Inequalities in Health and Intergenerational Equity

In the popular folklore three-score-years-and-ten is treated as a fair innings for people, and thereby serves as an informal reference point for judgements about distributive justice within a community. But length of life alone is an insufficient basis for such judgements - a person's health-related quality-of-life also needs to be taken into account. If one of the objectives of public policy is to reduce inequalities in lifetime health, it will be demonstrated that this is very likely to require systematic discrimination against the older members of a community. The notion of community solidatity will also be tested, because a decision will need to be made as to whether the same fair innings applies to all members of the community, or whether some are entitled to more than others. The strength of the fair innings principle is that it brings these issues to the fore in a systematic way which should ais their resolition in a practical context.     

Infant responses to adult happy and sad vocal and facial expressions during face-to-face interactions

We examined 5-month-olds’ responses to adult facial versus vocal displays of happy and sad expressions during face-to-face social interactions in three experiments. Infants interacted with adults in either happy-sad-happy or happy-happy-happy sequences. Across experiments, either facial expressions were present while presence/absence of vocal expressions was manipulated or visual access to facial expressions was blocked but vocal expressions were present throughout. Both visual attention and infant affect were recorded. Although infants looked more when vocal expressions were present, they smiled significantly more to happy than to sad facial expressions regardless of presence or absence of the voice. In contrast, infants showed no evidence of differential responding to voices when faces were obscured; their smiling and visual attention simply declined over time. These results extend findings from non-social contexts to social interactions and also indicate that infants may require facial expressions to be present to discriminate among adult vocal expressions of affect.     

Reducing reactive aggression in schoolchildren through child,parent, and conjoint parent‐child group interventions: An efficacy study of longitudinal outcomes

This study was the first to evaluate the effectiveness of three different group interventions to reduce children's reactive aggression based on the social information processing (SIP) model. In the first stage of screening, 3,734 children of Grades 4–6 completed the Reactive–Proactive Aggression Questionnaire (RPQ) to assess their reactive and proactive aggression. Respondents with a total score of z ≥ 1 on the RPQ were shortlisted for the second stage of screening by qualitative interview. Interviews with 475 children were conducted to select those who showed reactive aggression featuring a hostile attributional bias. Finally, 126 children (97 males and 29 females) aged 8 to 14 (M = 9.71, SD = 1.23) were selected and randomly assigned to one of the three groups: a child group, a parent group, and a parent–child group. A significant Time × Intervention effect was found for general and reactive aggression. The parent–child group and child group showed a significant drop in general aggression and reactive aggression from posttest to 6‐month follow‐up, after controlling for baseline scores, sex, and age. However, the parent group showed no treatment effect: reactive aggression scores were significantly higher than those in the child group at 6‐month follow‐up. This study has provided strong evidence that children with reactive aggression need direct and specific treatment to reconstruct the steps of the SIP involving the selection and interpretation of cues. The intervention could help to prevent severe violent crimes at the later stage of a reactive aggressor.     

Stepfamilies Doing Family: A Meta‐Ethnography

The present review examines how stepfamily members without a shared history co‐construct a shared family identity and what family processes are relevant in this stepfamily formation. Three databases (Web of Science, PsycInfo, and ProQuest) were systematically searched, resulting in 20 included qualitative studies. The meta‐ethnography approach of Noblit and Hare allowed synthesizing these qualitative studies and constructing a comprehensive framework of stepfamilies doing family. Three interdependent family tasks were identified: (a) honoring the past, (b) marking the present, and (c) investing in the future. Stepfamily members’ experiences of these family tasks are strongly affected by the dominant societal perspectives and characterized by an underlying dialectical tension between wanting to be like a first‐time family and feeling the differences in their family structure at the same time. These findings clearly demonstrate the family work that all stepfamily members undertake and provide a broader context for interpreting stepfamilies’ co‐construction of a new family identity.     

Recruitment and Retention of Low‐SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood

Low‐SES couples have limited resources to manage the chronic and acute stressors with which they are disproportionately faced. Although these couples are at greater risk for negative individual and relationship outcomes, evaluations of the impact of couple relationship education (CRE) in low‐SES couples have been plagued by methodological problems, most notably challenges associated with recruitment and retention. We review the literature on challenges couples face associated with low‐SES, as well as on recruitment, retention, and CRE in low‐SES, ethnic minority populations. We illustrate some of these challenges in a case study of CRE for low‐SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited from a community health clinic and randomized to either an experimental treatment condition (EXP; N = 11) or a treatment‐as‐usual control condition (TAU; N = 10). This study sought to mitigate documented challenges with recruitment and retention: We leveraged community partnerships, attempted to build and maintain strong relationships with study participants, provided incentives for assessments as well as intervention meetings, and attempted to reduce potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment and retention. We integrate these findings and experiences with our review of previous work in this area. We make recommendations for future CRE research and practice that have potential implications for public policy in this area.     

Anger Can Help: A Transactional Model and Three Pathways of the Experience and Expression of Anger

Anger is a significant human emotion with far‐reaching implications for individuals and relationships. We propose a transactional model of anger that highlights its relational relevance and potentially positive function, in addition to problematic malformations. By evolutionary design, physical, self‐concept, or attachment threats all similarly trigger diffuse physiological arousal, psychologically experienced as anger‐emotion. Anger is first a signaling and motivational system. Anger is then formed to affirming, productive use or malformed to destructive ends. A functional, prosocial approach to anger organizes it for protective and corrective personal and relational adaptation. In our model, threat perception interacts with a person's view of self in relation to other to produce helpful or harmful anger. Inflated or collapsed views of self in relation to other produce distinct manifestations of destructive anger that are harmful to self, other, and relationship. Conversely, a balanced view of self in relation to other promotes constructive anger and catalyzes self, other, and relationship healing. Clinical use of the model to shape healing personal and relational contact with anger is explored.     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Disrupted narrative and narrative symbol

In this article a specific type of narrative, which often appears in analytic sessions, is discussed. It is characterized by a seemingly ordinary, everyday topic and by a peculiar disruption of the narrative flow. The threefold structure of this type of narrative is described, along with its main characteristics. One element of this type of narrative is very similar to symbolic content or complex symbolic structures, e.g. dreams, the sort of material that can be used for the purpose of interpretation. The similarities as well as the differences are elaborated in the article. Thanks to the observed general structure and ‘symbolic’ nature of some parts of the narrative, it is easy to notice some of the unconscious elements, which are not familiar to the patient's ego, and to make an interpretation. Because these elements are close to the threshold of consciousness, the patient willingly accepts an interpretation based on them. This is especially true for patients whose dominant function is thinking. A temporary, working name for this type of narrative is proposed in the article: ‘disrupted narrative’ ? and for its disruptive part ‘narrative symbol’.     

On matters of mind and body: regarding Descartes

In this paper the author considers Descartes’ place in current thinking about the mind‐body dilemma. The premise here is that in the history of ideas, the questions posed can be as significant as the answers acquired. Descartes’ paramount question was ‘How do we determine certainty?’ and his pursuit of an answer led to cogito ergo sum. His discovery simultaneously raised the question whether mind is separate from or unified with the body. Some who currently hold that brain and subjectivity are unified contend that the philosopher ‘split’ mind from body and refer to ‘Descartes’ error’. This paper puts forward that Descartes’ detractors fail to recognise Descartes’ contribution to Western thought, which was to introduce the Enlightenment and to give a place to human subjectivity. Added to this, evidence from Descartes’ correspondence with Princess Elisabeth of Bohemia supports the conclusion that Descartes did in fact believe in the unity of mind and body although he could not reconcile this rationally with the certainty from personal experience that they were separate substances. In this Descartes was engaged in just the same dilemma as that of current thinkers and researchers, a conflict which still is yet to be resolved.