"At the end of the day, someone done lost their child": A mixed methods analysis of Black families' experiences of the sociopolitical climate.

How Black Americans in the United States (U.S.) make sense of a sociopolitical climate marked by racist imagery, tensions, and police violence is important to understand given the numerously documented detrimental effects of racism-related stress on the well-being of Black parents and children. Informed by Racism-Related Stress Theory, the current study employed a convergent parallel mixed methods design to better understand the ways racism-related stressors in the sociopolitical climate impacted the daily lives and mental health of a sample of Black families with low income. Seventy-eight Black American preadolescents (Mage = 11.0; 43.6% girls) and their parents (79% mothers; 76% living below the U.S. federal poverty level [FPL]) from the southwestern U.S. reported their symptoms of depression and how they had been affected by racial stressors in the sociopolitical climate between Fall 2018 and Summer 2019. A nested sample of 10 parents (80% mothers; 80% living below the FPL) from the quantitative sample also participated in a semi-structured interview. Meta-inferences across methods were drawn pertaining to the influence of child gender on parents' interpretation of effects for children, the toll racism-related stress in the sociopolitical climate takes on Black families, and the transferal of effects on parents to children through parenting and parental depressive symptoms. Findings spotlight the need for policies and family-centered programming that address the racism-related stress faced by many Black youth and their families. Providing families with opportunities and tools that can potentially mitigate harmful effects and foster empowerment could promote positive and lasting change.

Effects of borderline personality disorder symptoms on dialectical behavior therapy outcomes for eating disorders.

Existing literature on the effects of borderline personality disorder (BPD) and eating disorder (ED) comorbidity in terms of clinical presentation and treatment outcome has been limited and inconclusive. The present study examined whether clients with EDs and varying levels of BPD symptoms presented with more severe ED symptoms at admission, and whether they responded to dialectical behavior therapy (DBT)-based treatment. Participants (N = 176) were adults in a DBT-based partial hospitalization program for EDs at an academic medical center. Participants completed self-report measures at admission, 1-month postadmission, discharge, and 6-month follow-up. Results suggested that patients with elevated BPD symptoms at admission had greater ED symptoms during treatment, evidenced by small to moderate effect sizes. However, patients with high BPD symptoms demonstrated steeper declines in binge eating, fasting, and parasuicidal behavior early during treatment compared to patients with low BPD symptoms. Individuals with high BPD symptoms at admission (i.e., probable BPD diagnosis) were as likely to meet remission criteria and relapse as individuals with low BPD symptoms, though this null finding may be influenced by small cell sizes. Our findings also suggest that DBT skills use does not predict changes in symptoms. In sum, our findings suggest that while clients with higher BPD symptoms may improve during DBT-based partial hospitalization, their ED symptoms may remain more severe. Future studies are needed to determine whether adjunctive treatments improve outcomes for clients with EDs and comorbid BPD symptoms in DBT programs and whether skills use quality is a better predictor of ED symptom changes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Message received: Concordance between parents and children in perceptions of messages about race and ethnic identity development.

OBJECTIVE: The objective of this study was to examine the agreement between African American and Latinx parents and their school-age children regarding the amount of ethnic-racial socialization (ERS) parents provided and relations to youth ethnic-racial identity development. METHOD: The sample included 353 parents and their 10-11 year-old children (57% Latinx; 55% boys), who both completed surveys 1 year apart. Latent difference scores were used to quantify agreement between parents and youth and to examine the relation between agreement and family and child characteristics including youth ethnic-racial identity development. RESULTS: Parents reported higher levels of ERS than children, and differences were greater for preparation for bias than cultural socialization. Higher levels of cultural socialization and greater discrepancies between parent and youth reports were associated with greater ethnic-racial identity development 1 year later. Greater discrepancies in report of bias preparation were associated with less ethnic-racial identity development, but this effect was not significant once the impact of parent-reported bias preparation was accounted for. CONCLUSION: Incorporating both parent and youth reports of ERS provides a more complete picture of these practices and associated outcomes. Implications for the study of ERS and clinical intervention are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Preparing Black and Latinx children for police encounters: Caregiver response profiles and child self-regulation.

We hypothesized that the goodness-of-fit between profiles of observed, caregiver-provided ethnic-racial socialization (ERS), and child self-regulation (i.e., inhibitory control) would differentially associate with child behavioral outcomes. Conversations between 80 caregivers (45% Latinx; 55% Black) and their children (M age  = 11.09; 46% female) were rated for ERS. Measures included an inhibitory control composite (ages 2.5-3.5) and the Child Behavior Checklist (CBCL; age 12). Three profiles were determined: Comprehensive (n  = 34), Reactive (n  = 8), and Pragmatic (n  = 38). Only youth with low inhibitory control in preschool appeared to benefit from Pragmatic ERS, whereas youth with normative or high inhibitory control in early childhood displayed lower internalizing and externalizing behaviors when they had Comprehensive or Reactive rather than Pragmatic caregivers.

Transmuting Girls Into Women: Examining the Adultification of Black Female Sexual Assault Survivors Through Twitter Feedback.

The present study explored the adultification of young Black girls, specifically through the mythos of the fast-tailed girl, by examining the commentary on Twitter associated with the #SurvivingRKelly hashtag. Applying critical discourse analysis, three discursive themes emerged: (1) calling out the culture of accepting, (2) resistance through provocation and inquiry, and (3) challenging transgenerational dating. This study's results indicate the need for further research on the social construction of Black girlhood and how societal and cultural beliefs may serve as discursive mechanisms by which the adultification of young Black girls is perpetuated.

Form of dietary selenium affects mRNA encoding interferon-stimulated and progesterone-induced genes in the bovine endometrium and conceptus length at maternal recognition of pregnancy.

Widespread regions of the southeast United States have soils, and hence forages, deficient in selenium (Se), necessitating Se supplementation to grazing cattle for optimal immune function, growth, and fertility. We have reported that supplementation with an isomolar 1:1 mix (MIX) of inorganic (ISe) and organic (OSe) forms of Se increases early luteal phase (LP) concentrations of progesterone (P4) above that in cows on ISe or OSe alone. Increased early LP P4 advances embryonic development. Our objective was to determine the effects of the form of Se on the development of the bovine conceptus and the endometrium using targeted real-time PCR (qPCR) on day 17 of gestation, the time of maternal recognition of pregnancy (MRP). Angus-cross yearling heifers underwent 45-d Se-depletion then repletion periods, then at least 90 d of supplementation (TRT) with 35 ppm Se per day as either ISe (n = 10) or MIX (n = 10). Heifers were inseminated to a single sire after detected estrus (day 0). On day 17 of gestation, caruncular (CAR) and intercaruncular (ICAR) endometrial samples and the developing conceptus were recovered from pregnant heifers (ISe, n = 6 and MIX, n = 6). qPCR was performed to determine the relative abundance of targeted transcripts in CAR and ICAR samples, with the expression data subjected to one-way ANOVA to determine TRT effects. The effect of TRT on conceptus development was analyzed using a one-tailed Student's t-test. When compared with ISe-treated heifers, MIX heifers had decreased (P < 0.05) abundance of several P4-induced and interferon-stimulated mRNA transcripts, including IFIT3, ISG15, MX1, OAS2, RSAD2, DGAT2, FGF2 in CAR and DKK1 in ICAR samples and tended (P ≤ 0.10) to have decreased mRNA abundance of IRF1, IRF2, FOXL2, and PGR in CAR samples, and HOXA10 and PAQR7 in ICAR samples. In contrast, MIX-supplemented heifers had increased (P < 0.05) mRNA abundance of MSTN in ICAR samples and an increase in conceptus length (ISe: 17.45 ± 3.08 cm vs. MIX: 25.96 ± 3.95 cm; P = 0.05). Notably, myostatin increases glucose secretion into histotroph and contributes to advanced conceptus development. This advancement in conceptus development occurred in the presence of similar concentrations of serum P4 (P = 0.88) and whole blood Se (P = 0.07) at MRP.

In regions with soils deficient in selenium (Se), it is recommended that this trace mineral is supplemented to the diet of forage-grazing cattle. We have previously reported that the form of Se supplemented to cattle affects the function of multiple tissues, including the testis, liver, ovary, and pituitary. The objective of this study was to determine how the form of Se supplemented to heifers to achieve a Se-adequate status affects endometrial function and development of the conceptus at maternal recognition of pregnancy (MRP). Heifers were supplemented with the industry standard, an inorganic form of Se (ISe), or a 1:1 mix of organic and inorganic forms (MIX), with the reproductive tract recovered on day 17 of pregnancy. Real-time PCR was performed to determine the relative abundance of targeted mRNA transcripts in caruncular (CAR) and intercaruncular (ICAR) endometrial samples. The form of supplemental Se affected the abundance of multiple progesterone-induced and interferon-stimulated mRNA transcripts in CAR and ICAR samples, as well as the length of the conceptus that was recovered at MRP (day 17). Overall, our results indicate differences in endometrial function and increased development of the conceptus in cattle provided with MIX vs. ISe, suggesting that the MIX form of supplemental Se may increase fertility in cattle grazing soils deficient in this trace mineral.

Evaluating the use of lamotrigine to reduce mood lability and impulsive behaviors in adults with chronic and severe eating disorders.

BACKGROUND: Gold-standard psychological and pharmacological treatments for bulimic-spectrum eating disorders only result in remission for around 50% of patients; patients with affective lability and impulsivity represent a subgroup with particularly poor outcomes. Both dialectical behavior therapy (DBT), a treatment for emotion dysregulation, and lamotrigine, a mood stabilizer, have demonstrated promise for targeting affective lability and impulsivity; however, data exploring the combination of these interventions remain limited. OBJECTIVE: We followed a group of women with recurrent dysregulated eating behaviors (N = 62) throughout intensive DBT treatment and compared the symptom trajectory of those prescribed lamotrigine (n = 28) and those who were not (n = 34). METHOD: Participants completed surveys every 2 weeks throughout treatment. RESULTS: Group analyses suggested that all participants self-reported decreases in emotional reactivity, negative urgency, and symptoms of borderline personality disorder (BPD). The lamotrigine group reported greater elevations in BPD symptoms at baseline, but demonstrated steeper decreases in emotion and behavioral dysregulation than the non-matched comparison group. Within-subject analyses suggested that within the lamotrigine group, subjects reported greater decreases in symptoms following prescription of lamotrigine. CONCLUSIONS: Findings provide initial data suggesting that lamotrigine could be useful as an adjunctive treatment for patients with affective lability and impulsivity. LEVEL OF EVIDENCE: IV, time series without randomization.

Changes in cognitive and behavioral control after lamotrigine and intensive dialectical behavioral therapy for severe, multi-impulsive bulimia nervosa: an fMRI case study.

PURPOSE: Adults with bulimia nervosa (BN) and co-occurring emotional dysregulation and multiple impulsive behaviors are less responsive to existing interventions. Initial data suggest that the combination of Dialectical Behavior Therapy (DBT) and a mood stabilizer, lamotrigine, significantly reduces symptoms of affective and behavioral dysregulation in these patients. Identifying candidate neurobiological mechanisms of change for this novel treatment combination may help guide future randomized controlled trials and inform new and targeted treatment development. Here, we examined neurocognitive and symptom changes in a female patient with BN and severe affective and behavioral dysregulation who received DBT and lamotrigine. METHODS: Go/no-go task performance data and resting-state functional MRI scans were acquired before the initiation of lamotrigine (after 6 weeks in an intensive DBT program), and again after reaching and maintaining a stable dose of lamotrigine. The patient completed a battery of symptom measures biweekly for 18 weeks over the course of treatment. RESULTS: After lamotrigine initiation, the patient made fewer errors on a response inhibition task and showed increased and new connectivity within frontoparietal and frontolimbic networks involved in behavioral and affective control. Accompanying this symptom improvement, the patient reported marked reductions in bulimic symptoms, behavioral dysregulation, and reactivity to negative affect, along with increases in DBT skills use. CONCLUSION: Improved response inhibition and cognitive control network connectivity should be further investigated as neurocognitive mechanisms of change with combined DBT and lamotrigine for eating disorders. Longitudinal, controlled trials integrating neuroimaging and symptom measures are needed to fully evaluate the effects of this treatment. LEVEL OF EVIDENCE: IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.

Development, Implementation, and Evaluation of an Early Mobility Protocol in a Regional Level II Trauma Center.

The purpose of this project was to develop and evaluate a collaborative nursing/therapist protocol for early mobility in a medical-surgical intensive care unit (MICU) in a regional level II trauma center. Data for patients in the MICU were compared for the periods August 3, 2015-August 2, 2016, and August 3, 2014-August 2, 2015. Semistructured interviews were conducted with 10 nurses and 1 therapist. Average MICU length of stay decreased from 3.81 to 3.50 days (P = .057). Mean time in mobility chairs did not change (0.12 days vs 0.11 days, P = .389). Mean number of days to first documented level 2-5 activity decreased significantly, from 1.81 to 1.51 days (P = .036). The percentage of hospitalizations with any documented level 3 or 4 activity increased significantly (from 3.8% to 7.4% and from 61.5% to 66.7%, P = .003 and P = .031, respectively). Barriers/challenges to implementation included having enough people to assist, space, documentation, having to coax the physician to place order for upright mobility, availability of therapists for later stages of protocol, patient variability, fear of patient falls, availability of therapy chairs, staff changes, time, and patient refusal. A multidisciplinary approach to protocol development for early mobility in an intensive care unit was successfully implemented at a regional level II trauma center.

Implementation of Data-Based Decision-Making: Linking Research From the Special Series to Practice.

The papers in the special series describe the role of data-based decision-making (DBDM) in improving the outcomes of students with learning disabilities based on research across Germany, the Netherlands, and the United States. The articles address multiple aspects of a model of DBDM that includes the role of teacher knowledge, skills, beliefs, and sources of professional learning and the role of systems-level factors in improving student achievement. In this article, the conclusions of each paper are described in terms of that model. The papers illustrate that DBDM can improve achievement for students with learning disabilities through a DBDM process called data-based individualization (DBI)-especially if teachers have innovative supports (e.g., new technologies). For teachers, DBDM professional development (PD) can improve DBDM knowledge and implementation, but PD may not be adequate in all cases, with practical experience playing a central role. In addition, classroom-level DBDM may not translate to success for students with learning disabilities. Finally, the articles reveal a need to focus more on systems-level factors in successful DBDM systems like DBI-especially when implemented outside the experimental context. These findings provide a contemporary lens on DBDM as it related to students with learning disabilities and establish foci for future research.

Sowing the seeds: Sociocultural resistance in the psychological sciences.

Objective: This article problematizes the use of resilience as a psychological and developmental indication of well-being. We base our argument on the possibility that resilience theories internalize responsibility for survival within the individual, and that survival is dependent on the ability to assimilate to injustice. Resistance, on the other hand, represents acts of intentional, active, and often collective survival which can expose and oppose social injustice. Method: Bringing together transdisciplinary scholarship on resistance, we propose a conceptual framework of sociocultural resistance. This framework seeks to forward studies of health that acknowledge the complexity of relationships, culture, and power constitutive of the human condition. Results: We provide examples of sociocultural resistance in the psychological and developmental sciences and suggest the use of diverse theory and methods in the study of resistance. Conclusions: Resistance research is a timely, necessary, and critical turning point in the social sciences with the potential to change unjust systems and promote a nuanced view of health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Public perceptions on pathology: a fundamental change is required.

Pathology has been mostly invisible for the public. The missing recognition affects the pathologists' reputation, and efforts with recruitment and advocacy. Our survey with 387 respondents confirms that the public knowledge on the role of the pathologists has not improved despite campaigns and advocacy efforts. Pathology was identified as a medical specialty by 79.1% of the respondents. Only 34.8% assumed that it takes more than 8 years of post-high school training to become a pathologist. Most commonly, another medical specialist was identified as the ultimate diagnostician on Pap tests (gynaecologist), breast biopsies or malignant surgical excisions (oncologist), gastrointestinal biopsies (gastroenterologist) or prostate biopsies (urologist). The experience gained by undergoing these procedures had minimal impact on understanding the pathologists' role, since they were identified as ultimate diagnosis makers by the minority of these patients (13.8%-36.4%). The integration of pathologist-interactions into patient care may be a potential solution with benefits beyond improved perceptions.

Early predictors of treatment outcome in a partial hospital program for adolescent anorexia nervosa.

OBJECTIVE: Previous research supports the relevance of early symptom change in eating disorder (ED) treatment; however, few studies have distinguished early weight change from early change in ED psychopathology, particularly in higher levels of care. Thus, the present study examined whether early change in weight and ED psychopathology predicted outcome for adolescents with anorexia nervosa (AN) in a partial hospitalization program. METHOD: Adolescents with AN (n = 99) completed assessments at admission, 1-month after treatment admission, discharge, and 6-month follow-up. RESULTS: Higher admission percent expected body weight (%EBW), greater early change in %EBW, longer duration of treatment, shorter length of illness, and earlier age of onset predicted greater change in %EBW at discharge, but not follow-up. Greater ED psychopathology at admission and greater early change in ED psychopathology predicted later change in ED symptoms at discharge, but not follow-up. Neither early change in %EBW nor ED psychopathology predicted likelihood of remission at discharge and follow-up. DISCUSSION: Results support the importance of early change in predicting later change in the same ED outcome variables and suggest that early change in both %EBW and ED psychopathology in adolescents may be an important area for future research.

Emotion Regulation Difficulties During and After Partial Hospitalization Treatment Across Eating Disorders.

Emotion regulation deficits are associated with eating disorder (ED) symptoms, regardless of eating disorder diagnosis. Thus, recent treatment approaches for EDs, such as dialectical behavior therapy (DBT), have focused on teaching patients skills to better regulate emotions. The present study examined changes in emotion regulation among adult patients with EDs during DBT-oriented partial hospital treatment, and at follow-up (M[SD] = 309.58[144.59] days from discharge). Exploratory analyses examined associations between changes in emotion regulation and ED symptoms. Patients with anorexia nervosa, restricting (AN-R, n = 77), and binge-eating/purging subtype (AN-BP, n = 46), or bulimia nervosa (BN, n = 118) completed the Difficulties in Emotion Regulation Scale (DERS) at admission, discharge, and follow-up. Patients with BN demonstrated significant improvements across all facets of emotion dysregulation from admission to discharge and maintained improvements at follow-up. Although patients with AN-BP demonstrated statistically significant improvements on overall emotion regulation, impulsivity, and acceptance, awareness, and clarity of emotions, from admission to discharge, these improvements were not significant at follow-up. Patients with AN-R demonstrated statistically significant improvements on overall emotion dysregulation from treatment admission to discharge. Changes in emotion regulation were moderately correlated with changes in ED symptoms over time. Results support different trajectories of emotion regulation symptom change in DBT-oriented partial hospital treatment across ED diagnoses, with patients with BN demonstrating the most consistent significant improvements.

Dialectical behavioral therapy for the treatment of adolescent eating disorders: a review of existing work and proposed future directions.

Over the past several decades, Dialectical Behavior Therapy (DBT) has been adapted for a range of presenting problems related to emotion dysregulation. Considerable enthusiasm exists regarding the use of DBT for treating eating disorders; however, to date, there have been no reviews summarizing empirical efforts to adapt DBT for eating disorders in youth. Accordingly, in the present narrative review, we provide a comprehensive summary of existing work testing DBT for adolescent eating disorders. First, we briefly review existing work applying DBT to eating disorders in adults and general adolescent samples. We then review research focused specifically on the use of DBT for adolescent eating disorders, including both those studies applying DBT as the primary treatment and investigations of DBT as an adjunctive treatment. Overall, initial results for DBT-based approaches are promising. However, rigorous empirical work testing DBT for treating adolescent eating disorders remains limited; the majority of existing research is comprised of case series and small-scale studies. Therefore, we close with specific recommendations for future research testing this approach.

Correlates of co-occurring eating disorders and substance use disorders: a case for dialectical behavior therapy.

Given the high rates of comorbidity between eating disorders (EDs) and substance use disorders (SUDs), it is important to develop effective treatment approaches for individuals with both an ED and SUD (ED-SUD). To date, there is limited information guiding the concurrent treatment of these disorders. To build on existing research, the present study compared adult patients with ED-SUD (n = 36) to patients with ED-only (n = 62) in terms of demographics, psychiatric comorbidity, and self-reported eating disorder and related psychopathology. Results indicated that ED-SUD patients had a higher number of psychiatric comorbidities, were more likely to be prescribed mood stabilizers, and were more sensitive to reward. They also reported greater difficulty with emotion regulation, including more difficulty engaging in goal-directed activity, higher impulsivity, and more limited access to emotion regulation strategies. These differences highlight the importance of targeting emotion dysregulation for ED-SUD, and provide evidence for the importance of integrated, transdiagnostic treatment to simultaneously address the SUD, ED, and other psychiatric comorbidities. Implications for tailoring treatment are discussed with a focus on Dialectical Behavior Therapy (DBT).