Targeted Prevention of Childhood Anxiety: Engaging Parents in an Underserved Community

Selective prevention programs hold the promise of alleviating child anxiety symptoms, decreasing the risk for emotional problems across the lifespan. Such programs have particular public health import for young children of poor, underserved communities. Identifying factors related to parent engagement, and methods to improve engagement, are paramount in the effort to develop anxiety‐focused, community prevention programs. This feasibility study investigated the effect of an enhanced recruitment strategy to maximize parent engagement, as well as factors related to attendance in a single session focused on anxiety prevention. Participants were poor, ethnic minority parents of children aged 11–71 months (n = 256) who completed a survey that assessed anxiety risk according to trauma exposure, child anxiety, or parent anxiety, as well as preferences for preventive services (phase 1). Those meeting risk criteria (n = 101) were invited to a preventive group session (phase 2). Half of parents received enhanced recruitment (ER), which included personalized outreach, matching parent preferences, and community endorsement. Other parents were invited by mail. Chi square analyses indicated that ER was associated with planning to attend (49 vs. 6 % of control). Parents receiving ER were 3.5 times more likely to attend. Higher sociodemographic risk was correlated with higher child anxiety symptoms but not attendance. Results highlight the need for improved strategies for engaging parents in preventive, community‐based interventions.     

Emotion comprehension and attachment: A conversational intervention with school-aged children

IntroductionAs part of the flourishing line of enquiry into children's emotion understanding, we report the results of a conversation-based intervention study aimed at improving participants’ emotion comprehension, and exploring the intervention effect as a function of attachment security.MethodThe study was conducted at school with the participation of 98 second-grade children (mean age: 7 years, 7 months; SD: 3.4 months). Participants were assigned to experimental and control groups that were balanced with respect to attachment security and insecurity as evaluated using the Separation Anxiety Test (SAT). The experimental group was exposed to a conversational intervention, in which short story readings with emotional content were used to stimulate discussion on the nature, causes and regulation of emotion. The children in the control group listened to the same stories, but did not take part in the conversational activity. Children from both groups were individually pre- and post-tested on measures of emotional lexicon (ELT) and emotion comprehension (TEC).ResultsThe training was found to have a significant effect on the emotion comprehension of the children allocated to the experimental group. In addition, non-secure children displayed higher gains in emotion comprehension than secure participants. The implications of the findings for educational and school contexts are discussed.     

Memory flexibility training for autobiographical memory as an intervention for maintaining social and mental well-being in older adults

Autobiographical memory specificity (AMS) reduces with increasing age and is associated with depression, social problem-solving and functional limitations. However, ability to switch between general and specific, as well as between positive and negative retrieval, may be more important for the strategic use of autobiographical information in everyday life. Ability to switch between retrieval modes is likely to rely on aspects of executive function. We propose that age-related deficits in cognitive flexibility impair AMS, but the “positivity effect” protects positively valenced memories from impaired specificity. A training programme to improve the ability to flexibly retrieve different types of memories in depressed adults (MemFlex) was examined in non-depressed older adults to determine effects on AMS, valence and the executive functions underlying cognitive flexibility. Thirty-nine participants aged 70+ (MemFlex, n?=?20; control, n?=?19) took part. AMS and the inhibition aspect of executive function improved in both groups, suggesting these abilities are amenable to change, although not differentially affected by this type of training. Lower baseline inhibition scores correlated with increased negative, but not positive AMS, suggesting that positive AMS is an automatic process in older adults. Changes in AMS correlated with changes in social problem-solving, emphasising the usefulness of AMs in a social environment.     

Development and Open Trial of a Depression Preventive Intervention for Adolescents With Attention-Deficit/Hyperactivity Disorder

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for experiencing unipolar depressive symptoms and disorders. The current study describes the development of a behaviorally oriented depression preventive intervention tailored for adolescents with ADHD targeting variables empirically shown to mediate ADHD and depression (i.e., reward responsivity, emotion regulation, and family support). Eight adolescents with a history of ADHD and currently elevated depressive symptoms and their parents participated in an open trial of the Behaviorally Enhancing Adolescents’ Mood (BEAM) program. Adolescents and their parents reported high satisfaction with BEAM. Staff reported BEAM was easy to implement with high adherence. Following BEAM, there were significant reductions in parent-report of adolescents’ depressive symptoms and emotion regulation at posttreatment and the 6-week follow-up and adolescent-report of reward responsivity at posttreatment. Case vignettes are also provided to illustrate implementation of the BEAM program. In spite of the small sample, lack of a control group, and some discrepancies across informants, results overall support the feasibility and acceptability of the BEAM program, and suggest it has promise in reducing depressive symptoms in adolescents with ADHD.     

The Development of a Brief Distress Reduction Intervention for Individuals Recently Diagnosed With HIV in China

In China, where there are few mental health resources, the majority of HIV-related efforts have focused on medical treatment and transmission prevention rather than psychosocial support. Yet people living with HIV/AIDS (PLWHA) report high levels of psychological distress, especially upon first receiving their HIV diagnosis. We conducted mixed methods research of a qualitative study with (N = 31) individual interviews and 3 focus groups (n = 6 in each group) of HIV-affected participants, and a quantitative survey (N = 200) with individuals living with HIV in Shanghai and Beijing, China. Our qualitative data revealed themes of forms of distress experienced and types of psychosocial support that our participants wished they could have accessed upon diagnosis as well as suggestions for intervention structure that would be most feasible and acceptable. Our quantitative surveys provided further evidence of the high degree of psychosocial distress among recently diagnosed PLWHA. Our findings informed the development of the Psychology Toolbox intervention, a brief CBT skills-based intervention comprising cognitive restructuring, behavioral activation, and paced breathing, designed to be integrated into primary care for recently diagnosed PLWHA. This study describes the intervention development process and contents of each session. Future research should evaluate the intervention for efficacy as well as examine best strategies for eventual implementation and dissemination.     

Adult Male Perpetrators’ Perspectives on What Prevention Approaches Work Best for Young Boys at Risk of Future Intimate Partner Violence Perpetration

As part of a 2-year ethnographic study, 49 adult men who had been convicted of intimate partner violence (IPV) perpetration were interviewed on what they thought would have prevented them from engaging in perpetration behaviors, or rather what they believed prevention with young boys needed to include in order to prevent future IPV perpetration. The authors’ open-ended interviews yielded five main themes: (a) messages about healthy relationship behaviors, (b) the need to promote respect for women, (c) teaching effective skills for communicating and managing anger, (d) programs that provide role models and are school-based, and (e) addressing the impact of experiencing violence as a child. The authors conclude that prevention efforts focused on changing both attitudes regarding IPV and behaviors might be most effective for reducing perpetration, and that greater attention needs to be paid towards prevention among youth most at risk of IPV perpetration, those experiencing violence in their homes.     

Being transformed: Delivering a psychotherapeutic group intervention targeting repeat suicide attempts

Clients who make repeat suicide attempts have complex needs, are at high risk of completed suicide and pose a range of challenges for clinicians. Targeted interventions are required. Acceptability, the perceived appropriateness of an intervention, is associated with successful implementation, engagement and effectiveness of interventions. Despite the advantages of group interventions, there is limited research into the acceptability of groups with this population. Using Interpretative Phenomenological Analysis, this paper reports on facilitators’ experiences (n = 9) of the acceptability of a therapeutic group intervention (PISA – a Psychoeducational/psychosocial Intervention for persons who make recurrent Suicide Attempts). Analysis of focus group data revealed how involvement with the intervention profoundly influenced facilitators’ perceptions of and approach to their work with this client group. They embraced the model, developed a deeper appreciation of clients’ resources and became unburdened from sole responsibility for the clients, the therapeutic process and outcomes. PISA provided a model that helped facilitators to work in a focused, compassionate and creative manner as they addressed the central concern of these clients, their suicidal desire, with newly found confidence and eagerness. PISA was experienced as acceptable to facilitators as it was useful to them and deemed appropriate and beneficial to the target population.     

群组发展模型——干预研究的新方法

群组发展模型(group-based trajectory model,GBTM)是一种用于研究群体异质性的新方法,旨在识别群体内遵循不同发展轨迹的亚组,并描绘亚组成员特征。这一模型为干预研究提供了新的研究视角,群组发展模型不仅可以探讨干预是否引起分组比例变化,也关注干预对个体的发展轨迹的影响,并评估干预对不同轨迹组的效果差异。     

Multiplicity Within and Between: Addressing Multiple Roles Through Role Profiles in Couples

The purpose of this study is to test the validity of a personality assessment, Role Profiles, by exploring the relationship between role balance and individual well-being and the relationship between couples’ role profiles similarity and their marital satisfaction. Twenty couples were recruited and completed the assessments. This study partially supported Role Profiles’ validity and the findings were consistent with previous studies: individuals with higher role confusion were more likely to report lower self-esteem, and couples who shared many identical roles in their roles profiles were more likely to report higher marital satisfaction. The utility of Role Profiles as a clinical assessment in couples therapy is discussed.