Developmental screening of full-term infants at 16 to 18 months of age after in-utero exposure to maternal SARS-CoV-2 infection.

OBJECTIVE: To screen for neurodevelopmental delays in a cohort of full-term infants born to mothers with SARS-CoV-2. STUDY DESIGN: This was a prospective, descriptive cohort study of full-term infants born to mothers with SARS-CoV-2 during pregnancy. Subjects underwent neurodevelopmental screening using the Ages and Stages Questionnaires®-Third Edition (ASQ®-3) at 16 to 18 months age. RESULTS: Of 51 subjects, twelve (24%) were below cutoff, and twenty-seven (53%) were either below or close to the cutoff in at least one developmental domain. Communication (29%), fine motor (31%), and problem-solving (24%) were the most affected domains. There were no differences in outcomes between infants born to asymptomatic and mildly symptomatic mothers. CONCLUSION: We observed increased risk of neurodevelopmental delays during screening of infants born at full-term to mothers with SARS-CoV-2 at 16 to 18 months age. These results highlight the urgent need for follow-up studies of infants born to mothers with SARS-CoV-2.

From Patient to Provider: How Personal Medical Trauma Can Inform Supervision and Clinical Practice.

Two predoctoral psychology interns share their personal reflections of neurological injuries they experienced during their adolescence and how it has informed and shaped their clinical work. Through their reflections, they provide insights and lessons learned as they have the unique first-hand experience of being a patient and now a rehabilitation psychology trainee and provider. Additionally, they describe how they have applied such knowledge during their clinical work with clients experiencing neurological and chronic health conditions. Issues involving communication with clients, families, and the treatment teams, the benefits and risks of self-disclosure, and the role of hope, meaning in life, and spirituality are discussed. The clinical practice implications of these insights are invaluable for trainees and healthcare specialists at all levels of experience, including the crucial role of supervision during the predoctoral internship year. Recommendations are made for clinical practice including providing developmentally appropriate communication and promoting an environment for growth and recovery. The authors are hopeful that the reflections provided in this article can inspire other trainees to feel comfortable in sharing their personal medical and psychological challenges as appropriate and relevant to help integrate their professional development.

How are expert therapists similar, different, and integrative in the treatment of borderline personality disorder?

This study examined the use of therapeutic skills by different, well-known experts in psychology who have published extensively on the treatment of borderline personality disorder to ascertain areas of technique similarity, difference, and integration. Initial videotaped sessions from these expert therapists working with the same patient were independently rated, using an established measure, on cognitive-behavioral and psychodynamic-interpersonal techniques by 6 trained clinicians. These raters also independently identified what they believed were the most clinically significant segments of each session. The 6 raters demonstrated excellent levels of reliability. Results of this empirically based comparative process analysis suggest significant similarity, integration, and common focus across these 7 expert therapists in the specific techniques they used and in the themes and issues explored during the most clinically significant segments. All therapists took an active stance in exploring areas of clinical focus and initiating topics of discussion in this first meeting. Therapists tended to focus on the patient's pattern of romantic relationships ending abruptly and his lack of understanding why they ended, or his role in them ending. Almost all these segments included the therapist providing the patient with an alternative way to understand his experiences not previously recognized. Moreover, several of the therapists tended to both explore his irrational thoughts (e.g., all-or-nothing thinking, being incomplete without a partner) and relate perceptions of these relationships (e.g., being a victim, minimizing his anger/violence) to his interpersonal difficulties. Likewise, therapists often used the information gained from this process to provide psychoeducation regarding treatment approach and rationale. Finally, therapists would often return to key specific themes and issues that were clinically significant within the session in order to further explore and work through their meaning with the patient. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Relationship between Trauma History and Eating Disorders in Adolescents.

Reasons for developing an eating disorder (ED) are complex, yet one plausible risk factor gaining more relevance in adolescents with EDs is childhood trauma. The current study is the first to examine the presence of childhood trauma in relation to ED symptomatology in adolescents using DSM-5 criteria. It was hypothesized that patients with more traumatic experiences also have more severe ED symptoms. 112 therapists currently treating adolescent patients diagnosed with an ED completed an online survey consisting of a DSM-5 ED symptom checklist and a childhood trauma questionnaire on a current adolescent patient whom they have seen for at least eight sessions. Children with multiple traumatic experiences and the severity of those experiences demonstrated a relationship to overall ED (r = .179, p = .059) and bulimia symptoms (r = .183, p = .054), specifically binging (r = .188, p = .047). and purging (r = .217, p = .021). In addition, logistic regression analyses indicated that adolescents high on bulimia nervosa (B = 4.694, p = .044) were more likely to have been traumatized victims of violence. Exploratory analyses support prior literature that suggest similarities between adolescents' lack of control of the experienced trauma(s) with lack of control of ED symptoms. These findings highlight the importance of exploring trauma history when treating an adolescent with an ED, especially bulimia.

Psychologists' Willingness to Provide Services to Individuals at Risk of Suicide.

OBJECTIVE: This study examined psychologists' willingness to accept a new client into their private practice as a function of the client's clinical presentation (with or without overt suicidality). Psychologists' openness to working with a client at risk of suicide was evaluated in the context of potential barriers to treatment provision, such as practitioners' endorsement of stigmatizing attitudes, concerns over liability and inadequate training, and limited access to community resources. METHOD: Eighty-six licensed psychologists practicing within the United States were surveyed via e-mail and randomly assigned to one of two conditions, consisting of exposure to a vignette describing either a client reporting current suicidal ideation and a history of attempts or a client without explicitly elevated suicide risk. All participants were asked to complete a questionnaire assessing their likelihood of accepting the hypothetical client into their practice and examining possible explanations for disinclination to provide treatment. RESULTS: Psychologists were less willing to work with a client experiencing suicidality than an individual without elevated suicide risk. Those indicating a reluctance to provide services reported greater concerns over the adequacy of their suicide-related skills and training and fewer resources in the community. CONCLUSIONS: Recommendations for improving the responsiveness of private practitioners are provided, with an emphasis on enhancing clinical training and increasing the availability and accessibility of mental health resources.