Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Coping strategies in obsessive-compulsive patients during Covid-19 lockdown

Background/ObjectiveThe main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpretation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depression levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.     

Behavioural deficiencies of aggressive 8–9 year old boys: An observational study

The nature of aggressive boys' behaviour is examined. Pre-selected matched pairs of aggressive and control boys were observed in a naturalistic setting which facilitated comparison of the way in which recorded behaviours affected their respective peer relationships. A continuous commentary describing the child's interactions with others was recorded simultaneously with the child's speech during school play. These data were transcribed and coded according to activity, social participation, neighbours, and interactions. Individual behavioural items were grouped on the basis of their functional similarity. Marked differences were found between the two groups on certain categories, giving a clear indication of specific deficiencies in the behavioural repertoire of the aggressive boys.     

Lack of effects of environmental changes on agonistic behaviour patterns in a stabilizing group of stumptailed macaques (Macaca arctoides)

To evaluate how constant the form of agonistic interactions in the event of environmental changes is, a group of 11 stumptailed macaques, formed shortly before the start of the study, was observed under the following spatial conditions: in 10 and 18 m² cages, and in a 50,000 m² woodland. Results showed that the frequency of agonistic interactions was little affected by spatial density; however, the number of participants involved in aggressive interactions increased in the cage. Formal biting, which presumably acts as a regulator of social tension, was less frequent in the park. Patterning of agonistic interactions was little affected by spatial density. Such “robustness” makes the form of aggression liable to be used as a potentially useful parameter in interspecific comparisons.     

Conversation Orientation Moderates the Relationship between Information Sharing of Medically Assisted Reproduction and Child Adjustment

Parents who experienced infertility have increasingly used medically assisted reproduction (MAR) to add children to their families over the past few decades. These parents will need to decide if they will tell their children about being conceived using MAR. Although MAR information sharing operates within family contexts, little is known about the role of conversation orientation—one family contextual factor—in child outcomes associated with MAR information sharing in middle childhood. Derived from the Family Communication Patterns Theory, this study proposes that conversation orientation moderates the associations between MAR information sharing and children's psychosocial adjustment. This proposal was tested using a sample of 81 6- to 12-year-old MAR-conceived children from 55 families and a structured observational measure of conversation orientation. Multiple regression analyses showed that MAR information sharing interacted with conversation orientation to influence children's behavioral and attention problems but not emotional problems. In families with high conversation orientation, MAR information sharing was not significantly associated with children's behavioral and attention problems. In families with low conversation orientation, MAR information sharing was significantly associated with an increase in children's behavioral and attention problems. Results of this exploratory study demonstrate the potential significance of general communication orientation in understanding child outcomes of MAR information sharing and highlight the needed family context nuances in MAR research.     

Fathers’ Dosage in Community-based Programs for Low-income Fathers

Community-based programs for low-income fathers often struggle to get fathers to attend services and activities. This paper reviews the literature examining approaches to measuring dosage in fatherhood programs, rates of dosage, influences on dosage, and the associations between dosage and fathers’ outcomes. Studies were limited to programs that conducted randomized control trials, quasi-experimental studies, and one-group pretest/post-test designs. Although most programs report low or moderate dosage levels, some programs achieve high levels of fathers’ participation in parenting, coparenting, and economic security classes. Few studies examined dosage in relation to father outcomes. All but one of seven studies reporting effects showed that higher dose levels had positive associations with outcomes such as engagement with children, parenting satisfaction and self-efficacy, perception of coparenting quality, payment of child support, and earnings from work. This paper discusses future directions for studying father's dosage in fatherhood programs.     

Romantic Conflict Narratives in Emerging Adult Couples: Viewpoint and Gender Matter

Healthy romantic relationships entail understanding the needs of the self and other when interpreting conflict events. Yet how couples make meaning around specific conflicts and their capacity to reflect on their own and their partners’ unmet needs is understudied. Using narratives, we examined destructive (e.g., extreme anger and break-up anxiety) and constructive (e.g., perspective taking) interpretations of past romantic conflicts in 80 emerging adult heterosexual couples and the extent to which such interpretations varied by viewpoint and gender. Couple members were interviewed separately about two conflict episodes in which their partner did not meet their needs (victim viewpoint) and two episodes in which they did not meet their partners’ needs (perpetrator viewpoint). As anticipated, destructive interpretations were more evident in the victim viewpoint and for female couple members. In contrast, within constructive interpretations, the use of insight was greater in the perpetrator than the victim viewpoint. Although perspective taking was expected to be more common in the perpetrator viewpoint and in female narratives, this was not the case, as this type of constructive interpretation was infrequent in narratives about conflict. The findings revealed aspects of meaning making that might be useful to mental health professionals concerned with building skills to improve romantic competence in emerging adult couples.     

The Role of Children's Neurophysiological Functioning in the Links Between Emotion-Parenting Behaviors and Child Anxiety Symptoms: A Biological Sensitivity to Context Framework

A plethora of data supports links between parenting behaviors and child anxiety, but few studies have examined factors that can contribute to variability in these relations. Adopting a biological sensitivity to context framework, this study explored the role of children's physiological stress reactivity in the links between emotion-parenting and child anxiety symptoms in a group of Chinese families. Sixty-one parent–child dyads (child M_age = 8.21 years, SD = 1.40, range = 6–12 years) participated in an acute stress protocol, from which children's physiological (cortisol and respiratory sinus arrhythmia) responses to a social speech task were recorded. Participants then completed questionnaires assessing parents’ emotion-parenting behaviors and children's anxiety symptoms. Results showed that the relation between supportive emotion-parenting and child anxiety was stronger in the context of greater child RSA suppression to acute stress, such that children higher in RSA suppression exhibited lower anxiety symptoms when supportive emotion-parenting was higher than when it was lower. Thus, these findings supported the biological sensitivity to context model. No significant moderation effect was detected for cortisol reactivity or recovery. Instead, exploratory mediation analyses showed that supportive emotion-parenting was negatively related to child anxiety via greater cortisol recovery. There was also a significant indirect path where unsupportive emotion-parenting was related to blunted cortisol recovery, which in turn was associated with higher child anxiety. The results highlight the importance of coaching parents to respond in supportive ways to children's emotional expressions, particularly in the context of greater child reactivity, to help buffer against childhood anxiety symptoms.     

A Phenomenological Study on the Experience of Syrian Asylum-Seekers and Refugees in the United States

Violence in Syria has displaced an unprecedented number of people from their homes. While couple/family therapy (C/MFT) scholars have explored migration experiences, particularly among refugees, there is still limited research using a bioecological framework. This exploratory study examined the experiences of Syrian asylum-seekers and refugees living in the United States using a qualitative phenomenological approach. Twelve Syrians (n = 8 men, n = 4 women) between 20 and 52 years of age (M = 35.8, SD = 10.7) were interviewed about their experiences across three stages of resettlement: (1) pre-resettlement, (2) resettlement/migration, and (3) post-resettlement. Findings suggest that the effects of conflict-induced displacement and resettlement permeate across multiple ecologies. These range from the individual and his or her interpersonal relationships to their larger community and society. C/MFTs should account for contextual factors while becoming familiar with the sociopolitical impact of displacement and resettlement in their clinical work with this population.     

Perceived Collective Efficacy and Parenting Competence: The Roles of Quality of Life and Hope

Parents' perceptions of their parenting competence predict successful implementation of parenting tasks and contribute to their interest and involvement in parenting and to their children's development. Thus, identifying factors that contribute to parents' perceptions of parenting competence can help inform efforts to promote children's safety and well-being. The present study employs social disorganization theory to examine the relationship between collective efficacy and parents' sense of competence, measured along two dimensions: parental efficacy and parental satisfaction. It examines the direct association between the two constructs and whether the association is mediated by parent perceptions of their quality of life (QOL) and sense of hope. Data were collected from 198 parents residing in a neighborhood in southern Tel Aviv, Israel. The analyses indicated that high collective efficacy was directly associated with high parental efficacy, but not with high parental satisfaction. Using structural equation modeling, a mediation model was found whereby higher collective efficacy was associated with (a) higher QOL, which in turn was related to a greater sense of hope, which was linked with higher parental efficacy; and (b) higher QOL, which was directly associated with higher parental satisfaction. The findings provide further support to the idea that neighborhood characteristics play an important role in parents' ability to care for their children.