Faculty Bibliography

BACKGROUND: There is a paucity of research on psychosocial treatments for depression in adults with intellectual disability (ID). In this pilot study, we explored the efficacy of a group CBT treatment that involved a caregiver component in adults with mild ID with a depressive disorder. METHOD: Sixteen adults with mild ID and a depressive disorder participated in a 10-week group CBT treatment and 8 adults with mild ID with a depressive disorder served as a treatment as usual (TAU) control group. Adults with mild ID and caregivers completed measures of depressive symptoms, behavior problems, and social skills at pre-treatment, post-treatment, and a 3-month follow-up. Adults with mild ID also completed a series of tasks to measure their understanding of the principles of cognitive therapy pre- and post-treatment. RESULTS: The CBT group demonstrated significant decreases in depressive symptoms and behavior problems from pre-treatment to post-treatment and these effects were maintained at a 3-month follow-up. The CBT group demonstrated significant improvements in their ability to infer emotions and thoughts based on various situation-thought-emotion pairings from pre-treatment to post-treatment. CONCLUSIONS: Findings indicate that adults with mild ID with a depressive disorder benefitted from a group CBT treatment with a caregiver component. Moreover, adults with mild ID appeared to benefit, at least in part, from the cognitive therapy components of the treatment, in addition to the behavior therapy components.

Using the distillation component of the Distillation and Matching Model framework (Chorpita, Daleiden, & Weisz, 2005 ), we examined which engagement practices were associated with three domains of treatment engagement: attendance, adherence, and cognitive preparation (e.g., understanding of, readiness for treatment). Eighty-nine engagement interventions from 40 randomized controlled trials in children' s mental health services were coded according to their engagement practices and outcomes. Analyses examined whether the practices used in successful interventions differed according to engagement domain. Practice patterns differed somewhat depending on whether attendance, adherence, or cognitive preparation was the outcome of interest. For example, assessment of barriers to treatment frequently occurred in successful interventions targeting attendance, whereas homework assignment frequently occurred in successful interventions when adherence was the target outcome. Modeling and expectation setting were frequently used in successful interventions targeting cognitive preparation for treatment. Distillation provides a method for examining the practice patterns associated with different engagement outcomes. An example of the application of these findings to clinical practice includes using certain practices (e.g., assessment, psychoeducation about services, and accessibility promotion) with all youth and families to promote attendance, adherence, and cognitive preparation. Then, other practices (e.g., modeling, homework assignment) can be added on an as-needed basis to boost engagement or to address interference in a particular engagement domain. The use of a distillation framework promotes a common language around engagement and highlights practices that lend themselves well to training, thereby promoting the dissemination of engagement interventions.

This article examines key setting events and personal factors that are associated with support for either non-violent activism or violent activism among Somali refugee young adults in the United States. Specifically, this article examines the associations of trauma, stress, symptoms of posttraumatic stress disorder (PTSD), posttraumatic growth (PTG), strength of social bonds, and attitudes towards legal and non-violent vs. illegal and violent activism. Structured interviews were conducted with a sample of Somali refugee males ages 18-25 living in the northeastern United States (N=79). Data were analyzed using multiple linear regressions and path analysis. Greater exposure to personal trauma was associated with greater openness to illegal and violent activism. PTSD symptoms mediated this association. Strong social bonds to both community and society moderated this association, with trauma being more strongly associated with openness to illegal and violent activism among those who reported weaker social bonds. Greater exposure to trauma, PTG, and stronger social bonds were all associated with greater openness to legal non-violent activism.

There is growing awareness that students' experiences of stress may impede academic success, compromise mental health, and promote substance use. We examined these factors in an under-studied population, private/independent high school students, using a multi-method (qualitative and quantitative), iterative data collection and analytic process. We first conducted qualitative interviews with faculty and staff at a number of highly competitive private schools, followed by an anonymous quantitative survey with 128 11th grade students from two of these settings. We then conducted a qualitative exploration of the quantitative results with a subset of students. Next, a set of Expert Panel members participated in qualitative interviews to reflect on and interpret study findings. Overall, we found students experienced high levels of chronic stress, particularly in relation to academic performance and the college admissions process. While students described a range of effective, adaptive coping strategies, they also commonly internalized these serious pressures and turned to alcohol and drugs to cope with chronic stress, although not typically at problematic levels. We discuss study implications for both schools and families derived from the Expert Panel.

Social buffering, which is the attenuation of stress hormone release by a social partner, occurs in many species throughout the lifespan. Social buffering of the infant by the caregiver is particularly robust, and animal models using infant rodents are uncovering the mechanisms and neural circuitry supporting social buffering. At birth, the hypothalamic-pituitary-adrenal (HPA) stress system is functional but is suppressed via extended social buffering by the mother: the profound social buffering effects of the mother can last for one to two hours when pups are removed from the mother. At 10 days of age, pups begin to mount a stress response immediately when separated from the mother. The stimuli from the mother supporting social buffering are broad, for tactile stimulation, milk, and an anesthetized mother (no maternal behavior) all sufficiently support social buffering. The mother appears to produce social buffering by blocking norepinephrine (NE) release into the hypothalamic paraventricular nucleus (PVN), which blocks HPA activation. Since the infant amygdala relies on the presence of corticosterone (CORT), this suggests that social buffering of pups by the mother attenuates the neurobehavioral stress response in infancy and prevents pups from learning about threat within mother-infant interactions.

Reviews the book, Life, Animated: A Story of Sidekicks, Heroes, and Autism by Ron Suskind (2014). The book is not about autism and it is not even a story of a boy with autism. At times while experiencing Life, Animated, the reviewer thought that it was the story of a parent and family coming to understand and cope with a child with autism. The book, in fact, could be read with that idea in mind and still be an immensely rewarding experience for anyone who treats or works with children with autism and their families. In the end, however, the story is much more universal than that. It is the story of a father coming to know his son. It is the story of members of a family coming to know themselves. It is the story of a child's unique experience of his internal and external worlds. Beyond showing us the experience families have in dealing with difficult mental illness and disability or suggesting unique ways of engaging with children who might communicate in a different way, the book expands what one thinks of as the human experience. It suggests that experiencing life in a way that is considered more normative in the spectrum of human experience is not necessarily a better or right way to see things.

BACKGROUND: Borderline personality disorder (BPD) is a prevalent psychiatric disorder associated with significant distress, dysfunction, and treatment utilization. Though, theoretically, BPD is posited to arise from a combination of trait and environmental risk factors, few studies have tested trait-by-environment interactions in BPD. We investigated the roles of rejection sensitivity (RS) and childhood emotional neglect and abuse (ENA) as well as their interaction in BPD. SAMPLING AND METHODS: Eighty-five adults with a lifetime mood disorder who were recruited for outpatient studies in a psychiatric clinic were assessed for ENA using the Childhood Trauma Questionnaire and for RS with the Adult Rejection Sensitivity Questionnaire. BPD diagnoses were made by consensus using data collected on the Structured Clinical Interview for DSM-IV. Hierarchical logistic regression was used to test associations between RS, ENA, their interaction and BPD. RESULTS: RS and ENA interacted to predict co-occurring BPD in our sample of mood-disordered patients, with the strength of the relationship between RS and BPD depending on the severity of ENA. In the context of little or no ENA, RS and BPD were more strongly related than when ENA was more severe. CONCLUSIONS: Our results extend previous findings suggesting RS and ENA are risk factors for BPD. They also provide preliminary support for contemporary theories of BPD positing trait-by-environment interactions in the development of BPD. Prospective studies are needed to confirm these findings. (c) 2014 S. Karger AG, Basel.

Presents an obituary of Bel Kaufman, 100-year-old academician, world traveler, a celebrated author, whose historic roots go back to the revered Sholom Aleichem. Ms. Kaufman was the embodiment of humor and aging well. She graduated from Columbia University with highest honors and was an adjunct professor at Hunter College where she taught a course on Jewish humor. Bel Kaufman's humility and sense of humor carried her through her 103 years until her death in July of 2014. Her sense of humor was infused in her approach to life as well as her teaching. As she had noted, "Seeing the humor in situations helps to break the cyclical nature of problematic situations and helps the individual to endure, increases physical health and certainly assists in maintaining mental health." This philosophy meshes with intrinsic social work values that remain timeless. Bel Kaufman will be sorely missed.