Impact of racial microaggressions in psychotherapy vignettes with african american clients: An experimental analogue design.

Mental health researchers have focused on promoting culturally sensitive clinical care (Herman et al., 2007; Whaley & Davis, 2007), emphasizing the need to understand how biases may impact client well-being. Clients report that their therapists commit racial microaggressions-subtle, sometimes unintentional, racial slights-during treatment (Owen et al., 2014). Yet, existing studies often rely on retrospective evaluations of clients and cannot establish the causal impact of varying ambiguity of microaggressions on clients. This study uses an experimental analogue design to examine offensiveness, emotional reactions, and evaluations of the interaction across three distinct levels of microaggression statements: subtle, moderate, and overt. We recruited 158 adult African American participants and randomly assigned them to watch a brief counseling vignette. We found significant differences between the control and three microaggression statements on all outcome variables. We did not find significant differences between the microaggression conditions. This study, in conjunction with previous correlational research, highlights the detrimental impact of microaggressions within psychotherapy, regardless of racially explicit content. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Gender differences in prosthesis-related outcomes among veterans: Results of a national survey of U.S. veterans.

BACKGROUND: Women with lower extremity amputations (LEAs) tend to have poorer prosthesis-related outcomes than men, although the literature is sparse. To our knowledge, there are no prior studies examining prosthesis-related outcomes of women veterans with LEAs. OBJECTIVE: To examine gender differences (overall and by type of amputation) among veterans who underwent LEAs between 2005 and 2018, received care at the Veterans Health Administration (VHA) prior to undergoing amputation, and were prescribed a prosthesis. It was hypothesized that compared to men, women would report lower satisfaction with prosthetic services, poorer prosthesis fit, lower prosthesis satisfaction, less prosthesis use, and worse self-reported mobility. Furthermore, it was hypothesized that gender differences in outcomes would be more pronounced among individuals with transfemoral than among those with transtibial amputations. DESIGN: Cross-sectional survey. Linear regressions were used to assess overall gender differences in outcomes and gender differences based on type of amputation in a national sample of veterans. SETTING: VHA medical centers. PARTICIPANTS: The sample consisted of 449 veterans who self-identified their gender (women = 165, men = 284) with transtibial (n = 236), transfemoral (n = 135), and bilateral LEAs (n = 68) including all amputation etiologies. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Orthotics and Prosthetics User's Survey, Trinity Amputation and Prosthesis Experiences Scale, and Prosthetic Limb Users Survey of Mobility-Short Form were used to assess satisfaction with prosthetic services, prosthesis fit, prosthesis satisfaction, prosthesis use, and self-reported mobility. RESULTS: Women had poorer self-reported mobility than men (d = -0.26, 95% confidence interval -0.49 to -0.02, p < .05); this difference was small. There were no statistically significant gender differences in satisfaction with prosthetic services, prosthesis fit, prosthesis satisfaction, daily hours of prosthesis use, or by amputation type. CONCLUSIONS: Contrary to the hypothesis, prosthesis-related outcomes were similar between men and women with LEAs. Minimal differences may in part be due to receiving care from the VHA's integrated Amputation System of Care.

Coparenting support in the context of difficult children: Mother and father differences.

While parenting children with difficult behaviors can intensify stress within the entire family system, families may lean on other familial relationships to mitigate that stress. The coparenting relationship is known to play a key role within the family system for child outcomes and familial interactions, but it is not clear whether it eases the stress and challenge of raising a difficult child, nor how that plays out differently for mothers versus fathers. Ninety-six couples (89.7% married) parenting young children (Mean age = 3.22 years) were included in this study. Using cross-sectional and aggregated daily response data, actor-partner interdependence models were used to examine how mothers' and fathers' perceived coparenting support lessened or intensified parenting stress and/or daily problems with their child/children-for themselves or their parenting partner. We found that greater coparenting support reported by mothers coincided with stronger links between the mother's report of child difficulty and daily problems encountered by both mothers and fathers. In contrast, when fathers reported greater coparenting support, the intensity between reported child difficulty and daily problems decreased for mothers, and fathers reported lower parenting stress. Coparenting support also moderated associations between parents' perception of child difficulty and daily problems with their children. These results suggest that mothers incur heightened coparenting support from fathers when experiencing more difficult child behavior and that coparenting support experienced by fathers may alleviate parenting challenges for mothers. These findings further contribute to the literature by emphasizing distinct differences between mothers and fathers in coparenting associations within the family system.

Centering and decentering client disclosures: A qualitative study of therapists' responses to clients' experiences of discrimination.

Clients who are societally marginalized because of their identities may seek support from therapists to process experiences of discrimination and oppression. Therapist navigation of these cultural conversations is a crucial skill. However, there is limited research examining how therapists immediately respond to clients when they disclose experiences of discrimination. In this study, 66 participants watched two brief videos of fictitious clients disclosing experiences of covert and overt discrimination. Participants watched one of two video vignettes, with one focusing on a White lesbian woman client and another focusing on a Black woman client. After watching each video, participants were asked to respond to clients as if they were the clients' therapist. We used reflexive thematic analysis to code participant responses, which spanned three themes: (a) invalidation and decentering of client's emotions, appraisals, and experiences; (b) incongruence and avoidance of client's language around identities; and (c) empathic attunement and centering of client emotions, appraisals, and experiences. While some participant responses were interpreted as emotionally aligning with the client, other participant responses were coded as minimizing or questioning client experiences of discrimination or using language incongruent with how the client self-identified. We discuss implications for research, training, and practice in navigating conversations about discrimination with psychotherapy clients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Evidence for an adolescent sensitive period to family experiences influencing adult male testosterone production.

Across vertebrates, testosterone is an important mediator of reproductive trade-offs, shaping how energy and time are devoted to parenting versus mating/competition. Based on early environments, organisms often calibrate adult hormone production to adjust reproductive strategies. For example, favorable early nutrition predicts higher adult male testosterone in humans, and animal models show that developmental social environments can affect adult testosterone. In humans, fathers' testosterone often declines with caregiving, yet these patterns vary within and across populations. This may partially trace to early social environments, including caregiving styles and family relationships, which could have formative effects on testosterone production and parenting behaviors. Using data from a multidecade study in the Philippines (n = 966), we tested whether sons' developmental experiences with their fathers predicted their adult testosterone profiles, including after they became fathers themselves. Sons had lower testosterone as parents if their own fathers lived with them and were involved in childcare during adolescence. We also found a contributing role for adolescent father­son relationships: sons had lower waking testosterone, before and after becoming fathers, if they credited their own fathers with their upbringing and resided with them as adolescents. These findings were not accounted for by the sons' own parenting and partnering behaviors, which could influence their testosterone. These effects were limited to adolescence: sons' infancy or childhood experiences did not predict their testosterone as fathers. Our findings link adolescent family experiences to adult testosterone, pointing to a potential pathway related to the intergenerational transmission of biological and behavioral components of reproductive strategies.

Knowledge and Attitudes Toward an Artificial Intelligence-Based Fidelity Measurement in Community Cognitive Behavioral Therapy Supervision.

To capitalize on investments in evidence-based practices, technology is needed to scale up fidelity assessment and supervision. Stakeholder feedback may facilitate adoption of such tools. This evaluation gathered stakeholder feedback and preferences to explore whether it would be fundamentally feasible or possible to implement an automated fidelity-scoring supervision tool in community mental health settings. A partially mixed, sequential research method design was used including focus group discussions with community mental health therapists (n = 18) and clinical leadership (n = 12) to explore typical supervision practices, followed by discussion of an automated fidelity feedback tool embedded in a cloud-based supervision platform. Interpretation of qualitative findings was enhanced through quantitative measures of participants' use of technology and perceptions of acceptability, appropriateness, and feasibility of the tool. Initial perceptions of acceptability, appropriateness, and feasibility of automated fidelity tools were positive and increased after introduction of an automated tool. Standard supervision was described as collaboratively guided and focused on clinical content, self-care, and documentation. Participants highlighted the tool's utility for supervision, training, and professional growth, but questioned its ability to evaluate rapport, cultural responsiveness, and non-verbal communication. Concerns were raised about privacy and the impact of low scores on therapist confidence. Desired features included intervention labeling and transparency about how scores related to session content. Opportunities for asynchronous, remote, and targeted supervision were particularly valued. Stakeholder feedback suggests that automated fidelity measurement could augment supervision practices. Future research should examine the relations among use of such supervision tools, clinician skill, and client outcomes.

Social support moderates the relation between childhood trauma and prenatal depressive symptoms in adolescent mothers.

BACKGROUND: Depression is a concern during pregnancy, but it is especially prevalent for pregnant adolescents. Because prenatal depression is a strong predictor of postpartum depression and other forms of psychopathology in both mothers and children, it is important to understand potential risk and protective factors for prenatal depression. OBJECTIVES: The present study examined whether social support buffered the impact of childhood trauma on prenatal depression, and whether social support exerted a stronger buffering effect for adolescents compared to adults. METHOD: Self-reported levels of childhood trauma, social support, and prenatal depression were collected in a racially and ethnically diverse sample of 682 first-time mothers, 58% were adolescents (n = 396; Mage = 17.38 years) and 42% were adults (n = 286; Mage = 26.29 years). RESULTS: Using multi-group moderation analyses, we found that pregnant adolescents with more social support were buffered from the effects of childhood trauma on prenatal depression symptoms, but pregnant adults with more social support were not. CONCLUSION: Findings support the stress-buffering model in that those with more stressors may benefit more from social support than those with fewer stressors. These results highlight the importance of social support and inform prenatal depression prevention/intervention strategies particularly with pregnant adolescents.

Fathers' oxytocin responses to first holding their newborns: Interactions with testosterone reactivity to predict later parenting behavior and father-infant bonds.

Little is known about human fathers' physiology near infants' births. This may represent a period during which paternal psychobiological axes are sensitive to fathers' new experiences of interacting with their newborns and that can provide insights on how individual differences in fathers' biology relate to post-partum parenting. Drawing on a sample of men in South Bend, IN (U.S.), we report results from a longitudinal study of fathers' oxytocin, cortisol, and testosterone (N = 211) responses to their first holding of their infants on the day of birth and men's reported caregiving and father-infant bonding at 2-4 months post-partum (N = 114). First-time fathers' oxytocin was higher following first holding of their newborns, compared to their pre-holding levels. Contrasting with prior results, fathers' percentage change in oxytocin did not differ based on skin-to-skin or standard holding. Drawing on psychobiological frameworks, we modeled the interactions for oxytocin reactivity with testosterone and cortisol reactivity, respectively, in predicting father-infant outcomes months later. We found significant cross-over interactions for (oxytocin × testosterone) in predicting fathers' later post-partum involvement and bonding. Specifically, we found that fathers whose testosterone declined during holding reported greater post-partum play if their oxytocin increased, compared to fathers who experienced increases in both hormones. We also observed a similar non-significant interaction for (oxytocin × cortisol) in predicting fathers' post-partum play. Fathers whose testosterone declined during holding also reported less involvement in direct caregiving and lower father-infant bonding if their oxytocin decreased but greater direct care and bonding if their testosterone increased and oxytocin decreased. The results inform our understanding of the developmental time course of men's physiological responsiveness to father-infant interaction and its relevance to later fathering behavior and family relationships.

How do you feel? Using natural language processing to automatically rate emotion in psychotherapy.

Emotional distress is a common reason for seeking psychotherapy, and sharing emotional material is central to the process of psychotherapy. However, systematic research examining patterns of emotional exchange that occur during psychotherapy sessions is often limited in scale. Traditional methods for identifying emotion in psychotherapy rely on labor-intensive observer ratings, client or therapist ratings obtained before or after sessions, or involve manually extracting ratings of emotion from session transcripts using dictionaries of positive and negative words that do not take the context of a sentence into account. However, recent advances in technology in the area of machine learning algorithms, in particular natural language processing, have made it possible for mental health researchers to identify sentiment, or emotion, in therapist-client interactions on a large scale that would be unattainable with more traditional methods. As an attempt to extend prior findings from Tanana et al. (2016), we compared their previous sentiment model with a common dictionary-based psychotherapy model, LIWC, and a new NLP model, BERT. We used the human ratings from a database of 97,497 utterances from psychotherapy to train the BERT model. Our findings revealed that the unigram sentiment model (kappa = 0.31) outperformed LIWC (kappa = 0.25), and ultimately BERT outperformed both models (kappa = 0.48).

Whose parenting stress is more vulnerable to marital dissatisfaction? A within-couple approach examining gender, cognitive reappraisal, and parental identity.

Conflict and tension in the couple relationship transfers to the parent-child relationship, amplifying the stress parents experience while parenting young children. Pinpointing moderating and individual-level factors that exist in this spillover process may identify both couple and individual areas where spillover might be mitigated. This study used a within-couple approach to test for gender differences in marital-to-parenting spillover and to examine the moderating roles of gender, parental identity, and the emotion regulation strategy cognitive reappraisal in the linkages between marital-parenting spillover. From a larger study of parenting experiences, 96 mother-father couples of young children (mean age = 3.22 years) reported on measures of marital satisfaction, cognitive reappraisal, parenting identity, and parenting stress. Using path model comparisons, we found more similarities than differences between mothers and fathers and, contrary to the hypothesis, that mothers experienced greater spillover between marital satisfaction and parental distress than fathers. Results differed between outcome measures, suggesting that parents experience more spillover from marital satisfaction to parenting in the context of parental distress than in dysfunctional interactions with their child. Importantly, we found that higher parental identity strengthened marital-to-parenting spillover for mothers in contrast to expectations based on theoretical assumptions, whereas cognitive reappraisal weakened marital-to-parenting spillover, supporting the broader emotion regulation literature. These results signify the importance of situating the marriage to parenting transfer in the context of affective experiences and intensified parenting expectations, wherein flexibility in role identity may help alleviate parenting stress.

El conflicto y la tensión en la relación de pareja se traslada a la relación entre padres e hijos, lo cual intensifica el estrés que sufren los padres mientras crían a niños pequeños. La detección de los factores moderadores e individuales que existen en este proceso de desbordamiento puede identificar las áreas tanto a nivel de la pareja como individual donde el desbordamiento podría mitigarse. En este estudio se usó un enfoque dentro de la pareja para examinar las diferencias de género en el desbordamiento del matrimonio hacia la crianza de los niños y para analizar los roles moderadores del género, la identidad parental y la revaluación cognitiva de la estrategia de regulación emocional en las asociaciones entre el desbordamiento desde el matrimonio hacia la crianza. De un estudio más extenso de experiencias de crianza, 96 parejas de madres y padres de niños pequeños (edad promedio = 3.22 años) informaron medidas de satisfacción conyugal, revaluación cognitiva, identidad parental y estrés por la crianza. Utilizando comparaciones del modelo de pautas, encontramos más similitudes que diferencias entre las madres y los padres, y, contrariamente a la hipótesis, las madres experimentaron un mayor desbordamiento entre la satisfacción conyugal y el distrés parental que los padres. Los resultados variaron entre los criterios de valoración, lo cual indica que los padres experimentan más desbordamiento desde la satisfacción conyugal hacia la crianza en el contexto del distrés parental que en las interacciones disfuncionales con su hijo. Cabe destacar que descubrimos que una mayor identidad parental fortaleció el desbordamiento del matrimonio hacia la crianza en las madres en contraste con las expectativas basadas en supuestos teóricos, mientras que la revaluación cognitiva debilitó el desbordamiento desde el matrimonio hacia la crianza, lo cual respalda la bibliografía más amplia sobre regulación emocional. Estos resultados indican la importancia de ubicar el traslado desde el matrimonio a la crianza en el contexto de las experiencias afectivas y las expectativas de crianza intensificadas, donde la flexibilidad en la identidad de roles puede contribuir a aliviar el estrés por la crianza.

Automated rating of patient and physician emotion in primary care visits.

OBJECTIVE: Train machine learning models that automatically predict emotional valence of patient and physician in primary care visits. METHODS: Using transcripts from 353 primary care office visits with 350 patients and 84 physicians (Cook, 2002 [1], Tai-Seale et al., 2015 [2]), we developed two machine learning models (a recurrent neural network with a hierarchical structure and a logistic regression classifier) to recognize the emotional valence (positive, negative, neutral) (Posner et al., 2005 [3]) of each utterance. We examined the agreement of human-generated ratings of emotional valence with machine learning model ratings of emotion. RESULTS: The agreement of emotion ratings from the recurrent neural network model with human ratings was comparable to that of human-human inter-rater agreement. The weighted-average of the correlation coefficients for the recurrent neural network model with human raters was 0.60, and the human rater agreement was also 0.60. CONCLUSIONS: The recurrent neural network model predicted the emotional valence of patients and physicians in primary care visits with similar reliability as human raters. PRACTICE IMPLICATIONS: As the first machine learning-based evaluation of emotion recognition in primary care visit conversations, our work provides valuable baselines for future applications that might help monitor patient emotional signals, supporting physicians in empathic communication, or examining the role of emotion in patient-centered care.

Determining the therapist's contribution in therapist multicultural competence process and outcome.

Efforts to help therapists improve their multicultural competence (MCC) rely on measures that can distinguish between different levels of competence. MCC is often assessed by asking clients to rate their experiences with their therapists. However, differences in client ratings of therapist MCC do not necessarily provide information about the relative performance of therapists and can be influenced by other factors including the client's own characteristics. In this study, we used a repeated measures design of 8,497 observations from 1,458 clients across 35 therapists to clarify the proportion of variability in MCC ratings attributed to the therapist versus the client and better understand the extent that an MCC measure detects therapist differences. Overall, we found that a small amount of variability in MCC ratings was attributed to the therapist (2%) and substantial amount attributed to the client (70%). These findings suggest that our measure of MCC primarily detected differences at the client level versus therapist level, indicating that therapist MCC scores were largely dependent on the client. Clinical implications and recommendations for future MCC research and measurement are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

US fathers' reports of bonding, infant temperament and psychosocial stress based on family sleep arrangements.

BACKGROUND AND OBJECTIVES: Evolutionary-grounded sleep research has been critical to establishing the mutual dependence of breastfeeding and nighttime sleep proximity for mothers and infants. Evolutionary perspectives on cosleeping also often emphasize the emotional motivations for and potential benefits of sleep proximity, including for parent-infant bonding. However, this potential link between infant sleep location and bonding remains understudied for both mothers and fathers. Moreover, in Euro-American contexts bedsharing has been linked to family stress and difficult child temperament, primarily via maternal reports. We know relatively little about whether paternal psychosocial dynamics differ based on family sleep arrangements, despite fathers and other kin often being present in the cosleeping environment across cultures. Here, we aim to help address some of these gaps in knowledge pertaining to fathers and family sleep arrangements. METHODOLOGY: Drawing on a sample of Midwestern U.S. fathers (N=195), we collected sociodemographic and survey data to analyze links between infant nighttime sleep location, paternal psychosocial well-being, father-infant bonding, and infant temperament. From fathers' reports, families were characterized as routinely solitary sleeping, bedsharing, or roomsharing (without bedsharing). RESULTS: We found that routinely roomsharing or bedsharing fathers, respectively, reported stronger bonding than solitary sleepers. Bedsharing fathers also reported that their infants had more negative temperaments and also tended to report greater parenting-related stress due to difficulties with their children. CONCLUSIONS: These cross-sectional results help to highlight how a practice with deep phylogenetic and evolutionary history, such as cosleeping, can be variably expressed within communities with the potential for family-dependent benefits or strains.

Machine learning and natural language processing in psychotherapy research: Alliance as example use case.

Artificial intelligence generally and machine learning specifically have become deeply woven into the lives and technologies of modern life. Machine learning is dramatically changing scientific research and industry and may also hold promise for addressing limitations encountered in mental health care and psychotherapy. The current paper introduces machine learning and natural language processing as related methodologies that may prove valuable for automating the assessment of meaningful aspects of treatment. Prediction of therapeutic alliance from session recordings is used as a case in point. Recordings from 1,235 sessions of 386 clients seen by 40 therapists at a university counseling center were processed using automatic speech recognition software. Machine learning algorithms learned associations between client ratings of therapeutic alliance exclusively from session linguistic content. Using a portion of the data to train the model, machine learning algorithms modestly predicted alliance ratings from session content in an independent test set (Spearman's ρ = .15, p < .001). These results highlight the potential to harness natural language processing and machine learning to predict a key psychotherapy process variable that is relatively distal from linguistic content. Six practical suggestions for conducting psychotherapy research using machine learning are presented along with several directions for future research. Questions of dissemination and implementation may be particularly important to explore as machine learning improves in its ability to automate assessment of psychotherapy process and outcome. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Detecting conversation topics in primary care office visits from transcripts of patient-provider interactions.

OBJECTIVE: Amid electronic health records, laboratory tests, and other technology, office-based patient and provider communication is still the heart of primary medical care. Patients typically present multiple complaints, requiring physicians to decide how to balance competing demands. How this time is allocated has implications for patient satisfaction, payments, and quality of care. We investigate the effectiveness of machine learning methods for automated annotation of medical topics in patient-provider dialog transcripts. MATERIALS AND METHODS: We used dialog transcripts from 279 primary care visits to predict talk-turn topic labels. Different machine learning models were trained to operate on single or multiple local talk-turns (logistic classifiers, support vector machines, gated recurrent units) as well as sequential models that integrate information across talk-turn sequences (conditional random fields, hidden Markov models, and hierarchical gated recurrent units). RESULTS: Evaluation was performed using cross-validation to measure 1) classification accuracy for talk-turns and 2) precision, recall, and F1 scores at the visit level. Experimental results showed that sequential models had higher classification accuracy at the talk-turn level and higher precision at the visit level. Independent models had higher recall scores at the visit level compared with sequential models. CONCLUSIONS: Incorporating sequential information across talk-turns improves the accuracy of topic prediction in patient-provider dialog by smoothing out noisy information from talk-turns. Although the results are promising, more advanced prediction techniques and larger labeled datasets will likely be required to achieve prediction performance appropriate for real-world clinical applications.

Is one secure attachment enough? Infant cortisol reactivity and the security of infant-mother and infant-father attachments at the end of the first year.

Attachment security is theorized to shape stress reactivity, but extant work has failed to find consistent links between attachment security to mothers and infant cortisol reactivity. We examined family configurations of infant-mother and infant-father attachment security in relation to infant cortisol reactivity. One-year old infants (N = 180) participated in the Strange Situation with mothers and fathers in two counterbalanced lab visits, one month apart (12 and 13 months). Infants with secure attachments only to their fathers and not their mothers had higher cortisol levels than infants with a secure attachment to mother and also exhibited a blunted cortisol response (high at baseline and then a decrease after stress). Results suggest that a secure attachment to father may not be enough to reduce infant stress reactivity when the infant-mother attachment is insecure, and future research is needed to uncover the family dynamics that underlie different family configurations of attachment security.

Adult attachment and testosterone reactivity: Fathers' avoidance predicts changes in testosterone during the strange situation procedure.

We assessed parents' testosterone reactivity to the Strange Situation Procedure (SSP), a moderately stressful parent-infant interaction task that pulls for parental nurturance and caregiving behavior. Parents (146 mothers, 154 fathers) interacted with their 1-year-old infants, and saliva samples were obtained pre- and post-task to assess changes in testosterone. We examined whether testosterone reactivity differed between mothers and fathers, the extent to which parents' characteristic approaches to closeness (i.e., adult attachment orientation) contributed to testosterone changes, and whether any influences of adult attachment orientation were independent of more general personality characteristics (i.e., the Big Five personality dimensions). Results revealed that mothers and fathers showed comparable declines in testosterone during the SSP, and that these declines were attenuated among fathers with a more avoidant attachment orientation (i.e., those less comfortable with closeness). Associations between fathers' avoidance and testosterone reactivity were statistically independent of broader personality traits. Our findings provide some of the first evidence for short-term changes in both mothers' and fathers' testosterone in contexts that pull for nurturance. Moreover, these findings demonstrate that individual differences in adult attachment may play an important role in understanding such changes. We discuss possible explanations for gender differences in associations between adult attachment and parents' testosterone reactivity, and the extent to which testosterone reactivity might be sensitive to changes in context for mothers versus fathers.

Fatherhood and psychobiology in the Philippines: Perspectives on joint profiles and longitudinal changes of fathers' estradiol and testosterone.

OBJECTIVES: Research on the psychobiology of partnering and fathering has focused on testosterone (T), oxytocin, and prolactin (PRL) as mechanisms that potentially mediate life history trade-offs related to those roles. Less is known about other hormones that might be responsive to life history transitions and implicated in fathering, such as estradiol (E2). We examined how E2 changed during the transition to marriage and fatherhood, its correlation with fathers' caregiving, and its joint within-individual production with other hormones (T, PRL). METHODS: Data were collected from a total of 913 Filipino men (aged 25.9 years ± 0.3 SD at follow-up) enrolled in a longitudinal cohort study. Morning saliva samples collected at baseline (2005) and follow-up (2009) were assayed for T and E2 (n = 329), dried blood spots from baseline were assayed for PRL. Fathers reported on caregiving in 2009. RESULTS: When compared with men who remained single non-fathers over the study period, men who became married residential fathers experienced larger declines in E2. This effect was non-significant when we controlled for longitudinal changes in T. E2 was not significantly related to fathers' caregiving, controlling for T. In cross-sectional analyses for PRL, T, and E2, married residential fathers exhibited within-individual profiles of reduced T and elevated PRL, whereas single non-fathers exhibited the opposite profile of elevated T and reduced PRL. CONCLUSIONS: Our findings point to the need for future research to consider the mutually regulatory dynamics and/or combinatorial implications of multiple physiological axes acting within individuals to underpin life history trade-offs and behavioral strategies.

Fathers' cortisol and testosterone in the days around infants' births predict later paternal involvement.

Human paternal behavior is multidimensional, and extant research has yet to delineate how hormone patterns may be related to different dimensions of fathering. Further, although studies vary in their measurement of hormones (i.e., basal or reactivity), it remains unclear whether basal and/or reactivity measures are predictive of different aspects of men's parenting. We examined whether men's testosterone and cortisol predicted fathers' involvement in childcare and play with infants and whether fathers' testosterone and cortisol changed during fathers' first interaction with their newborn. Participants were 298 fathers whose partners gave birth in a UNICEF-designated "baby-friendly" hospital, which encourages fathers to hold their newborns 1 h after birth, after mothers engage in skin-to-skin holding. Salivary testosterone and cortisol were measured before and after fathers' first holding of their newborns. Basal and short-term changes in cortisol and testosterone were analyzed. Fathers were contacted 2-4 months following discharge to complete questionnaires about childcare involvement. Fathers' cortisol decreased during the time they held their newborns on the birthing unit. Fathers' basal testosterone in the immediate postnatal period predicted their greater involvement in childcare. Both basal and reactivity cortisol predicted fathers' greater involvement in childcare and play. Results suggest that reduced basal testosterone is linked with enhanced paternal indirect and direct parenting effort months later, and that higher basal cortisol and increases in cortisol in response to newborn interaction are predictive of greater paternal involvement in childcare and play, also months later. Findings are discussed in the context of predominating theoretical models on parental neuroendocrinology.

"It's hard to argue with a computer:" Investigating Psychotherapists' Attitudes towards Automated Evaluation.

We present CORE-MI, an automated evaluation and assessment system that provides feedback to mental health counselors on the quality of their care. CORE-MI is the first system of its kind for psychotherapy, and an early example of applied machine-learning in a human service context. In this paper, we describe the CORE-MI system and report on a qualitative evaluation with 21 counselors and trainees. We discuss the applicability of CORE-MI to clinical practice and explore user perceptions of surveillance, workplace misuse, and notions of objectivity, and system reliability that may apply to automated evaluation systems generally.