Treating distressed couples with coexisting mental and physical disorders: directions for clinical training and practice

Relationship difficulties frequently coexist with significant emotional, behavioral, and physical health problems in one or both partners. Moreover, couple therapists report individual emotional and behavioral disorders as among the most difficult problems that they encounter in clinical practice. In this article, we summarize empirical evidence regarding the association between relationship distress and the onset, course, and treatment of mental and physical health problems. Based on these findings, we propose five critical implications for clinical training and the practice of couple therapy.     

Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization

To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (<25 years), depression, a history of substance abuse treatment, a history of forced sex, gender-based discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender persons. In addition, increasing societal acceptance of the transgender community and decreasing gender-based prejudice may help prevent suicide in this highly stigmatized population.     

Child care subsidy and child maltreatment

This study examined the relationship between receipt of child care subsidies and child maltreatment investigations in a sample of low‐income mothers in Illinois. We expected that receiving child care subsidies would have a protective effect on child maltreatment risk and therefore decrease the likelihood of child protective services investigations. Using structural equation modelling, we tested the direct and indirect paths of the receipt of child care subsidies to physical abuse or neglect. We found only direct effects of receiving child care subsidies on both physical abuse and neglect investigations. The findings suggest an important protective role of child care subsidies in the lives of low‐income families.     

Why are Children with Married Parents Healthier? The Case of Pediatric Asthma

Among a recent birth cohort in U.S. cities, young children were far more likely to be diagnosed with asthma and to experience an asthma-related emergency if their parents were unmarried. Using longitudinal data from the Fragile Families and Child Wellbeing Study, I find that the child health benefits of marriage seem to stem from the benefits of parental coresidence and the demographic and socioeconomic correlates of marriage. Children whose parents live apart appear to be at heightened risk of asthma even after taking into account demographic and socioeconomic characteristics. The child health benefits of marriage are only weakly related to mothers’ health behaviors and are not related to father involvement. An analysis of relationship transitions suggests that marital disruption may be more harmful for children than the disruption of cohabiting unions. The results provide some cautions and considerations for the U.S. government’s Healthy Marriage Initiative.

Potential impacts of emerald ash borer invasion on biogeochemical and water cycling in residential landscapes across a metropolitan region

Trees provide important ecological services in cities, yet the vulnerability of the urban forest to massive tree losses from pest outbreaks could threaten those services, with unknown environmental consequences. The outbreak of emerald ash borer is an imminent threat to the ash population in North America. In the Minneapolis?CSaint Paul, Minnesota, metropolitan area, ash trees are present in 50?% of residential landscapes in Ramsey and Anoka Counties. We used a large survey of household activities, a tree inventory, a Household Flux Calculator accounting tool, and a set of annual evapotranspiration measurements, to quantify the current carbon, nitrogen, and phosphorus storage in ash trees, the cycling of these elements, and the total evapotranspiration from ash trees in residential areas in the metropolitan region. Ash represented 6?% of the trees in residential areas and the removal of the entire ash population would correspondingly reduce net primary production and carbon sequestration by only a few percent and would have negligible effects on losses of nitrogen and phosphorus from residential landscapes. Similarly, the effects of ash loss on the hydrologic cycle would be minimal and would depend largely on management choices for the ground currently underneath ash tree canopies. Overall, the percentage change in biogeochemical and hydrological fluxes corresponded closely with the percent of the total urban tree population that was represented by ash, suggesting that areas with higher densities of ash would experience correspondingly larger effects. A hypothetical tree replacement scenario with similar broadleaf species was determined to be likely to re-establish the original biogeochemical and hydrological conditions once the replacement trees reach maturity.     

Effects of Exogenous and Endogenous Distracters on Immediate and Long‐Term Recall in Toddlers

We explored the role that exogenous and endogenous competitors for attention play in infants’ abilities to encode and retain information over a 6‐month period. Sixty‐six children visited the laboratory at 15 months, and 32 returned for a second visit at 21 months. Children observed models of conventional‐ relation and enabling‐relation action sequences. Half the children were distracted by a “Mister Monkey” mechanical toy during the conventional‐relation sequence, while the other half was distracted during the enabling‐relation sequence. The Early Childhood Behavior Questionnaire indexed endogenous factors at both ages. Immediate postmodel production of target actions indexed encoding efficiency, and 6‐month production of target actions indexed long‐term recall. The exogenous distracter impacted encoding efficiency (i.e., immediate recall), but not long‐term recall. Endogenous factors (i.e., temperament) were primarily associated with long‐term recall. Of special interest was our finding that endogenous factors, especially surgency, moderated the effect of the exogenous distracter. It appears that when learning conventional‐relation sequences in the presence of exogenous distracters, surgency mobilizes attentional resources toward the learning objective; however, when learning enabling‐relation sequences under the same conditions, surgency either boosts the saliency of the distracters or boosts children’s susceptibility to them.     

Bayesian hierarchical duration model for repeated events: an application to behavioral observations

This article presents a continuous-time Bayesian model for analyzing durations of behavior displays in social interactions. Duration data of social interactions are often complex because of repeated behaviors (events) at individual or group (e.g. dyad) level, multiple behaviors (multistates), and several choices of exit from a current event (competing risks). A multilevel, multistate model is proposed to adequately characterize the behavioral processes. The model incorporates dyad-specific and transition-specific random effects to account for heterogeneity among dyads and interdependence among competing risks. The proposed method is applied to child–parent observational data derived from the School Transitions Project to assess the relation of emotional expression in child–parent interaction to risk for early and persisting child conduct problems.     

The Effect of Social Work Education and Self-Esteem on Students' Social Discrimination of People with Disabilities

Social work education on disability content has become more important due to political changes in the last two decades. The United States protected people with disabilities from discrimination in community and employment settings with the enactment of the Americans with Disabilities Act of 1990. These changes have empowered people with disabilities to become more independent; however, social workers primarily fulfill roles as case managers, and often make decisions for people with disabilities. This is not consistent with the empowerment perspective embedded in the disability movement. Most social work schools have minimal courses covering disability content. Previous research and the Self-Esteem Hypothesis indicate that social work education, social proximity to people with disabilities, self-esteem and other demographic characteristics are associated with social discrimination, or attitudes, toward people with disabilities. Social work students (n = 73) participated in a survey in the last semester of their program to assess how these characteristics were associated with their attitudes towards people with disabilities. A multiple linear regression revealed that social work education preparedness to work with people with disabilities, an MSW education, self-esteem, and having a friend with a disability were significantly associated with students' social discrimination towards people with disabilities.