Paternal Support and Involvement in Unmarried Fragile Families: Impacts on Long-Term Maternal Mental Health

Fragile families are defined as those that include unmarried or romantically unstable parents who have children and are socioeconomically disadvantaged. Mothers in fragile families may experience risk factors that lead to increased depressive symptoms that inhibit their ability to bounce back after stressful events. Risk factors for poorer maternal mental health may include declines in father involvement and a lack of coparenting support. This study examined the connected nature of coparenting and father involvement over time among continuously unmarried mothers from the Fragile Families and Child Wellbeing Study. A bidirectional latent growth curve analysis demonstrated that early father involvement was associated with a more gradual decline in coparenting support over the child's first 5 years, while early coparenting support also predicted a slower decline in father involvement over time. Steeper declines in coparenting support and father involvement over time were linked with more maternal depression and lower maternal life satisfaction when their child was nine. Results demonstrate a clear need for targeted intervention with both parents in fragile families to promote involved fathering behavior and enhance coparental relationships.     

Exploring emotions in dialog between health provider,parent and child. An observational study in pediatric primary care

IntroductionThis paper is part of the theoretical thread of health psychology and it presents a study aimed to recognize information useful to implement psychological interventions finalized to personalize medical treatments and engage users in pediatrics.ObjectiveIn this paper is presented an observational study aimed to explore doctor-patient dialog about worries in pediatric primary care; it has been carried out identifying dialogical interaction patterns, or typical dialog between health providers, parent and child.MethodWe documented conversations in 265 visits; we audio-recordered, transcribed and analyzed them with Verona Coding Definitions of Emotional Sequences. Dialogs between participants were analyzed one by one. Frequencies of emotions’ signals (cues/concerns) and responses were analyzed through Redundancy Analysis, aimed to establish a quantitative relationship between these pair of groups of variables considering the asymmetrical relationship between them.ResultsSix “Dialogical Interaction Patterns” were obtained by interpreting these relationships; they show dialogs mainly aimed at obtaining information useful for diagnosis and treatment, with a limited exploration of worries or issues related to the condition of the child. Pediatric conversations seem to be characterized by a very high attention to cognitive aspects of medical questions with a poor consideration of emotions as useful information to medical practice.ConclusionsThese dialogs seem to ensure the rapidity and the efficiency of medical visits. Nevertheless, it could be useful to implement psychological interventions to achieve an enrichment of the dialog between participants, helping them to recognize users’ emotions as useful to define shared medical strategies.     

Spouses' responses to the dietary nonadherence of their partners managing diabetes

The association between patients' dietary nonadherence and spouses' involvement in patients' diabetes diet was examined, with spouses' anxiety about nonadherence considered as a mediator of this association. Daily diary data from 128 older adult patients with type 2 diabetes and their spouses were analyzed using multilevel models. Results revealed that on days when patients reported less adherence to their diabetes diet than usual, spouses reported greater anxiety about patients' diabetes management, which, in turn, was related to greater spousal persuasion and pressure the same day. The association between patients' nonadherence and diet‐related support on the same day was not mediated, however, through spouses' anxiety. The findings contribute to an understanding of spouses' responses to patients' nonadherence to their diabetes regimen.     

Water contaminant levels interact with parenting environment to predict development of depressive symptoms in adolescents

Contaminants in drinking water, such as lead, nitrate, and arsenic, have been linked to negative physical health outcomes. We know less, however, about whether such pollutants also predict mental health problems and, if so, the conditions under which such effects are strongest. In this longitudinal study, we examined whether drinking water contaminants interact with negative family environments (parental psychological control) to predict changes in depressive symptoms in 110 adolescents—a developmental period when symptoms often first emerge. We found that for adolescents in psychologically controlling families, levels of drinking water contaminants prospectively predicted depressive symptoms 2 years later; this effect was not present in adolescents in non‐controlling families. Importantly, these associations were not accounted for by family‐ or community‐level socioeconomic resources, demographic features, or by the adolescents’ stress exposure. These findings highlight the interplay of physical and psychological environments in influencing depressive symptoms in adolescents. A video abstract of this article can be viewed at https://youtu.be/thBV-DwnGcY     

Daily relations between social perceptions and physical activity among college women

ObjectivesThere is a need to develop more effective physical activity (PA) promotion programs for college women. Theory and evidence suggest that perceptions of the social environment play a role in college women’s PA, though little is known about how these perceptions are associated with PA at the day level. The goal of this study was to examine relations between changes in college women’s daily social perceptions and objectively assessed PA over seven days.DesignDaily diary method.MethodCollege women (n = 80, M_Age = 20, M_BMI = 23.1 kg/m²) wore Fitbit wristbands and completed daily self-reports of (1) the quantity and perceived intensity of their social interactions (positive/negative), and (2) the occurrence of social comparisons (based on appearance/health/status) for seven days.ResultsMultilevel models showed daily variability in predictors and outcomes (ps < 0.0001), as well as relations between within-person changes in social perceptions and PA. Increases in negative interactions (particularly those with friends) were consistently associated with decreases in daily PA, whereas increases in positive interactions showed limited relations (srs = −0.22-0.34). Days with health comparisons were days with greater PA for women who had stronger overall interest in comparisons, but were days with less PA for women with weaker overall interest (srs = 0.22–0.33). PA did not differ between days with vs. without appearance comparisons.ConclusionsSocial perceptions show meaningful day-to-day variability and relations with college women’s daily PA, and specific associations may be useful for improving tailored interventions for college women.     

Pox Parties for Grannies? Chickenpox,Exogenous Boosting,and Harmful Injustices

Abstract

Some societies tolerate or encourage high levels of chickenpox infection among children to reduce rates of shingles among older adults. This tradeoff is unethical. The varicella zoster virus (VZV) causes both chickenpox and shingles. After people recover from chickenpox, VZV remains in their nerve cells. If their immune systems become unable to suppress the virus, they develop shingles. According to the Exogenous Boosting Hypothesis (EBH), a person’s ability to keep VZV suppressed can be ‘boosted’ through exposure to active chickenpox infections. We argue that even if this hypothesis were true, immunization policies that discourage routine childhood varicella vaccination in order to prevent shingles for other people are unethical. Such policies harm children and treat them as mere means for the benefit of others, and are inconsistent with how parents should treat their children and physicians should treat their patients. These policies also seem incompatible with institutional transparency.     

Ethically Allocating COVID-19 Drugs Via Pre-approval Access and Emergency Use Authorization

Abstract

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research. In conditions of scarcity, prioritization approaches should minimize harm, maximize benefit, and promote fairness. To promote continued data collection, patients seeking access to unproven COVID-19 drugs should receive lower priority for allocation when they decline to participate in clinical trials, either of the requested drug or other investigational products, offering a comparable balance of risks and benefits; special attention should be paid to concerns of voluntariness and distrust. In addition, institutional treatment protocols that can contribute more robust real world data should be preferred to single patient requests for access, with priority for inclusion based on traditional clinical allocation criteria relying on available evidence. Fairness demands distribution of these protocols across a diverse range of sites, particularly those serving marginalized populations, among other protections.     

Counselling and psychotherapy post‐COVID‐19

We consider how the prolonged, complex and uncertain aftermath of the COVID‐19 crisis will present challenges and opportunities for counselling and psychotherapy. Increased mental strain on populations, individuals and professionals is likely to be compounded by further constraints in therapeutic resources. Nevertheless, emerging needs and priorities will offer ground for systems thinking in linking the application of a range of therapeutic frameworks, theories to address global challenges, integration of counselling and psychotherapy into new sectors, service models for the most vulnerable, use of digital approaches, support mechanisms for professionals and interdisciplinary research.     

心理健康素养：内涵、测量与新概念框架

本文概述了国内外心理健康素养概念的研究及其测量的演进。在此基础上尝试提出国民心理健康素养的新概念框架。新概念将心理健康素养定义为个体在促进自身及他人心理健康,应对自身及他人心理疾病方面所养成的知识、态度和行为习惯。新概念框架包含“心理疾病应对——心理健康促进”和“自我——他人”两个维度;在内容上包含知识、态度和行为习惯三个方面。文章还探讨了未来的研究方向。