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1.
Infant Ment Health J ; 44(2): 137-141, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36857483

RESUMO

Nancy E. Suchman's contributions to the fields of infant mental health, maternal reflective functioning, and attachment-based intervention will have long-lasting impacts. In particular, through the development and dissemination of her intervention program, Mothering from the Inside Out (MIO), she innovated a way of working with mothers with substance use disorders that represented a paradigm shift within the field of addiction. In this introduction to the special issue, written to honor her life and work, we review Nancy's background and briefly describe her academic accomplishments. The special issue contains nine qualitative and quantitative research reports written by Nancy's colleagues and their collaborators. All nine papers pertain to the theme of understanding, measuring, and promoting parents' capacity for reflective functioning. Four provide findings that advance our understanding of parental reflective functioning. The other five highlight insights from continuing evaluations of MIO, including new adaptations of the model. To introduce the special issue, we provide an overview of the scope of the work done within these projects. Finally, the special issue concludes with two commentaries contributed by Linda Mayes and Arietta Slade, leading scholars within the field who were also Nancy's close colleagues. Both provide insight into Nancy's impact on the field.


Las contribuciones de Nancy E Suchman a los campos de la salud mental infantil, del funcionamiento materno con reflexión y de la intervención con base en la afectividad tendrá un impacto duradero. Particularmente a través del desarrollo y divulgación de su programa de intervención, Cuidados Maternales de Dentro hacia Afuera (MIO), ella es innovadora de una manera de trabajar con madres con trastornos de uso de sustancias, lo cual representa un cambio de paradigma dentro del campo de la adicción. En esta introducción al número especial, dedicado en honor a su vida y trabajo, se examina la trayectoria profesional de Nancy y brevemente se describen sus logros académicos. El número especial contiene nueve reportes de investigación cualitativa y cuantitativa, escritos por colegas y colaboradores de Nancy. Todos los nueve ensayos se refieren al tema de cómo comprender, medir y promover la capacidad de los progenitores para el funcionamiento con reflexión. Cuatro de ellos aportan resultados que profundizan nuestra comprensión del funcionamiento con reflexión del progenitor. Los otros cinco resaltan ideas de las continuas evaluaciones del MIO, incluyendo nuevas adaptaciones del modelo. Para introducir el número especial, presentamos una revisión general del alcance del trabajo llevado a cabo en estos proyectos. Finalmente, el número especial concluye con dos comentarios que son contribución de Linda Mayes y Arietta Slade, líderes investigadoras profesionales dentro del campo y quienes también fueron colegas allegadas a Nancy. Ambas aportan ideas sobre el impacto que Nancy tiene en su campo.


Les contributions de Nancy E. Suchman aux domaines de la santé mentale du nourrisson et de la petite enfance, du fonctionnement de réflexion maternel et de l'intervention basée sur l'attachement auront des impacts à long terme. Plus particulièrement, au travers du développement et de la dissémination de son programme d'intervention Mothering from the Inside Out (MOI, en français le Maternage de l'Intérieur), elle a tracé une nouvelle voix innovatrice de travail avec des mères toxicomanes, voix représentant un changement de paradigme au sein même du domaine de l'addiction. Dans cette introduction à ce numéro spécial, écrite afin d'honorer sa vie et son travail, nous passons en revue le contexte personnel de Nancy et décrivons brièvement ses réalisations académiques. Ce numéro spécial contient neuf rapports de recherches qualitatives et quantitatives écrits par les collègues de Nancy et ses collaboratrices et collaborateurs. Ces neufs articles portent sur le thème de la compréhension, la mesure et la promotion de la capacité des parents à se consacrer au fonctionnement de réflexion. Quatre de ces articles offrent des conclusions qui font avancer notre compréhension du fonctionnement de réflexion parental. Les autres cinq articles mettent en lumière le travail émanant d'évaluations en cours du MOI, y compris de nouvelles adaptations du modèle. Pour présenter ce numéro spécial nous offrons un survol de la portée du travail fait au sein de ces projets. Enfin, ce numéro spécial conclut avec deux commentaires présentés par Linda Mayes et Arietta Slade, grandes spécialistes au sein de ce domaine de recherche, qui étaient aussi les proches collègues de Nancy. Elles nous offrent toutes deux un aperçu de l'impact qu'a eu Nancy sur ce domaine de recherches.


Assuntos
Pais , Transtornos Relacionados ao Uso de Substâncias , Lactente , Feminino , Humanos , Mães/psicologia , Saúde Mental , Terapia Comportamental
2.
Infant Ment Health J ; 44(2): 240-254, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36857469

RESUMO

The Parental Reflective Functioning Questionnaire (PRFQ) provides an efficient way to measure a parent's capacity to recognize their child's mental states and to understand the relationship between underlying mental states and behavior. To date, limited work evaluates its psychometric properties beyond initial validation studies. Here we examined the reliability and validity of the PRFQ in three samples of varying clinical risk (e.g., community sample, previous mental health diagnosis, substance use disorder diagnosis). Across samples, the majority (e.g., 75%-78%) of mothers identified as White; all mothers were from the USA. We compared the PRFQ to task-based measures of mentalization, the Parent Development Interview (PDI), and measures of the parent-child relationship. The PRFQ was a reliable measure across samples, and it was associated in theoretically consistent ways with task-based measures of mentalization. Parental RF across the PDI and PRFQ were not highly correlated in a sample of mothers with substance use disorders. Existing RF measures may be tapping into a different component of the broader construct of parental reflective functioning (PRF). The PRFQ was further validated by demonstrating relationships with parent-report measures of the parent-child relationship. Taken together, these findings provide additional support for the reliability and validity of the PRFQ.


El Cuestionario del Funcionamiento con Reflexión del Progenitor (PRFQ) aporta una manera eficaz de medir la capacidad del progenitor para reconocer los estados mentales de su niño y comprender la relación entre los estados mentales subyacentes y el comportamiento. A la fecha, un trabajo limitado evalúa sus propiedades sicométricas más allá de los estudios de validación inicial. Aquí examinamos la confiabilidad y validez del PRFQ en tres grupos muestra de riesgo clínico variado (v.g. grupo comunitario, previa diagnosis de salud mental, diagnosis de trastorno por uso de sustancias). A través de los grupos muestra, la mayoría (v.g., 75-78%) de las madres se identifican como blancas; todas las madres eran de los Estados Unidos. Comparamos el PRFQ con medidas de mentalización basadas en tareas, la Entrevista del Desarrollo del Progenitor (PDI), y medidas de la relación progenitor-niño. El PRFQ fue una medida confiable a lo largo de los grupos muestra, y se asoció de maneras teoréticamente consistentes con las medidas de mentalización basadas en tareas. El funcionamiento con reflexión del progenitor a lo largo del PDI y PRFQ no se correlacionaron altamente en un grupo muestra de madres con trastornos de uso de sustancias. Las medidas del funcionamiento con reflexión existentes pudieran sacar provecho de un componente diferente de la más amplia edificación del funcionamiento con reflexión del progenitor. Se validó además el PRFQ por medio de demostrar las relaciones con las medidas auto reportadas por el progenitor de la relación progenitor-niño. Tomados en conjunto, estos resultados aportan un apoyo adicional para la confiabilidad y validez del PRFQ.


Le Questionnaire de Fonctionnement de Réflexion Parental (QFRP) offre une manière efficace de mesurer la capacité d'un parent à reconnaître les états mentaux de leur enfant et de comprendre la relation entre les états mentaux sous-jacents et le comportement. Jusqu'à présent peu d'études ont évalué ses propriétés psychométriques au-delà des études initiales de validation. Nous examinons ici la fiabilité et la validité du QFRP chez trois échantillons de risque clinique varié (soit un échantillon communautaire, un diagnostic de santé mentale précédent, un diagnostic de trouble lié à l'usage d'une substance). Au travers des échantillons la majorité (c'est-à-dire 75-78%) des mères se sont identifiées comme étant blanches et toutes les mères étaient américaines (des USA). Nous avons comparé le QFRP à des mesures de mentalisation faites à partir d'une tâche, à l'Entretien de Développement du Parent (en anglais Parent Development Interview, soit PDI), et à des mesures de la relation parent-enfant. Le QFRP s'est avéré être une mesure fiable au travers des échantillons et était lié de manières théoriquement cohérentes à des mesures de mentalisation (basées sur des tâches). Le FR parental au travers du PDI et le QFRP n'étaient pas fortement liés chez un échantillon de mères avec un trouble lié à l'usage d'une substance. Il est possible que les mesures FR qui existent puisent dans un composant différent de la structure plus large du fonctionnement de réflexion parental, Le QFRP a été en outre validé par la démonstration de la relation entre les mesures rapportées par les parents de la relation parent-enfant. Pris dans l'ensemble ces résultats offrent un soutien supplémentaire pour la fiabilité et la validité du QFRP.


Assuntos
Mães , Pais , Feminino , Humanos , Autorrelato , Reprodutibilidade dos Testes , Pais/psicologia , Mães/psicologia , Inquéritos e Questionários
3.
Infant Ment Health J ; 44(2): 142-165, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36862381

RESUMO

Mothering from the Inside Out (MIO) is a mentalization-based parenting intervention developed to address challenges common among mothers experiencing substance use disorders (SUDs) and previously deemed effective when delivered by research clinicians. This randomized clinical trial was designed to test the efficacy of MIO when delivered by community-based addiction counselors in Connecticut, USA. Ninety-four mothers [M(SD)age = 31.01(4.01) years; 75.53% White] caring for a child 11-60 months of age were randomly assigned to participate in 12 sessions of either MIO or psychoeducation. Caregiving, psychiatric, and substance use outcomes were assessed repeatedly from baseline through 12-week follow-up. Mothers who participated in MIO showed decreased certainty about their child's mental states, and decreased depression; their children demonstrated increased clarity of cues. Participation in MIO was not associated with the same degree of improvement that was observed in prior trials where MIO was delivered by research clinicians. However, when delivered by community-based clinicians, MIO may be protective against a deterioration in caregiving over time often seen in mothers with addictions. The drop in efficacy of MIO in this trial raises questions about intervention-intervenor fit. Research should examine factors influencing MIO effectiveness to close the science-to-service gap common in the dissemination of empirically validated interventions.


Cuidados Maternales desde Dentro (MIO) es una intervención de crianza con base en la mentalización desarrollada para discutir los retos que son comunes entre las madres que experimentan trastornos de uso de sustancias (SUD) y que previamente eran considerados eficaces cuando los ofrecían los investigadores clínicos. Este ensayo clínico al azar se diseñó para examinar la efectividad de MIO cuando la ofrecen consejeros en asuntos de adicción con base en la comunidad, en Connecticut, Estados Unidos. Noventa y cuatro madres [M(SD) edad = 31.01(4.01) años; 75.53% blancas] con un niño de 11 a 60 meses de edad bajo su cuidado fueron asignadas al azar para participar en 12 sesiones, ya sea de MIO o de psicoeducación. Los resultados del cuidado prestado, los siquiátricos y los de uso de sustancia se evaluaron repetidamente a partir de los datos básicos hasta el seguimiento a las 12 semanas. Las madres que participaron en MIO mostraron una disminución en la certeza acerca de los estados mentales de sus niños, y una disminución en la depresión; sus niños demostraron un aumento en la claridad de las señales. La participación en MIO no se asoció con el mismo grado de mejoramiento que se observó en ensayos previos en los que MIO fue ofrecido por investigadores clínicos. Sin embargo, cuando es ofrecido por clínicos con base comunitaria, MIO pudiera servir de protección contra el deterioro de la prestación de cuidado a lo largo del tiempo, a menudo visto en madres con adicciones. La disminución de la efectividad de MIO en este ensayo genera preguntas acerca de cuán compenetrados está el interventor con la intervención. La investigación debe examinar factores que influyan en la efectividad de MIO para cerrar el vacío entre servicio y ciencia, común en la diseminación de las intervenciones empíricamente validadas.


Le maternage de l'intérieur (abrégé ici MIO pour reprendre l'anglais Mothering from the Inside Out) est une intervention de parentage basée sur la mentalisation, développée afin de répondre aux défis courants chez les mères ayant un trouble lié à l'usage d'une substance (TUS) et préalablement considérée comme efficace lorsque faite par des chercheurs cliniques. Cette étude clinique randomisée a été conçue pour tester l'efficacité du MIO lorsque offert par des intervenants en dépendance communautaires dans l'état du Connecticut aux Etats-Unis. Quatre-vingt-dix-neuf mères [M(SD)âge = 31,01(4,01) ans; 75,53% blanches] prenant soin d'un enfant de 11-60 mois ont été réparties au hasard pour participer soit au MIO soit à une psychoéducation. Les résultats de soins, les résultats psychiatriques et les résultats de toxicomanie ont été évalués de façon répétée de la base jusqu'au suivi à 12 semaines. Les mères ayant participé au MIO ont fait preuve d'une certitude diminuée à propos des états mentaux de leur enfant, et d'une dépression diminuée; leurs enfants ont fait preuve d'une clarté des indices accrue. La participation au MIO n'était pas liée au même degré d'amélioration qui a été observé dans les études préalables quand le MIO a été utilisé par des chercheurs cliniciens. Cependant, lorsqu'administré par des cliniciens communautaires, le MIO pourrait s'avérer protecteur d'une détérioration dans les soins au fil du temps que l'on voit souvent chez les mères toxicomanes. Le déclin d'efficacité du MIO dans cette étude soulève des questions quant à l'ajustement intervention-intervenant. Les recherches devraient se pencher sur les facteurs influençant l'efficacité du MIO pour réduire l'écart de la science au service dans la dissémination d'intervention validées empiriquement.


Assuntos
Mentalização , Transtornos Relacionados ao Uso de Substâncias , Criança , Feminino , Humanos , Adulto , Poder Familiar/psicologia , Mães/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Sinais (Psicologia)
4.
Proc Natl Acad Sci U S A ; 116(24): 12045-12053, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31138685

RESUMO

Many components of the circadian molecular clock are conserved from flies to mammals; however, the role of mammalian Timeless remains ambiguous. Here, we report a mutation in the human TIMELESS (hTIM) gene that causes familial advanced sleep phase (FASP). Tim CRISPR mutant mice exhibit FASP with altered photic entrainment but normal circadian period. We demonstrate that the mutation prevents TIM accumulation in the nucleus and has altered affinity for CRY2, leading to destabilization of PER/CRY complex and a shortened period in nonmature mouse embryonic fibroblasts (MEFs). We conclude that TIM, when excluded from the nucleus, can destabilize the negative regulators of the circadian clock, alter light entrainment, and cause FASP.


Assuntos
Proteínas de Ciclo Celular/genética , Relógios Circadianos/genética , Ritmo Circadiano/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , Mutação/genética , Sono/genética , Animais , Linhagem Celular , Fibroblastos/fisiologia , Células HEK293 , Humanos , Luz , Masculino , Camundongos , Camundongos Endogâmicos C57BL
5.
Ann Neurol ; 88(4): 830-842, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32715519

RESUMO

OBJECTIVE: The objective of this study was to identify the genetic cause for progressive peripheral nerve disease in a Venezuelan family. Despite the growing list of genes associated with Charcot-Marie-Tooth disease, many patients with axonal forms lack a genetic diagnosis. METHODS: A pedigree was constructed, based on family clinical data. Next-generation sequencing of mitochondrial DNA (mtDNA) was performed for 6 affected family members. Muscle biopsies from 4 family members were used for analysis of muscle histology and ultrastructure, mtDNA sequencing, and RNA quantification. Ultrastructural studies were performed on sensory nerve biopsies from 2 affected family members. RESULTS: Electrodiagnostic testing showed a motor and sensory axonal polyneuropathy. Pedigree analysis revealed inheritance only through the maternal line, consistent with mitochondrial transmission. Sequencing of mtDNA identified a mutation in the mitochondrial tRNAVal (mt-tRNAVal ) gene, m.1661A>G, present at nearly 100% heteroplasmy, which disrupts a Watson-Crick base pair in the T-stem-loop. Muscle biopsies showed chronic denervation/reinnervation changes, whereas biochemical analysis of electron transport chain (ETC) enzyme activities showed reduction in multiple ETC complexes. Northern blots from skeletal muscle total RNA showed severe reduction in abundance of mt-tRNAVal , and mildly increased mt-tRNAPhe , in subjects compared with unrelated age- and sex-matched controls. Nerve biopsies from 2 affected family members demonstrated ultrastructural mitochondrial abnormalities (hyperplasia, hypertrophy, and crystalline arrays) consistent with a mitochondrial neuropathy. CONCLUSION: We identify a previously unreported cause of Charcot-Marie-Tooth (CMT) disease, a mutation in the mt-tRNAVal , in a Venezuelan family. This work expands the list of CMT-associated genes from protein-coding genes to a mitochondrial tRNA gene. ANN NEUROL 2020;88:830-842.


Assuntos
Doença de Charcot-Marie-Tooth/genética , RNA Mitocondrial/genética , RNA de Transferência/genética , Adolescente , Adulto , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Linhagem , Venezuela , Adulto Jovem
6.
Proc Natl Acad Sci U S A ; 115(13): 3434-3439, 2018 03 27.
Artigo em Inglês | MEDLINE | ID: mdl-29531056

RESUMO

Adequate sleep is essential for physical and mental health. We previously identified a missense mutation in the human DEC2 gene (BHLHE41) leading to the familial natural short sleep behavioral trait. DEC2 is a transcription factor regulating the circadian clock in mammals, although its role in sleep regulation has been unclear. Here we report that prepro-orexin, also known as hypocretin (Hcrt), gene expression is increased in the mouse model expressing the mutant hDEC2 transgene (hDEC2-P384R). Prepro-orexin encodes a precursor protein of a neuropeptide producing orexin A and B (hcrt1 and hcrt2), which is enriched in the hypothalamus and regulates maintenance of arousal. In cell culture, DEC2 suppressed prepro-orexin promoter-luc (ore-luc) expression through cis-acting E-box elements. The mutant DEC2 has less repressor activity than WT-DEC2, resulting in increased orexin expression. DEC2-binding affinity for the prepro-orexin gene promoter is decreased by the P384R mutation, likely due to weakened interaction with other transcription factors. In vivo, the decreased immobility time of the mutant transgenic mice is attenuated by an orexin receptor antagonist. Our results suggested that DEC2 regulates sleep/wake duration, at least in part, by modulating the neuropeptide hormone orexin.


Assuntos
Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Regulação da Expressão Gênica , Mutação , Orexinas/genética , Regiões Promotoras Genéticas , Sono/fisiologia , Animais , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Orexinas/metabolismo
7.
Nature ; 493(7432): 416-9, 2013 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-23283171

RESUMO

Protein kinase M-ζ (PKM-ζ) is a constitutively active form of atypical protein kinase C that is exclusively expressed in the brain and implicated in the maintenance of long-term memory. Most studies that support a role for PKM-ζ in memory maintenance have used pharmacological PKM-ζ inhibitors such as the myristoylated zeta inhibitory peptide (ZIP) or chelerythrine. Here we use a genetic approach and target exon 9 of the Prkcz gene to generate mice that lack both protein kinase C-ζ (PKC-ζ) and PKM-ζ (Prkcz(-/-) mice). Prkcz(-/-) mice showed normal behaviour in a cage environment and in baseline tests of motor function and sensory perception, but displayed reduced anxiety-like behaviour. Notably, Prkcz(-/-) mice did not show deficits in learning or memory in tests of cued fear conditioning, novel object recognition, object location recognition, conditioned place preference for cocaine, or motor learning, when compared with wild-type littermates. ZIP injection into the nucleus accumbens reduced expression of cocaine-conditioned place preference in Prkcz(-/-) mice. In vitro, ZIP and scrambled ZIP inhibited PKM-ζ, PKC-ι and PKC-ζ with similar inhibition constant (K(i)) values. Chelerythrine was a weak inhibitor of PKM-ζ (K(i) = 76 µM). Our findings show that absence of PKM-ζ does not impair learning and memory in mice, and that ZIP can erase reward memory even when PKM-ζ is not present.


Assuntos
Deleção de Genes , Memória/fisiologia , Proteína Quinase C/deficiência , Proteína Quinase C/genética , Animais , Ansiedade/genética , Comportamento Animal , Benzofenantridinas/farmacologia , Cocaína , Condicionamento Clássico , Sinais (Psicologia) , Éxons/genética , Medo , Feminino , Masculino , Camundongos , Proteína Quinase C/análise , Proteína Quinase C/imunologia
8.
Proc Natl Acad Sci U S A ; 113(11): E1536-44, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26903630

RESUMO

In humans, the connection between sleep and mood has long been recognized, although direct molecular evidence is lacking. We identified two rare variants in the circadian clock gene PERIOD3 (PER3-P415A/H417R) in humans with familial advanced sleep phase accompanied by higher Beck Depression Inventory and seasonality scores. hPER3-P415A/H417R transgenic mice showed an altered circadian period under constant light and exhibited phase shifts of the sleep-wake cycle in a short light period (photoperiod) paradigm. Molecular characterization revealed that the rare variants destabilized PER3 and failed to stabilize PERIOD1/2 proteins, which play critical roles in circadian timing. Although hPER3-P415A/H417R-Tg mice showed a mild depression-like phenotype, Per3 knockout mice demonstrated consistent depression-like behavior, particularly when studied under a short photoperiod, supporting a possible role for PER3 in mood regulation. These findings suggest that PER3 may be a nexus for sleep and mood regulation while fine-tuning these processes to adapt to seasonal changes.


Assuntos
Afeto/fisiologia , Proteínas Circadianas Period/genética , Transtorno Afetivo Sazonal/genética , Idoso , Sequência de Aminoácidos , Animais , Relógios Circadianos/genética , Feminino , Humanos , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Pessoa de Meia-Idade , Dados de Sequência Molecular , Proteínas Circadianas Period/metabolismo , Fotoperíodo , Estabilidade Proteica , Transtornos do Sono do Ritmo Circadiano/genética
9.
Psychoanal Psychol ; 36(1): 82-92, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30853749

RESUMO

Although it is known that mothers with substance abuse disorders struggle to provide adequate parenting to their children, little is understood about the mechanisms behind this. This cross-sectional study uses an attachment perspective to examine whether reflective functioning mediates the relationship between mental representations of caregiving and maternal sensitivity, in an ethnically diverse sample of 142 substance-abusing mothers (M [SD] = 29.83 [5.79] years of age) and their toddlers (M [SD] = 24.04 [15.15] months of age). Data were baseline measures from two randomized controlled trials. The three variables of primary interest were positively correlated. As expected, there was a significant relationship between mental representations of caregiving and maternal sensitivity that was largely explained by reflective functioning. Confounding and alternate explanations were not supported by a secondary data analyses. The findings underscore the importance of reflective functioning in positive parenting within this high-risk population of mothers, and they provide support for the development of attachment-based interventions.

10.
Infant Ment Health J ; 39(1): 92-105, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29283178

RESUMO

The process of mental health intervention implementation with vulnerable populations is not well-described in the literature. The authors worked as a community-partnered team to adapt and pilot an empirically supported intervention program for mothers of infants and toddlers in an outpatient mental health clinic that primarily serves a low-income community. We used qualitative ethnographic methods to document the adaption of an evidence-based intervention, Mothering from the Inside Out, and the pilot implementation in a community mental health clinic. Seventeen mothers and their identified 0- to 84-month-old children were enrolled in the study. Key lessons from this implementation include (a) the importance of formative work to build community relationships and effectively adapt the intervention to meet the needs of the therapists and their clients, (b) the importance of designing plans for training and reflective supervision that fit within the flow of the clinic and can tolerate disruptions, and (c) that use of an interdisciplinary approach is feasible with the development of a plan for communication and the support of a trained reflective clinical supervisor. These key lessons advance the scientific knowledge available to healthcare managers and researchers who are looking to adapt mental health clinical interventions previously tested in clinical trials to implementation in community settings.


Assuntos
Mães/educação , Poder Familiar/psicologia , Adulto , Assistência Ambulatorial , Terapia Comportamental/métodos , Criança , Pré-Escolar , Serviços Comunitários de Saúde Mental/organização & administração , Atenção à Saúde/organização & administração , Educação não Profissionalizante , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Saúde Mental , Projetos Piloto , Pobreza
11.
Dev Psychopathol ; 29(1): 215-234, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-26899949

RESUMO

This longitudinal study of affluent suburban youth (N = 319) tracked from 6th to 12th grade is parsed into two segments examining prospective associations concerning emotional-behavioral difficulties and academic achievement. In Part 1 of the investigation, markers of emotional-behavioral difficulty were used to cluster participants during 6th grade. Generalized estimating equations were then used to document between-cluster differences in academic competence from 6th to 12th grade. In Part 2 of the study, indicators of academic competence were used to cluster the same students during 6th grade, and generalized estimating equations were used to document between-cluster differences in emotional-behavioral difficulty from 6th to 12th grade. The results from Part 1 indicated that patterns of emotional-behavioral difficulty during 6th grade were concurrently associated with poorer grades and classroom adjustment with some group differences in the rate of change in classroom adjustment over time. In Part 2, patterns of academic competence during 6th grade were concurrently associated with less emotional-behavioral difficulty and some group differences in the rate of change in specific forms of emotional-behavioral difficulty over time. These results suggest that the youth sampled appeared relatively well adjusted and any emotional-behavioral-achievement difficulty that was evident at the start of middle school was sustained through the end of high school.


Assuntos
Logro , Emoções/fisiologia , Comportamento Problema/psicologia , Ajustamento Social , Estudantes/psicologia , Adolescente , Criança , Escolaridade , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Instituições Acadêmicas , Classe Social
12.
Dev Psychopathol ; 29(2): 617-636, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28401850

RESUMO

Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering From the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of parent education (PE), a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother-child interaction quality, and child attachment were evaluated at baseline and posttreatment and 3-month follow-up. Mother-child interaction quality was assessed again at 12-month follow-up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at posttreatment and 3-month follow-up. At 12-month follow-up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother-child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.


Assuntos
Relações Mãe-Filho/psicologia , Mães/psicologia , Poder Familiar/psicologia , Psicoterapia/métodos , Transtornos Relacionados ao Uso de Substâncias/terapia , Teoria da Mente/fisiologia , Adulto , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Educação de Pacientes como Assunto , Adulto Jovem
13.
Attach Hum Dev ; 18(6): 596-617, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27575343

RESUMO

Mothers who are involved with mental health services (for themselves or their children) rarely receive adequate support for their role as parents. Mental illness in a parent or child often exacerbates the challenges of managing psychological distress that is germane to the parenting roll. Mentalization-based approaches to psychotherapy for parents have the potential to address challenges of emotional regulation in parents by supporting their capacity to recognize and modulate negative affect during stressful parenting situations. In this study, we piloted Mothering from the Inside Out (MIO) with 17 mothers receiving services at a community-based mental health clinic. MIO is a 12-week, mentalization-based parenting intervention that demonstrated efficacy in two previous randomized controlled trials with substance using mothers. In this study, we were interested in determining whether community-based clinicians could deliver MIO with sustained fidelity. We were also interested in examining the preliminary feasibility, acceptability and efficacy of MIO when delivered by clinicians in a community mental health center. Finally, we were interested in replicating prior tests of the proposed treatment mechanisms. Treatment outcomes included maternal reflective functioning, psychiatric and parenting stress, and mother-child interaction quality. Our findings indicated that MIO was feasible and acceptable when delivered in the community-based setting and that all maternal indices improved. However, no improvement in mother-child interaction quality was found, possibly because of insufficient time for these changes to consolidate.


Assuntos
Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Relações Mãe-Filho/psicologia , Apego ao Objeto , Psicoterapia/métodos , Adolescente , Adulto , Criança , Serviços Comunitários de Saúde Mental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães/psicologia , Poder Familiar/psicologia , Projetos Piloto , Fatores Socioeconômicos , Estresse Psicológico/psicologia , Teoria da Mente , Adulto Jovem
14.
Pers Individ Dif ; 75: 190-194, 2015 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-25554716

RESUMO

Adults who abuse substances are at increased risk for contracting sexually transmitted infections, including HIV. Within this population, sexual risk behaviors have been associated with increased impulsivity. Studies in non-clinical populations showing gender-related differences in sexual decision-making and casual sexual partnering suggest impulsivity has a greater influence on men than women, but these differences have not been documented in substance-using patients. In a sample of 89 adults with recent cocaine use and receiving outpatient psychiatric treatment, we tested the hypothesis that gender moderates the effect of impulsivity on sexual risk-taking. Using logistic regression modeling, we tested the main and gender-moderated effects of task-related impulsivity on the probability of having a casual sexual partner and multiple sexual partners. Results confirmed a significant gender-by-impulsivity interaction; men who were more impulsive on a continuous performance task had significantly higher rates of sexual risk-taking than less impulsive men, but women's impulsivity was unrelated to these outcomes. Impulsive men were over three times as likely as less impulsive men to have a recent casual partner. Implications of these results and suggestions for future research are discussed.

15.
Alcohol Clin Exp Res ; 38(1): 170-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23905844

RESUMO

BACKGROUND: Prkcz has been identified as a gene whose expression is positively correlated with ethanol (EtOH) consumption in mice and is also induced by EtOH. Two proteins are produced from Prkcz: protein kinase M zeta (PKMζ), which is expressed in the nervous system and protein kinase C zeta (PKCζ), which is expressed in other tissues. We examined Prkcz(-/-) mice that lack PKCζ and PKMζ to investigate the role of this gene in behavioral responses to EtOH. METHODS: Male Prkcz(-/-) and wild-type littermates were tested for EtOH consumption using 4 procedures: 24-hour intermittent access, 4-hour limited intermittent access, 4-day drinking-in-the-dark, and 24-hour continuous access. We also assessed the acute hypnotic effect of EtOH, EtOH reward, and taste preference for sweet-, bitter-, salty-, and umami-flavored solutions. Finally, we determined whether EtOH could increase PKMζ and PKCζ transcripts and protein expression in wild-type mice using quantitative PCR and Western blot analysis. RESULTS: Prkcz(-/-) mice consumed more EtOH than their wild-type littermates in both intermittent access procedures, but not in the drinking-in-the-dark or 24-hour continuous access procedures. EtOH exposure increased Prkcz transcripts in cultured PC12 cells, and intermittent EtOH consumption increased PKMζ protein in the ventral striatum of wild-type mice. CONCLUSIONS: Absence of PKMζ in the brain is associated with increased EtOH intake during procedures that incorporate intermittent consumption sessions every other day. Our data suggest that EtOH induces PKMζ, which acts in a negative feedback loop to limit binge-like EtOH consumption.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Etanol/administração & dosagem , Deleção de Genes , Proteína Quinase C/deficiência , Regulação para Cima/fisiologia , Consumo de Bebidas Alcoólicas/genética , Consumo de Bebidas Alcoólicas/prevenção & controle , Animais , Regulação para Baixo/efeitos dos fármacos , Regulação para Baixo/fisiologia , Masculino , Camundongos , Camundongos da Linhagem 129 , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Células PC12 , Proteína Quinase C/genética , Ratos , Regulação para Cima/efeitos dos fármacos
16.
Subst Abus ; 35(1): 80-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24588298

RESUMO

BACKGROUND: Although women with substance use disorders (SUDs) have high rates of trauma and posttraumatic stress, many addiction programs do not offer trauma-specific treatments. One promising intervention is Pennebaker's expressive writing, which involves daily, 20-minute writing sessions to facilitate disclosure of stressful experiences. METHODS: Women (N = 149) in residential treatment completed a randomized clinical trial comparing expressive writing with control writing. Repeated-measures analysis of variance was used to document change in psychological and physical distress from baseline to 2-week and 1-month follow-ups. Analyses also examined immediate levels of negative affect following expressive writing. RESULTS: Expressive writing participants showed greater reductions in posttraumatic symptom severity, depression, and anxiety scores, when compared with control writing participants at the 2-week follow-up. No group differences were found at the 1-month follow-up. Safety data were encouraging: although expressive writing participants showed increased negative affect immediately after each writing session, there were no differences in pre-writing negative affect scores between conditions the following day. By the final writing session, participants were able to write about traumatic/stressful events without having a spike in negative affect. CONCLUSIONS: Results suggest that expressive writing may be a brief, safe, low-cost, adjunct to SUD treatment that warrants further study as a strategy for addressing posttraumatic distress in substance-abusing women.


Assuntos
Emoções Manifestas , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos Relacionados ao Uso de Substâncias/terapia , Redação , Adulto , Terapia Combinada , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Escalas de Graduação Psiquiátrica , Tratamento Domiciliar , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento , Adulto Jovem
17.
Am J Orthopsychiatry ; 2024 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-39446632

RESUMO

Exposure to childhood trauma confers intergenerational risk on child development. However, the mechanism linking a mother's childhood trauma with her child's cognitive development remains poorly understood. This study recruited 71 mother-child dyads affected by substance use disorder from local, community-based, outpatient substance use treatment programs. Maternal exposure to childhood trauma, caregiving behavior, and child cognitive development were assessed in each mother-child dyad. These were measured through a comprehensive biopsychosocial interview, an observed dyadic interaction coded using the Coding Interactive Behavior system, and the Bayley Scales of Infant and Toddler Development, Screening Test, respectively. We hypothesized that compromised caregiving behavior would mediate a negative relationship between maternal childhood trauma and child cognitive development. Analyses did not support this hypothesis. Specifically, maternal childhood trauma was not significantly associated with child cognitive development nor the four dimensions of maternal caregiving behavior. However, caregiving behavior (specifically maternal sensitivity and limit setting) was associated with child cognitive development, when controlling for maternal childhood trauma and child age. The lack of associations observed suggests that protective factors may buffer the intergenerational impact of childhood trauma. Furthermore, the relationship between quality of caregiving and child cognitive development highlights the importance of interventions which foster sensitive caregiving behaviors that may bolster child cognitive development in the context of maternal substance use disorder and maternal childhood trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

18.
bioRxiv ; 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38352599

RESUMO

The circadian clock synchronizes metabolic and behavioral cycles with the rotation of the Earth by integrating environmental cues, such as light. Nutrient content also regulates the clock, though how and why this environmental signal affects the clock remains incompletely understood. Here, we elucidate a role for nutrient in regulating circadian alignment to seasonal photoperiods. High fat diet (HFD) promoted entrainment to a summer light cycle and inhibited entrainment to a winter light cycle by phosphorylating PER2 on serine 662. PER2-S662 phospho-mimetic mutant mice were incapable of entraining to a winter photoperiod, while PER2-S662 phospho-null mutant mice were incapable of entraining to a summer photoperiod, even in the presence of HFD. Multi-omic experimentation in conjunction with isocaloric hydrogenated-fat feeding, revealed a role for polyunsaturated fatty acids in nutrient-dependent seasonal entrainment. Altogether, we identify the mechanism whereby nutrient content shifts circadian rhythms to anticipate seasonal photoperiods in which that nutrient state predominates. HIGHLIGHTS: High fat diet promotes entrainment to summer but inhibits entrainment to winter.Calorie restriction promotes entrainment to winter but inhibits entrainment to summer.PER2-S662 phosphorylation is required for nutritional regulation of seasonal circadian entrainment.Dietary polyunsaturated fatty acids regulate seasonal circadian entrainment.

19.
bioRxiv ; 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38077090

RESUMO

The microbiome is increasingly recognized for its complex relationship with host fitness. Bumblebees are host to a characteristic gut microbiome community that is derived and reinforced through social contact between individuals. The bumblebee microbiome is species-poor, and primarily composed from a small number of core taxa that are associated with the greater tribe of corbiculate bees. Experimental findings support a role for the core bumblebee microbiome in resistance to severe infections by a common trypanosomal parasite, Crithidia bombi. However, most studies have been small in scale, often considering just one or two bumblebee species, or making use of commercially-reared bees. To better understand the microbiome diversity of wild populations, we have deeply sampled field populations of ten sympatric species found throughout central and down east Maine in a three-year microbiome field survey. We have used 16S amplicon sequencing to produce microbiome community profiles, and qPCR to screen samples for infections by Crithidia bombi. The breadth of our dataset has enabled us to test for seasonal and interspecific trends in the microbiome community. Controlling for these external sources of variation, we have identified microbial factors associated with infection and parasite load that support the role of the core microbiome in resistance to severe infection.

20.
Nature ; 444(7120): E14; discussion E14-5, 2006 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-17151608

RESUMO

Gedney et al. attribute an increase in the twentieth-century continental runoff to the suppression of plant transpiration by CO2-induced stomatal closure, by replicating a continental runoff data set. However, we have concerns about this data set and the methods used to construct it, in addition to those already raised, which we believe may undermine their conclusions.


Assuntos
Dióxido de Carbono/farmacologia , Água Doce/análise , Transpiração Vegetal/efeitos dos fármacos , Dióxido de Carbono/metabolismo , Bases de Dados Factuais , Efeito Estufa , História do Século XIX , História do Século XX , Humanos , Modelos Teóricos , Reprodutibilidade dos Testes , Fatores de Tempo
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