Helping families improve: an evaluation of two primary care approaches to parenting support in the Netherlands

The present study evaluated two primary care parenting interventions. First, we evaluated the most widely used Dutch practices for primary care parenting support. Second, we assessed the applicability of the Primary Care Triple P approach, which is now being utilized in a wide variety of primary care settings. Both interventions target parents of children with mild to moderate behavioural and/or emotional problems, with the aim of improving parenting skills and thereby decreasing child problems. We examined the interventions in pre‐, post‐ and follow‐up assessment, and compared the results. Both interventions produced significant reductions in reported child emotional and behaviour problems, that also remained after 3 months. For both groups, parenting styles were also found to have improved at both post‐test and follow‐up measurement. When compared with the regular Dutch parenting consultation practices, however, the Primary Care Triple P approach produced greater reductions in parental laxness and total parenting dysfunction, and greater improvement in total parenting competence at both post‐test and follow‐up. Primary Care Triple P may even—in light of the greater improvements in parenting skills and total parental competences in the Triple P group than in the regular Dutch parenting consultation group—produce better results in the long run concerning child behaviour and emotional problems. Copyright © 2009 John Wiley & Sons, Ltd.     

The predicting brain: Unconscious repetition, conscious reflection and therapeutic change

Neuroscience indicates that 'repetition' is fundamental to brain function. The brain non-consciously predicts what is most likely to happen and sets in motion perceptions, emotions, behaviors and interpersonal responses best adapted to what is expected-before events occur. Predictions enable individuals to be ready 'ahead of time' so reactions occur rapidly and smoothly when events occur. The brain uses past learning as the guide for what to expect in the future. Because of prediction, present experience and responses are shaped by the past. Predictions from early life can be deeply encoded and enduring. Predictions based on the past allow for more efficient brain function in the present, but can lead to mistakes. When what is predicted does not occur, consciousness can be engaged to monitor and correct the situation. But if a perception or emotion seems reasonable for the situation, a person might not notice an error, and a maladaptive 'repetition' may remain unchanged. The author discusses how predictions contribute to psychological defenses and transference repetition, and how conscious self-reflection facilitates therapeutic change. The neuroscience of prediction indicates why, in certain cases, active engagement by the analyst may be necessary. The author makes the argument for use of a 'neuroscience interpretation'.     

Adolescent development of motor imagery in a visually guided pointing task

The development of action representation during adolescence was investigated using a visually guided pointing motor task (VGPT) to test motor imagery. Forty adolescents (24 males; mean age 13.1 years) and 33 adults (15 males; mean age 27.5 years) were instructed to both execute and imagine hand movements from a starting point to a target of varying size. Reaction time (RT) was measured for both Execution (E) and Imagery (I) conditions. There is typically a close association between time taken to execute and image actions in adults because action execution and action simulation rely on overlapping neural circuitry. Further, representations of actions are governed by the same speed-accuracy trade-off as real actions, as expressed by Fitts’ Law. In the current study, performance on the VGPT in both adolescents and adults conformed to Fitts’ Law in E and I conditions. However, the strength of association between E and I significantly increased with age, reflecting a refinement in action representation between adolescence and adulthood.     

A model for predicting behavioural sleep problems in a random sample of Australian pre‐schoolers

Behavioural sleep problems (childhood insomnias) can cause distress for both parents and children. This paper reports a model describing predictors of high sleep problem scores in a representative population‐based random sample survey of non‐Aboriginal singleton children born in 1995 and 1996 (1085 girls and 1129 boys) in Western Australia. Longitudinal repeated data were collected up to age 4 years by caregiver report. Children's sleep rhythmicity levels in their first year, as well as conflicted and lax parenting in their second year, predicted higher scores on the sleep problem scale from the Child Behaviour Checklist/2–3 in the children's third year. Higher scores on the sleep problem scale in the children's third year predicted higher scores on the aggressive behaviour subscale of the Child Behaviour Checklist/4–16. The results support a model in which sleep problems mediated the relationship between parental conflict and aggressive behaviour, even when controlling for maternal depression, which has been associated with children's aggressive behaviour. Copyright © 2007 John Wiley & Sons, Ltd.     

Understanding body image disturbance in the promotion of mental health: a discourse analytic study

Health care interventions in the area of body image disturbance and eating disorders largely involve individual treatment approaches, while prevention and health promotion are relatively underexplored. A review of health promotion activities in the area of body image in Australia revealed three programmes, the most extensive and longest standing having been established in 1992. The aims of this programme are to reduce body image dissatisfaction and inappropriate eating behaviour, especially among women. Because health promotion is concerned with the social aspects of health, it was hypothesized by the authors that a social understanding of body image and eating disorders might be advanced in a health promotion setting and reflected in the approach to practice. In order to examine approaches to body image in health promotion, 10 health professionals responsible for the design and management of this programme participated in a series of semi‐structured interviews between 1997 and 2000. Three discursive themes were evident in health workers' explanations of body image problems: (1) cognitive‐behavioural themes; (2) gender themes; and (3) socio‐cultural themes. While body image problems were constructed as psychological problems that are particularly experienced by women, their origins were largely conceived to be socio‐cultural. The implications of these constructions are critically discussed in terms of the approach to health promotion used in this programme. Copyright © 2001 John Wiley & Sons, Ltd.     

Can Voters Predict Changes in Theor Own Attitudes?

Although scholars have established that voters have unstable preferences (e.g., Converse, 1964; Zaller, 1992) and that they are not accurate when recalling past preferences (e.g., Markus, 1986; Niemi, Katz, & Newman, 1980; Smith, 1984), existing research has not systematically explored whether voters can accurately predict the changing nature of their own opinions. The question of whether whether people recognize the instability of their political preferences was explored in a random sample of Pennsylvania registered voters who were surveyed in August and October 1996, during the presidential election campaign. The first survey elicited respondents' positions on two political issues (welfare reform and the environment) and on the two major candidates, and also asked them to estimate the likelihood that each of these positions would change during the next 2 months. The second survey elicited positions at that time and also asked voters to recall their prior positions. Measured both by expectations and recall, respondents tended to underestimate the degree to which their own positions would change or had changed over time. This research has implications for the use of public opinion polling and more broadly for the practice of democratic politics.     

Is it all in the reward? Peers influence risk‐taking behaviour in young adulthood

The presence of peers is suggested to increase risk‐taking behaviour by heightening response to reward. The current study investigated this using a computerized financial risk‐taking task which was performed twice by a group of young adults (n = 201, median age 19.8 years): once alone and once while in the presence of two peers. An overall increase in risk‐taking was observed when with peers compared to when alone (CHANGE). CHANGE was positively associated with self‐reported levels of reward responsiveness and fun seeking while older age and lack of perseverance were associated with reduced CHANGE. The association between risk‐taking when with peers and both resistance to the influence of peers and age was indirect through reward responsiveness. Reward responsiveness was positively associated with impulsiveness. Only in those who showed a peer‐related decrease in risk‐taking (1/3 of participants), risk‐taking in the presence of peers was associated with increased impulsiveness. The current findings suggest an important role for reward responsiveness in risk‐taking behaviour and demonstrate the influence of peers. Increased understanding of these processes has direct implications for prevention and intervention efforts. Placing risk‐taking behaviour within varying (social) contexts with an eye for differences in personality, development, and emotions provides ample scope for future research.     

Motivated reasoning in the prediction of sports outcomes and the belief in the “hot hand”

The present paper explores the role of motivation to observe a certain outcome in people’s predictions, causal attributions, and beliefs about a streak of binary outcomes (basketball scoring shots). In two studies we found that positive streaks (points scored by the participants’ favourite team) lead participants to predict the streak’s continuation (belief in the hot hand), but negative streaks lead to predictions of its end (gambler’s fallacy). More importantly, these wishful predictions are supported by strategic attributions and beliefs about how and why a streak might unfold. Results suggest that the effect of motivation on predictions is mediated by a serial path via causal attributions to the teams at play and belief in the hot hand.     

Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention

Objective: Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology.

Design: Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants.

Main Outcome Measures: Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models.

Results: TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13–20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6–38%) and behaviour (average 30%, range 6–55%) were significant.

Conclusion: Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases.     

Know thy agency in predictive coding: Meta-monitoring over forward modeling

Though the computation of agency is thought to be based on prediction error, it is important for us to grasp our own reliability of that detected error. Here, the current study shows that we have a meta-monitoring ability over our own forward model, where the accuracy of motor prediction and therefore of the felt agency are implicitly evaluated. Healthy participants (N = 105) conducted a simple motor control task and SELF or OTHER visual feedback was given. The relationship between the accuracy and confidence in a mismatch detection task and in a self-other attribution task was examined. The results suggest an accuracy-confidence correlation in both tasks, indicating our meta-monitoring ability over such decisions. Furthermore, a statistically identified group with low accuracy and low confidence was characterized as higher schizotypal people. Finally, what we can know about our own forward model and how we can know it is discussed.