Race in the Space: Clinical Considerations for Addressing Race in Treatment

During a period of intense racial unrest in the nation, we were working as clinicians delivering a manualized protocol to LGBTQ adults of varying racial and ethnic backgrounds. Intrigued by the differences in our modes of engagement with clients, we, a Black, cis female therapist and White, cis male therapist, set out to further explore how our positionalities informed our communications with, and expectations of, White and non-White clients during this time. In this paper, we reflect on these differences when delivering therapy in cross-racial and same-race dyads. We highlight where our experiences overlap as clinicians trained in the same program and where they diverge due to our respective worldviews. We conclude with considerations for practitioners to engage with race in psychotherapeutic treatment.     

Hair sampling for cortisol analysis with mother-toddler dyads living in low-income homes

BackgroundA first step to advance stress science research in young children is understanding the relationship between chronic stress in a mother and chronic stress in her child. One non-invasive measure of chronic stress is hair cortisol. However, little is known about strategies for hair sampling in mother-toddler dyads living in low-income homes in the U.S. To address prior limitations, the purpose of this study was to understand the feasibility of sampling hair for cortisol analysis in mother-toddler dyads living in low-income homes in the U.S. We examined feasibility related to participation, eligibility, and gathering an adequate hair sample weight.MethodsWe approached 142 low-income, racially diverse, urban-dwelling mothers who were participating in an ongoing longitudinal birth cohort study for informed consent to cut approximately 150 hairs from the posterior vertex of their scalp and their toddlers’ (20–24 months) scalp. We demonstrated the process of sampling hair with a hairstyling doll during home visits to the mother and toddler using rounded-end thinning shears.ResultsOverall, 94 of 142 mother-toddler dyads (66 %) participated in hair sampling. The most common reason for participation refusal was related to hairstyle. All but three hair samples were of adequate weight for cortisol extraction.DiscussionThe findings from this study can help researchers address sampling feasibility concerns in hair for cortisol analysis research in mother-toddler dyads living in low-income homes in the U.S.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Changes over time in head and neck cancer patients’ and caregivers’ illness perceptions and relationships with quality of life

Objective: This study investigated changes in illness perceptions from diagnosis to six months later in patients with head and neck cancer (HNC) and their caregivers. The study also examined whether discrepancy in patient and caregiver perceptions at diagnosis predicted patient health-related quality of life (HRQL) at six months.

Design: Forty-two patient–caregiver dyads completed the Brief Illness Perception Questionnaire (Brief IPQ) at diagnosis and again six months later. Patients also completed a HRQL questionnaire at both time points. Analyses were performed using the Actor–Partner Interdependence Model.

Main Outcome Measure: Total patient HRQL assessed by the Functional Assessment of Cancer Therapy (FACT-H&N).

Results: Perceptions of emotional impact and illness concern reduced over time in patients and caregivers. Perceptions of treatment control and identity increased in caregivers only. After controlling for the effects of baseline HRQL, and the individual contribution of patient and caregiver illness perceptions, greater discrepancy in perceptions of timeline, personal control, and illness identity among dyads at diagnosis predicted lower patient HRQL at six-month follow-up.

Conclusion: Patients’ and their caregivers’ perceptions of HNC are dynamic over time. Greater discrepancy between patients’ and caregivers’ illness perceptions at diagnosis predict poorer subsequent patient HRQL.     

Differences between follower and dyadic measures of LMX as mediators of emotional intelligence and employee performance,well-being,and turnover intention

Both leader and follower emotional intelligence (EI) have been posited in the literature to influence leader–member exchange (LMX). We collected data from 203 independent leader–follower dyads working in the insurance industry in Malaysia and examined relationships between leader and follower trait-EI and follower outcomes mediated through LMX. We added a further dimension to our study by comparing results using follower and then a dyadic measure of LMX. We found that leader EI predicted a dyadic measure of LMX, whilst only follower EI predicted a follower measure of LMX. As hypothesized, leader EI had both direct and indirect effects on follower job performance. By contrast, follower EI demonstrated both direct and indirect effects on follower well-being. We found a dyadic measure of LMX to be a stronger predictor of follower job performance, well-being, and turnover intention than a follower only measure. Our results suggest that significant relationships between leader and follower trait EI and LMX depend on whether follower or dyadic measures of LMX are used. The study draws attention to the importance of emphasizing the level at which EI effects are expected to operate in LMX.     

Affect and the therapeutic action of psychoanalysis1

In connection with controversial IJP articles by Stern et al. and Fonagy on the interpretation of the repressed and the recovery of past memories, the author maintains that the affect that is inherent in positive transference is at the heart of therapeutic action. Points of view put forward in the controversy (based on neurobiological knowledge) are related to Freudian metapsychology, as well as to their precursors whose scope was necessarily limited by a lack of access to more recent scientific discoveries. The author demonstrates metapsychological elements of therapeutic action inherent in the intersubjective relationship, especially identification, manifested in introjection and empathy. He describes cognitive development as spontaneously blossoming from the affective nucleus, and he explains the neuroscientic bases of this step forward. The classic (interpretative) psychoanalytic method makes up the cognitive superstructure necessary for the organisation of the mind that has sprung from the affective substructure. As a primary factor in psychic change, interpretation is limited in effectiveness to pathologies arising from the verbal phase, related to explicit memories, with no effect in the pre‐verbal phase where implicit memories are to be found. Interpretation the method used to the exclusion of all others for a century is only partial; when used in isolation it does not meet the demands of modern broad‐spectrum psychoanalysis, as the clinical material presented illustrates.     

从人际关系看人格--认知-情感系统理论的视角

人格的认知—情感系统理论(cognitive-affective system theory of personality,简称CAPS)被视为是与大五人格理论齐名的一种人格理论。该文拟从个体外部的人际关系层面来阐述该理论,以加深对理论的理解。然后,又从CAPS与其它人际关系理论的契合说明该理论是一种整合性的人格理论。最后,指出了CAPS的优点和局限性,并由此对人格研究的未来发展方向进行了探讨。     

Stressed parents: a dyadic perspective on perceived infant temperament

The study employed the actor–partner interdependence model (APIM) to test whether one parent's experiences of recent life events as more stressful (the PSS) are associated with the same parent's own (the actor effect) and the other parent's (the partner effect) perceptions of the infant temperament as more negatively and/or less positively tuned (the IBQ; n=584 parents, 292 dyads). The results indicated that the more stress one parent reported the more negatively tuned were the same parent's own, and the other parent's perceptions of the infant. Perceptions of the infant temperament were least positive for members of parent dyads who were more, relative to less, similar in the experienced stress. The associations were independent of the parent gender and the parent‐reported level of trait anxiety. The findings augment prior knowledge on the factors that steer parental perceptions, and suggest that the dyadic perspective may offer valuable insight into the dynamics of interacting within a family consisting of two biological parents and an infant. Copyright © 2006 John Wiley & Sons, Ltd.     

The mind-brain relationship: the emergent self

This paper explores the mind-brain relationship, using insights from contemporary neuroscience. It seeks to investigate how our brains become who we are, how subjective experience arises. In order to do this some explanation is given of the basic concepts of how the brain produces our subjective mental life. Current neuropsychological and neurobiological understanding of early brain development, memory, emotion and consciousness are explored. There is also an attempt at mapping the mind-brain-self relationship from a uniquely Jungian perspective. Clinical material is included in order to show the relevance of these insights to our work in the consulting room, arguing the value of the affect-regulating, relational aspects of the analytic dyad that forge new neural pathways through emotional connection. Such experience forms the emotional scaffolding necessary for the emergence of reflective function.