Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.     

Short‐term cognitive‐behavioral treatment in multicultural primary care of patients with longstanding backache

The efficacy of cognitive‐behavioral therapy in multi‐cultural primary care patients with longstanding backache is not evaluated. The purpose of this study was to investigate the outcome of a four weekly‐treatment given by primary care physicians regarding pain‐related worry, depression and severe pain and to determine which social, clinical or gender factors were associated with outcome.The study group consisted of 245 patients in consecutive order from 19 countries, 18 to 45 years, entering rehabilitation program because of longstanding backache. Prevalences of pain‐related worry and depression and severe pain was counted and compared before and after. Logistic regression was used to calculate the odds (OR; 95% CI) for persistent pain‐related worry and/or persistent depression and severe pain (VAS ≥ 50). The prevalences of pain‐related worry and depression were both significantly lower after treatment (pain‐related worry 83% before vs. 38% after; depression 43% before vs. 31% after). Also the number of patients scoring ≥ 50 VAS was a little, but significantly, fewer (68% vs. 61%). Use of interpreter doubled the risk of having persistent pain‐related worry (OR 2.1; 95% CI 1.1–4.1) but the risk was not significant regarding persistent depression (OR 1.8; 0.6‐5.4). The rating of VAS rating ≥ 50 after treatment was twice as high, OR 2.3 (95% CI 1.1–4.6) in the 38–45 year old age group. To conclude, a focus on pain ideas reduced pain‐related worry and depression in these patients with various sociocultural backgrounds and longstanding backache.     

Internet‐based CBT intervention for gamblers in Finland: Experiences from the field

From September 2007 to May 2011 a total of 471 participants (325 males and 146 females) signed up for an 8‐week Internet‐based cognitive behavioral therapy offered for gamblers in Finland. Sixty‐four percent of the participants were pathological gamblers (PGs) (NODS 5> points), 14% were problem gamblers (NODS 3–4 points) and 10% were at risk of gambling problems (NODS 1–2 points). Two hundred and twenty four participants completed the treatment and after the treatment period significant changes were found in the following variables: gambling related problems (NODS), gambling urge, impaired control of gambling, alcohol consumption (AUDIT‐C), social consequences, gambling‐related cognitive erroneous thoughts and depression (MARD‐S). In this sample co‐morbid alcohol consumption was stronger among males. The main finding of this study was that the onset age of gambling was associated with a greater amount of gambling‐related cognitive erroneous thoughts.     

Effect of the Healthy MOMs Lifestyle Intervention on Reducing Depressive Symptoms Among Pregnant Latinas

Depression during the prenatal and postpartum periods is associated with poor maternal, perinatal and child outcomes. This study examines the effectiveness of a culturally and linguistically tailored, social support-based, healthy lifestyle intervention led by trained community health workers in reducing depressive symptoms among pregnant and early postpartum Latinas. A sample of 275 pregnant Latinas was randomized to the Healthy MOMs Healthy Lifestyle Intervention (MOMs) or the Healthy Pregnancy Education (control) group. More than one-third of participants were at risk for depression at baseline. MOMs participants were less likely than control group participants to be at risk for depression at follow-up. Between baseline and 6 weeks postpartum, MOMs participants experienced a significant decline in depressive symptoms; control participants experienced a marginally significant decline. For MOMs participants, most of this decline occurred during the pregnancy intervention period, a time when no change occurred for control participants. The change in depressive symptoms during this period was greater among MOMs than control participants (“intervention effect”). From baseline to postpartum, there was a significant intervention effect among non-English-speaking women only. These findings provide evidence that a community-planned, culturally tailored healthy lifestyle intervention led by community health workers can reduce depressive symptoms among pregnant, Spanish-speaking Latinas.     

Beyond silence: working with Phoebe

This paper gives an account of a three-year period of silence that took place during the course of the intensive psychotherapy of a pre-adolescent girl with a diagnosis of ‘major depression’. The meaning and significance of silence in the therapeutic context is explored, as well as the importance of the ‘safety’ (Quinodoz, ‘The psychoanalytic setting as the instrument of the container function’, International Journal of Psycho-Analysis, 73: 627–35, 1992) and containing function of the setting that allows patients with a similar pathology a much needed regression, eventually enabling the birth and development of mature ‘verbal’ object relationships. Challenges and changes in the countertransference during a silent period in the course of psychotherapy are also discussed.     

Trait anxiety and trait anger measured by ecological momentary assessment and their correspondence with traditional trait questionnaires

Ecological momentary assessments (EMA) of anxiety and anger/hostility were obtained every 25–30 min over two 24-h periods, separated by a median of 6 months, from 165 employees at a university in the Northeast. We used a multilevel trait-state-error structural equation model to estimate: (1) the proportion of variance in EMA anxiety and anger/hostility attributable to stable trait-like individual differences; (2) the correspondence between these trait-like components of EMA anxiety and anger/hostility and traditional questionnaire measures of each construct; and (3) the test–retest correlation between two 24-h averages obtained several months apart. After adjustment for measurement error, more than half the total variance in EMA reports of anxiety and anger/hostility is attributable to stable trait-like individual differences; however, the trait-like component of each construct is only modestly correlated with questionnaire measures of that construct. The 6-month “test–retest” correlations of latent variables representing the true 24-h EMA average anxiety and average anger are quite high (r ? 0.83). This study represents the longest follow-up period over which EMA-based estimates of traits have been examined. The results suggest that although the trait component (individual differences) of EMA momentary ratings of anxiety and anger is larger than the state component, traditional self-report questionnaires of trait anxiety and anger correspond only weakly with EMA-defined traits.     

Guilt as a Source of Narcissistic Gratification

This article takes as its starting point a paper by Hugo Bleichmar presented at the 2003 Joseph Sandler Research Conference on Depression. The author argues in favour of viewing depression in a broad perspective. The Freudian prototype of “guilty depression” represents only one of many pathways leading to depressive states. Psychoanalytic understanding of depression should represent a multidimensional approach, characterised by interacting determinants, both internal and external. In clinical practice, this would imply an attitude of greater freedom and flexibility in the analyst. The paper compares the psychoanalytic account of depression with that given by the cognitive approach. It is argued that within a diverse research field, where depression is studied from different angles—as a disorder of the brain and in terms of cognitive deficits—the contribution of psychoanalysis is that depression is most usefully studied at the level of psychological causation. The psychoanalytic understanding of depressive states in terms of unconscious interpretation and meaning of experience represents a distinct contribution. Implications of viewing depression as an “illness” are discussed.     

Parental Attitudes,Beliefs, and Responses to Childhood Obsessive Compulsive Disorder: The Parental Attitudes and Behaviors Scale

ABSTRACT

This paper documents preliminary examination of the factor structure and psychometric properties of the Parental Attitudes and Behaviors Scale (PABS), an OCD-specific measure of parental attitudes, beliefs, and behavioral strategies related to childhood OCD. Employing a sample of 123 youth (mean age = 11.7; 59% male, 79% Caucasian) diagnosed with OCD in an outpatient child anxiety clinic, we used exploratory factor analysis to produce a 3-factor solution representing the following domains of parental responses to childhood OCD: accommodation, empowerment, and hostility/blame. These scales demonstrated adequate internal consistency and concurrent validity, providing preliminary evidence for the psychometric integrity of the PABS.     

Family and Cultural Predictors of Depression Among Samoan American Middle and High School Students

This study investigated family intergenerational conflict and collective self‐esteem as predictors of depression in a sample of 128 Samoan middle and high school students. Simultaneous regression analyses revealed that each independent variable significantly contributed to an overall model that accounted for 13% of the variance in depression. Implications for counseling research and practice are discussed in terms of how schools may consider ways to promote these youth's cultural worth and positive family dynamics. Este estudio investigó el conflicto familiar intergeneracional y la autoestima colectiva como predictores de depresión en una muestra de 128 estudiantes samoanos de enseñanza media y secundaria. Los análisis simultáneos de regresión revelaron que cada variable independiente contribuyó de forma significativa a un modelo general que explicó un 13% de la varianza en depresión. Se discuten las implicaciones para la investigación y práctica de la consejería, en términos de cómo las escuelas pueden considerar formas de promover el valor cultural de estos jóvenes y una dinámica familiar positiva.