Therapeutic progress and symptom elevation in treating dismissive attachment: A case study

A dismissive or avoidant attachment style can present clinical challenges in psychotherapy as the attachment style may interfere with the development of a constructive therapeutic alliance and impact the level of disclosure, expressions of distress, and risks for premature drop-out. This paper reports a naturalistic case study and offers an in-depth examination of a treatment with a client with dismissive attachment, including a detailed examination of relational interventions and countertransference struggles. Furthermore, this paper considers the notable differences between quantitative scores on a well-validated, practice-based clinical symptom inventory and the qualitative outcomes for this client to offer clinical and research implications in treatment with dismissive attachment.     

Parenting practices and adolescent social anxiety: A direct or indirect relationship?

Background/ObjectivesAccording to existing evidence, parental educational practices and social anxiety are to some degree connected. However, the possibility that this relationship is an indirect one and is mediated by individual factors such as self-esteem or emotional regulation has not yet been explored. The aim of this study was therefore to explore the relationship between maternal and paternal educational practices and social anxiety, and test both the direct and the indirect pathways. Method: The representative sample consisted of 2,060 Andalusian students (47.7% girls, M_age = 14.34) who filled in various self-reports. Results: The structural equation models confirmed that a direct relationship, with a low effect size, exists between parental educational practices and social anxiety and that there is also an indirect relationship, mediated by negative self-esteem and emotional suppression (the emotional regulation strategy), which accounted here for 49.1% of the variance in social anxiety. Conclusions: Parental education practices seem to act as a family asset which either promotes or hinders the development of basic attitudes and competencies such as self-esteem or emotional regulation and, by doing this, either encourages or prevents the emergence of problems such as social anxiety.     

Childhood obesity and parental reflective functioning: Is there a relation?

Background/ObjectiveIn recent decades, the prevalence of childhood obesity has increased, with the major implications for public health. However, the factors that contribute to obesity in children are still poorly understood. The present study aimed to investigate the role of parental reflective functioning (PRF) in childhood obesity.MethodIn a cross-sectional design, 120 sets of parents of 60 children (n = 30 with obesity, age range 6–11) were recruited by local paediatricians. Parents completed the Parental Reflective Functioning Questionnaire. Children's and parents’ weight (assessed by BMI), as well as their socio-economic status (SES), were assessed to explore the contribution of PRF in the prediction of children's weight, controlling for parents’ weight and SES.Resultst-test showed significant differences with medium effect sizes in BMI, SES and PRF between parents of children with and without obesity. The best model resulted from hierarchical multiple regression analyses and showed that mothers’ PRF predicted children's BMI above and beyond the prediction by parents’ BMI and SES.ConclusionsLow maternal PRF could be an important target for intervention strategies, highlighting the need to consider parental responses to children's emotions in the treatment of childhood obesity, particularly in parents with low SES and high BMI.     

ICD-11 guidelines for psychotic,mood, anxiety and stress-related disorders in Mexico: Clinical utility and reliability

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tools.     

Effectiveness of therapy group in women with localized breast cancer

Background/ObjectiveBreast cancer causes high levels of anxiety and depression, deteriorating quality of life of patients. Several studies have found that group therapy reduces depression and anxiety also improves the quality of life. The aim of this study is to analyze group therapy effectiveness in emotional state and quality of life in women with breast cancer after finalized medical treatments.MethodParticipants in this study were 100 adult women diagnosed of breast cancer non-mestastasic and were divided into two types of intervention groups (Self-esteem-Social Skills and Cognitive-Behavioral Therapy). Evaluation instruments were questionnaire Functional Assessment of Breast-cancer Therapy (FACT-B) and Hospital Anxiety and Depression Scale (HADS).ResultsA statistically significant effect of group therapy in reducing anxiety and depression were observed. Quality of life and emotional well-being significantly improved. These effects remain three months after intervention.ConclusionsThe results show that the psychological intervention group is efficient to improve emotional state and quality of life of women with breast cancer.     

Treatment impact on recidivism of family only vs. generally violent partner violence perpetrators

Background/ObjectiveThe outcome of a treatment program for a large sample of male perpetrators on probation for intimate partner violence (IPV) was evaluated with particular reference to the differential impact on family only (FO) versus generally violent (GV) perpetrators.MethodOfficial rates of recidivism for three years post termination of treatment and probation were examined for 456 perpetrators after they were classified as FO and GV.ResultsBoth treatment completion and type of perpetrator were predictive of IPV recidivism and time to recidivism. However, analyses conducted separately for the two groups indicated that participation in the intervention predicted both recidivism and time to recidivism for the GV but not FO perpetrators who participated in treatment. Specifically, GV men were responsive to treatment whereas FO men were not. Results were somewhat different depending on who was included in the no treatment comparison group.ConclusionsImplications of these findings for one size fits all interventions in IPV are discussed with specific reference to the need to develop different interventions for GV and FO perpetrators.     

Studying entrepreneurial occupations in the Terman women

To achieve a better understanding of entrepreneurship development in women, longitudinal data on 672 individuals collected from 1922 to 1959 were analysed in a secondary investigation of the Terman Longitudinal Study. Women's reports on their occupations during 10 different years were assigned to one of two categories: work for pay (0/1), and work allowing for self‐employment (0/1) in the respective year. Structural equation modelling supported earlier results concerning male entrepreneurial activity. Personality and aspects of the parenting context the women had experienced by the average age of 12 predicted early entrepreneurial competencies (inventions, leadership) and occupational interests by age 13, which related to an entrepreneurship‐related career goal in 1936, when the participants were about 27 years of age on average. Such a career goal in turn predicted a higher number of occasions of entrepreneurship‐prone work. Surprisingly, we also found a relationship to divorce. Women who had experienced the failure of a marriage were in occupations with a potential for entrepreneurship more often. Reasons are discussed against a backdrop of historical timing and current findings to identify general aspects of entrepreneurship development.     

Exploring the Effects of Creativity Training on Creative Performance and Creative Self‐Efficacy: Evidence from a Longitudinal Study

In organizations and educational institutions, creativity trainings are the preferred approach to enhancing individual creative abilities. However, three issues regarding these trainings still remain largely unsolved. First, the question of how long‐lasting creativity training effects are has not been sufficiently answered so far. Second, the question arises whether all participants benefit from such trainings equally in terms of their creative performance (CP). Third, an increasing number of studies have shown that creativity trainings may also be able to increase participants' creative self‐efficacy (CSE), that is, the confidence in one's own creativity. Other studies, however, did not find evidence for this effect. Therefore, this article aims to address these issues by analyzing data from three measurement waves. Results reveal that participants' CP increased during the training and decreased only slightly 4 weeks after the training. Additionally, we found an effect of diminishing training returns in that the higher a participant's CP before the training the lower the training effect was. In contrast to most prior literature, we found no support for an effect of creativity training on participants' CSE. We discuss these findings and offer implications for both theory and practice. Finally, we state this study's limitations and derive avenues for further research.     

A Prospective Analysis of Near-Death Experiences in Cardiac Arrest Patients

The objective of this study was to assess prospectively the frequency of near-death experiences (NDEs) in patients suffering a cardiac arrest, to characterize these experiences, and to assess their impact on psychosocial and spiritual attitudes. We prospectively evaluated all patients who suffered a cardiac arrest at Barnes-Jewish Hospital from April 1991 through February 1994, excluding those in the surgical intensive care unit, using a scale designed to specify criteria for NDEs, a recorded interview regarding the experience, an experience rating form, and a follow-up questionnaire regarding psychosocial attitudinal life changes. Of the 174 patients who suffered a cardiac arrest, 55 patients survived, of whom 30 patients were interviewable. Of those 30 patients interviewed, seven (23 percent) had a NDE, and four others (13 percent) reported an NDE during a prior life-threatening illness. The experiences were most frequently characterized by ineffability, peacefulness, painlessness, lack of fear, detachment from the body, and no sense of time or space. Significant differences were noted in the follow-up psychosocial assessment between patients who experienced an NDE and those who did not with regard to personal understanding of life and self, attitudes toward others, and changes in social customs and religious/spiritual beliefs. Of importance, patients reported it was beneficial to receive psychosocial support before hospital discharge after having an NDE. The results suggest that NDEs are fairly common in cardiac arrest survivors. The experiences consisted of a number of core characteristics and changed psychological, social, and spiritual awareness over both the short and long term.     

Placing Age Differences in Cultural Context: A Comparison of the Effects of Age on PTSD After Disasters in the United States, Mexico, and Poland

Criterion symptoms of posttraumatic stress disorder (PTSD) were measured 6–12 months after Hurricane Andrew in the United States (non-Hispanic n = 270), Hurricane Paulina in Mexico (n = 200), and the 1997 flood in Poland (n = 285), using English, Spanish, and Polish versions of the Revised Civilian Mississippi Scale. The samples ranged in age from 18 to 88. Linear and quadratic effects of age were tested by using hierarchical multiple regression, with the effects of gender, trauma, and education controlled. Among Americans, age had a curvilinear relation with PTSD such that middle-aged respondents were most distressed. Among Mexicans, age had a linear and negative relation with PTSD such that younger people were most distressed. Among Poles, age had a linear and positive relation with PTSD such that older people were most distressed. Thus, there was no one consistent effect of age; rather, it depended upon the social, economic, cultural, and historical context of the disaster-stricken setting.