Verbal and nonverbal communication in at-risk mother-child dyads: Implications for relationship quality and developing positive social behaviours in middle-childhood

Factors that promote healthy relationships have been understudied. The objective of this study is to examine mother–child verbal and nonverbal communication (separately), relationship quality and children's positive social behaviours in an at-risk sample framed within the developmental psychopathology approach. Mothers are part of a 35-year longitudinal prospective study who, as children, were rated by peers on measures of aggression and social withdrawal. These mothers, with their own 9- to 13-year-old children, participated in conflict and game-playing tasks. Verbal and nonverbal communication were coded separately using systematic observational measures. Maternal childhood histories of aggression and withdrawal predicted poorer dyad verbal communication, relationship quality and children's positive social behaviours. Frequently displayed positive verbal and nonverbal communication were associated with better relationship quality and children's positive social behaviours. The results highlight the unique contributions of verbal and nonverbal communication to adaptive development and to promoting healthy relationships in at-risk families during middle-childhood.     

Achieving socially significant reductions in problem behavior following the interview‐informed synthesized contingency analysis: A summary of 25 outpatient applications

Jessel, Hanley, and Ghaemmaghami (2016) reported the results of 30 interview‐informed, synthesized contingency analyses (IISCAs) and found the IISCAs to be an effective tool for identifying the functions of problem behavior across a variety of topographies, participants, and settings. Jessel et al. did not, however, include data on the effectiveness of the corresponding treatments. In the current study, we collected and summarized 25 additional applications, from analysis to treatment, in which the IISCA was applied in an outpatient clinic. The IISCA identified various social functions of problem behavior, which informed personalized treatments of functional communication training with contingency‐based reinforcement thinning. A 90% or greater reduction in problem behavior was obtained for every participant by the end of the treatment evaluation. The assessment and treatment process was socially validated by caregivers who rated the procedures highly acceptable and helpful, and the improvement in their child's behavior highly satisfactory.     

Rethinking Diakonia and Transforming Our World

This article analyzes how ecumenical diakonia contributes to a critical view of the power dimension of the Sustainable Development Goals (SDGs). At the same time, it presents both the opportunities and the challenges the SDGs provide in rethinking diakonia and diaconal praxis. The commitment of the global community to the SDGs signifies a new context for diaconal praxis at local and international levels. In this article, power relations and the priority of the marginalized are presented as key concerns for rethinking diakonia in the current context. A model for diaconal reflection, based on perspectives from development studies and theology, is suggested as a tool for an interdisciplinary rethinking of diakonia aiming at renewed praxis in the context of the SDGs.     

Young Women’s Social and Occupational Development and Mental Health in the Aftermath of Child Sexual Abuse

We examined social role functioning and depressive symptoms of young adults who were abused as children in data from a longitudinal community sample. Sexually abused women and men were more depressed during their senior year of high school, and this difference was more pronounced 2 years later. We then examined a mediational model to determine whether social functioning explained the course of depressive symptoms over this transitional period. Focusing only on young women, for whom the prevalence of abuse was much higher, results indicated that two-thirds of the effect of abuse on depressive symptoms was explained by experiences and choices in the domains of work, education and intimate relationships. Having less supportive intimate relationships and lower rates of attendance at 4-year colleges were particularly important. Findings reveal the key role played by early adult interpersonal and occupational development in perpetuating the mental health impact of childhood trauma.     

Onset of Illness and Developmental Factors in Social Anxiety Disorder: Preliminary Findings from a Retrospective Interview

Although many advances have been made in the treatment of Social Anxiety Disorder (SAD), less is known about its onset and factors related to its course and severity. The current study aimed to investigate developmental factors (e.g., onset of illness, behavioral inhibition, socially traumatic experiences) that research has suggested are related to the course and severity of SAD in a sample of adults diagnosed with generalized SAD. Results showed behavioral inhibition to be the only consistent predictor of current severity. Results for age of onset were consistent with previous studies suggesting an early childhood and later adolescent pattern. In addition, an earlier age of onset negatively impacted improvement in cognitive behavior therapy for SAD, but no other developmental factors were related to treatment outcome. Future research using longitudinal designs and multiple informants is needed to confirm findings from retrospective reports.

癌症要告知实情吗？

面对癌症病人,应该不应该告知实情?这是临床医务人员常常面临的问题,目前尚无统一的标准。新的医疗事故处理条例规定、病人得知癌病的途径、临床治疗现状等方面分别论述告知癌症病人实情的理由。探讨了癌症告知策略:面对家属直言相告、面对病人通过交谈了解病人的性格特点、文化层次和情感类型,列举了不同类型的病人告知的方法。论述其告知病情后如何让病人走出误区,消除恐惧,把生存的压力转变成求生的动力,从而达到配合治疗,使病人敢于正视疾病,面对明天可能发生的任何事情。     

以同伴教育形式进行医学沟通学教学的探讨

从医学沟通重要性出发,提出以同伴教育的教育方式进行医学沟通教学和实践的建议,认为运用同伴教育没有代沟、平等交流和参与性强的特点,将抽象说教变为具体的言行训练与沟通能力培养,学生容易接受,对提高学生的沟通能力产生较好的效果。     

临床决策：医患交流与合作的过程

一切医学实践活动都是从决策问题开始。由于我们的决策面对的是需要治疗的患者,而患者的价值观是不一样的;同时,医学知识和技术是在不断发展和进步的,所以医生需要改变传统的决策方式,重视医学证据、可用资源和患者的价值取向。医患之间的相互信任是合理决策的前提。这种信任需在充分沟通的基础上达到互相认可。促进医患共同决策,将成为21世纪医疗服务的努力方向。     

Evaluation of a class wide teaching program for developing preschool life skills

Recently, nonmaternal center-based child care has been linked to problem behavior in young children (National Institute of Child Health and Human Development, 2003). In response, a comprehensive program to promote prosocial skills was evaluated in a classroom of 16 children between the ages of 3 and 5 years. Classroom observations were conducted during evocative situations to determine the likelihood of problem behavior (noncompliance, vocal or motor disruptions, aggression) and preschool life skills. A classwide teaching program was then implemented in a staggered manner across instruction following, functional communication, delay tolerance, and friendship skills. These four categories of preschool life skills, which included two to four related skills, were selected for classwide teaching because they were either identified by educators as important for early school success, have often been taught following functional assessments of more severe problem behavior, or both. Skills were taught on a classwide basis during typically scheduled activities (circle, free play, transitions, meals) via instructions, modeling, role play, and feedback. A multiple probe design showed that the program resulted in an 74% reduction in problem behavior and a more than four-fold increase in preschool life skills. Similar beneficial effects of the program were evident in questionnaire data gathered prior to and at the close of the evaluation. Finally, the teachers who implemented the program reported overall high levels of satisfaction with the classwide teaching program, the target skills, and the results. Implications for the design of early childhood experiences for preempting the development of serious problem behavior are discussed.