Post-discharge outcomes for mothers and the mother–infant relationship following admission to a psychiatric Mother–Baby Unit

Mother–Baby Unit research has focussed on maternal psychopathology over the course of an admission. Less is known about the baby's well-being, the shared relationship, or the mother's recovery. In an initial sample of 45 women, we describe discharge and post-discharge outcomes for maternal psychopathology (using maternal report and the Global Assessment of Function, GAF) and the mother–infant relationship (using the Child and Adult Relational Experimental Index, CARE Index). Three months post-discharge, one third of women described themselves as “completely recovered,” one third were experiencing significant deterioration and 17% were readmitted to inpatient care. Poorer GAF scores were associated with a clinical diagnosis of comorbid personality disorder, antenatal presence of the index illness, partner illicit substance use, maternal perception of her bond, infant social withdrawal, and child protection concern. Post-discharge, the mother–infant relationship results were concerning. Only 17% were regarded as adequate. Improvement was observed across this period in 56% but relational deterioration occurred for 35%. Maternal and relational outcomes were weakly correlated at discharge (r² = 0.29, p = 0.07) but this was lost post-discharge (r² = 0.03, p = 0.89). The shared relationship and infant mental health should both be targets for intervention; both during MBU admission, and post-discharge.     

原发性乳腺癌新辅助化疗与过度医疗、无效治疗

新辅助化疗已经使众多原发性乳腺癌患者受益.依据不同的判断标准,它又可以被视为无效治疗或过度医疗.新辅助化疗应用于临床,引起了哲学意义上的争议.医者原因是重要原因之一.要重视矛盾问题"底线"的研究,提供相对宽松的技术、学术、文化氛围;医者持续的、有计划的学习与培训是增强其主体性的保证和前提.     

经济心理学:超越与创新

经济心理学超越了传统经济学在理论假设、研究方法等方面所面临的困境,拓展了心理学对于学科界限的自我困囿．并以其独特的学科分野、理论贡献和跨学科的研究方法实现了对人类经济行为的更好解释与预测,对于现实经济生活它也已经并将继续发挥其独有的作用。     

Interrater agreement on behavioral executive function measures in adolescents with Attention Deficit Hyperactivity Disorder

Background/ObjectiveThough most children with Attention Deficit Hyperactivity Disorder (ADHD) show difficulties in behavioral measures of executive functions (EF), few studies have examined interrater agreement in these measures.Objective: To analyze the agreement between parents, teachers and self-reports of behavioral EF in adolescents with ADHD and controls. Method: A sample of 118 adolescents (75 with ADHD and 43 controls) was rated by parents, teachers and the adolescents themselves using the Comprehensive Executive Function Inventory. The intraclass correlation coefficient (ICC) and Bland and Altman methods were used to evaluate agreement. Results: The ICC between parents, teachers and self-report was poor or moderate in the group with ADHD; in the control group the agreement was fair to good. The Bland and Altman graphs show that, in the control group, most of the scores are below to the clinical cut-off point, while in the group with ADHD they are above. Conclusions: Agreement between all raters was low. Parents, teachers and adolescents agreed on the absence of deficits in behavioral EF in the control group, and on the presence of deficits in the group with ADHD, although they did not agree on the frequency of these deficits.     

The Cultural Adaptation of a Community‐Based Child Maltreatment Prevention Initiative

A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6‐year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community‐level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community‐based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance.     

The future of Jungian analysis: strengths,weaknesses, opportunities,threats (‘SWOT’)

Using a methodology derived from management and organizational studies, the author reviews the future of Jungian analysis. The methodology is termed SWOT – strengths, weaknesses, opportunities, threats. A selected list in each of these categories is presented. The author is transparent in allowing for the fact that the paper not only derives from a public lecture on the topic, but also retains the immediacy and the contrarian and opinionated style of such a lecture.     

Religion and civic engagement: the case of Iglesia ni Cristo in the Philippines

The Iglesia ni Cristo (INC) is one of the fastest-growing indigenous Christian churches in the world. They have an estimated membership of 2.25 million adherents in more than 100 countries. In recent years its civic engagements have expanded through bigger relief operations and charity dedicated to the poor and those affected by calamities. These initiatives are typically articulated in terms of unity, duty and obedience to God. This article gives attention to this expansion by spelling it out and explaining it in view of its newfound role in civil society. This is an important intervention in the literature. Studies on INC have mainly focused on its successes in the political and religious spheres. INC now repackages itself as a civic organisation, which cares about public welfare. My argument is that this is how it manifests its new triumphalism in the Philippines, but with implications on its expanding presence in civil society.     

Immigrant youth of Indian origin: Generational differences in self-critical perfectionism

A community sample of foreign-born first generation (n = 53) and U.S.-born secondgeneration (n = 57) youth of Indian origin (ages 18–25) was studied. Variables predicting self-critical perfectionism were perceived prejudice, enculturation, and communication difficulty with parents and their interaction with generation status. The differences between the two generations pointed to nuanced self-pressures of Indian immigrant youth, despite good academic standing and middle-class family income. Implications discuss counseling with Indian immigrant youth.     

Interventions to Empower Adults with Eating Disorders and Their Partners around the Transition to Parenthood

The transition to parenthood is perceived as a stressful life event, when parents experience an immense change of their psychological focus and a reorientation of roles and responsibilities in the family system. This process may be even more challenging in the presence of a parental eating disorder history. This paper reviews the impact of parental eating disorders on the parents, the couple relationship, and their child during the perinatal period. A parental eating disorder is associated with more negative expectations of parental efficacy as well as specific difficulties in couple communication over the child’s feeding, shape, and weight. Providers who better understand the effects of an eating disorder on parental functioning can more effectively intervene early on. We also present couple- or parent-based, empirically supported interventions for adults with eating disorders and their partners in the prenatal and postnatal periods: Uniting Couples in the treatment of Anorexia Nervosa (UCAN) and Uniting couples In the Treatment of Eating disorders (UNITE) both enhance recovery from the eating disorder through a couple-based intervention; the Maudsley Model of Treatment for Adults with Anorexia Nervosa (MANTRA) incorporates the support of partners, when appropriate; Parent-Based Prevention (PBP) focuses on improving parental functioning and reducing risk of negative parental and child outcomes. Finally, we discuss the clinical implications of addressing parental eating disorders and encourage more research on these families.     

Dreaming under fire: the psyche in times of continuous stress

Continuous stress and trauma are manifested in dreams, the study of which can expand our knowledge concerning unconscious reactions to trauma and efforts of coping with continuous traumatic situations. In our research we asked people living under continuous threat of rocket attacks to record their dreams and their associations to them during four consecutive weeks. We collected 609 dreams from 44 women and 18 men (age range 14-62). The dreams submitted were analysed according to the Jungian approach in the light of the information and associations presented by the subjects. Full dream series of dreamers from each group were analysed in an attempt to capture the depth-psychological experience of living and dreaming under fire. The most frequent themes found were: ‘concrete vs. symbolic', ‘togetherness', ‘active ego', ‘fear and anxiety', ‘shadow' and ‘personal issue'. The subjects were divided into three age groups. Differences between the occurrences of themes were examined. On the unconscious level our results showed that the adolescents group seemed to be the most vulnerable to the stress situation (preponderance of concrete dreams), the mature adults group was the least influenced by it (preponderance of symbolic dreams and of the ‘personal issue' theme) and the young adults group made the greatest psychological efforts for coping (preponderance of ‘active ego' theme). We noted few anima figures appearing in the men's dreams, while animus figures appeared in the women's dreams. In another study undertaken immediately after one of the recent wars in Gaza we collected dreams of Israelis living in the south of Israel who were under heavy daily rocket attacks, and dreams of Palestinians living in the West Bank. The most significant difference we found between the groups was a preponderance of symbolic dreams among the Palestinians, as opposed to a preponderance of concrete trauma dreams among the Israeli group living on the Gaza border. In both groups we found archetypal symbols of evil. In conclusion, dreams can help us detect emotional distress, even when subjects seem ‘ok'. Early detection and working with dreams can help prevent the severity of delayed PTSD.