Confidentiality and Mental Health/Chaplaincy Collaboration

Confidentiality can both facilitate and inhibit working relationships of chaplains and mental health professionals addressing the needs of service members and veterans in the United States. Researchers conducted this study to examine opportunities for improving integration of care within the Department of Defense (DoD) and Department of Veterans Affairs (VA). Interviews were conducted with 198 chaplains and 201 mental health professionals in 33 DoD and VA facilities. Using a blended qualitative research approach, researchers identified several themes from the interviews, including recognition that integration can improve services; chaplaincy confidentiality can facilitate help seeking behavior; and mental health and chaplain confidentiality can inhibit information sharing and active participation on interdisciplinary teams. Cross-disciplinary training on confidentiality requirements and developing policies for sharing information across disciplines is recommended to address barriers to integrated service delivery.     

Childhood maltreatment is associated with increased neural response to ambiguous threatening facial expressions in adulthood: Evidence from the late positive potential

Childhood maltreatment increases lifetime vulnerability for psychopathology. One proposed mechanism for this association is that early maltreatment increases vigilance for and attention to subtle threat cues, persisting outside of the environment in which maltreatment occurs. To test this possibility, the present study examined neural responses to ambiguous and nonambiguous threatening facial expressions in a sample of 25 adults reporting a history of low-to-moderate levels of abuse in childhood and 46 reporting no or low levels of childhood maltreatment. The measure of neural response used was the late positive potential (LPP), a neural marker of sustained attention to motivationally salient information that is sensitive to subtle variation in emotional content. Participants passively viewed angry–neutral and fearful–neutral face blends and rated emotional intensity for each face. In the maltreated group, as fearful faces increased in emotional intensity, the LPP similarly increased, suggesting increased sensitivity to subtle variation in threatening content. Moreover, the LPP at each level of emotional intensity was not related to current symptoms of anxiety and depression. However, contrary to our hypotheses, adults with a history of abuse did not rate angry or fearful faces as more threatening, nor did they exhibit a larger LPP to angry faces, compared to controls. These findings suggest that childhood maltreatment may be associated with increased sensitivity to ambiguous threatening information in adulthood.     

Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: a meta-analysis

A meta-analysis of the group intervention research for parents of children with developmental disabilities was conducted in order to characterize the efficacy of treatments in reducing depressive symptoms and other forms of psychological distress associated with stress in parents of children with developmental disabilities. An extensive search led to the identification of 17 studies which were divided into three categories for comparative purposes: parenting education studies usually based on behavioral parent training, coping skills education studies based primarily on cognitive behavioral training, and studies that combined these methods along with other support services. Studies were rated for the quality of the research designs and of the reports. Consistent positive benefits were found in the form of reductions in parents' distress, and these effects were comparable to those reported in other syntheses of parenting interventions for parents of children without disabilities. The studies were evaluated in order to assess whether or not they met standards for established evidence-based practices. On the basis of the quality and number of the randomized trials, we present evidence to support the claim that there are established evidence-based interventions for reducing psychological distress at least in middle-class mothers in the short term. The interventions for fathers are promising as are the data on somewhat longer-term effects. The need for replications with a more diverse group of parents and longer-term follow-up were discussed. Multiple component interventions addressing both parent well-being and behavioral parent training were significantly more effective than either behavioral parent training or cognitive behavioral training along.