Sally I. Powers

Dating Couples’ Attachment Styles and Patterns of Cortisol Reactivity and Recovery in Response to a Relationship Conflict

This study investigated theoretically predicted links between attachment style and a physiological indicator of stress, salivary cortisol levels, in 124 heterosexual dating couples. Cortisol was assessed at 7 points before and after an experimental conflict negotiation task, creating a trajectory of stress reactivity and recovery for each participant. Growth modeling of cortisol data tested hypotheses that (a) insecurely attached individuals show patterns of greater physiological stress reactions to interpersonal conflict than do securely attached individuals and (b) people with insecurely attached partners show patterns of greater stress in reaction to relationship conflict than those with securely attached partners. Hypothesis 1 was supported, but men and women differed in the type of insecure attachment that predicted stress trajectories. Hypothesis 2 was supported for men, but not for women. The discussion emphasizes the role of gender role norms and partner characteristics in understanding connections between adult attachment and patterns of cortisol responses to interpersonal stress.

Vitamin D intake from foods and supplements and depressive symptoms in a diverse Population of Older Women.

BACKGROUND Vitamin D may plausibly reduce the occurrence of depression in postmenopausal women; however, epidemiologic evidence is limited, and few prospective studies have been conducted. OBJECTIVE We conducted a cross-sectional and prospective analysis of vitamin D intake from foods and supplements and risk of depressive symptoms. DESIGN Study participants were 81,189 members of the Womens Health Initiative (WHI) Observational Study who were aged 50-79 y at baseline. Vitamin D intake at baseline was measured by food-frequency and supplement-use questionnaires. Depressive symptoms at baseline and after 3 y were assessed by using the Burnam scale and current antidepressant medication use. RESULTS After age, physical activity, and other factors were controlled for, women who reported a total intake of ≥800 IU vitamin D/d had a prevalence OR for depressive symptoms of 0.79 (95% CI: 0.71, 0.89; P-trend < 0.001) compared with women who reported a total intake of <100 IU vitamin D/d. In analyses limited to women without evidence of depression at baseline, an intake of ≥400 compared with <100 IU vitamin D/d from food sources was associated with 20% lower risk of depressive symptoms at year 3 (OR: 0.80; 95% CI: 0.67, 0.95; P-trend = 0.001). The results for supplemental vitamin D were less consistent, as were the results from secondary analyses that included as cases women who were currently using antidepressant medications. CONCLUSIONS Overall, our findings support a potential inverse association of vitamin D, primarily from food sources, and depressive symptoms in postmenopausal women. Additional prospective studies and randomized trials are essential in establishing whether the improvement of vitamin D status holds promise for the prevention of depression, the treatment of depression, or both.

Vitamin D Supplementation and Depression in the Women's Health Initiative Calcium and Vitamin D Trial

While observational studies have suggested that vitamin D deficiency increases risk of depression, few clinical trials have tested whether vitamin D supplementation affects the occurrence of depression symptoms. The authors evaluated the impact of daily supplementation with 400 IU of vitamin D(3) combined with 1,000 mg of elemental calcium on measures of depression in a randomized, double-blinded US trial comprising 36,282 postmenopausal women. The Burnam scale and current use of antidepressant medication were used to assess depressive symptoms at randomization (1995-2000). Two years later, women again reported on their antidepressant use, and 2,263 completed a second Burnam scale. After 2 years, women randomized to receive vitamin D and calcium had an odds ratio for experiencing depressive symptoms (Burnam score ≥0.06) of 1.16 (95% confidence interval: 0.86, 1.56) compared with women in the placebo group. Supplementation was not associated with antidepressant use (odds ratio = 1.01, 95% confidence interval: 0.92, 1.12) or continuous depressive symptom score. Results stratified by baseline vitamin D and calcium intake, solar irradiance, and other factors were similar. The findings do not support a relation between supplementation with 400 IU/day of vitamin D(3) along with calcium and depression in older women. Additional trials testing higher doses of vitamin D are needed to determine whether this nutrient may help prevent or treat depression.

Moral Judgement Development Within the Family

Abstract This paper examines research and theory regarding the process of moral judgement development within the family environment. Four major issues in research on the familys influence on moral judgement development are outlined and the existing data relevant to these issues are briefly presented. The authors approach to studying these issues is described. The implications of research on moral development within the family for moral education are also addressed.

Sex Differences within the Family: Studies of Adolescent and Parent Family Interactions.

Sex differences in verbal family interactions were investigated in a group of 79 adolescents and parents from normal and psychiatric settings. The analyses were designed to study these differences in both generations, parent and adolescent. Parent and adolescent interactions with one another were observed in a semistructured, revealed-differences family discussion. All of the individual speeches were then scored with our Constraining and Enabling Coding System (CECS). Initial predictions involved both adolescent and parent differences. These hypotheses were only partially confirmed. The strongest findings pertained to parent sex differences, as we found strikingly higher levels of cognitive enabling speeches expressed by fathers and significantly more speeches addressed to fathers. We discuss several alternative interpretations of these findings. Perspectives included in our considerations are direction of effect and influences of task/context upon the expression of family sex differences.

Does Attachment Get Under the Skin? Adult Romantic Attachment and Cortisol Responses to Stress:

Although many studies have indicated that people in low-quality relationships are less healthy, precisely how relationships influence health remains unclear. We focus on one physiological pathway that may provide clues to the link between relationships and health: the hypothalamic-pituitary-adrenal (HPA) axis. Evidence indicates that attachment processes in adult romantic relationships are associated with HPA responses to stress (assessed via cortisol levels). Specifically, attachment insecurity predicts different cortisol patterns in response to stress than does attachment security, especially when the stressor potentially threatens the relationship. Thus, attachment may get under the skin through biological responses to attachment-relevant stressors, but further work is needed to pinpoint the complete physiological and behavioral pathways through which attachment may influence health and disease outcomes.

Antisocial Behavioral Syndromes Among Residential Drug Abuse Treatment Clients

We compared residential addictions treatment clients meeting full criteria for antisocial personality disorder (ASPD+) with those reporting syndromal levels of antisocial behavior only in adulthood (AABS+) on demographics, antisocial symptomatology, drug history, axis I comorbidity and characteristics of index treatment episode. We examined these issues in the sample as a whole, as well as separately in male and female respondents. Among both men and women, ASPD+ initiated their antisocial behavior earlier, met more ASPD criteria and endorsed more violent symptoms, than AABS+. Male ASPD+ also met criteria for more lifetime axis I diagnoses and reported more years of drug involvement than male AABS+. Trends were observed toward poorer retention in treatment among ASPD+ than among AABS+ participants of both genders randomized to a planned duration of 180 days, but retention did not differ between ASPD+ and AABS+ randomized to a planned duration of 90 days. Our findings, which replicate and extend previously published results, carry potential implications for treatment programming and for the nosology of ASPD.

Gender differences in manifestations of antisocial personality disorder among residential drug abuse treatment clients

We examined gender differences in manifestations of DSM-III-R antisocial personality disorder in 106 male and 34 female drug abusers enrolled in residential relapse prevention/health education treatment. In childhood, compared to males, females had more often run away but less often used weapons in fights, been cruel to animals, and set fires. Females also reported less vandalism. In adulthood, women had more often been irresponsible as parents and in financial matters, engaged in prostitution, made money finding customers for prostitutes, been physically violent against sex partners and children, failed to plan ahead, and lacked remorse. Our findings suggest that addiction treatment programs need to consider gender differences in antisocial symptomatology in the development of individualized treatment programs for both male and female clients.

Evaluating ego defense mechanisms using clinical interviews: an empirical study of adolescent diabetic and psychiatric patients *

Ego defense mechanisms were studied in three groups of early adolescents: diabetic patients, non-psychotic psychiatric patients, and healthy high school students. Defenses were assessed from ratings of open-ended, in-depth interviews. High levels of denial and low levels of asceticism were found in all three groups. Comparisons between groups indicated that psychiatric patients had a distinctive profile of defense usage, in comparison to adolescents from the other two groups. An independent measure of ego development was positively correlated with the defenses of altruism, intellectualization, and suppression, while it was negatively correlated with acting out, avoidance, denial, displacement, projection, and repression. The findings of substantial differences in defense usage between the psychiatric and non-psychiatric samples, and the size and directions of the correlations with ego development level, lend support to the validity of the defense codes.

Ego Development and Self-Esteem in Diabetic Adolescents

This study explores the impact of diabetes mellitus upon aspects of adolescent development. Using specific assessment techniques and interviews, we followed ego development and self-esteem variables. Clinical considerations suggest that both personality dimensions are important for the understanding of diabetic adolescents. The significance of ego development is implied in many case reports, which note the disruption in individual coping that frequently follows the onset of diabetes. Clinical observations and empirical studies have also commented upon diminished self-esteem in diabetic patients. Our sample consisted of male and female diabetic adolescents, whose average age was 13. All patients completed Loevingers sentence completion test of ego development and the Coopersmith self-esteem inventory. Previous studies have indicated favorable reliability and validity for both instruments. A subgroup of the sample was also interviewed. The ego development and self-esteem scores were contrasted with two groups of similar age adolescents who had previously completed these same tests, and a control group. The diabetic adolescents were clearly at lower levels of ego development than the nondiabetic groups. These lower stages were not correlated with duration of illness. A second finding was that the boys were at lower levels of ego development than the girls, regardless of age or illness duration. Self-esteem scores were associated with both illness duration and ego development. Subjects at the lowest levels of ego development also had the lowest self-esteem. Study of the interviews revealed that the patients at these lower ego development levels manifested concrete, more stereotyped, and resigned responses than those patients at the higher ego development stages.