Bulletin of the Menninger Clinic最新文献

The term Failure to launch (FTL) has been used to describe abled adults who do not work, do not attend school, and live with- and at the expense of-their parents. FTL can be beneficially addressed through parent training, a treatment method that is rarely used with adults (i.e., individuals past the age of majority). The authors first review the goals of parent training programs offered to parents of adults. The review demonstrates that these goals dovetail with key aspects of FTL. The authors then describe a new parent training approach for parents of individuals with FTL, based on SPACE (Supportive Parenting for Anxious Childhood Emotions). They highlight five key components of SPACE-FTL: Psychoeducation, Reducing Parental Accommodation, Increasing Parental Support, De-Escalation, and Engaging Supporters. The authors conclude by discussing SPACE-FTL in relation and comparison to other parent training programs and their components.

Mindfulness and forgiveness can contribute to decreased rumination, which in turn has been found to play an important role in sleep problems, such as insomnia and poor sleep quality. The authors explored rumination as a potential explanatory variable underlying the association of mindfulness with insomnia and sleep quality, with a model encompassing different mindfulness facets and controlling for interpersonal dispositional forgiveness. One hundred adults (74% females, M_age = 27.62, SD = 8.11) completed measures of Mindfulness, Forgivingness, Rumination, Sleep Quality, and Insomnia. Nonjudging was the main mindfulness facet contributing to better sleep quality. Rumination completely mediated the associations of nonjudgmental attitude with insomnia and sleep quality, and partially mediated the associations of dispositional forgiveness with the outcomes. These findings suggest that a mindful nonjudgmental attitude toward the self and a forgiving interpersonal disposition may reduce rumination by helping individuals let go of thoughts, mental images, and emotions, thus promoting better sleep.

Although long-acting reversible contraceptives (LARC) remain the most effective method of contraception for teenagers, most adolescents continue to use less reliable methods. The purpose of this study was to investigate possible psychological factors that may lead to this low uptake rate by studying the LARC decisionmaking process among teenagers. In-depth, semistructured, open-ended interviews of sexually active teenagers who had LARC devices placed prior to 18 years of age were conducted. Four key themes emerged from the interviews: (a) the influences of peers (friends and family members) on LARC decision-making; (b) the lack of awareness about obtaining LARC devices; (c) the fear of weight gain as a driving force during contraceptive and LARC decision-making; and (d) the disproportional anxiety about pain from LARC insertion. The results suggest that a paradigm shift in contraceptive counseling is necessary in order to tackle these psychological barriers to teenage LARC use.

Sleep problems among frontline medical staff during the COVID-19 epidemic require attention. A total of 249 frontline medical staff who were recruited to support Wuhan completed this cross-sectional study. A web-based questionnaire about insomnia, depression, anxiety, and fatigue was used to assess mental health status. The prevalence of sleep disorders among frontline medical staff was 50.6%. More time spent in Wuhan and a history of insomnia, depression, anxiety, and fatigue were associated with a higher risk of insomnia. People who stayed in Wuhan for a long time with a history of insomnia, depression, anxiety, and fatigue symptoms might be at high risk of insomnia.

This qualitative study explored the treatment experience and the therapeutic relationship of participants receiving an integrated psychological treatment for comorbid alcohol use problems and depressive disorders. Semistructured interviews targeting experience of therapy and the relationship with the therapist were carried out with seven participants. Transcripts were analyzed using Interpretive Phenomenological Analysis to reveal major themes. Four major themes were identified. "Nature of the relationship" describes the importance of the client's perception of the therapeutic relationship experienced, "Confidence in therapy" and "Acknowledgment of experience" address components assisting the development of a positive alliance, and "Meeting unmet needs for connection" illustrates the importance of a positive therapeutic relationship for this population. Participants thought that clinicians would benefit from a good understanding of the role the alliance relationship plays within comorbidity treatment, of the need this relationship meets for this population, and the importance of engendering confidence in therapy and recognizing client perspectives.

The authors compared the defense mechanisms used by a community sample of people with and without self-reported psychopathic traits. Defense mechanisms were assessed using the Defense Style Questionnaire-60 and psychopathy was assessed using the Levinson Self-Report Psychopathy Scale in a sample of 225 adults recruited on the Internet. Results found that people with self-reported psychopathy traits used significantly more immature and neurotic defense mechanisms than people without a psychopathic personality profile. All participants reported equal use of mature defenses.

Engagement in psychotherapy is partially contingent on present-moment focus, mindfulness, and emotion regulation skills. These skills can be linked to parasympathetic functioning with theoretical explanations provided by polyvagal and neurovisceral integration theories. The specific aims of this project were to evaluate relationships between a measure of parasympathetic functioning (respiratory sinus arrythmia [RSA]) and measures of client reports of engagement in an experiential and emotionally evocative group-based intervention. Twenty-one community residents received group-based acceptance and commitment therapy (ACT) for work stress. RSA was measured 1 week before the intervention. Client ratings of relationship support, task focus, and hindering experiences were assessed after each session. Results indicated that clients perceived the ACT intervention to be supportive, task-focused, and without significant therapy-hindering experiences. Higher levels of RSA were significantly associated with higher levels of relationship support. These results support predictions derived from the polyvagal and neurovisceral integration theories.

The prevalence of anxiety and its associated factors in Ethiopians necessitates availability of a valid questionnaire tool to screen for this disorder. Therefore, this study aimed to assess the factor structure, its stability, and psychometric measures of the Generalized Anxiety Disorder-7 Scale GAD-7) in Ethiopian university students. A cross-sectional study with random sampling was carried out in students (n = 354, age = 21.79 ± 4.49) attending Mizan-Tepi University, Ethiopia. The GAD-7, the Perceived Stress Scale (PSS), and a sociodemographic questionnaire were completed by participants. The unidimensional model of the GAD-7 showed configural, metric, scalar, and strict invariance among gender groups. The Cronbach's alpha (0.77), item-total score correlations (r = .51-.72, p < .01), and inter-item correlations (all significant, p < .05) indicated adequate internal consistency. GAD-7 scale scores correlated significantly with the PSS, suggesting desired convergent validity. The GAD-7 has good psychometric validity with Ethiopian university students.

This commentary addresses the importance of work as a social determinant of health and the role that behavioral health interventions play in its successful execution. Data on the influence of nonmedical factors on wellness of vulnerable populations is reviewed as well as the need to facilitate acquisition of meaningful employment for post-high school graduates, referred to as opportunity youth. It also discusses the role of behavioral health professionals to proactively manage mental health concerns that negatively influence the employment process. Moreover, it suggests that behavioral health professionals can potentially predict work acquisition success based on participant risks and barriers to employment. Such analyses can affect decisions regarding program participant selection and the assessment of program/staff resources required for a successful pathway to job acquisition. Such insights can provide useful guideposts on how to apply this social determinant theory to effectively integrate this unutilized workforce into productive jobs.