Tailoring Cognitive Behavioral Treatment for Binge Eating in Adolescent Girls

Whereas effective treatments exist for adults with recurrent binge eating, developmental factors specific to adolescents point to the need for a modified treatment approach for youth. We adapted an existing cognitive behavioral therapy treatment manual for adults with bulimia nervosa and binge eating disorder (Fairburn, 2008) for use with adolescents. This paper presents a number of clinical case vignettes, drawn directly from interactions with teen participants, that illustrate some of the developmental factors common to adolescents—as well as the importance of our adaptations to address for these factors.     

Parenting Cognitions Associated with the Use of Psychological Control

Psychological control is a pattern of parenting that is intrusive and manipulative of children's thoughts, feelings, and attachment to parents. Although little is known about the determinants of psychological control, it has been linked to the psychological status of the parent. We hypothesized that several parenting cognitions reflecting personal concerns would be associated with the use of psychological control: low perceived control, sensitivity to hurt, and a disapproving attitude to negative emotion. We also examined moderating associations with child temperament and child gender. Participants were 198 mothers and fathers of 3- and 4-year-olds (106 boys, 92 girls; M age = 4.10 years, SD = 0.26). Parents completed self- and spouse-report measures of psychological control, rated their child's temperamental characteristics, and completed measures of parenting cognitions. Predictions were generally supported for two of the three cognitions. Sensitivity to hurt and disapproval of negative emotion were associated with more frequent reported use of psychological control. There were some moderating effects of child characteristics.     

Therapeutic Intervention,Bipolar Inclination,and Literary Creativity

Richards (1997) proposes an "edge-of-chaos" theory of creativity, suggesting that circumstances that present widely disparate perspectives and ideas not perfectly coordinated with each other can stimulate creative thought, especially among persons of bipolar mood inclination. Barnes's (1996) play therapy procedure is well constituted to meet the criteria stipulated by this theory. Forty-four college students experienced 40 min of play therapy, and another 44 read and interpreted children's stories from different cultures. Half the students in each condition showed an inclination toward bipolar mood disorder as measured by the Millon Clinical Multiaxial Inventory (3rd ed.; Millon, 1994); the other half did not. Persons with an inclination toward bipolar disorder who underwent play therapy exhibited creative performance significantly more than other persons.     

Coping with Sexual Identity Stigma in the U.S. Military: An Examination of Identity Management Practices Prior to and After the Repeal of “Don’t Ask,Don’t Tell”

This study assesses the identity management strategies employed by gays, lesbians, and bisexuals in the U.S. military prior to and after the repeal of “Don’t Ask, Don’t Tell.” In-depth interviews were conducted with gay, lesbian, and bisexual service members and veterans. Data were analyzed using constant comparative analysis. Findings revealed that these service members made thoughtful and deliberate decisions about whether or not, and to whom, they would reveal their sexual identities. Identity concealment was practiced most often, even after the repeal, which was found to incite feelings of self-reproach, isolation, and stress. However, several new identity management strategies emerged after the repeal of “Don’t Ask, Don’t Tell” (i.e., strategies of openness) that stimulated positive self-feelings. By engaging in some level of openness, participants in this study were able to overcome some of the adverse effects of their minority stress.     

Parent Proneness to Shame and the Use of Psychological Control

We examined the link between parent proneness to shame and two forms of psychological control, overprotection and critical/rejecting behavior, in parents of preschoolers. Because shame is self-condemning, proneness to shame affects intrapersonal and interpersonal functioning. We hypothesized that parents’ emotion-regulatory responses to shame would increase the likelihood of psychological control: anxiety by leading to overprotection mediated by a worrisome approach to the child, and anger/hostility by leading to critical/rejecting parenting mediated by negative reactivity to the child. Participants were 198 mother-father pairs with a child 3.6 to 4.5 years of age. Overprotective and critical/rejecting parenting were assessed using both self and spouse reports of parenting practices. In addition, parents completed measures of proneness to shame, worrisome overconcern about the child, and negative reactivity to the child. Structural equation modeling yielded results that supported mediation by negative approach to the child for mothers’ and fathers’ critical/rejecting behavior. For fathers but not mothers, shame was indirectly associated with overprotective parenting through worrisome approach to the child. Parents’ proneness to shame may be an important factor leading to the use of psychological control.     

Shame and Depressive Symptoms: Self-compassion and Contingent Self-worth as Mediators?

Research has identified the experience of shame as a relevant predictor of depressive symptoms. Building upon resilience theory, this is the first study to investigate if self-compassion and/or contingent self-worth (i.e., family support and God’s love) mediate the link between shame and depressive symptoms. Participants were 109 African Americans, within the age range of 18 and 64, who sought service following a suicide attempt from a public hospital that serves mostly low-income patients. Findings suggest that shame was related to depressive symptoms through self-compassion but not through contingent self-worth, underscoring the significant role that self-compassion plays in ameliorating the aggravating effect of shame on depressive symptoms. Results highlight the value of incorporating self-compassion training into interventions for suicidal African Americans in an effort to reduce the impact of shame on their depressive symptoms and ultimately their suicidal behavior and as a result enhance their capacity for resilience.     

Varying response effort in the treatment of pica maintained by automatic reinforcement

Pica is a life-threatening behavior displayed by many individuals with developmental disabilities. In the current study, automatic reinforcement maintained the pica of 3 participants. Following functional analyses of pica, response-effort manipulations were conducted in which the effort to obtain pica or alternative items was varied systematically. Several general relations emerged as a result of the study. First, levels of pica were reduced relative to baseline when alternative items were available independent of the effort required to obtain alternative items or pica. Second, increasing the effort for alternative items resulted in increases in pica relative to when effort for alternative items was low. Third, increasing response effort for pica produced reductions in pica relative to baseline when alternative items were unavailable. Fourth, the highest levels of pica occurred when the effort to engage in pica was low or medium and no alternative items were available. These findings are discussed in terms of the relative effects of quality of reinforcement and response effort on behavior.