Judith C. Baer

Child maltreatment and insecure attachment: a meta‐analysis

The validity of the insecure/disorganized attachment pattern has been clearly established in over 80 studies with more than 100 samples. However, given that child maltreatment is considered one of the most important causes of insecure/disorganized attachment, it is notable that few studies have been published specifically examining the maltreatment/insecure attachment hypothesis. The purpose of this paper was to review the research findings and conduct a meta‐analysis to examine the effect size of maltreatment and insecure attachment across studies. A second goal was to conduct a subpopulation analysis to investigate effect size by type of maltreatment. Following a literature search which yielded 25 articles, we identified eight studies (n = 791) that: (a) consisted of children who experienced different types of maltreatment including cases of malnutrition and failure‐to‐thrive, (b) consisted of children under 48 months of age, (c) used the Strange Situation or a modification of it to measure attachment, (d) had comparison groups, and (e) contained sufficient detail to conduct a meta‐analysis. Results showed that the maltreated infants were significantly more likely to have an insecure attachment than the controls. A subpopulation analysis by type of abuse was conducted. Overall the findings support the maltreatment/insecure attachment hypothesis. The subpopulation analysis, although extremely small, indicates that different types of maltreatment affect the magnitude of the effect. These findings suggest further investigation into the differential impact by type or multiple types of maltreatment as well as the frequency of events on outcomes.

Does the DSM-IV Clinical Significance Criterion for Major Depression Reduce False Positives? Evidence From the National Comorbidity Survey Replication

OBJECTIVE To reduce false positive diagnoses, DSM-IV added a clinical significance criterion to many diagnostic criteria sets requiring that symptoms cause significant distress or impairment. The DSM-V Task Force is considering whether clinical significance should remain a diagnostic threshold or become a separate dimension, as it is in ICD. Yet, the criterions effectiveness in validly reducing the prevalence of specific disorders remains unclear. Critics have argued that for some categories, notably major depression, the criterion is redundant with symptoms, which are inherently distressing or impairing. The authors empirically evaluated the criterions effect on the prevalence of major depression in the community. This report also considers more broadly the relationship of symptoms to impairment in diagnosis. METHOD Subjects were respondents, aged 18 to 54 years, who participated in the National Comorbidity Survey Replication (N=6,707). The effect of the clinical significance criterions distress and impairment components on major depression was assessed in this sample. Distress questions were administered to all respondents reporting persistent sadness (> or = 2 weeks) or the equivalent. Questions pertaining to role impairment were asked of all respondents satisfying major depression symptom-duration criteria. RESULTS Of 2,071 individuals reporting persistent sadness or the equivalent, 97.2% (N=2,016) satisfied criteria for distress. Of 1,542 individuals satisfying depression symptom-duration criteria, 96.2% (N=1,487) satisfied criteria for impairment. CONCLUSIONS These findings support the redundancy thesis. Distress is virtually redundant with symptoms of persistent sadness, even in the absence of major depression, and impairment is almost always entailed by major depression-level symptoms. Thus, the clinical significance criterion does not substantially reduce the prevalence of major depression in the community. The DSM-V Task Force should consider eliminating the criterion and explore alternative ways to identify false positives in the diagnosis of depression. The criterions status for other disorders should be evaluated on a disorder-by-disorder basis because the diagnostic relationship between symptoms and impairment varies across categories.

The Vicissitudes of Measurement: A Confirmatory Factor Analysis of the Emotional Autonomy Scale

This study examined the factor structure of the Emotional Autonomy Scale (EAS) as proposed by Steinberg and Silverberg. Participants were from three independent samples of adolescents in grades 6 (n = 1,842), 8 (n = 1,769), and 10 (n = 1,232), with each sample consisting of three ethnic groups: African American, European American, and Mexican American. None of the confirmatory factor analyses for these samples supported the factor structure proposed by Steinberg and Silverberg. From the three models tested, the EAS is best described by the four originally proposed factors, combined with two method factors, one consisting of the positively worded scale items and one consisting of the negatively worded scale items. Results show that the EAS exhibits poor construct validity and behaves quite differently for the different grade and ethnic groups. The strong impact of method variance on the factor structure is discussed. Although various alternative solutions to the psychometric problems in the EAS are proposed, the most credible solution may be to reexamine the conceptual foundations of emotional autonomy and develop better measures of those concepts for adolescents.

Did Narrowing the Major Depression Bereavement Exclusion From DSM-III-R to DSM-IV Increase Validity?: Evidence From the National Comorbidity Survey

The DSMs major-depression “bereavement exclusion” eliminates bereavement-related depressive episodes (BRDs) from diagnosis unless they are “complicated” by prolonged duration or certain severe symptoms. The exclusion was substantially narrowed in DSM-IV to decrease false-negative diagnoses, but the impact of this change remains unknown. We divided BRDs in the National Comorbidity Survey into uncomplicated versus complicated categories using broader DSM-III-R and narrower DSM-IV exclusion criteria. Using 6 pathology validators (symptom number, melancholic depression, suicide attempt, interference with life, medication for depression, and hospitalization for depression), we compared the validity of the 2 exclusion criteria sets using 2 tests: (1) which criteria set yielded less pathological uncomplicated cases or more pathological complicated cases; (2) which yielded the largest separation between uncomplicated and complicated pathology levels. Results of both tests indicated that the narrower DSM-IV criteria substantially decreased the exclusions validity. These results suggest caution regarding the current proposal to eliminate the bereavement exclusion in DSM-5.

The aftermath of childhood trauma on late life mental and physical health: a review of the literature

This article is an examination of the empirical literature published in peer-reviewed journals, which investigated samples of adults aged 50 and older, who had experienced trauma, in childhood with follow-up of the impact on later life mental and physical health. Articles were identified through searches of EBSCO host databases, such as PubMed, SocioIndex, and PsychoLit. Search terms such as childhood trauma and cumulative trauma were paired with the term older adults in varying combinations. The collective findings of 23 studies published between 1996 and 2001 suggested that trauma first documented as occurring in childhood is associated with later life mental and physical health. Methodological limitations and future directions as well as recommendations for practice, policy, and research with older adults and trauma are delineated. Language: en

Relation between duration and severity in bereavement‐related depression

Wakefield JC, Schmitz MF, Baer JC. Relation between duration and severity in bereavement‐related depression.

Random Acts of Delinquency: Trauma and Self-Destructiveness in Juvenile Offenders

This article provides an explanatory model of the way in which trauma leads to serious delinquency. Using perspectives from information processing, social learning, and self-regulation theories, we present evidence to suggest that adolescents whose lives were shaped by trauma perceive and encode social cues differently than non-traumatized individuals. A number of assessment tools and therapeutic interventions are recommended, followed by suggestions for advocating on the behalf of adolescents incarcerated in the juvenile justice system.

Family Relationships, Parenting Behavior, and Adolescent Deviance in Three Ethnic Groups

This was a study of adolescent deviance from a family and developmental perspective. Seventh-, eighth-, and ninth-grade boys and girls from Mexican American (N = 2549), African American (N = 1837), and Euro-American (N = 3025) ethnic groups were surveyed about their family relationships, parental behavior, and their deviant activities. Some significant ethnic and gender differences were found. Implications for practice and prevention are discussed.

STUDENTS' DISTRESS OVER GRADES: ENTITLEMENT OR A COPING RESPONSE?

Faculties across disciplines have noted an increasing number of students whoare highly distressed over grades, and this distress is accompanied by pervasivedemands on professors. The student behavior takes several forms, includingdemands for higher grades, expectations of special accommodations by faculty,and the predictions of dire outcomes for grades less than an A. This study surveyeda group of MSW students using an instrument consisting of the AcademicEntitlement Scale and the Rosenberg Self-Esteem Scale. Using LatentClass Analysis, 2 distinct subgroups were identified: students with high andlow self-esteem. High self-esteem students were more likely to make pervasivedemands on professors. Findings suggest this behavior is a coping response tointernal distress. Suggestions and implications follow.

Fusion or Familialism: A Construct Problem in Studies of Mexican American Adolescents

This study was an investigation of intergenerational relationships related to the individuation process as reported by Mexican (N = 2,388) and European American (N = 2,907) adolescents. The primary aim was to examine the construct within theories of adolescent development that emotional separation in parent-adolescent relationships is an inherent aspect of the developmental process that occurs across the two ethnic groups. The authors conducted confirmatory factor analyses on a subscale INFUS of an instrument developed to measure family process, the Personal Authority in the Family System Questionnaire (PAFS-Q) developed by Bray, Williamson, and Malone. In sum, findings indicate (a) the need for better measurement testing, (2) the need to revisit the concept of autonomy from the family as a universal task during adolescent development, and (3) caution in the clinical use of concepts such as fusion and independence when delivering mental health services to Mexican adolescents and their families.