Development in the Americanization of the adult immigrant in Massachusetts, from 1918-1922

Thesis (M.A.)--Boston Universit

A controlled study of hostile-helpless states of mind among borderline and dysthymic women

The aim of this study was to determine whether women with borderline personality disorder (BPD) are more likely than those with dysthymia to manifest contradictory Hostile-Helpless (HH) states of mind. A reliable rater blind to diagnosis evaluated features of such mental representations in transcripts of Adult Attachment Interviews from 12 women with BPD and 11 women with dysthymia of similar socioeconomic status (SES), all awaiting psychotherapy. In keeping with three hierarchical (non-independent) a priori predictions regarding the mental representations of women with BPD, the results were that (a) all those with BPD, compared with half the group with dysthymia, displayed HH states of mind; (b) those with BPD manifested a significantly higher frequency of globally devaluing representations; and (c) they exhibited a strong trend toward identifying with the devalued hostile caregiver (58% BPD vs. 18% dysthymic). In addition, significantly more BPD than dysthymic patients made reference to controlling behavior towards attachment figures in childhood. These findings offer fresh insights into the nature of BPD and extend previous evidence concerning affected individuals' patterns of thinking and feeling about childhood attachment figures

Physical Therapists Clinical Instructors Perceptions, Practices and Experience when Supervising an Underperforming Student in Clinical Education

Physical Therapist (PT) clinical instructors’ (CIs) perceptions, practices, and experiences when supervising an underperforming student. Background: The experience of supervising an underperforming student (UPS) in clinical education and failure to fail (FTF) are described in health professions such as nursing and medicine but there is little description of it in Physical Therapist (PT) clinical education. Purpose: To explore the PT clinical instructors’ (CIs) perceptions, practices and experience when supervising an under-performing student, and to determine if failure to fail exists in PT clinical education and if so, what organizational, personal, and demographic factors may be related to it. Methods: A non-experimental, descriptive, explanatory sequential mixed methods design, consisting of investigator created electronic survey, followed by semi structured interviews, using a qualitative phenomenological approach was employed. Snowball sampling was used for the survey. Interview participants volunteered at end of survey. The survey asked CIs questions regarding their perceived role, ability, and grading practices. CIs who had supervised an UPS where asked questions specific to their experience. Delphi process for face and content validity, Exploratory Factor Analysis (EFA) for construct validity and Cronbach alpha (alpha=.721) for survey internal consistency reliability were used. Descriptive statistics and Spearman correlation assessed associations between variables. Interviews were transcribed verbatim. Transcripts were coded using in-vivo and descriptive coding then collapsed into categories for thematic analysis. Interviews were conducted until saturation in codes was achieved. Intercoder consensus was obtained. Results: 397 CIs completed the survey; 177 had supervised an UPS; 7 participated in interviews. EFA showed variables loaded on 8 factors: DCE support, stress/time, perceived ability, doubt-distress, pressure to pass, professional duty, failure to fail (FTF) perceptions, and co-worker support (Eigenvalues \u3e1). Greater than 95% of CIs agreed they would be able to effectively manage an UPS, and they have a duty to both profession and student to provide objective evaluations. Despite this, greater than 50% agreed they would submit a satisfactory evaluation to an UPS who was trying, in an earlier experience or not experiencing safety issues. Of those who had supervised an UPS, \u3e 60% experienced stress, distress, and conflict. Strategies used by CIs included: one-on-one practice/instruction, feedback, goal setting and lowering expectations. 14% reported that they had FTF an UPS. Reasons cited were student effort/improvement or it was an early experience. There were significant, weak, correlation between perceptions of failing (r=.294, p=.000), pressure to pass (r=.174, p=.030), sense of duty (r=. -182, p=.023), support of DCE (r=. -194, p=.024), CI perceived preparation and ability (r=-.170, p.034) with FTF. Qualitative data revealed that CIs’ experience supervising an UPS was difficult and challenging and they experienced negative emotions. CIs had negative perceptions of failing a student. Student level in the program played a role in FTF. Despite a weak correlation, comments reflect support from DCE and coworkers as beneficial. (1497) Conclusions: Supervising an UPS is difficult and challenging. FTF does occur in PT clinical education. No conclusions can be made based on statistical correlations due to the low strength of relationships. Qualitative analysis supports that student level in the program and support from academic institution may play a role in FTF

Teaching Elementary Children with Autism: Addressing Teacher Challenges and Preparation Needs

Teachers’ perception of self-efficacy may have a significant impact on their ability to accept the challenges inherent in including children with autism in their classrooms. The Nominal Group Technique (NGT) was used to identify perceived challenges and needs of 31 graduate students in a university course of which 14 of the 23 students were actively teaching in rural schools located in southeast Alabama. Five faculty members used the resulting NGT data to draft six recommendations for improving the teacher preparation program at Troy University

The interface between attachment and intersubjectivity: Perspective from the longitudinal study of disorganized attachment

This article considers the interface between the concepts of attachment and intersubjectivity in light of accumulated research on infant development. Both Tomasello (1999) and Hobson (2002) have argued persuasively that the flexible human capability for sharing mental states with others reframes and revolutionizes our older, more highly channeled primate biological heritage. In contrast to this emphasis on discontinuity from primate to humanevolution, attachment theorists have stressed the continuities between human attachment and attachment in other primates. The implication of new work on infant intersubjectivity for reframing aspects of attachment theory is first explored. By the same token, however, the extent to which the infantcaregiver attachment relationship functions to maintain positive engagement and regulate the infant's fearful arousal will have escalating consequences over development for the organization of intersubjectivity. Therefore, attachment research has much to offer in understanding the development of joint attention and the sharing of mental states under conditions of increased emotional arousal. The potential contributions of attachment research for understanding the development of intersubjectivity are discussed in light of recent work from the author's lab on forms of young adult symptomatology associated -595 -with deviance in the early intersubjective dialogue between mother and infant. The clinical implication emerging from all these diverse areas of research is that fostering more collaborative forms of communication may lie at the heart of evolutionary change, developmental change, and changes resulting from psychodynamic psychotherapy. Rethinking Mechanisms of Attachment during the First Year: Evolution and Intersubjective Awareness Alot has been Written Recently about a Shift in the Basis of evolutionary change from biologic to what I will call dialogic mechanisms, or from -genes to memes.‖ For example, Tomasello (1999) has pointed out that with the relatively recent emergence of Homo sapiens as a species, more complex cultural innovations have been introduced in the last 200,000 years than were introduced in the previous 6 million years. He theorizes that a biological change occurred that shifted the basis for evolutionary change from the biological evolutionary mechanisms that had governed change for 6 million years to cultural evolutionary mechanisms that are many orders of magnitude faster than those of biologic evolution. He, as well as Hobson This capacity for social engagement is manifest first at the level of affective sharing and later at the level of explicit teaching and learning. In -596 -contrast to other primates, the human infant does not have to acquire first hand all the knowledge and experiences necessary to survival. Instead, the infant needs to develop the skills for sharing affective evaluations and intentional states with others. This allows the infant to participate in the cultural learning processes of humansociety. In contrast to the emphasis on discontinuity in evolutionary processes that is highlighted by Tomasello, Hobson, and others, attachment theorists have stressed thecontinuities between human attachment and attachment in other primates. As is well-known, John Bowlby thoroughly documented th

Risks and Outcomes Associated with Disorganized/Controlling Patterns of Attachment at Age Three in the NICHD Study of Early Child Care and Youth Development

Disorganized/controlling attachment in preschool has been found to be associated with maternal and child maladjustment, making it of keen interest in the study of psychopathology. Additional work is needed, however, to better understand disorganized/controlling attachment occurring as early as age three. The primary aims of this study were to evaluate risk factors and outcomes associated with disorganized/controlling behavior at age three and to evaluate the risk factors and outcomes differentiating the four subtypes of disorganized/controlling attachment. Analyses were conducted with the first two phases of the NICHD Study of Early Child Care and Youth Development, a prospective study of 1,364 children from birth. At 36 months of age, across the attachment-relevant domains of maternal well-being, mother-child interactions, and child social adaptation, the disorganized/controlling group evidenced the most maladaptive patterns in comparison to both secure and insecure-organized groups. At 54 months of age, the disorganized/controlling group displayed the highest levels of internalizing and externalizing behavior problems, as rated by mothers and teachers, and the lowest quality relationships with teachers. Significant differences found among the disorganized/controlling subtypes indicated that the behaviorally disorganized and controlling-punitive subtypes had more maladaptive patterns across variables than did the controlling-caregiving and controlling-mixed subtypes

How do mothers with borderline personality disorder mentalize when interacting with their infants?

Mothers with borderline personality disorder (BPD) have been theorized to have decreased mentalization ability, which is the capacity to perceive and interpret mental states. This could increase the risk for troubled relationships with their infants and therefore have adverse consequences for child social and emotional development. Mind-mindedness (MM), which codes the mother's references to her infant's mental states during an interaction, is one method of indexing mothers' mentalizing ability. However, research has yet to examine MM in mothers with BPD. Our objective was to assess the MM ability of 38 mothers during interactions with their 12-month-old infants, including 10 mothers with BPD and 28 mothers without a psychiatric diagnosis. Trained observers assessed maternal MM from 2 min of videotaped mother-infant free play. BPD was assessed with the Structured Clinical Interview for DSM-III-R-Personality Disorders (SCID-II). Mothers with and without BPD did not differ in the proportion of total comments referring to infant mental states. However, mothers in the BPD group proportionately made 3.6 times more misattuned mind-related comments than control mothers. Thus, mothers with and without BPD appear equally likely to envision mental states in their infants. However, mothers with BPD also appear more likely to misread their infants' mental states

Association between dopaminergic polymorphisms and borderline personality traits among at-risk young adults and psychiatric inpatients

Background: In the development of borderline personality disorder (BPD) both genetic and environmental factors have important roles. The characteristic affective disturbance and impulsive aggression are linked to imbalances in the central serotonin system, and most of the genetic association studies focused on serotonergic candidate genes. However, the efficacy of dopamine D2 receptor (DRD2) blocking antipsychotic drugs in BPD treatment also suggests involvement of the dopamine system in the neurobiology of BPD.Methods: In the present study we tested the dopamine dysfunction hypothesis of impulsive self- and other-damaging behaviors: borderline and antisocial traits were assessed by Structured Clinical Interview for Diagnosis (SCID) for DSM-IV in a community-based US sample of 99 young adults from low-to-moderate income families. For the BPD trait analyses a second, independent group was used consisting of 136 Hungarian patients with bipolar or major depressive disorder filling out self-report SCID-II Screen questionnaire. In the genetic association analyses the previously indicated polymorphisms of the catechol-O-methyl-transferase (COMT Val158Met) and dopamine transporter (DAT1 40 bp VNTR) were studied. In addition, candidate polymorphisms of the DRD2 and DRD4 dopamine receptor genes were selected from the impulsive behavior literature.Results: The DRD2 TaqI B1-allele and A1-allele were associated with borderline traits in the young adult sample (p = 0.001, and p = 0.005, respectively). Also, the DRD4 -616 CC genotype appeared as a risk factor (p = 0.02). With severity of abuse accounted for in the model, genetic effects of the DRD2 and DRD4 polymorphisms were still significant (DRD2 TaqIB: p = 0.001, DRD2 TaqIA: p = 0.008, DRD4 -616 C/G: p = 0.002). Only the DRD4 promoter finding was replicated in the independent sample of psychiatric inpatients (p = 0.007). No association was found with the COMT and DAT1 polymorphisms.Conclusions: Our results of the two independent samples suggest a possible involvement of the DRD4 -616 C/G promoter variant in the development of BPD traits. In addition, an association of the DRD2 genetic polymorphisms with impulsive self-damaging behaviors was also demonstrated. © 2010 Nemoda et al; licensee BioMed Central Ltd