Centre Stage Diagramming: Late-stage Parkinson’s disease and Alzheimer’s disease

Using the method of centre stage diagramming, this 3-year [2007–2009] longitudinal study reports a single case study of Ben and Mary that maps the onset of Alzheimer's disease within Ben's late-stage Parkinson's disease and the impact, adjustment and meaning that this had for the couple. It is believed that that this is the first time that such a transition has been documented within a qualitative research design. The importance of Ben and Mary obtaining a diagnosis of Alzheimer's disease is reported as the diagnosis helped to locate the meaning of Ben's memory and behavioural changes within a ‘dementia’ context, rather than as an extension of late-onset Parkinson's disease as was originally considered by the couple. Ben and Mary's search for stability within their life once the diagnosis of Alzheimer's disease was made is also shared. The couple was recruited from the caseload of a Parkinson's disease nurse specialist in North Wales and the couple was visited five times over the duration of the study. All interviews were conducted in Ben and Mary's own home and with their full involvement in the development and reporting of each centre stage diagram. Policy and practice implications are also considered.     

Parting words: Trauma,silence and survival

Abstract

This article examines an enigma at the heart of Freud's work on trauma: the surprising emergence, from within the theory of the death drive, of the drive to life, a form of survival that both witnesses and turns away from the trauma in which it originates. I analyse in particular the striking juxtaposition, in Freud's founding work Beyond the Pleasure Principle, of his two primary examples of trauma: the repetitive nightmares of battle suffered by the soldiers of World War I, and the game of the child, faced with the loss of its mother, who plays fort and da (there and here) with his spool. My own understanding of Freud's insight did not emerge, however, simply through a reading of his text but began, in fact, in my encounter with a real child in Atlanta, a child whose best friend was murdered in the street and who is interviewed by the friend's mother. I thus read together the language of the nightmare and the language of the child in Freud's text, and then attempt to understand how Freud's text and the language of the real child shed light upon each other.     

Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma

The potential effects of maternal trauma on mother–infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother–infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4–6 months. Split‐screen videotaped interaction was coded on a one‐second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self‐contingency and interactive contingency of behavior by time‐series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper‐contingent, high‐arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.     

Associations of Low‐Income Working Mothers' Daily Interactions With Supervisors and Mother‐Child Interactions

This study investigated associations of low‐income working mothers' daily interactions with supervisors and their interactions with children. Sixty‐one mothers of preschool‐aged children were asked to report on their interactions with their supervisors at work and their interactions with children for 2 weeks (N = 520 workdays). Results show significant within‐day spillover from the quality of mothers' perceived work interactions with supervisors to their reports of interactions with children. Supervisor criticism was positively correlated with harsh and withdrawn mother–child interactions on the same day. Supervisor recognition for good work was positively associated with warm mother–child interactions on the same day. Lagged analyses showed some significant associations between perceived supervisor interactions on a given day and mother–child interactions the next day.     

Associations of Mothers' Friendship Quality with Adolescents' Friendship Quality and Emotional Adjustment

Little research has examined the association of parents' friendships with adolescent's well‐being, perhaps because the association was considered too distal. However, developmental theories suggest that contexts in which parents, but not their children, are situated may be related to child development (Bronfenbrenner, 1979 , 1986 ). The current work examined associations between the quality of mothers' own friendships and their adolescent children's friendship quality and emotional adjustment. Fifth‐, eighth‐, and eleventh‐graders (N = 172) whose mothers' friendships were characterized by conflict and antagonism reported having friendships that were high in negative friendship qualities as well as elevated internalizing symptoms. These associations held after controlling for mother–child relationship quality, suggesting that mothers' friendships may have a unique association with adolescents' adjustment.     

Male Pregnancy Intendedness and Children's Mental Proficiency and Attachment Security During Toddlerhood

Using a sample of biological resident fathers and their children from the Early Childhood Longitudinal Study Birth Cohort (ECLS‐B) 9‐ and 24‐month surveys (N = 5,300), this study examines associations and the direct and indirect pathways through which men's pregnancy intentions influence toddlers' mental proficiency and attachment security. Findings indicate that unwanted and mistimed pregnancies for fathers had negative consequences for toddlers' mental proficiency and attachment security. Additionally, men's pregnancy intentions were found to work indirectly through lower prenatal behaviors and father engagement and greater mother‐father relationship conflict to negatively influence toddlers' mental proficiency. Men's pregnancy intentions also worked indirectly through greater relationship conflict and higher father involvement to influence attachment security.     

Trauma Symptoms: Relationship With Career Thoughts,Vocational Identity,and Developmental Work Personality

Knowledge of traumatic events and how trauma symptoms relate to social and psychological well‐being continues to grow. One aspect of an individual's functioning that may be affected by exposure to traumatic events is the ability of the individual to engage in career‐ and work‐related activities (D. H. Coursol, J. Lewis, & L. Garrity, 2001). The current study examines the relationship between trauma symptoms and the career development process of 131 college students. Results indicate a significant relationship between higher levels of trauma symptoms and higher levels of dysfunctional career thoughts and lower levels of work personality. Implications for career counselors are discussed.     

Maternal Into‐The‐Face Behavior,Shared Attention,and Infant Distress During Face‐to‐Face Play at 12 Months: Bi‐directional Contingencies

We describe a new maternal intrusion behavior, moving a toy or hand “into‐the‐face” of the infant, and we investigate its bi‐directional associations with infant‐initiated shared attention, infant distress, and infant gaze, during mother–infant face‐to‐face play at 12 months. The play was videotaped split‐screen, with infants seated in a high chair. Videotapes were coded on a 1‐sec time base for mother and infant gaze (at partner, toy, both, or gaze away); infant distress; and maternal intrusion behavior, “into‐the‐face.” We defined “infant‐initiated shared attention” as mother and infant looking in the same second at a toy that the infant‐initiated interest in. We documented that maternal into‐the‐face behavior decreased the likelihood of infant‐initiated shared attention, increased the likelihood of infant distress, and decreased the likelihood of infant gazing away. Reciprocally, infant distress and gazing away increased the likelihood of mother into‐the‐face. In moments when the dyad was engaged in infant‐initiated shared attention, mother into‐the‐face was less likely. This work documents bi‐directional contingencies in the regulation of maternal intrusion and infant behavior during face‐to‐face play at 12 months. We suggest that mother into‐the‐face behavior disturbs an aspect of the infant's experience of recognition.     

Capturing Capital to Negotiate the Intersections of Motherhood and Work

Women are judged and judge themselves in response to cultural norms about motherhood and employment. While much has been written in sociology and other disciplines about the intersections of motherhood and work, there is not much on their ideals and the enactment of the ideals of womanhood and worker in connection to various forms of capital. In this paper, we review the literature on motherhood to explore the ways in which these ideals are related to the meanings of mother and worker. Further, we highlight how differential access to economic and non‐economic capital due to one's social location influences a woman's ability to be viewed successful simultaneously as mother and worker.     

Impact of Genetic Relatedness and Emotional Closeness on Intergenerational Relations

Both emotional closeness and genetic relatedness are known to influence helping behavior between family generations, yet few studies have explored them together. The authors investigated the associations between (a) parenthood and perceived emotional closeness toward own parents and parents‐in‐law and (b) emotional closeness and receiving child care from grandparents across and within lineage lines. The data include information on the 8 dyads of possible parent–grandparent relations from a nationally representative survey of young adults in Finland (born 1962–1990, sample N = 1,216). The results show that parenthood was associated with women's emotional closeness to their own mothers and men's emotional closeness to their parents‐in‐law. Maternal grandmothers provided the most grandchild care. After controlling for emotional closeness, the difference in child care provision between one's own mother and one's mother‐in‐law disappeared for women but was accentuated in men. Thus, emotional closeness shapes intergenerational relations differently for kin and in‐laws.     

Reclaiming the Mother-daughter Relationship after Sexual Abuse

This paper seeks to provide direction to therapists working with mothers and daughters after a disclosure of father-daughter sexual abuse. The importance of the mother's belief in and support for the child's recovery is highlighted, as are some of the cultural assumptions about mothers and daughters which negatively impact on the relationship. Despite paying lip service to offender responsibility, there continues to be a culture of mother blaming in the child sexual abuse and family therapy literature on incest. Current research findings challenge some of the prevalent myths about mothers’ responses to their children's disclosures. Few clinical sources have addressed this issue, and therapists who reject the mother blaming literature are therefore left with little guidance as to how to work more effectively with mothers and daughters. Consequently they may unwittingly further undermine the relationship. Work with mothers and daughters as they recover from intrafamilial sexual abuse is discussed, and key therapeutic themes and guidelines for practice presented. We explore the significant theme of the rebuilding of trust between mothers and daughters and facilitate a process whereby the woman is able to bear witness to and acknowledge the trauma experienced by her daughter.     

Maternal Depression and the Ability to Facilitate Joint Attention With 18‐Month‐Olds

Maternal depression has been associated with the mother‐child dyad's ability to engage in joint attention. This study of 69 depressed and 63 control mothers and their 18‐month‐olds addresses how aspects of maternal psychopathology are related to joint attention during a snack interaction. Although nondepressed‐mother dyads appeared better at joint attention than depressed‐mother dyads, this difference was not statistically significant. Among the depressed‐mother dyads, joint attention was related to presence of a comorbid Axis I diagnosis (usually an anxiety disorder) versus a diagnosis of major depressive disorder (MDD) only. Surprisingly, dyads with mothers who met criteria for a comorbid diagnosis were better at joint attention than those with MDD only, despite the fact that those mothers were likely to have longer and more severe depressive histories. The relationship between comorbid status and joint attention was mediated by the mother's affect. Rationale for the paradoxical finding that the “more pathological” mothers had greater success in engaging in joint attention is discussed.     

Couple Forgiveness and its Moderating Role in the Intergenerational Transmission of Veterans’ Posttraumatic Stress Symptoms

This study examined the moderating effect couple forgiveness (as perceived by the wives/mothers) may have on the intergenerational transmission of posttraumatic stress symptoms (PTSS) among families of combat veterans and former prisoners of war (ex‐POWs). The sample included 123 (79 ex‐POWs and 44 control combatants) Israeli father–mother–adult offspring triads. Self‐report measures were administered at 2008 to veterans, at 2010–2011 to wives, and at 2013–2014 to offspring. The findings indicated that ex‐POWs’ PTSS were positively related to their offspring's PTSS, while couple forgiveness buffered this effect, particularly, and detrimentally, when couple forgiveness was low. These findings imply that apprehending the quality of the forgiving atmosphere within the marital relationship may be important for understanding the apparatus of intergenerational transmissions of trauma.     

Delivery Pain and the Development of Mother—Infant Interaction

This study examined delivery pain as a possible risk factor for the development of mother‐infant interaction. Eighty‐one mothers completed the Pain Catastrophizing Scale, the State‐Trait Anxiety Inventory, and the Edinburgh Postnatal Depression Scale. A retrospective evaluation of labor pain was performed using the Visual Analog Scale at 2 days postpartum. Six weeks after birth the mothers were visited at home, completed measures of anxiety and depression, and were observed during a free play session with the infant. The mother's tendency to catastrophize pain predicted lower levels of mother‐infant reciprocity at 6 weeks, controlling for maternal age, education, parity, epidural analgesia, pain perception, anxiety, and depression. Trait anxiety was related to lower maternal sensitivity. The mother's tendency to catastrophize pain was discussed in relation to the personality trait of exaggerated emotional perception of pain and its potential interference with the formation of the mother‐infant relationship.     

Psychodynamic psychotherapy: When it helps people in recovery

You have almost never read about psychoanalysis or its less intense relative, psychodynamic psychotherapy, in these pages. It's because it doesn't work to treat active substance use disorders (SUDs). But psychodynamic psychotherapy, with all of the psychoanalytic underpinnings, can be very helpful to patients in recovery, because in fact many of these patients are self‐medicating a past trauma.     

Clusters and Correlates of Experiences With Parents and Peers in Early Adolescence

This study used a person‐oriented approach to examine links between adolescents' experiences with parents and peers. Cluster analysis classified 361, White, working‐ and middle‐class youth (mean age=12.16 years) based on mothers' and fathers' reports of parental acceptance and adolescents' reports of perceived peer competence. Three patterns were identified: high mother and father acceptance and high peer competence; low mother and father acceptance and high peer competence; and high mother acceptance, moderate father acceptance, and low peer competence. The groups differed with respect to youth's and parents' individual characteristics, family and peer dynamics, and youth functioning over time. Discussion focuses on the utility of a person‐oriented approach for studying parent–peer linkages in early adolescence and their implications.     

Moving “Up and Out” Together: Exploring the Mother–Child Bond in Low‐Income,Single‐Mother‐Headed Families

Bearing children is often viewed as negatively impacting the social mobility of low‐income single mothers. This analysis draws on 66 in‐depth interviews with low‐income, single‐mother participants in an antipoverty program in Boston. The author argues that the mother–child relationship is at the center of efforts by these single mothers to move out of poverty. Interviewees repeatedly expressed the primacy of their children's needs being met in order for them to move forward. Mothers tried to include their children in efforts to move out of poverty, thus fulfilling the role of a “good mother” while exhibiting proper behavior for a poor person trying to achieve economic independence. The data here highlight the limitations of policy initiatives that fail to acknowledge the centrality of children's well‐being to the lives of single mothers and suggest that the mother–child bond may be an untapped resource for policies and programs serving this community.     

Infant Looking Behavior in Ambiguous Situations: Social Referencing or Attachment Behavior?

Is infant looking behavior in ambiguous situations best described in terms of information seeking (social referencing) or as attachment behavior? Twelve‐month‐old infants were assigned to 1 of 2 conditions (Study 1); each infant's mother provided positive information about an ambiguous toy and an experimenter provided positive information. In Study 2, 12‐month‐old infants were assigned to 1 of 3 conditions: mother provided positive information about the toy, mother was inattentive, or mother provided negative information; the experimenter was inattentive. The infants preferred to look at the experimenter in almost all conditions and they regulated their behavior in accordance with information obtained from the experimenter. None of the studies lends support for an explanation in terms of behaviors deriving from the attachment system, and they raise questions concerning social referencing interpretations of infants' looking behavior. Other alternatives for explaining infant looking behavior in social referencing situations (e.g., associative learning) are discussed.