Relationship Distress as a Mediator of Adverse Childhood Experiences and Health: Implications for Clinical Practice with Economically Vulnerable Racial and Ethnic Minorities

Adverse childhood experiences (ACE) are interpersonal sources of distress negatively correlated with physical and mental health, as well as maladaptive intimate partner conflict strategies in adulthood. Economically vulnerable racial and ethnic minorities report the greatest disparities in exposure to ACE, as well as relationship distress and health. Yet, little is known about the connections between ACE, relationship distress, and health. We therefore tested a theoretical model for the mediating role of relationship distress to explain the ACE‐health connection with a sample (N = 96) predominantly racial/ethnic minorities (87%) with low income. We applied partial least squares structural equation modeling with bootstrapping (N = 500). Relationship distress strengthened the predictive relationship between ACE and health, and accounted for 42% of the variance in health. The results provide preliminary support for relationship distress as a social determinant of health disparities with implications for interdisciplinary health intervention.     

In Our Lives and Under Our Skin: An Investigation of Specific Psychobiological Mediators Linking Family Relationships and Health Using the Biobehavioral Family Model

The objective of this study was to use the Biobehavioral Family Model (BBFM) to delineate which psychophysiological variables link romantic and family relationship satisfaction variables to health outcomes. Data from individuals who reported being partnered from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), Project 4 (n = 812) were used to test a structural equation model which explored which psychophysiological variables potentially mediated associations between positive and negative family emotional climate variables and disease activity. This model found that current and past family variables had larger associations with the psychophysiological variables than romantic partner variables; depressive symptoms, anxiety, and inflammation partially mediated associations between family relationships and health; and, contrary to the hypotheses, romantic partner and family support were linked to worse health outcomes. However, the findings should be viewed with regard to the cross‐sectional design of the study. Overall, the findings support the use of the BBFM as a model that can guide clinical interventions.     

The link between stress,well-being,and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

Background/Objective: Prolonged stress can overwhelm coping resources, leading people to seek mental health care. Acceptance and commitment therapy (ACT) is an intervention that enhances well-being and reduces distress, assumedly by means of increasing psychological flexibility (PF). We examined the association between a total increase in PF during an intervention and decreases in stress and increases in well-being during and after the intervention. Method: The intervention was a randomized controlled trial of an ACT-based self-help intervention. Participants were 91 individuals reporting elevated levels of work-related stress. Measurements were completed at preintervention, postintervention, and 3-month follow-up. Results: Structural equation models revealed that the total increase in PF during the intervention was negatively associated with a decrease in stress (b = -0.63, SE = 0.14, p < .001) and positively associated with an increase in well-being during the intervention (b = 0.48, SE = 0.11, p < .001), but not with a decrease in stress (b = 0.03, SE = 0.27, p > .05) and well-being (b = -0.04, SE = 0.39, p > .05) following the intervention. Conclusions: Our study provides empirical support for decreasing stress and promoting well-being through ACT and emphasizes the potential of PF in promoting well-being.     

Let's Talk About Race: Evaluating a College Interracial Discussion Group on Race

The authors evaluate Dialogues on Race, an interracial group intervention in which undergraduate student facilitators led conversations about race with their peers. The evaluation process is described, including developing collaborative relationships, identifying program goals, selecting measures, and analyzing and presenting results. The authors discuss lessons learned about evaluating an interracial dialogue intervention that did not originally include researchers in the hope that this examination will encourage others to evaluate similar campus interventions. Diálogos sobre Raza es una intervención de grupo interracial en la que estudiantes universitarios moderaron conversaciones sobre raza con sus compañeros. Se describe el proceso de evaluación, incluyendo el desarrollo de relaciones de colaboración, la identificación de objetivos del programa, la selección de medidas, y el análisis y presentación de los resultados. Los autores discuten las lecciones aprendidas sobre la evaluación de una intervención interracial dialogada que en principio no incluyó a investigadores con la esperanza de que este examen animará a otros a evaluar intervenciones similares en sus campus.     

CAREGIVER'S DEPRESSIVE SYMPTOMS AND YOUNG CHILDREN'S SOCIOEMOTIONAL DEVELOPMENT DELAYS: A CROSS‐SECTIONAL STUDY IN POOR RURAL AREAS OF CHINA

Poverty and its associated factors put people at risk for depression. The aims of this study were to describe the prevalence of depressive symptoms (DS) of primary caregivers and socioemotional development (SED) delays of young children in poor rural areas of China, and to explore the association between them. Cross‐sectional data of 2,664 children aged 3 to 35 months and their primary caregivers were used for analysis. Characteristics of the child, caregiver, and family were collected through face‐to‐face caregiver interviews. DS were assessed by the Zung Self‐Rating Depression Scale (W.W. Zung, 1965, as cited in World Health Organization, 2016b ), and SED was evaluated by the Ages and Stage Questionnaires: Social‐Emotional (J. Squires, D. Bricker, & L. Potter, 1997). The χ² test, stratification analysis, and logistic regression analyses were used to explore the association. Among the caregivers, 40.3% (95% confidence interval [CI] [38.4, 42.1]), reported DS. Caregivers who were male, older and ethnic minorities as well as had a low level of education, a low family income, or more children were more likely to have DS. Of the children, 24.4% (95% CI [22.8, 26.0]) were recognized with SED delays. Older children displayed more delays than did younger children, but no significant differences between males and females were found. SED delays were significantly associated with mother outmigrating, male caregivers, older age, ethnic minorities, and low education or families with a single parent, low‐income, and having more children. Caregivers having DS, odds ratio (OR) = 2.40, 95% CI [1.99, 2.88], was a significant predictor of increased odds of SED delays; other factors were single‐parent family, OR = 1.99, 95% CI [1.37, 2.89], inadequate care, OR = 1.69, 95% CI [1.30, 2.21], physical punishment, OR = 1.61, 95% CI [1.33, 1.95], ethnic minorities, OR = 1.41, 95% CI [1.17, 1.71], and child age in months, OR = 1.03, 95% CI [1.02, 1.04], according to the logistic regression analysis. DS are prevalent among caregivers with young children in poor rural areas. Interventions to improve the mental health of caregivers and their parenting behaviors are needed to improve children's SED.     

IGNORING CHILDREN'S BEDTIME CRYING: THE POWER OF WESTERN‐ORIENTED BELIEFS

Ignoring children's bedtime crying (ICBC) is an issue that polarizes parents as well as pediatricians. While most studies have focused on the effectiveness of sleep interventions, no study has yet questioned which parents use ICBC. Parents often find children's sleep difficulties to be very challenging, but factors such as the influence of Western approaches to infant care, stress, and sensitivity have not been analyzed in terms of ICBC. A sample of 586 parents completed a questionnaire to investigate the relationships between parental factors and the method of ICBC. Data were analyzed using structural equation modeling. Latent variables were used to measure parental stress (Parental Stress Scale; J.O. Berry & W.H. Jones, 1995), sensitivity (Situation‐Reaction‐Questionnaire; Y. Hänggi, K. Schweinberger, N. Gugger, & M. Perrez, 2010), Western‐oriented parental beliefs (Rigidity), and children's temperament (Parenting Stress Index; H. Tröster & R.R. Abidin). ICBC was used by 32.6% (n = 191) of parents in this study. Parents’ Western‐oriented beliefs predicted ICBC. Attitudes such as feeding a child on a time schedule and not carrying it out to prevent dependence were associated with letting the child cry to fall asleep. Low‐sensitivity parents as well as parents of children with a difficult temperament used ICBC more frequently. Path analysis shows that parental stress did not predict ICBC. The results suggest that ICBC has become part of Western childrearing tradition.     

Cultivating Resilience in Families Who Foster: Understanding How Families Cope and Adapt Over Time

Families who foster offer essential care for children and youth when their own parents are unable to provide for their safety and well‐being. Foster caregivers face many challenges including increased workload, emotional distress, and the difficulties associated with health and mental health problems that are more common in children in foster care. Despite these stressors, many families are able to sustain fostering while maintaining or enhancing functioning of their unit. This qualitative study applied an adaptational process model of family resilience that emerged in previous studies to examine narratives of persistent, long‐term, and multiple fostering experiences. Data corroborated previous research in two ways. Family resilience was again described as a transactional process of coping and adaptation that evolves over time. This process was cultivated through the activation of 10 family strengths that are important in different ways, during varied phases.     

Creating a Space for Acknowledgment and Generativity in Reflective Group Supervision

Small group supervision is a powerful venue for generative conversations because of the multiplicity of perspectives available and the potential for an appreciative audience to a practitioner's work. At the same time, the well‐intentioned reflections by a few practitioners in a room can inadvertently duplicate normative discourses that circulate in the wider culture and the profession. This article explores the use of narrative practices for benefiting from the advantages of group supervision while mindful of the vulnerability that comes with sharing one's work among colleagues. The reflective group supervision processes described were modified from the work of Tom Andersen and Michael White to provide a venue that encourages the creative multiplicity of group conversation while discouraging unhelpful discourses which constrain generative conversation.     

C. G. Jung and intuition: from the mindscape of the paranormal to the heart of psychology

Intuition is central in the work, practice, and philosophical legacy of C. G. Jung. In this paper, I will first discuss the importance of intuition for Jung in the paradigm usually designated the ‘paranormal’. Jung was attracted to intuition as an extra‐ordinary gift or function in the traditional sense, and this is considered here in relation to his 1896‐1899 Zofingia Lectures and 1902 On the Psychology and Pathology of So‐called Occult Phenomena: A Psychiatric Study. A significant development then occurred in 1913, when esotericist intuitions were turned toward psychological use with Jung's Red Book. There, his personal and private use of intuition – and we know how extraordinarily intuitive he was – led Jung to fully incorporate intuition at the core of his psychology. Not only in his practice, in the crucial intuitive form of empathy, but as we will see, also at the very heart of his theory. In 1921, Jung wrote Psychological Types, where intuition became one – the first – of the four fundamental functions and types of the psyche next to thinking, feeling, and sensation. In 1921, Jung proved to the world in rational argument that intuition was no longer a psychologist's hobby for table turning, but the most significant function of the psyche.     

Freud,Jung and The Great Chain of Being

For some time, it has been clear that psychoanalytic theories are built upon the kind of master narratives Roy Schafer, a New York psychoanalyst, described in 1980. As such, psychoanalytic theories may today have lost some of their initial scientific credibility in that they can no longer be seen as summarizing findings from data collected in a research environment. As aids in participating in their patients’ process of healing, however, narratives continue to be used by practitioners and reflect allegiance to core beliefs and propositions with roots in long‐standing Western thought. In this article, the metaphors in master narratives of Freud and Jung are compared with a conceptual system identified by cognitive linguists as ‘The Great Chain of Being’. Based on this analysis, the article proposes that theoretical formulations have mainly a secondary role to play in achieving good outcomes. The most critical element is the therapist's capacity to access a specific narrative for what transpires throughout each treatment.