Patterns of emotional availability between mothers and young children: Associations with risk factors for borderline personality disorder

Emotional availability (EA) characterizes a warm, close relationship between caregiver and child. We compared patterns (clusters) of EA on risk factors, including those for borderline personality disorder (BPD). We sampled 70 children aged 4 to 7 years from low socio‐economic backgrounds: 51% of whose mothers had BPD. We coded filmed interactions for EA: mothers' sensitivity, structuring, non‐intrusiveness, non‐hostility, and children's responsiveness to, and involvement of, mothers. We additionally coded children's over‐responsiveness and over‐involvement. Using person‐centred analyses, we identified four clusters: high functioning, low functioning, asynchronous (mothers above average on two of four dimensions and children below), and below average. Mothers in the low‐functioning cluster had lower income, less social support, more of the borderline feature of negative relationships, and more depression than did mothers in the high‐functioning cluster. The children in the low‐functioning group had more risk factors for BPD (physical abuse, neglect, and separation from, or loss of caregivers, and negative narrative representations of the mother–child relationship in their stories) than did children in the high‐functioning group. The asynchronous group included older girls who were over‐responsive and over‐involving with their mothers in an apparent role reversal. Interventions targeting emotional availability may provide a buffer for children facing cumulative risks and help prevent psychopathology.

Highlights

• This paper investigated how mother‐child emotional availability (warmth and closeness) relates to risk factors for borderline personality disorder, including mother‐child role reversal.
• In filmed mother‐child interactions, low emotional availability was associated with risk for borderline personality disorder and role reversal was more likely for older girls.
• Findings support the cumulative risk hypothesis and may inform interventions to improve mother‐child emotional availability to prevent the development of psychopathology.

     

Mental health practitioners' attitudes towards transgender people: A systematic review of the literature

Background: A systematic review was conducted to critically evaluate and synthesize literature investigating mental health practitioners' attitudes towards transgender people.

Objective: Three primary objectives were outlined; first, establish whether overall attitudes are positive or negative. Second, explore whether training, education or experience influences attitudes and finally, examine participant demographics in relation to attitude trends.

Method: A systematic electronic search was carried out in March 2017 using Medline, PsycINFO, PsycArticles, CINAHL, ASSIA, and Web of Science electronic databases. Manual citation and ancestral searches were conducted on identified papers. Qualitative, quantitative and mixed method studies were eligible for inclusion. A total of 13 papers of mixed quality were identified.

Results: Existing literature is limited to cross-sectional, quantitative data and fails to investigate differences between implicit and explicit attitudes. Small to moderate convenience samples reduce the generalizability of data. Overall attitudes were positive although negative attitudes were more frequent in male, Caucasian, heterosexual, religious, conservative mental health professionals.

Conclusions: Refined scales are needed to address the unique heterogeneity within transgender populations. Future research should focus on how attitudes impact care provided and employ longitudinal designs to explore the sustainability of targeted attitudinal training.     

Non-binary youth: Access to gender-affirming primary health care

ABSTRACT

Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.     

负性情绪强度对双加工再认提取的影响

双加工理论认为再认提取存在回想和熟悉性两种认知加工过程。本研究采用修正的“记得/知道”范式,考察不同强度的负性情绪对这两种再认提取过程的影响。结果发现：（1）在记得反应上不同负性情绪强度的材料呈现出以下模式：高度负性 > 中度负性 > 轻度负性 > 中性;（2）在知道反应上,不同负性情绪强度的材料呈现出以下模式：中性 > 轻度负性 > 中度负性 > 高度负性。这些结果表明,不同强度的负性材料对情绪记忆的影响表现为两条途径：依赖于回想的再认随着负性情绪强度的增加而逐步提高,另外一个依赖于熟悉性的再认随着负性情绪强度的增加而逐步降低。     

学校正念干预的应用与特点

“学校正念干预”(School-Based Mindfulness Intervention)是将正念理论及技术应用到教育领域而形成的非医疗健康干预新策略。一方面,学校正念干预能有效帮助学生改善身心行为问题,提高认知能力;另一方面,它能够增强教师压力管理能力和幸福感。总的来说,学校正念干预是以“大健康”为目标、以“非评判接纳”为视角、以校园为干预情境、以传统学校项目为基础的校园非医疗健康干预,是学校心理健康工作者、学校专业社工可采取的策略。未来研究应注重其成效评估和测量、理论机制及应用问题的研究。     

返回抑制和情绪信息注意偏向的竞争：来自眼动的证据

返回抑制与情绪注意偏向是研究视觉注意的两个视角,二者的优先性一直存在争议。本研究采用线索—靶子范式,在靶子位置呈现情绪图片,结合眼动技术,对整体反应时进行分解,探讨情绪信息与实验任务相关条件下的返回抑制和情绪注意偏向。结果发现：返回抑制效应出现;情绪信息与实验任务的相关性影响了个体对情绪信息早期的注意捕获;有效线索对情绪信息的加工抑制有限,情绪信息的加工表现出了自动化倾向。     

A case-controlled field study evaluating ICD-11 proposals for relational problems and intimate partner violence

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).     

Well-being in major depression and social phobia with and without comorbidity

Background/Objective: Lower levels in well-being have been observed in individuals with Major Depression (MDD) and Social Phobia (SP), but well-planned direct comparisons with control individuals, not suffering from a mental disorder, are lacking. Furthermore, MDD is highly comorbid with anxiety disorders, and SP with depressive disorders. This study is among the first to examine differences in well-being in individuals with a clinical diagnosis of MDD or SP compared to individuals with no such diagnosis and to test differences in well-being within the combined diagnostic categories respective with and without anxiety-depressive comorbidity. Method: Participants were 119 individuals with a diagnosis of MDD, 47 SP and 118 controls. Results: Results revealed that overall well-being as well as emotional, psychological, and social well-being were lower in the MDD and SP group compared to the control group. Individuals with comorbidity reported lower well-being than individuals without comorbidity. Conclusions: These findings have clinical implications as presence of comorbidity may require a different therapeutic approach than with no comorbidity.     

Utilitarian and emotion-related components of moral judgement: Gender and age effects and the relationship with prosocial and hostile roles in bullying

This study investigated the utilitarian and emotion-related components of morality, both as a function of gender and age and in relation to hostile vs. pro-social behaviors in bullying. We presented 45 primary and 62 middle school students with different types of moral and control dilemmas to assess their acceptance of utilitarian behaviors that did or did not violate moral norms (with high or low emotional involvement) in relation to their propensity to assume hostile and/or pro-social roles. We found greater acceptance of utilitarian solutions to dilemmas in boys, older children and those inclined to take on hostile roles. An inverse association was found between utilitarian styles and pro-social roles, particularly when utilitarian thinking violated a moral norm with high emotional involvement. We discuss these results in terms of different functioning styles in typically developing children.     

压力对“蚁族”群体心理健康的影响:希望的调节作用

以广州市棠下、上社、岑村、赤沙等地340名"蚁族"(高校毕业生低收入聚居群体)为被试,采用成人希望特质量表(ADHS)、压力知觉量表(CPSS)、一般心理健康问卷(GHQ),考察了"蚁族"群体的希望水平,并分析了希望在压力和心理健康之间的调节作用。结果发现:①从整体上看,该群体的希望处于中等偏上水平。②压力对于心理健康水平有显著的负向影响;希望能够起到压力缓冲作用,调节压力与一般健康问题、忧郁情绪和自我肯定感之间的关系。③希望对心理健康的忧郁、自我肯定维度的调节作用大小不同,对于忧郁情绪的调节作用更大,而对自我肯定调节作用较小。