Rosanne Menna

Posttraumatic Growth, Coping Strategies, and Psychological Distress in Adolescent Survivors of Cancer

Only recently have researchers begun to empirically examine positive outcomes such as posttraumatic growth in adolescent cancer. This article examines associations between posttraumatic growth, coping strategies, and psychological distress in adolescent cancer survivors. Adolescents who finished cancer treatment 2 to 10 years prior (N = 31) completed self-report measures of posttraumatic growth, coping, symptomatology, and disease-related characteristics. Younger age at diagnosis and less use of avoidant coping strategies predicted lower levels of psychological distress. Adolescents’ beliefs that they were more likely to relapse and the use of more acceptance coping strategies predicted higher levels of posttraumatic growth. Adolescent cancer survivors may be capable of experiencing posttraumatic growth. Those who believe they are more prone to relapse and use more acceptance coping strategies are likely to have higher levels of posttraumatic growth. As health care professionals encourage adolescent cancer survivors to use fewer avoidant coping strategies, they can also encourage survivors to use more acceptance coping strategies.

Assessing Readiness for Change in Adolescents with Eating Disorders.

The Readiness and Motivation Interview (RMI) is a semistructured interview measure of readiness and motivation to change that can be used for all eating disorder diagnoses. The RMI has demonstrated excellent psychometric properties and has both clinical and predictive utility in adult samples. This study examined the psychometric properties of the RMI in a younger population, namely, 12- to 18-year-old girls with eating disorders. Study participants (N = 65) completed the RMI and measures of convergent, discriminant, and criterion validity. Adolescents with eating disorders were able to conceptualize and articulate their readiness for change and to report the extent to which change efforts were for themselves versus for others. RMI readiness profiles across eating disorder symptom domains in adolescents were comparable to those in adults, with higher reported readiness to change binge eating than to change dietary restriction or compensatory strategies. Differences in internal consistency between adult and adolescent samples are discussed. Interviewing adolescents early in treatment about readiness may assist clinicians in forming an alliance with this difficult-to-engage population, while also providing valuable information for treatment planning.

An Evaluation of a Group Intervention for Parents with Aggressive Young Children: Improvements in Child Functioning, Maternal Confidence, Parenting Knowledge and Attitudes.

This study evaluated the effectiveness of a group intervention with the mothers of aggressive, non‐compliant children (aged three to six years). The intervention consisted of a parenting program, Helping Encourage Affect Regulation. Mothers who attended the program were compared with a waitlist control group. The sample consisted of 35 children and their mothers. Post‐treatment assessment showed significant differences in parent‐reported externalizing behavior in children, parenting knowledge, sense of competence and attitudes towards parenting their child in the Helping Encourage Affect Regulation program compared with the waitlist control group Findings are discussed with a focus on the process of change that the group intervention is likely to have facilitated in the parents.

Physical and relational aggression in young children: the role of mother–child interactional synchrony

This study examined the relationships between the quality of parent–child interactions, specifically interactional synchrony (IS), and physical and relational aggression in young children. Seventy-three children (3–6 years; 44 males, 29 females) and their mothers participated in this study. The childrens level of aggression was assessed through questionnaires completed by their mothers and teachers/caregivers. Mother–child dyads engaged in a free play task and a structured task that were coded for IS. The level of IS only in the free play task, but not in the structured block task predicted childrens parent-rated physical aggression levels, with lower levels of IS predicting more aggression. No significant sex differences were found in the levels of IS, physical or relational aggression. The findings are helpful for better understanding of parent–child relationships and problem behaviours and for making intervention recommendations.

Play between Aggressive Young Children and their Mothers

There is a growing number of pre-schoolers presenting to clinics with high levels of aggression. These children are at risk of developing conduct disorder, especially when the symptoms are severe. Treatment for older children with aggressive symptoms has often relied on teaching their parents behavior management techniques and has ignored affective and relationship issues. After presenting observations of the play interactions of aggressive pre-schoolers with their mothers and other relevant research findings, this article explores important aspects of the parent-child interaction and affective relationship. These aspects include the mothers difficulty in tolerating and modulating the childs negative affect, reluctance to enter the play metaphor and failure to gradually move aggressive play to more pro-social themes. The importance of these interactions and affective relationship aspects and their contribution to the childs difficulty are discussed in light of their implications for treatment. Also, suggestions are made for caregivers working with these children to help them self-regulate and acquire appropriate cognitive strategies to contain the negative affects.

Working with parents of aggressive preschoolers: an integrative approach to treatment.

In this article, we briefly review contributory factors within the child, parent-child interaction, and parents that have been put forward to explain the causes of aggressive problems in children. We then review various treatment approaches that have been used with this population and identify which component--the child, parent, or interaction--is targeted in each approach. A case example is provided to illustrate our perspective on treatment. We use a structured interview to categorize the mothers perceptions and subjective experience of her child and their relationship. Associations between the mothers perception of the relationship with her child, her parenting behavior, and the behavior of the child are discussed.

A qualitative analysis of aspects of treatment that adolescents with anorexia identify as helpful.

This study aimed to identify aspects of treatment that adolescents with anorexia nervosa (AN) believe are helpful or unhelpful. Adolescent females receiving treatment for AN or subthreshold AN (n=21) were prompted during semi-structured interviews to generate responses to open-ended questions on what they felt would be most helpful or unhelpful in treating adolescents with eating disorders. Eight codes were developed and the two most frequently endorsed categories were (1) Alliance, where the therapist demonstrates clinical expertise and also expresses interest in the patient (n=21, 100.0%), and (2) Client Involvement in treatment (n=16, 76.2%). These top two categories were shared by participants with AN versus subthreshold AN and participants with high versus low readiness to change their dietary restriction behaviours. Development of the coding scheme and sample participant responses will be discussed. The integration of identified factors into empirically supported treatments for adolescent AN, such as Family-based Treatment, will be considered. This study provides initial information regarding aspects of treatment that adolescents identify as most helpful or unhelpful in their treatment.

The mediating role of emotional control in the link between parenting and young children's physical aggression

ABSTRACT Aggression in early childhood has been found to predict future psychopathology, academic problems, and delinquency. In a sample of 136 mother–child pairs (Mage = 4 years, 11 months, SD = 11 months, 58% boys) associations among mothers’ responding with distress to childrens negative emotions, childrens emotional control, and childrens physically aggressive behaviours were explored. Childrens emotional control problems mediated the relation between mothers’ distress responses and childrens physical aggression – higher levels of distress responses by mothers to childrens negative emotions were associated with increases in emotional control problems in children, which in turn were associated with higher levels of childrens physical aggression. Contrary to expectations, childrens negative emotionality (i.e. temperament) did not significantly moderate the association between mothers’ responding with distress to childrens negative emotions and childrens emotional control problems. Results emphasize the importance of focusing on childrens emotional control skills and adaptive maternal responses to childrens negative emotions.

Therapeutic engagement: Perspectives from adolescents with eating disorders

This study aimed to identify factors that adolescents with eating disorders (ED) consider important for therapeutic engagement, and to examine similarities and differences in the number of identified factors considered important for therapeutic engagement based on diagnostic status and readiness and motivation to change dietary restriction behaviors. Treatment seeking adolescent females (n=34, Mage=16.33, SD=1.34) with an ED were prompted to generate responses to 4 constructs related to therapeutic engagement: (1) Trust, (2) Agreement on therapeutic goals, (3) Confidence in Ability to Change and (4) Feelings of Inclusion in therapeutic decisions. A coding scheme for each construct was developed using a random sample of responses, and each category within a construct was rated as present or absent for each participant. Frequencies and percentages of participants who reported each category within each construct are reported. Additionally, findings indicate that the top two out of three categories reported within each construct were the same between participants with AN versus EDNOS, and between participants high and low in readiness and motivation to change dietary restriction behaviors. This study is a first step in identifying aspects of therapeutic engagement that are important to adolescents with ED, which may differ from adults.

Perceptions of disordered eating and associated help seeking in young women

ABSTRACT Disordered eating is common among young women, but rates of help-seeking are remarkably low. Studies attempting to understand how disordered eating is perceived by young women have exposed participants to fictional vignettes that describe characters exhibiting eating pathologies, and assessed beliefs about the women’s issues. These studies have informed our understanding of how young women perceive disordered eating in other women, but do not address the question of how disordered eating is perceived in oneself. In the present study, we randomly assigned 204 young women (ages 18–25 years) to one of two conditions (self or other). In each condition, participants read a hypothetical vignette in which the main character (the participant herself [self] or another female student [other]) exhibited disordered eating, and answered questions about her behavior and her need for help. Data were analyzed using Pearson correlations, chi square tests, multiple regression analyses, multinomial logistic regressions, and independent samples t-tests. Overall, results supported the existence of a broad discrepancy in how young women perceive disordered eating in themselves versus in other women. Specifically, relative to women who read the vignette about another individual, women who read the vignette about themselves were more likely to attribute their behavior to a general mental health issue (as opposed to an eating disorder); to believe that they were able to cope with their problem alone; and to believe that they did not need to seek help for their eating behaviors (despite perceiving fewer barriers to doing so). These findings highlight the need for empirical research to consider this self-other discrepancy when using findings to inform the development of disordered eating prevention and intervention programs; if not considered, we risk developing programs based on information that may not accurately represent the young women in need of services.