A narrative analysis of helplessness in depression.

The transcripts of semistructured clinical interviews with forty psychiatrically hospitalized adolescents were subjected to narrative analysis in an effort to map the logic of their explanations as they spontaneously talked about helplessness experiences, and to determine how helplessness is embedded in broader story lines. Three types of narrative composition were discerned, and are discussed by means of excerpts from the interviews. In a first and predominant type of narrative, a disturbing confrontation with another is pivotal: the other's intentions are obscure; this frightens the narrator, who does not know what to do. Helplessness arises as a direct result of not knowing how to manage the "unbearable riddle" of the other's intentions. In the second, more marginal type of narrative, helplessness is embedded in an account of emptiness and boredom. The protagonist relates enduring experiences of emptiness due to loss and the suffering consequent on it. In the third, also more marginal type of narrative, helplessness is framed in a context of failure: the protagonist adheres to strict standards, feels he or she has fallen short, and concludes that he or she is a failure. Only the first type of narrative is significantly related to the psychiatric diagnoses of mood disorder and major depression.

Depressive symptoms and bias in perceived social competence among young adults.

We examined associations between depressive symptoms and young adults' self-perceptions of social competence to explore whether higher symptoms are associated with self-evaluations that are more accurate (i.e., depressive realism), negatively biased (i.e., cognitive distortion), or less accurate (i.e., self-verification perspective). In 133 young adults, depressive symptoms and discrepancies between self- and peer ratings of social competence were assessed. Results demonstrated a linear relationship between depressive symptoms and self-peer discrepancies, such that higher symptoms were associated with underestimation of the self and low symptom levels were linked with overestimation of the self relative to peer evaluations. These findings suggest negative bias in dysphorics' self-perceptions, supporting cognitive distortion models, as well as positive bias in self-perceptions of those with low depressive symptoms.

Prospective associations from family-of-origin interactions to adult marital interactions and relationship adjustment.

To test the social learning-based hypothesis that marital conflict resolution patterns are learned in the family of origin, longitudinal, observational data were used to assess prospective associations between family conflict interaction patterns during adolescence and offspring's later marital conflict interaction patterns. At age 14 years, 47 participants completed an observed family conflict resolution task with their parents. In a subsequent assessment 17 years later, the participants completed measures of marital adjustment and an observed marital conflict interaction task with their spouse. As predicted, levels of hostility and positive engagement expressed by parents and adolescents during family interactions were prospectively linked with levels of hostility and positive engagement expressed by offspring and their spouses during marital interactions. Family-of-origin hostility was a particularly robust predictor of marital interaction behaviors; it predicted later marital hostility and negatively predicted positive engagement, controlling for psychopathology and family-of-origin positive engagement. For men, family-of-origin hostility also predicted poorer marital adjustment, an effect that was mediated through hostility in marital interactions. These findings suggest a long-lasting influence of family communication patterns, particularly hostility, on offspring's intimate communication and relationship functioning.

Continuity and Change from Adolescence to Emerging Adulthood: Adolescence-limited vs. Life-course-persistent Profound Ego Development Arrests.

Participants (n = 36) with consistent Pre-conformist ego development levels during multiple adolescent assessments were studied to determine whether and how their ego levels had changed at age 25. Those (n = 12) whose ego levels remained at the Pre-conformist level were assigned to a life-course-persistent profound ego development arrest trajectory group; those (n = 24) whose ego levels reached the Conformist or Post-conformist level at age 25 were assigned to an adolescence-limited profound ego development arrest trajectory group. Analysis of predictors and age 25 correlates of group membership revealed that selected age 14 family interaction behaviors differentiated the two groups. At age 25, members of the adolescence-limited group showed superior performance on several measures of interpersonal and intrapersonal functioning.

Being close and being social: peer ratings of distinct aspects of young adult social competence.

The present study had three main objectives: (1) to develop and validate scales of young adult social competence in two domains, close relationships and social groups, using peer ratings of California Q-sort (Block, 1974; Kremen & Block, 2002) items; (2) to test the hypothesis that social competence is associated with young adult well-being and ego development; (3) to test the hypothesis that close relationship competence aligns more closely than social group competence with young adult functioning. Psychometric data on peer ratings of social competence are presented. For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development). Associations were generally stronger for competence in close relationships than in social groups.

Beyond psychopathology: assessing seriously disruptive students in school settings.

OBJECTIVE: To obtain a demographic profile of aggressive students in an urban setting and discern psychiatric diagnoses, functional impairment, and psychosocial stressors. STUDY DESIGN: Participants were 33 students in an urban public school district referred for comprehensive psychiatric evaluation by school staff because they were viewed as a threat to school safety. Evaluations included a review of records, interviews with school and mental health professionals, and student and parent interviews. RESULTS: Students were characterized by severe and untreated or undertreated psychopathology together with high levels of psychosocial stressors and learning disorders. Thirty-two students received at least one Axis I diagnosis, and the mean number of diagnoses for each student was 3; 33% had substance abuse problems, and 30% had nonpsychiatric medical conditions. CONCLUSIONS: The sample is a chronically impaired group of students confronting serious adversity in their daily lives, whose psychosocial and psychiatric needs are not met by current educational and mental health programming. Necessary interventions include prevention and early identification, substance abuse and family treatment, and appropriate psychopharmacological treatment. A comprehensive psychiatric assessment can help change the outcomes for this group of aggressive students.

Bilingual children: cross-sectional relations of psychiatric syndrome severity and dual language proficiency.

The severity of child psychiatric disorders is commonly associated with child language delays. However, the characteristics of these associations in the fast-growing population of bilingual children remain unknown. To begin to address this gap, we studied a unique sample of Spanish-English bilingual children with significant parent-reported psychopathology (n = 29), focusing on their language proficiencies and psychiatric severity using the Child Behavior Check List. We present cross-sectional analyses of associations of general and specific language proficiency in Spanish and English with the severity of specific psychiatric syndromes. We found Spanish language-proficiency scores to have negative correlations with a wide range of psychiatric symptoms, particularly externalizing (i.e., delinquency and aggression) symptoms (r = -.38 to -.61, p < or = .05). English scores were similarly associated. Dual language tests covering multiple specific language dimensions explained a large proportion (51%) of overall variance in aggression symptoms and also important proportions (40%) of total and attentional symptoms. While children's proficiency levels in both Spanish and English showed similar associations with the symptom severity measures (explaining close to 20% of the symptom variance; r(sp) = -.44, p < .01), these proficiency levels explain nonconverging variance in children's symptomatology. The findings suggest that clinical evaluation of language functioning is often needed in such populations and that it should be comprehensive and include both languages. Such thorough evaluation of bilingual children suffering from psychopathology will help us to precisely identify (1) language deficits, (2) specific relations of these deficits to the child's psychopathology, (3) differential implications of communication at home (e.g., in Spanish) and at school (e.g., in English) for clinical presentation and the child's competence in those differing contexts, and (4) language of choice for therapy, evaluation, and educational services. The findings are discussed in the context of clinical and conceptual implications and future research needs.

Narrative in the study of resilience.

The authors trace the contribution of narrative studies to the study of resilience. Narrative studies infiltrated the mental health field more slowly than they did the medical and social sciences, despite its long reliance on "talking therapies. " With the development of the Adult Attachment Interview, however narrative studies began to come into their own in developmental psychology, psychiatry, and psychoanalysis. Narrative studies are an especially apt tool in resilience studies. The authors discuss their use in this context, considering also some theoretical questions about the nature of narrative and its implications for psychotherapy.

Adolescents' behavior in the presence of interparental hostility: developmental and emotion regulatory influences.

Within-family covariation between interparental hostility and adolescent behavior across three interactions over a 2-year period was explored in a sample that included 37 typical adolescents and 35 adolescents recently hospitalized for psychiatric difficulties. More interparental hostility across the three interactions was associated with more adolescent hostility and more positive engagement (at a trend level) regardless of psychiatric background. Parent-to-child hostility in each interaction mediated the link for adolescent hostility but not for positive adolescent engagement. Emotion regulation capacities and age were linked to variability in adolescents' behavior in the presence of interparental conflict. In interactions with more interparental hostility, adolescents with greater capacity to tolerate negative affect were more likely to show increased positive engagement, and adolescents who were better able to modulate their emotional expression were less likely to show increased hostility. Covariation between interparental and adolescent hostility across the three family interactions decreased as the adolescent aged. These findings are consistent with the theory that exposure to interparental hostility is emotionally disequilibrating, and that adolescent responses may reflect differences in emotion regulation and other developmentally based capacities. Gender and variations across families in overall levels of hostile parenting were also linked with adolescent behavior in the presence of interparental hostility.

Adolescent psychiatric hospitalization and mortality, distress levels, and educational attainment: follow-up after 11 and 20 years.

BACKGROUND: Adolescents with early psychiatric hospitalization are likely to be at a significant risk for long-term difficulties. OBJECTIVE: To examine early adulthood outcomes of psychiatrically hospitalized adolescents. DESIGN: Inception cohort recruited from 1978 to 1981 and observed until 2002. SETTING: Northeastern United States. PARTICIPANTS: Adolescents (aged 12-15 years) from 2 matched cohorts were recruited and assessed repeatedly across 20 years: 70 psychiatrically hospitalized youths and 76 public high school students. MAIN OUTCOME MEASURES: Death, emotional distress, high school completion, and educational attainment. RESULTS: Psychiatrically hospitalized youths were significantly more likely to die and to report higher levels of emotional distress. Hospitalized youths were significantly less likely to graduate from high school and complete college and graduate school. CONCLUSIONS: The association between psychiatric symptoms sufficient to result in psychiatric hospitalization during adolescence and later mortality, emotional distress, high school completion, and educational attainment is striking. Further study is needed to identify and understand linkages between adolescent psychiatric impairment and decrements in adult functioning, particularly the processes that may underlie these linkages. Increasing school completion and educational attainment among hospitalized youths may minimize decrements in adult adaptation.

Reading others emotions: The role of intuitive judgments in predicting marital satisfaction, quality, and stability.

This study examined links between emotion expression in couple interactions and marital quality and stability. Core aspects of emotion expression in marital interactions were identified with the use of naive observational coding by multiple raters. Judges rated 47 marital discussions with 15 emotion descriptors. Coders' pooled ratings yielded good reliability on 4 types of emotion expression: hostility, distress, empathy, and affection. These 4 types were linked with concurrent marital satisfaction and interviewer ratings of marital adjustment as well as with marital stability at a 5-year follow-up. The study also examined the extent to which naive judges' ratings of emotion expression correspond to "expert" ratings using the Specific Affect Coding System (SPAFF). The unique advantages of naive coding of emotion expression in marital interaction are discussed.

Markers of Resilience and Risk: Adult Lives in a Vulnerable Population.

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25.Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to "bounce back" after a difficult adolescence.