From abandonment to symbiosis: A developmental reversal in suicidal adolescents.

This article presents the abandonment-symbiosis hypothesis. This hypothesis pertains to the dynamics of suicide in youngsters who experience difficulties in separation from their symbiotic families. It is suggested that such youngsters have experienced various types of rejection and abandonment in early childhood and have developed insecure attachment styles and insufficient ego functions in order to cope with difficulties. It is also suggested that these youngsters have become scapegoats by their dysfunctional families and that they are held in a symbiotic grip in order to continue to bear the negative projections of their families. As such, they are prevented from developing a proper sense of individuation and autonomy. The sequence that begins with abandonment and continues with symbiosis is a reversal of normal development is critical for the emergence of suicidal behavior. The various aspects of the abandonment-symbiosis hypothesis are demonstrated by case studies and empirical data. A combination of individual and family treatment is recommended as the best approach for the treatment of such youngsters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of deployment on U.S. military families.

Several recent articles have explored the effects of military deployment on U.S. service members' mental health outcomes. Although increased attention has also begun to focus on the effects of deployment on military families, providing a conceptualization for the mechanisms of this process can help organize existing information and inform future efforts. In this article we seek to draw greater attention to the effects of deployment on service members and to provide an overview of recent literature on the impact of deployment on service members and military families. A further goal is then to provide one conceptual perspective—a model of family stability—that may help inform our understanding of the impact of military deployment on families. Beyond informing research, the issues presented in this article have far-reaching consequences not only for American military families and their current mental health and primary care providers but also for practitioners in the broader mental health community who will be increasingly called upon to provide services to this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survivors of childhood cancer and comparison peers: The influence of early family factors on distress in emerging adulthood.

This prospective study examines family predictors of distress among survivors of childhood cancer and comparison peers during the transition to emerging adulthood. Children with cancer (n = 55), comparison peers (n = 60), and parents completed measures of distress, family environment, social support, and demographic characteristics during initial treatment, as well as follow-up measures of young adult distress and demographic characteristics soon after participants turned 18 years old. Severity of initial treatment and late effects were rated by healthcare providers for participants with cancer. For all participants, mother and father report of initial parent distress was associated with their report of young adult distress at follow-up. Young adult gender moderated this association. For survivors of childhood cancer, severity of initial treatment and late effects also moderated the association between parent and young adult distress. Improving parent distress may help reduce child distress in general. For survivors specifically, ameliorating the impact of initial treatment and long-term physical problems may be beneficial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Taking charge: How families can climb out of the chaos of addiction.

Reviews the book, Taking charge: How families can climb out of the chaos of addiction by Stephen E. Schlesinger and Lawrence K. Hornberg (1998). In this guidebook the authors present their multimodel approach, which is designed especially for family members of an addict. The authors encourage the reader throughout the book not to feel ashamed to look for professional help. The reviewer can recommend this book as an excellent resource for professional work, either for individual therapy or as an introductory reading for groups. The reviewer appreciates very much the themes of this book--to help family members become more aware of their own needs, to repair the damage caused by addiction, and to reunite them for a more satisfying and happier life. This change in the family interaction holds great promise for the addict who wants to recover. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of A family like yours: Breaking the patterns of drug abuse.

Reviews the book, A family like yours: Breaking the patterns of drug abuse by James L. Sorensen and Guillermo Bernal (1987). A family like yours is a self-help guide aimed at families with a drug-abusing member. It attempts to fill a gap in the self-help literature on substance abuse and families. The problem readers may encounter is one of integrating without outside help the overwhelming amount of material presented. The chapters cover many basic concepts in family systems and life cycle theory without sufficient space devoted to particular concepts or points. Points are made with little elaboration, and the reader may not be able to integrate much of the material. However, for the family that is involved in treatment, the book may prove helpful in promoting insights into the functioning of the family and may serve as a valuable adjunct to treatment by provoking questions and insights that can move a family toward change. The authors' emphasis on providing the family support and optimism tempered by realistic limits may also serve to make this book a useful adjunct to treatment. This book serves as a valuable addition to the self-help literature on drug abuse in families and partially fills a gap currently existing in that marketplace. It covers a great deal of material that is not easily available to the lay reader at this time. This book is more likely to be insight provoking, practical, and motivating, however, to the drug abusing family that is in treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recommendations for Family Interventions Following a Suicide.

Consistent with a culturally competent, developmentally informed, and gender-sensitive integrative model of family therapy, this article provides a framework for therapists working with families following the suicide of a loved one. Recommended clinical interventions are provided and organized around commonly encountered themes: addressing psychological distress and painful affects, understanding denial as a protective coping strategy, appreciating and managing concerns about family disintegration, helping families deal with stigmatization, and creating a suicide story. Clinical vignettes highlight common challenges faced by families in response to a loved one's suicide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dissecting daily distress in mothers of children with ADHD: An electronic diary study.

It is well known that parents of children with attention-deficit/hyperactivity disorder (ADHD) experience elevated levels of caregiver stress, but little is known about the ebb and flow of parental distress as it happens, or the degree of synchrony between short-term oscillations in child behaviors and maternal distress. Electronic diaries (eDiaries) were used to dissect daily distress in natural settings. Across 7 days during nonschool hours, half-hourly eDiaries were completed independently by mothers and their 8- to 12-year-old children (51 receiving medication for ADHD and 58 comparison peers). Diary items tapped behaviors, moods, and contexts, with children reporting their own behaviors and mothers reporting on themselves and their children. Maternal distress and child ADHD-type behaviors exhibited moderate to strong associations “in the moment,” whether child behaviors were reported by mothers or children. This mother-child synchrony emerged for the comparison as well as the ADHD group, although the associations were stronger when the dyad included a child with ADHD. Because fixed-effects analyses were conducted, these patterns are not attributable to levels of psychopathology or other stable individual differences in mothers or children. Further moderation analyses revealed that the links between child behaviors and maternal distress were strengthened by maternal risk and attenuated by child behavioral self-esteem; these effects were modest but detectable. These findings can help guide not only interventions targeted on improving quality of life in families of children with ADHD, but also programs designed to help all parents identify and manage their own parenting stressors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Family functioning among adolescents with bipolar disorder.

This study examined the characteristics of families of adolescents with bipolar disorder during or shortly following a period of mood exacerbation, using measures of family conflict, cohesion, adaptability, and expressed emotion (EE). Demographic, diagnostic, and family functioning data were collected from 58 families (mean age = 14.48; 33 female, 25 male) before entering a randomized trial of family focused treatment. Compared to scale scores reported by healthy adolescents and their families, cohesion and adaptability were more impaired in families with an adolescent with bipolar disorder. Levels of conflict, while higher than normative scores reported by healthy families, were not significantly different from scores gathered from distressed, clinic-referred families. Parents rated high in EE reported less cohesion and adaptability, and more conflict, than parents rated low in EE. Parents expressing greater numbers of critical comments also reported more conflict than those who expressed fewer criticisms. These EE group differences were not accounted for by concurrent adolescent symptom levels. Family adaptability, cohesion, and conflict may be important targets for family treatments administered during the postepisode phases of early onset bipolar disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life events and personal causation: Some relationships with satisfaction and distress.

Hypothesized that Ss who engaged in more positive origin activities would rate their lives as more satisfying than Ss who engaged in fewer such activities, and both would be more satisfied than control Ss. After completing a series of questionnaires including a life-event inventory, 3 groups of college students were selected from a pool of 141 and given instructions either to (a) engage in 12 activities from a self-selected list of pleasurable activities, (b) engage in 2 activities from that list, or (c) return after 1 mo for retesting only. Ss were then given a pleasantness-of-events test, an event-frequency test, the Perceived Quality of Life Scale, the Beck Depression Inventory, and a 54-item Symptom Check List. Covariance analyses revealed that Ss instructed to engage in either 2 or 12 pleasurable activities reported greater pleasantness and a higher quality of life than controls; there were no differences between groups on reports of psychiatric distress. Prior negative life change was treated as a factor in the design and was found to interact with the activity instructions: Ss reporting many prior negative changes exhibited less psychiatric distress along with greater pleasantness when instructed to engage in 12 activities rather than 2 or none. Results suggest that pleasant activities increase positive aspects of well-being in general, but may reduce distress only for people experiencing considerable life stress. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnic background, therapeutic alliance, and treatment retention in functional family therapy with adolescents who abuse substances.

In this study, the authors examined the role of balance between adolescent-therapist and parent-therapist alliances in the retention of functional family therapy clients. Therapeutic alliances of mothers, fathers, and adolescents were assessed from videotapes of the 1st treatment session for 43 Hispanic and 43 Anglo families. Hispanic families who dropped out before completing the requisite number of sessions were found to have greater imbalance in alliance (parent-adolescent) than those who did complete therapy. However, this finding was not replicated with Anglo families. Results are interpreted in terms of previous research on family-level balanced alliance effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's failure to communicate: An assessment of comparison and egocentrism explanations.

Studied 2 possible explanations of why many young children communicate poorly on tasks that require them to discriminate referents from nonreferents: (a) poor communicators do not compare the associative strength of potential messages to the referent and nonreferent or (b) poor communicators engage in an egocentric form of comparison activity such that their messages have private but not public meaning. The latter implies that children who communicate poorly to another person could make effective use of their own messages. To examine these explanations, 64 good and poor communicators from grades 3 and 5 were asked to identify referents from their own messages. Ss who communicated poorly were also less effective than good communicators on the self-communication task. Data suggest that poor communicators do not engage in comparison activity even for their own private understanding. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of peer rape myth acceptance and disclosure in a sample of college sexual assault survivors.

There are many empirically supported treatments available to help sexual assault survivors improve their postassault outcomes. Unfortunately, many survivors do not disclose their assault to others or seek formal treatment services and thus are not able to benefit from these treatments. This study examines the relations between survivors’ perceptions of peer rape myth acceptance (RMA), disclosure behaviors, and psychological well-being. Sixty-four sexually assaulted college undergraduates and 159 of their nonassaulted peers participated in this study. Survivors significantly overestimated their peers’ RMA, and this overestimation predicted posttraumatic symptoms. Contrary to hypotheses, the relation between estimated peer RMA and posttraumatic distress was not mediated by assault disclosure variables. As estimated peer RMA increased, survivors reported disclosing fewer assault details. These findings have implications for both sexual assault survivors and the general population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of help seeking for emotional distress among Chinese Americans: Family matters.

Using data from the Chinese American Psychiatric Epidemiological Study, the authors examined longitudinal predictors of help seeking for emotional distress in a community sample of 1,503 Chinese Americans. Specifically, they assessed the relative contribution of family relational variables (e.g., levels of family support and family conflict) in predicting help seeking for medical, mental health, and informal services. After traditional need, predisposing, and enabling factors were controlled for in hierarchical logistic regression analyses, family conflict predicted both mental health and medical service use, whereas family support was not predictive of help seeking. In addition to family conflict, mental health service use was predicted by negative life events, emotional distress, and insurance coverage. Implications of the findings for assessing and treating Asian American clients are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supporting and treating families with children on the autistic spectrum: The unique role of the generalist psychologist.

Research findings indicate that intensive behavior therapy (e.g., applied behavioral analysis, or ABA) represents an effective treatment for autistic spectrum disorders. Unfortunately, children with autism represent an underserved patient population. Parents often make treatment decisions with insufficient information and report problems in establishing and maintaining treatment programs. This practice review asserts that psychologists, including those without professional certification or coursework in ABA, are in a unique position to assist affected children and their families. Psychologists can provide critical information about evidence-based treatment; offer assistance in overcoming barriers to intensive treatment, including personnel selection; and provide ongoing support to family members. Case examples also illustrate how psychologists can help families address specific barriers to intensive treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Mothers and Toddlers Program: Preliminary findings from an attachment-based parenting intervention for substance-abusing mothers.

The authors examined pilot data from an attachment-based parenting intervention for substance-abusing mothers of toddlers (ages 12-36 months). The Mothers and Toddlers Program (MTP) is a 20-week individual therapy intervention that aims to help mothers develop more balanced representations of their children and improve their capacity for reflective functioning (i.e., recognition of the intentional nature of children's behavior). The authors hypothesized that improvement in maternal representational balance and maternal capacity for reflective functioning would correspond with improvements in maternal behavior with toddlers (e.g., sensitivity to cues, responsiveness to distress, and social-emotional growth fostering) and reduction in maternal psychiatric distress and substance abuse. Eight mothers who completed MTP showed moderate improvements in representational balance and reflective functioning, and these changes corresponded with significant improvements in maternal behaviors with toddlers. The authors also compared MTP completers and noncompleters on sociodemographic and psychosocial indexes and examined the validity of the intervention's proposed mechanisms of change. Preliminary findings support the importance of attachment mechanisms and indicate that attachment-based interventions may strengthen substance-abusing mothers' capacities to foster their toddlers' socioemotional development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Involvement of fathers in therapy: A survey of clinicians.

Clinicians providing treatment for children and families often question which family members to include in therapy. Historically, mothers were included in child-oriented therapy to a greater degree than were fathers. To determine actual rates of including fathers in therapy, 219 clinicians with specialization in clinical child psychology and family therapy were surveyed . In addition, personal and professional characteristics of clinicians were examined to establish the association between these characteristics and inclusion of fathers in treatment. Ways to help clinicians include fathers in child-oriented therapy are discussed in light of the findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decreased family accommodation associated with improved therapy outcome in pediatric obsessive–compulsive disorder.

Pediatric obsessive–compulsive disorder (OCD) is a chronic, disabling condition that affects both patients and their families. Despite the identification of efficacious treatments (e.g., cognitive–behavioral therapy and selective serotonin reuptake inhibitor medications), not all patients respond fully. The purpose of the present study was to examine whether the amount of family accommodation provided to pediatric patients with OCD is associated with treatment outcome, and whether decreases in accommodation are associated with improved outcome. The sample consisted of 49 youths (6–18 years of age), who participated in 14 sessions of family-based cognitive–behavioral therapy for OCD, and their parents. Participants completed measures at pretreatment and posttreatment. Results indicate that family accommodation was prevalent among families of pediatric patients with OCD and that such accommodation was associated with symptom severity at pretreatment. In addition, decreases in family accommodation during treatment predicted treatment outcome, even when controlling for pretreatment OCD severity–impairment. Results suggest that the level of accommodation provided by the family may indicate an important obstacle to, or predictor of, treatment outcome in pediatric OCD. Directions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Siblings of military servicemembers: A qualitative exploration of individual and family systems reactions.

How does having a sibling in the military affect young adults? Despite increasing attention to the challenges faced by spouses and children of servicemembers, the siblings of servicemembers have been largely ignored in the existing literature. This qualitative investigation uses unstructured narratives to explore siblings' perceptions of changes in their lives and changes in the family of origin associated with having a family member enlist in the United States military. Thematic analyses revealed an acute period of conflict followed by reorganization, awareness of the parents' distress, changes in the emotional climate of the family, shifts in family roles, admiration for the military sibling, and increased meaning and purpose for the family following the servicemember's enlistment. Computer-assisted text analyses revealed both positive and negative emotional expressions associated with the siblings' military service. For professional psychologists who come into contact with siblings of servicemembers, it is important to recognize that military enlistment can have ripple effects and complicate other common individual and family stresses. More generally, it is important to provide siblings and the family of origin with information about what to expect during and after the servicemember's enlistment, especially since these families may lack support from and contact with others going through similar transitions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Adjusting to life when assisted conception fails

According to our basic (psychosomatic) tenet, every somatic problem has its emotional side; therefore, medical treatment and counselling are not separate but are interlinked and equally important. First interviews and interviews after failed assisted reproductive technology (ART) are held together in four person settings; the couple with two counsellors. The sessions last for approximately 1 h. The aim is to help patients escape the agonizing and distressing state in which they are kept by their foci (psychogenic aspects causing distress). Stress and iatrogenic factors are discussed and when patients are able to re-experience their suffering, many possible psychological effects on infertility and/or treatment failure are explored. If the patients consciously perceive these mechanisms of action, they will turn to their basic emotional needs and perspectives; approximately 30% of them will conceive later while approximately 20% opt for adoption. However, half of the patients take no positive action, neither giving up nor continuing with activities for a child. Nor do they seek counselling. The analysis of many of their reports argues in favour of an adaptive model for coping with reproductive failure.     

Promoting and Protecting Youth Mental Health Through Evidence-Based Prevention and Treatment.

For decades, empirically tested youth interventions have prevented dysfunction by addressing risk and ameliorated dysfunction through treatment. The authors propose linking prevention and treatment within an integrated model. The model suggests a research agenda: Identify effective programs for a broadened array of problems and disorders, examine ethnicity and culture in relation to intervention adoption and impact, clarify conditions under which programs do and do not work, identify change mechanisms that account for effects, test interventions in real-world contexts, and make tested interventions accessible and effective in community and practice settings. Connecting the science and practice of prevention and treatment will be good for science, for practice, and for children, adolescents, and their families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)