Ethical Issues and At-Risk Behaviors in Marriage and Family Therapy: A Qualitative Study of Awareness

This exploratory study investigated perceptions of and relationship with professional ethics of therapists-in-training. A focus group of marriage and family therapy doctoral students explored self-awareness and at-risk behaviors regarding ethical competence and compliance. A grounded theory analysis of data is presented as a conditional matrix, which offers a theory of development between therapists and their perception of ethics. The Practitioner-Relationship Ethics Model represents findings of interaction between confidence in ethical principles, field experience, use of justification, and at-risk behaviors. Implications and limitations of these findings are presented, as are suggestions for research.     

Husbands' and Wives' Attachment Orientations and Depressive Symptoms: Predictors of Positive and Negative Conflict Behaviors in the Marriage

The present study examined both husbands' and wives' attachment orientations and depressive symptoms in predicting reports of marital conflict behaviors. Married couples (N = 60) completed questionnaires to assess their attachment orientations, depressive symptoms, and perceptions of positive and negative conflict behaviors in the marital relationship. Using hierarchical regression analyses, statistical models were tested wherein husbands' and wives' reports of marital conflict behaviors were regressed on their own and their spouses' attachment orientations and depressive symptoms. The results suggest that both attachment orientations and depressive symptoms were important predictors of reported marital conflict behaviors. However, different predictors were found for husbands' and wives' reports of positive and negative conflict behaviors. In general, spouses' attributes played only a small role in predicting reports of marital conflict behaviors.     

A Mediated-Moderation Model of Maternal Parenting Style,Association with Deviant Peers,and Problem Behaviors in Urban African American and European American Adolescents

We examined a model positing that association with deviant peers mediates the relation between perceived maternal parenting style, represented by the dimensions demandingness, responsiveness, and their interaction, and problem behaviors in an urban sample of 82 African American and 56 European American young adolescents. Regression analyses revealed that the data are consistent with a model where association with deviant peers mediates the relation between maternal responsiveness and problem behaviors for European Americans and African American males. In addition, a responsiveness by demandingness interaction was found for European Americans. Only the relation between association with deviant peers and problem behaviors was supported for African American females. The results suggest that ethnic and gender variables might interact with pathways from parenting to association with deviant peers and problem behaviors and that the dimensions of parenting might not be equal in their salience.     

Psychological Adjustment and Knowledge About Hereditary Hemochromatosis in a Clinic-Based Sample: A Prospective Study

This study assessed psychological adjustment and quality of life relative to population-based norms and knowledge about hereditary hemochromatosis in a sample of 101 patients who attended a hemochromatosis clinic. Participants were assessed prior to their clinic visit, and two weeks and 12 months after attendance, using self-administered questionnaires. Mean Mental Health Component Scores from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (45.3, 95% CI 43.2, 47.4) were as compromised as those found amongst stroke victims (45.9, 95% CI 42.8, 49.0) who had participated in a national health survey. Recall of the genetic testing result was less than optimal, in that only 69.3% of those with genetic testing results knew whether they carried one or two mutations. This study demonstrates that patients would benefit from routine assessment of psychological distress and referral to mental health professionals of those whose levels of distress suggest a need for clinical intervention. Results also show that patients may benefit from strategies aimed at improving recall of genetic testing results.     

The effects of safety-seeking behavior and guided threat reappraisal on fear reduction during exposure: an experimental investigation

We examined the effects of safety-seeking behavior and guided threat focus and reappraisal on fear reduction during exposure. Participants (N=46) displaying marked claustrophobic fear were randomized to one of three 30-min exposure conditions: (a) guided threat focus and reappraisal; (b) safety-behavior utilization; or (c) exposure only control. Tripartite outcome assessments during a behavioral approach test, along with measures of suffocation and restriction fears were obtained at pre- and post-treatment, and at a 2-week follow-up. Treatment process measures were collected throughout treatment and consisted of indices of fear activation; within and between-trial fear habituation; and suffocation and entrapment expectancies. Measures of safety behavior utilization and attentional focus were also collected to assess the integrity of the experimental manipulations. Consistent with prediction, those encouraged to utilize safety-behaviors during exposure showed significantly more fear at post-treatment and follow-up relative to those encouraged to focus and reevaluate their core threat(s) during exposure. Moreover, growth curve analyses of treatment process data analyses revealed that safety-behavior utilization exerted a detrimental effect on between-trial habituation; whereas guided threat reappraisal enhanced between-trial habituation.     

Influences on the Food Choice Behaviors of Adults With Severe Mental Illness

The objective of this research was to gain a deeper understanding of factors influencing the healthiness of food choice behaviors of community-dwelling adults with severe mental illness. Semi-structured interviews were conducted in an outpatient treatment facility with 20 program participants and 10 staff. Grounded theory analysis methods were used. Five dominant themes emerged: food availability, preference for simple food preparation, perceived cost of food, complexity of choice, and relative importance of healthy food choices. The theme of medication effects only emerged from staff interviews. This research can be useful to inform the design of nutrition interventions for this population.     

The Contribution of the Dyadic Parent-Child Interaction Coding System (DPICS) Warm-Up Segments in Assessing Parent-Child Interactions

This study evaluated the inclusion of uncoded segments in the Dyadic Parent-Child Interaction Coding System, an analogue observation of parent-child interactions. The relationships between warm-up and coded segments were assessed, as well as the segments’ associations with parent ratings of parent and child behaviors. Sixty-nine non-referred parent-child dyads engaged in the observation. Parents completed measures about their parenting and children's behaviors. Significant differences were observed between the first situation's warm-up and coded segments, whereas minimal differences were found for the second situation. Findings suggest that the second warm-up segment may not be necessary for optimal assessment of parent-child interactions.     

Effectiveness of Child-Directed Interaction Training for Young Japanese Children With Autism Spectrum Disorders

Abstract

This study examined the efficacy of Child-Directed Interaction Training (CDIT), the first phase of Parent-Child Interaction Therapy (PCIT), for Japanese children with autism spectrum disorders. The participants were 21 mother-child dyads with children aged 4–7 years; participants were assigned to an Immediate Treatment (IT) group or to a Waitlist (WL) control group. Across eight training sessions, mothers learned positive attention skills that were adapted from traditional PCIT training. Results showed CDIT not only improved social cognition skills and decreased disruptive behavior in Japanese children, but also reduced stress/distress among their mothers, particularly in relation to their own parenting skills and their child’s problem behaviors.     

Psychosocial correlates of emotional distress and risk behavior in african-american women at risk for hiv infection

We examined a model of stress and coping in 749 African-American women at risk for HIV infection. Women in the sample were either homeless, intravenous drug users (IVDUs) sexual partners of IVDUs, or prostitutes. A model was hypothesized based on stress and coping theory and research. Antecedents studied were personal resources, specifically self-esteem and available support. Mediators were threat appraisal and coping efforts. Outcomes studied were emotional distress and HIV risk behaviors. Structural equation modeling techniques were used to test hypothesized pathways between these variables. Forty-five percent of the variance in emotional distress in these women was explained by the model with self-esteem and avoidant coping the strongest predictors. Ten percent of the variance in risk behavior was explained by the model with emotional distress the strongest predictor. Direct and indirect pathways predicting risk behavior and distress are discussed. Implications of results for intervention and theory building are considered.     

School-Wide Discipline and Classroom Ecology

Abstract

Shortages of teachers with specialized skills, coupled with increased difficulty accommodating students with problem behaviors in general education classrooms, create pressures for performance and accountability in schools and with respect to teachers. Matters become increasingly problematic by initiatives that stress high academic competence, high graduation rates, and high performance standards. In addition, heightened cultural and linguistic diversity, diminished public satisfaction, and increased violence and disruptive behavior at school levels suggest a need for effective, easy-to-implement discipline procedures. In this investigation, we describe improvements in classroom ecology after implementation of a school-wide discipline model. These outcomes were positive and provide support for continuing efforts to improve discipline within the schools.