Social neuroscience of child and adolescent depression

The social neuroscience of child and adolescent depression is inherently multidisciplinary. Depressive disorders beginning early in life can have serious developmental and functional consequences. Psychopathology research has described depression's defining clinical and contextual features, and intervention research has characterized its response to treatment and prevention programs. Neuroendocrine, electrophysiological, and neuroimaging studies have identified core neurobiological aspects of early-onset mood disorders. These areas are reviewed using a developmental social neuroscience perspective for integrating disparate observations. The paper introduces a dynamic adaptive systems framework, and it discusses hedonic capacity, stress sensitivity, ruminative self-focus, and attentional impairments as fundamental components of mood disorders.     

Decreasing expulsions by a child with a feeding disorder: using a brush to present and re-present food

Previous research has demonstrated that extinction in the form of re-presentation of expelled bites is an effective intervention for treating food expulsion. The current study compared the effectiveness of re-presenting expulsions with a spoon to re-presenting with a Nuk brush for a 4-year-old boy with a feeding disorder. Fewer expulsions were observed when using the brush for re-presentation, and further reductions were observed when the brush was also used for initial presentations.     

Exercise training and health-related quality of life in generalized anxiety disorder

ObjectiveTo quantify the effects of six-weeks of resistance (RET) and aerobic exercise training (AET) on quality of life (QoL) among sedentary women with Generalized Anxiety Disorder (GAD).DesignData from our published randomized controlled trial of the effects of six-weeks of either RET or AET among GAD patients were analyzed.MethodThirty women with GAD were randomized to either six weeks of twice-weekly lower-body weightlifting or cycling, or wait-list control (WL). SF-36 subscales assessed dimensions of QoL. Hedges’ d effect sizes (95%CIs) quantified the magnitude of change in response to exercise training compared to WL.ResultsRET significantly improved role-physical (d = 1.04; 95%CI: [0.11–1.97]), role-emotional (d = 0.96; [0.04–1.89]), and mental health (d = 1.05; [0.11–1.98]). AET resulted in significant improvements in physical function (d = 1.31; [0.34–2.27]) and vitality (d = 0.93; [0.01–1.85]).ConclusionsExercise training improves dimensions of QoL among GAD patients. The largest effects were observed for role impairments, physical function, vitality, and mental health.     

Alliance rupture and repair processes in borderline personality disorder: A case study using dialogical sequence analysis

Objective: This study examined alliance rupture and repair processes in borderline personality disorder (BPD) and how the content of sessions interacts with the quality of the alliance.

Design: A mixed methods single case study design was employed incorporating quantitative and qualitative measures of process and outcome.

Methods: This case study examined a 22-year-old female with BPD who received 16 sessions of Cognitive Analytic Therapy. Measures of alliance, symptoms and global functioning were taken across multiple time-points. Selected sessions were analysed using dialogical sequence analysis (DSA), a theory-driven method of psychotherapy research that analyses utterances according to their author, addressee and referential object.

Results: Quantitative data indicated symptom reduction without functional improvement. DSA demonstrated that the first exchanges in therapy were reflective of key relational themes. The case suggests that, rather than simply negotiating tasks and goals, repairing ruptures involves systematically linking the manifest topic to the client’s core problems.

Conclusions: This case study points to the mediating role that the content of sessions has on alliance quality. Results underline the importance of the therapist stance, the need for a shared formulation to make sense of relational processes and the use of responsively timed interventions to decrease desperation and improve self-reflection.     

Loneliness and eating disorders

This article examines the link between loneliness and eating disorders. This concept is evaluated through a systematic review of the literature that links loneliness and eating disorders and through a survey of themes connecting the 2 conditions. Eating disorders-including anorexia nervosa, bulimia nervosa, and eating disorders that are not otherwise specified, which include binge eating disorder-are challenging health issues. Each of these diagnoses specifically relates to loneliness. This negative emotion contributes to and fuels eating disorder symptoms. Negative interpersonal relationships, both real experiences and individuals' skewed perceptions, exacerbate eating disorders and feelings of loneliness. Characteristics that have been associated with loneliness clearly relate to eating disorders. Understanding this relationship is vital, so that we can appreciate our patients' struggles and work to target these intense emotions within the treatment setting. We need to be aware of the power of loneliness as it applies to individuals in general and specifically to those struggling with disordered eating.     

Diagnosing,Conceptualizing, and Treating Eating Disorders Not Otherwise Specified: A Comprehensive Practice Model

This article presents research and evidence‐based practices for identifying, understanding, diagnosing, conceptualizing, and providing a continuum of treatment for the most commonly experienced types of eating‐related counseling concerns—namely, eating disorders not otherwise specified—among the population most likely to present these types of needs: adolescent girls and young adult and adult women.     

Description of an Intensive Dialectical Behavior Therapy Program for Multidiagnostic Clients With Eating Disorders

The authors describe an intensive outpatient dialectical behavior therapy (DBT) program for multidiagnostic clients with eating disorders who had not responded adequately to standard, empirically supported treatments for eating disorders. The program integrates DBT with empirically supported cognitive behavior therapy approaches that are well established for the treatment of eating disorders. Attention is given to inclusion and exclusion criteria, how the program differs from standard treatments for eating disorders, and the application of specific DBT treatment components for multidiagnostic clients with eating disorders.     

Improving left spatial neglect through music scale playing

The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right‐brain‐damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right‐brain‐damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age‐matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no‐sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder.     

Thematic Analysis of the Intersection of Spirituality and Eating Disorder Symptoms

The authors interviewed 12 female participants about the intersection of their spiritual beliefs and eating disorder symptoms. Three main themes emerged from the data: (a) spiritual beliefs as helpful, (b) choice not to ask for spiritual help, and (c) guilt.     

进食障碍发病机制的研究进展与思考

进食障碍是一组典型而严重的心身疾病。随着现代医学模式的转变,生物-心理-社会因素对进食障碍的影响日益受到关注。本文拟从生物学、心理学、社会学因素方面,综述近年来国内外对进食障碍发病机制的最新研究,并结合哲学相关理论对进食障碍发病机制的研究进行探讨分析。