Impairment in risk-sensitive decision-making in older suicide attempters with depression

Suicidal behavior is a potentially lethal complication of late-life depression. In younger adults, suicide has been linked to abnormal decision-making ability. Given that there are substantial age-related decreases in decision-making ability, and that older adults experience environmental stressors that require effective decision-making, we reasoned that impaired decision-making may be particularly relevant to suicidal behavior in the elderly. We thus compared performance on a probabilistic decision-making task that does not involve working memory ("Cambridge Gamble Task") in four groups of older adults: (1) individuals with major depression and a history of suicide attempt (n = 25), (2) individuals with major depression with active suicidal ideation but no suicide attempt (n = 13), (3) individuals with major depression without suicidality (n = 35), and (4) nondepressed control subjects (n = 22). There was a significant effect of group on quality of decision-making, whereby the suicide attempters exhibited poorer ability to choose the likely outcome, compared with the nonsuicidal depressed and nondepressed comparison subjects. There were no group differences in betting behavior. The suicide attempters differed in several aspects of social problem-solving on a self-report scale. Quality of decision-making was negatively correlated with the score on the impulsive/careless problem-solving subscale. These data suggest that older suicide attempters have a deficit in risk-sensitive decision-making, extending observations in younger adults. More specifically, older suicide attempters seem to neglect outcome probability and make poor choices. These impairments may precipitate and perpetuate suicidal crisis in depressed elders. Identification of decision-making impairment in suicidal elders may help with designing effective interventions.     

The Adaptation of Patients During the Hospitalization Period of Bone Marrow Transplantation

A longitudinally study was conducted among 42 bone marrow transplantation (BMT) patients to investigate the association between pretransplant psychosocial variables and psychophysiological outcomes during the immediate convalescence period. Family relationships (cohesion, expressiveness, and conflict) and coping resources (cognitive, social, emotional, spiritual/philosophical, and physical resources) were assessed on the admission day (Day –7 Time 1). Data on psychological distress and pain intensity were obtained on Day +7 (Time 2) and Day +14 (Time 3). The average scores at Times 2 and 3 were computed to indicate the overall adjustments of the patients during the hospitalization period after the day of actual transplant (Day 0). It was shown that higher expressiveness family relationships and higher resources to cope effectively with stressful situations were associated with less psychological distress during the above period. Both pretransplant psychosocial variables were not associated with pain intensity during hospitalization. Allogeneic transplant patients reported higher pain intensity than did autologous transplant patients. Psychological distress and pain intensity were positively correlated with each other. Our findings show that pretransplant family relationships and coping resources associate moderately with psychological distress during the immediate convalescent period of BMT. The present findings support the family-centered approach to BMT care and provide a scientific basis for pretransplant psychosocial interventions.     

Asian American-white American differences in expressions of social anxiety: a replication and extension

This study examined whether Asian American-White American differences on a trait measure of social anxiety extend to nonverbal behavior and to reports of anxiety-related emotions during a 3-min social performance task. Forty Asian Americans and 40 White Americans completed a trait measure of social anxiety and rated their emotions before, and immediately after, a social performance task. Their videotaped behavior was coded using microlevel behavioral codes (e.g., gaze avoidance, fidgeting). Results indicated that Asian Americans reported more anxiety than White Americans on the trait measure and on the emotion rating scales but that they did not differ substantially on microlevel behavioral indexes of social anxiety. Implications of ethnic variations in the patterns of anxious responding are discussed.     

Kunsttherapie in der Behandlung chronifizierter Schmerzpatienten

Integrated in the evaluation of an innovative concept of art therapy a questionnaire for the measurement of effects and progression of art therapy (FB-KT) was developed and evaluated. The study was performed as part of a multidisciplinary pain therapy on patients with somatization disorders at the day-care pain clinic of the University of Münster. It was a twelve month lasting study, which started in November 1998 and finished in November 1999. The dimensions of the questionnaire were defined by a sample testing of 108 people. To validate the scales of the FB-KT four relevant standardised instruments in pain therapy were used. The results show, that the quality criteria of the questionnaire can be described as satisfactory to excellent. The results further demonstrate that the FB-KT shows therapeutic effects in the dimensions of emotional experience just as clearly as other standardised instruments do. In addition, FB-KT gives informations about experiences during the therapy sessions.     

Flexible Work Arrangements Availability and their Relationship with Work‐to‐Family Conflict,Job Satisfaction,and Turnover Intentions: A Comparison of Three Country Clusters

The present study explored the availability of flexible work arrangements (FWA) and their relationship with manager outcomes of job satisfaction, turnover intentions, and work‐to‐family conflict (WFC) across country clusters. We used individualism and collectivism to explain differences in FWA availability across Latin American, Anglo, and Asian clusters. Managers from the Anglo cluster were more likely to report working in organisations that offer FWA compared to managers from other clusters. For Anglo managers, flextime was the only FWA that had significant favorable relationships with the outcome variables. For Latin Americans, part‐time work negatively related with turnover intentions and strain‐based WFC. For Asians, flextime was unrelated to time‐based WFC, and telecommuting was positively associated with strain‐based WFC. The clusters did not moderate the compressed work week and outcome relationships. Implications for practitioners adopting FWA practices across cultures are discussed.     

Entrepreneurship,professionalism, leadership: A framework and measure for understanding boundaryless careers

We propose a person-centered framework for conceptualizing subjective careers in an increasingly boundaryless work context. Specifically, we argue that entrepreneurship, professionalism, and leadership (EPL) can serve as three key dimensions of subjective career space. We relate this framework to earlier macro-level national and organizational career models proposed by Kanter (1989) and Schein (1978). Our empirical study involving 10,326 Singaporean university students demonstrated that entrepreneurial, professional, and leadership career aspirations (including motivations, efficacies, and intentions) can be measured independently, that these career dimensions are independent of vocational interests, and that they are to some degree viewed as competing career alternatives. We also show that EPL motivation profiles can operationalize the boundaryless and protean career concepts. Individuals concurrently high in entrepreneurial, professional, and leadership career motivations, and those high in entrepreneurial and leadership motivations are highest in boundaryless and self-directed career attitudes, while those primarily motivated for professional careers hold the most traditional career attitudes. We conclude by discussing the potential of the framework for understanding human resource issues at organizational and national levels and for enhancing the study of entrepreneurship, professionalism, and leadership.     

Progression along the bipolar spectrum: a longitudinal study of predictors of conversion from bipolar spectrum conditions to bipolar I and II disorders

Little longitudinal research has examined progression to more severe bipolar disorders in individuals with "soft" bipolar spectrum conditions. We examine rates and predictors of progression to bipolar I and II diagnoses in a nonpatient sample of college-age participants (n = 201) with high General Behavior Inventory scores and childhood or adolescent onset of "soft" bipolar spectrum disorders followed longitudinally for 4.5 years from the Longitudinal Investigation of Bipolar Spectrum (LIBS) project. Of 57 individuals with initial cyclothymia or bipolar disorder not otherwise specified (BiNOS) diagnoses, 42.1% progressed to a bipolar II diagnosis and 10.5% progressed to a bipolar I diagnosis. Of 144 individuals with initial bipolar II diagnoses, 17.4% progressed to a bipolar I diagnosis. Consistent with hypotheses derived from the clinical literature and the Behavioral Approach System (BAS) model of bipolar disorder, and controlling for relevant variables (length of follow-up, initial depressive and hypomanic symptoms, treatment-seeking, and family history), high BAS sensitivity (especially BAS Fun Seeking) predicted a greater likelihood of progression to bipolar II disorder, whereas early age of onset and high impulsivity predicted a greater likelihood of progression to bipolar I (high BAS sensitivity and Fun-Seeking also predicted progression to bipolar I when family history was not controlled). The interaction of high BAS and high Behavioral Inhibition System (BIS) sensitivities also predicted greater likelihood of progression to bipolar I. We discuss implications of the findings for the bipolar spectrum concept, the BAS model of bipolar disorder, and early intervention efforts.     

Effects of Parent Training on Callous-Unemotional Traits,Effortful Control,and Conduct Problems: Mediation by Parenting

Callous-unemotional (CU) traits and effortful control (EC) are personality and temperament traits implicated in early-onset antisocial trajectories. This secondary analysis of Hitkashrut’s randomized controlled trial first tested parent training’s effects on EC and CU traits while controlling for more general treatment effects on conduct problems (CP), and subsequently tested mediation by parenting. Prekindergarten teachers in three Israeli cities identified 209 3–5 year-old (163 boys; 46 girls) preschoolers with subclinical-clinical range conduct problems. All participants were Jewish ranging from ultra-orthodox to secular. They were assigned to 14-session co-parent training groups (n = 140 couples), or to minimal intervention control groups with referral to local services as necessary (n = 69 couples). We employed averaged indices of pre- and post-intervention questionnaires completed by both parents. The testing of all hypothesized models controlled for treatment effects on CP in order to strengthen the robustness of the analyses. We found significant concurrent treatment effects on CP and on either CU traits or EC. All effects were mediated by ineffective parenting (IP): a latent variable that was indicated by negative/inconsistent practices and perceived parenting inefficacy. This is the first demonstration of parenting mediated treatment effects on both EC and CU traits in a randomized controlled study conducted in everyday practice contexts. This finding supports a disruption model of change: the reduction of IP facilitates a caregiving environment that affects children’s behavior and developing personality. The changing of personality and temperament characteristics implicated in early-onset pathways suggests an innovative prevention strategy for disruptive behavior disorders.     

The Moderating Effects of Gratitude on the Association Between Perceived Parenting Styles and Suicidal Ideation

Suicidal ideation is defined as the thoughts about engaging in suicidal-related behaviors. Very few studies have been conducted on children’s suicidal ideation as there is a biased perception that suicidal behavior under the age of 12 is scarce. However, suicide is the leading cause of death among young children. Child suicidal ideation is predictive of suicidal ideation and suicide attempts in adulthood. Association between certain parenting styles and suicidal ideation have been found in empirical studies. However, little is known about the role of parenting and suicidal ideation in Chinese young children. We examined whether gratitude can reduce the risk of suicide by moderating the association between parenting styles and child suicidal ideation. We recruited 447 Chinese children (53.3% female; mean age?=?10.06, SD?=?1.76) to participate in a survey. Perceived parenting style (warmth/accepting, dominating, and autonomy granting), gratitude, and suicidal ideation were assessed using self-reported measures. We found that all three perceived parental styles were significantly associated with child suicidal ideation. Further, gratitude was found to have a significant moderating effect on suicidal ideation, across the analysis of the three perceived parenting styles. This suggests that gratitude may be adopted in preventive and clinical interventions so that children at risk can benefit from reducing the negative effects of ineffective parenting styles and suicidal ideation.     

When moderation is mediated and mediation is moderated

Procedures for examining whether treatment effects on an outcome are mediated and/or moderated have been well developed and are routinely applied. The mediation question focuses on the intervening mechanism that produces the treatment effect. The moderation question focuses on factors that affect the magnitude of the treatment effect. It is important to note that these two processes may be combined in informative ways, such that moderation is mediated or mediation is moderated. Although some prior literature has discussed these possibilities, their exact definitions and analytic procedures have not been completely articulated. The purpose of this article is to define precisely both mediated moderation and moderated mediation and provide analytic strategies for assessing each.