.