Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.     

Exploring Processes in Day-to-Day Parent–Adolescent Conflict and Angry Mood: Evidence for Circular Causality

Parent–adolescent conflict has been studied both as a precursor of long-term macrolevel developmental risks and as an outcome of microlevel, moment-to-moment interaction patterns. However, the family-level processes underlying the maintenance or regulation of conflict in daily life are largely overlooked. A meso-level understanding of parent–adolescent conflict offers important practical insights that have direct implications for interventions. The present study explores day-to-day reciprocal processes and carryover in parents’ and adolescents’ experiences of anger and conflict. Daily diary data provided by parent–adolescent dyads (N = 151) from two-caregiver households (adolescents: 61.59% female, mean age = 14.60 years) over 21 days were examined using a multivariate Poisson multilevel model to evaluate the circular causality principle in parents’ and adolescents’ daily conflict and anger. Findings offer empirical support for the theory, suggesting that parents’ and adolescents’ anger and conflict exist together in a feedback loop wherein conflict is both a consequence of past anger and also an antecedent of future anger, both within and across persons. Increased understanding of the daily interaction patterns and maintenance of parent–adolescent conflict can guide more informed, targeted, and well-timed interventions intended to ameliorate the consequences of problematic parent–adolescent conflict sequences.     

Reaching Up,Down, In,and Around: Couple and Family Coping During the Coronavirus Pandemic

The worldwide coronavirus (COVID-19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic’s challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience—“Reaching Up, Down, In, and Around.” “Reaching Up” includes accessing spiritual, religious, and ethical values. “Reaching Down” includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth’s recovery from decades of human-caused damage. “Reaching In” represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. “Reaching Around” involves reframing the mandate for “social distancing” as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed.     

Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

Anger Can Help: A Transactional Model and Three Pathways of the Experience and Expression of Anger

Anger is a significant human emotion with far‐reaching implications for individuals and relationships. We propose a transactional model of anger that highlights its relational relevance and potentially positive function, in addition to problematic malformations. By evolutionary design, physical, self‐concept, or attachment threats all similarly trigger diffuse physiological arousal, psychologically experienced as anger‐emotion. Anger is first a signaling and motivational system. Anger is then formed to affirming, productive use or malformed to destructive ends. A functional, prosocial approach to anger organizes it for protective and corrective personal and relational adaptation. In our model, threat perception interacts with a person's view of self in relation to other to produce helpful or harmful anger. Inflated or collapsed views of self in relation to other produce distinct manifestations of destructive anger that are harmful to self, other, and relationship. Conversely, a balanced view of self in relation to other promotes constructive anger and catalyzes self, other, and relationship healing. Clinical use of the model to shape healing personal and relational contact with anger is explored.     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Who is my Jung? Memories,Reflections, Prospects

The author describes his personal and professional journey in relation to the subject of the AJA 40^th anniversary conference, ‘Who is my Jung?’ The first part of the paper covers his early life and his attempt to bring together two opposing parts within him: valuation of a scientific approach, and an interest in the inner world, dreams and the paranormal. Discussion of his professional life follows, including his relationship with Gerhard Adler, past problems and splits within the Jungian community and the author's attempts to heal these. The value of both remembering and forgetting is questioned. This leads onto ideas that bring value and meaning to his work and life, and which bridge the inner divisions he felt in his early life: notably Jung's focus on applying scientific theory to the mystery of the psyche, his relational attitude (exemplified by the dialectical process and his interest in countertransference) and his theory of synchronicity. Recent discussion in Jungian writing has questioned the nature of synchronistic experiences and explored how they may emerge naturally from complex systems. The paper ends the author's continuing journey with two personal vignettes describing how meaning may emerge from the unconscious.