Social contexts: transcending their power and their fragility

For more than four decades, my colleagues and I have examined how social contexts and individuals influence each other. To provide a perspective on this work, I describe some lessons we have learned: situational influence exemplifies both the power and fragility of social contexts; common aspects of settings underlie their power, for better and for worse; individuals' health and well-being is affected by powerful forces in eight domains; and intervention programs are powerful settings that encompass risks as well as rewards. I then note some unresolved questions, such as how to balance the risks and rewards of powerful environments, how to better understand the interplay between individuals and the social contexts they select and create, how to learn from the fact that many people overcome the power of traumatic social contexts, and how to apply our knowledge to balance the risks and rewards of individual and community contexts.     

Concurrent disjoint and reciprocal classification by Cebus apella in seriation tasks: evidence for hierarchical organization

We report the results of a 4-year-long study of capuchin monkeys (Cebus apella ) on concurrent three-way classification and linear size seriation tasks using explicit ordering procedures, requiring subjects to select icons displayed on touch screens rather than manipulate and sort actual objects into groups. The results indicate that C. apella is competent to classify nine items concurrently, first into three disjoint classes where class exemplars are identical to one another, then into three reciprocal classes which share common exemplar (size) features. In the final phase we compare the relative efficiency of executive control under conditions where both hierarchical and/or linear organization can be utilized. Whilst this shows a superiority of categorical based size seriation for a nine item test set suggesting an adaptive advantage for hierarchical over linear organization, Cebus nevertheless achieved high levels of principled linear size seriation with sequence lengths not normally achieved by children below the age of six years.     

Do Brief Lab-Based Interventions Decrease Coercive Conflict Within Couples and Parent–Child Dyads?

Coercive conflicts between parents and children and between couples are implicated in the pathogenesis of a variety of psychological and physical health problems. Despite its seeming importance to population health, there are no widely available, easy-to-use methods with demonstrated efficacy to engage coercive conflict and reduce it. Identifying and testing potentially efficacious and disseminable micro-interventions (i.e., interventions that can be delivered in under 15 minutes via computer or paraprofessional) for targets with cross-cutting health implications, such as coercive conflict, is the focus of the National Institutes of Health Science of Behavior Change initiative. We experimentally tested four micro-interventions targeting coercive conflict in couple and parent–child dyads in a within-between design. There were mixed but supportive findings for the efficacy of most of the micro-interventions. Attributional reframing, implementation intentions, and evaluative conditioning all reduced coercive conflict as assessed by some but not all measures of observed coercion. No findings indicated any iatrogenic effects. Interpretation bias modification treatment improved at least one measure of coercive conflict for couples, but not for parents and children; additionally, it increased self-reported coercive conflict. Overall, these results are encouraging and suggest that very brief and highly disseminable micro-interventions for coercive conflict are a fruitful direction for inquiry. Optimizing micro-interventions and deploying them across the health care infrastructure could tremendously enhance family functioning and, in turn, health behaviors and health (ClinicalTrials.gov IDs: NCT03163082, NCT03162822).     

Opportunities of online analysis1

The question of whether tele-analysis is an acceptable way of conducting analysis has been discussed since it has become available. Merchant (2016) and others concluded that ‘the essentials of a genuine analytic process are not necessarily precluded’ (p. 1). In this paper, the author goes a step further and examines potential advantages of tele-analysis. There may be benefits for patients with a history of physical or sexual abuse who value the distance. The potential for a ‘safe place’ for work with erotic transference is also examined. In a further section the author is interested in allowing the analyst the freedom to practise in an authentic way, congruent with their personality. Also explored is the concept of the interactive field including the technological medium, which is subject to synchronistic events. Finally, the author gives examples of a deep connection between patient and analyst which came about despite the physical distance.     

From the Clinic to Schools: Iterative Development of a Depression Prevention Program for Adolescents With ADHD Within an Urban School System

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder, particularly among Black youth and youth in urban settings. In addition to well-documented academic and social dysfunction, ADHD is associated with increased risk for depression and suicide. However, there is a stark mismatch between services available and need among adolescents with ADHD, especially those from low-income backgrounds. Implementation of services in schools is one promising way to overcome barriers to care, decrease stigma associated with mental health care, and offer the ability to practice mental health skills in a more natural environment. As such, the current study aims to (a) describe the iterative development of a school-based depression prevention program (i.e., Behaviorally Enhancing Adolescents’ Mood in Schools [BEAMS]) for adolescents with ADHD in an underresourced, urban school district using stakeholder feedback; and (b) evaluate the preliminary effectiveness of an open trial of BEAMS. Raw data for all participants (n = 6; 83% Black, 17% biracial; 83% male) with indications for significant Reliable Change Indices are presented in addition to two case vignettes to illustrate treatment components and exemplify participant response. Pre- and posttreatment focus group data are presented to depict the development of the BEAMS program, lessons learned, and modifications made to BEAMS, in preparation for a larger randomized trial. Future directions are discussed.     

Taking control of violence against doctors

Violence against healthcare professionals is a serious but understudied global problem and one that lacks evidence-based solutions. The current research offers a novel explanation and intervention for addressing this issue: We propose that low feelings of control among patients and their family members play an important role in shaping doctor-patient relationships. To regain a sense of control, we suggest that patients attribute responsibility to doctors for their suffering, which may in turn lead to aggressive behavioural intentions against one's doctors. We conducted three studies to understand whether individuals with low perceived control blame doctors more, and whether threats to their sense of control cause participants to attribute more responsibility to doctors. Study 1 found that feelings of lack of control were an important predictor of attributing responsibility for negative illness-related incidents to doctors in a manner consistent with blame. Study 2 specified that the chaotic and unpredictable nature of illness, and not just its negative valence, is what drives attributions of increased responsibility to doctors. Study 3, which utilized a field setting in hospitals, found that an experimental intervention to increase feelings of control decreased frustration against (Study 3a/3b) and intention to harm doctors (Study 3b). These findings suggest that increasing feelings of control among patients can improve patient-doctor relationships. We also discuss the role of control and scapegoating during the COVID-19 pandemic.     

‘When my mummy and daddy aren't looking at me when I do my maths she helps me’; Children can be taught to create imaginary companions: An exploratory study

Spontaneous imaginary companion (SIC) creation in childhood is a typical imaginative play behaviour associated with advanced sociocognitive skills; however, the direction of causality has not been established. To investigate this experimentally, researchers must determine whether children can create, on request, qualitatively equivalent imaginary companions (ICs) to those created spontaneously. We examined whether children could create ICs, and how these compared to SICs. Nine elementary school children were encouraged to create ICs in a 3-month intervention. Accounts of elicited ICs were compared with an age-matched sample of interviewees with SICs. Seven children maintained ICs for 6 months post intervention. Template analysis of IC interviews found four themes: Realistic Play, Multifaceted IC Mind, Utility of the IC, and Elicited IC Across Time. Analysis suggests elicited and SICs were similar in nature and utility, although intervention ICs tended to have animal rather than human appearances. Findings support the argument that children can be encouraged to create ICs similar to SICs.