Department of Human Development and Family Science

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Dietary biomarkers: advances, limitations and future directions
Hedrick, Valisa E.; Dietrich, Andrea M.; Estabrooks, Paul A.; Savla, Jyoti S.; Serrano, Elena L.; Davy, Brenda M. (Biomed Central, 2012-12-14)
The subjective nature of self-reported dietary intake assessment methods presents numerous challenges to obtaining accurate dietary intake and nutritional status. This limitation can be overcome by the use of dietary biomarkers, which are able to objectively assess dietary consumption (or exposure) without the bias of self-reported dietary intake errors. The need for dietary biomarkers was addressed by the Institute of Medicine, who recognized the lack of nutritional biomarkers as a knowledge gap requiring future research. The purpose of this article is to review existing literature on currently available dietary biomarkers, including novel biomarkers of specific foods and dietary components, and assess the validity, reliability and sensitivity of the markers. This review revealed several biomarkers in need of additional validation research; research is also needed to produce sensitive, specific, cost-effective and noninvasive dietary biomarkers. The emerging field of metabolomics may help to advance the development of food/nutrient biomarkers, yet advances in food metabolome databases are needed. The availability of biomarkers that estimate intake of specific foods and dietary components could greatly enhance nutritional research targeting compliance to national recommendations as well as direct associations with disease outcomes. More research is necessary to refine existing biomarkers by accounting for confounding factors, to establish new indicators of specific food intake, and to develop techniques that are cost-effective, noninvasive, rapid and accurate measures of nutritional status.
Residual Effects of Slavery: What Clinicians Need to Know
Wilkins, Erica J.; Whiting, Jason B.; Watson, Marlene F.; Russon, Jody M.; Moncrief, Allena M. (Springer, 2013-03-01)
Marriage and family therapists grapple with the intersection of societal influence and African American clients' presenting problems. Questions include: what impact has the historical trauma of slavery had on African Americans and what are the clinical implications of this trauma? This paper reviews the literature on the various residual effects of slavery (RES) within the African American community. A case vignette and a broad discussion of therapeutic techniques will be used to highlight the clinical implications of RES.
Triple A (Allgrove) syndrome: an unusual association with syringomyelia
Bizzarri, Carla; Benevento, Danila; Terzi, Cesare; Huebner, Angela; Cappa, Marco (2013-06-24)
Triple A (Allgrove) syndrome was first described by Allgrove in 1978 in two pairs of siblings. Since then, about 100 cases have been reported, all of them displaying an autosomal recessive pattern of inheritance. Clinical picture is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure. A progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation is often associated. The triple A syndrome gene, designated AAAS, is localized on chromosome 12q13. It consists of 16 exons, encoding for a 546 aminoacid protein called ALADIN (Alacrimia-Achalasia-aDrenal Insufficiency Neurologic disorder).We report on a 13-year-old boy presenting with Addison’s disease, dysphagia, muscle weakness, excessive fatigue and recent onset gait ataxia. The analysis of the AAAS gene revealed a homozygous missense mutation in exon 12. It was a T > G transversion at nucleotide position 1224, resulting in a change of leucine at amino acid position 381 into arginine (Leu381Arg or L381R). Brain appearance was found normal at magnetic resonance imaging (MRI) and functional spectroscopy analysis showed normal levels of the main metabolites. Spine MRI showed a cystic cavity within the spinal cord (syringomyelia), localized between the sixth cervical vertebra and the first thoracic vertebra. Cerebellar tonsils descended 7-mm caudal to foramen magnum, consistently with a mild type 1 Chiari malformation. Mild posterior inter-vertebral disk protrusions were evident between T9 and T10 and between L4 and L5.To our knowledge, this is the first report describing type 1 Chiari malformation and multiple spinal cord abnormalities in a patient with Allgrove syndrome.
Authenticity and Career Decision-Making Self-Efficacy in Lesbian, Gay, and Bisexual College Students
Russon, Jody M.; Schmidt, Christa K. (Informa, 2014-01-01)
Theories in career development have discussed the importance of career decision-making self-efficacy (CDMSE); however, there has been little development in this area for the lesbian, gay, and bisexual (LGB) community. Research has shown that LGB individuals may experience disruptions in career development if psychological energy is diverted to developing sexual identity. The present study sought to determine if authenticity, a strength-based characteristic, predicted CDMSE among LGB individuals. Survey results from 95 LGB-identified individuals indicated that components of authenticity, specifically unbiased processing and awareness, accounted for a significant amount of variance in CDMSE. Implications for social service professionals are discussed.
Differential effect of motivational features on training improvements in school-based cognitive training
Katz, Benjamin; Jaeggi, Susanne M.; Buschkuehl, Martin; Stegman, Alyse; Shah, Priti (Frontiers, 2014-04-24)
Cognitive training often utilizes game-like motivational features to keep participants engaged. It is unclear how these elements, such as feedback, reward, and theming impact player performance during training. Recent research suggests that motivation and engagement are closely related to improvements following cognitive training. We hypothesized that training paradigms featuring game-like motivational elements would be more effective than a version with no motivational elements. Five distinct motivational features were chosen for examination: a real-time scoring system, theme changes, prizes, end-of-session certificates, and scaffolding to explain the lives and leveling system included in the game. One version of the game was created with all these motivational elements included, and one was created with all of them removed. Other versions removed a single element at a time. Seven versions of a game-like n-back working memory task were then created and administered to 128 students in second through eight grade at school-based summer camps in southeastern Michigan. The inclusion of real-time scoring during play, a popular motivational component in both entertainment games and cognitive training, was found to negatively impact training improvements over the three day period. Surprisingly, scaffolding to explain lives and levels also negatively impacted training gains. The other game adjustments did not significantly impact training improvement compared to the original version of the game with all features included. These findings are preliminary and are limited by both the small sample size and the brevity of the intervention. Nonetheless, these findings suggest that certain motivational elements may distract from the core cognitive training task, reducing task improvement, especially at the initial stage of learning.
Sexual socialization for Grenadian adolescents: An exploratory study
Frederick, Helyne I.; Wilkins, Erica; Russon, Jody M.; Kirkpatrick-Harrison, Rachel (www.ijessnet.com, 2014-12-01)
In the past decade, risky sexual behaviors have been a persistent concern for policy makers, parents, and social service providers in the Caribbean regions, including Grenada. When viewed from a social ecological perspective, adolescents’ knowledge and attitudes about sexuality can be learned from a range of sources to include parents, community, church, school, media, and peers. A grounded theory inquiry, investigating the sexual socialization of Grenadian, adolescent girls, revealed “sexual responsibility” as the central phenomenon through which emergent categories were structured. Findings from 12 participants indicated that Grenadian mothers largely relay values that have been learned from church and school experiences. Mothers seemed to serve as the primary source of guidance regarding adolescents’ perceptions of sexual health. Motherdaughter communication included: general messages about abstinence, asserting sexual limits, use of protection, abstinence until marriage, and abstinence due to school completion. Implications for further research, policy planning, and counseling practice are discussed.
Neither here nor there: Working with transnational immigrant families in marriage and family therapy
Muruthi, Bertranna Abrams; Bermudez, J. Maria; Chou, Jessica; Farnham, Andrea (2015, May/June)
The relationship between disordered eating and sexuality amongst adolescents and young adults
Shearer, Annie; Russon, Jody M.; Herres, Joanna; Atte, Tita; Kodish, Tamar; Diamond, Guy S. (Elsevier, 2015-12)
Research shows that gay and bisexual males are at increased risk for disordered eating symptoms (DES); however, studies examining DES amongst lesbians and bisexual women have produced mixed findings. Furthermore, few studies have included questioning or “unsure” individuals. This study examined DES symptoms in adolescents and young adults across self-reported sexual attraction and behavior. Participants were recruited from ten primary care sites in Pennsylvania and administered the Behavioral Health Screen (BHS) – a web-based screening tool that assesses psychiatric symptoms and risk behaviors – during a routine visit. As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females. Amongst females, there were no significant differences in DES scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex. More surprisingly, females who were unsure of who they were attracted to reported the highest DES scores of all. These findings are contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females. Females who are unsure or attracted to both sexes may actually be at increased risk for developing DES.
Attachment-Based Family Therapy as an Adjunct to Family-Based Treatment for Adolescent Anorexia Nervosa
Wagner, Ingrid; Diamond, Guy S.; Levy, Suzanne; Russon, Jody M.; Litster, Richard (Wiley, 2016-06)
Adolescent anorexia nervosa (AN) has a significant and long-standing impact for the health and well being of young people and their families. The determinants of illness are multi-factorial, however, adolescent AN has been consistently associated with parental distress (e.g., depression, anxiety, alcoholism), family conflict, and low parental warmth toward the adolescent. Whilst Family Based Therapy (FBT) for adolescent AN is the recommended first line of treatment, a substantial proportion of patients do not experience remission by the end of therapy or may relapse following remission. Although a range of adjuncts to FBT have been proposed, no preferred model has emerged. In this paper, we compare and contrast Attachment-Based Family Therapy (ABFT) with FBT, and argue that ABFT’s focus on relationships, rather than behaviours, could make a substantive contribution to the practice of FBT. We present a case study to demonstrate how ABFT may help to alleviate some of the maintaining factors of adolescent AN through the repair of parent–child relational ruptures.
Attachment-Based Family Therapy for Suicidal Lesbian, Gay, and Bisexual Adolescents: A Case Study
Levy, Suzanne; Russon, Jody M.; Diamond, Gary M. (Wiley, 2016-06)
The majority of sexual minority adolescents are well-adjusted and healthy, however, on average, 28% report suicidal ideation and between 15% and 40% make a suicide attempt each year. These rates are two to seven times higher than those found among heterosexual youths. Research has shown the protective function of parental support and acceptance, as well as the deleterious effects of parental criticism, invalidation, and rejection on the mental health of sexual minority adolescents. Given these risk and protective factors, these adolescents might benefit from an intervention that targets family relationships. Toward this goal, Attachment-Based Family Therapy (ABFT) specifically aims to improve the quality of adolescent–parent relationships. In prior treatment developmental work, ABFT was adapted and pilot tested for depressed and suicidal lesbian, gay, and bisexual (LGB) adolescents. By adopting an evidence-based case study format, this paper provides a case summary to illustrate how the therapy was conducted. The case study consists of a vignette, followed by therapy task descriptions and illustrative transcripts. Examples of key therapeutic moments in ABFT, for depressed and suicidal LGB adolescents, are discussed in the context of the case.
Differences in Mental Health Symptoms Across Lesbian, Gay, Bisexual, and Questioning Youth in Primary Care Settings
Shearer, Annie; Herres, Joanna; Kodish, Tamar; Squitieri, Helen; James, Kiera; Russon, Jody M.; Atte, Tita; Diamond, Guy S. (Elsevier, 2016-07)
Purpose: Lesbian, gay, bisexual, and questioning (LGBQ) youth exhibit significantly higher rates of mental health problems, including anxiety, depression, suicidal ideation, and nonsuicidal selfinjury than their heterosexual peers. Past studies tend to group LGBQ youth together; however, more recent studies suggest subtle differences in risk between sexual minority groups. This study examined differences in mental health symptoms across male and female youth who are attracted to the same sex (gay and lesbian), opposite sex (heterosexual), both sexes (bisexual), or are unsure of whom they were attracted to (questioning) in a sample of 2,513 youth (ages 14e24 years). Methods: Data were collected using the Behavioral Health Screenda Web-based screening tool that assesses psychiatric symptoms and risk behaviorsdduring routine well visits. Results: Bisexual and questioning females endorsed significantly higher scores on the depression, anxiety, and traumatic distress subscales than did heterosexual females. Lesbians, bisexual females, and questioning females all exhibited significantly higher lifetime suicide scores than heterosexual females. Interestingly, bisexual females exhibited the highest current suicide scores. Gay and bisexual males endorsed significantly higher scores on the depression and traumatic distress subscales than did heterosexual males. Gay males also exhibited higher scores on the anxiety subscale than heterosexual males, with bisexual males exhibiting a nonsignificant trend toward higher scores as well. Conclusions: Findings highlight varying level of risk across subgroups of LGBQ youth and suggest the importance of considering LGBQ groups separately in the context of a behavioral health assessment, especially for females.
Attachment-Based Family Therapy: A Review of the Empirical Support
Diamond, Guy S.; Russon, Jody M.; Levy, Suzanne (Wiley, 2016-09)
Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biological desire for meaningful and secure relationships. The therapy is grounded in attachment theory and provides an interpersonal, process-oriented, trauma-focused approach to treating adolescent depression, suicidality, and trauma. Although a process-oriented therapy, ABFT offers a clear structure and road map to help therapists quickly address attachment ruptures that lie at the core of family conflict. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanism of change. This article provides an overview of the clinical model and the existing empirical support for ABFT.
Web-Based Interventions for Weight Loss or Weight Loss Maintenance in Overweight and Obese People: A Systematic Review of Systematic Reviews
Sorgente, A.; Pietrabissa, Giada; Manzoni, G. M.; Re, F.; Simpson, S.; Perona, S.; Rossi, Alessandro; Cattivelli, Roberto; Innamorati, M.; Jackson, J. B.; Castelnuovo, Gianluca (JMIR Publications, 2017-06-01)
Diagnoses and characteristics of autism spectrum disorders in children with Prader-Willi syndrome
Dykens, Elisabeth M.; Roof, Elizabeth; Hunt-Hawkins, Hailee; Dankner, Nathan; Lee, Evon B.; Shivers, Carolyn; Daniell, Christopher; Kim, Soo-Jeong (Biomed Central, 2017-06-05)
Third-person self-talk facilitates emotion regulation without engaging cognitive control: Converging evidence from ERP and FMRI
Moser, Jason S.; Katz, Benjamin (Nature Research, 2017-07-03)
Does silently talking to yourself in the third-person constitute a relatively effortless form of self control? We hypothesized that it does under the premise that third-person self-talk leads people to think about the self similar to how they think about others, which provides them with the psychological distance needed to facilitate self control. We tested this prediction by asking participants to reflect on feelings elicited by viewing aversive images (Study 1) and recalling negative autobiographical memories (Study 2) using either “I” or their name while measuring neural activity via ERPs (Study 1) and fMRI (Study 2). Study 1 demonstrated that third-person self-talk reduced an ERP marker of selfreferential emotional reactivity (i.e., late positive potential) within the first second of viewing aversive images without enhancing an ERP marker of cognitive control (i.e., stimulus preceding negativity). Conceptually replicating these results, Study 2 demonstrated that third-person self-talk was linked with reduced levels of activation in an a priori defined fMRI marker of self-referential processing (i.e., medial prefrontal cortex) when participants reflected on negative memories without eliciting increased levels of activity in a priori defined fMRI markers of cognitive control. Together, these results suggest that third-person self-talk may constitute a relatively effortless form of self-control.
Measuring Walsh’s Family Resilience Framework: Reliability and Validity of the Family Resilience Assessment Among Women with a History of Breast Cancer
Duncan Lane, C.; Meszaros, Peggy S.; Savla, Jyoti S. (Informa, 2017-10-03)
Walsh’s family resilience framework presents a comprehensive and inclusive lens of family process that may assist clinicians, family service professionals, and health care providers with understanding the functioning of individuals and families in their care. A mechanism for using this framework is needed, as is empirical evidence of its cogency. This article reports on the development of the Family Resilience Assessment, a 29-item survey intended to assess dimensions of Walsh’s framework. The Family Resilience Assessment is presented as a reliable and valid mechanism for assessing the family resilience framework. Results of the use of the survey with women with a history of breast cancer demonstrate that it is a reliable instrument with content and construct validity.
Predicting Alliance for Depressed and Suicidal Adolescents: The Role of Perceived Attachment to Mothers
Ibrahim, Maliha; Jin, Bora; Russon, Jody M.; Diamond, Guy S.; Kobak, Roger (Informa, 2018-01-02)
Background. Although therapeutic alliance is a robust predictor of treatment outcomes in child and adolescent psychotherapy, less is known about relational factors, such as youth’s attachment, to mothers and fathers. The current study investigated anxious or avoidant attachment to mothers or fathers as predictors of early formation of the therapeutic alliance in a high-risk sample of depressed and suicidal adolescents. Methods. Changes in adolescents’ alliance ratings between the first and fourth treatment sessions was examined in a comparative efficacy trial (N = 115) of Attachment Based Family Therapy and Family Enhanced Non-Directive Supportive Therapy for suicidal and depressed adolescents. Multilevel regression analysis accounted for nested data by therapist and treatment condition. Results. After accounting for significant random effects in our multilevel model associated with therapist to treatment condition, results revealed a significant effect of perceived insecurity to mothers leading to lower levels of therapeutic alliance at session four (β = -0.49, p < .05). Discussion. The quality of adolescents’ attachments to parents may play an important role in adolescents’ ability to form strong working relationships with a therapist. Findings suggested that adolescents with avoidant attachment styles may be more difficult to engage in treatment and could benefit from specific interventions focused on alliance-building.
Aging and network properties: Stability over time and links with learning during working memory training
Iordan, Alexandru D.; Cooke, Katherine A.; Moored, Kyle D.; Katz, Benjamin; Buschkuehl, Martin; Jaeggi, Susanne M.; Jonides, John; Peltier, Scott J.; Polk, Thad A.; Reuter-Lorenz, Patricia A. (Frontiers Media S.A., 2018-01-04)
Growing evidence suggests that healthy aging affects the configuration of large-scale functional brain networks. This includes reducing network modularity and local efficiency. However, the stability of these effects over time and their potential role in learning remain poorly understood. The goal of the present study was to further clarify previously reported age effects on “resting-state” networks, to test their reliability over time, and to assess their relation to subsequent learning during training. Resting-state fMRI data from 23 young (YA) and 20 older adults (OA) were acquired in 2 sessions 2 weeks apart. Graph-theoretic analyses identified both consistencies in network structure and differences in module composition between YA and OA, suggesting topological changes and less stability of functional network configuration with aging. Brain-wide, OA showed lower modularity and local efficiency compared to YA, consistent with the idea of age-related functional dedifferentiation, and these effects were replicable over time. At the level of individual networks, OA consistently showed greater participation and lower local efficiency and within-network connectivity in the cingulo-opercular network, as well as lower intra-network connectivity in the default-mode network and greater participation of the somato-sensorimotor network, suggesting age-related differential effects at the level of specialized brain modules. Finally, brain-wide network properties showed associations, albeit limited, with learning rates, as assessed with 10 days of computerized working memory training administered after the resting-state sessions, suggesting that baseline network configuration may influence subsequent learning outcomes. Identification of neural mechanisms associated with learning-induced plasticity is important for further clarifying whether and how such changes predict the magnitude and maintenance of training gains, as well as the extent and limits of cognitive transfer in both younger and older adults.
What Is the Role of the Placebo Effect for Pain Relief in Neurorehabilitation? Clinical Implications From the Italian Consensus Conference on Pain in Neurorehabilitation
Castelnuovo, Gianluca; Giusti, Emanuele Maria; Manzoni, Gian Mauro; Saviola, Donatella; Gabrielli, Samantha; Lacerenza, Marco; Pietrabissa, Giada; Cattivelli, Roberto; Spatola, Chiara Anna Maria; Rossi, Alessandro; Varallo, Giorgia; Novelli, Margherita; Villa, Valentina; Luzzati, Francesca; Cottini, Andrea; Lai, Carlo; Volpato, Eleonora; Cavalera, Cesare; Pagnini, Francesco; Tesio, Valentina; Castelli, Lorys; Tavola, Mario; Torta, Riccardo; Arreghini, Marco; Zanini, Loredana; Brunani, Amelia; Seitanidis, Ionathan; Ventura, Giuseppe; Capodaglio, Paolo; D'Aniello, Guido Edoardo; Scarpina, Federica; Brioschi, Andrea; Bigoni, Matteo; Priano, Lorenzo; Mauro, Alessandro; Riva, Giuseppe; Di Lernia, Daniele; Repetto, Claudia; Regalia, Camillo; Molinari, Enrico; Notaro, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Simpson, Susan; Wiederhold, Brenda Kay; Gaudio, Santino; Jackson, Jeffrey B.; Tamburin, Stefano; Benedetti, Fabrizio (Frontiers, 2018-05-18)
Background: It is increasingly acknowledged that the outcomes of medical treatments are influenced by the context of the clinical encounter through the mechanisms of the placebo effect. The phenomenon of placebo analgesia might be exploited to maximize the efficacy of neurorehabilitation treatments. Since its intensity varies across neurological disorders, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCP) summarized the studies on this field to provide guidance on its use. Methods: A review of the existing reviews and meta-analyses was performed to assess the magnitude of the placebo effect in disorders that may undergo neurorehabilitation treatment. The search was performed on Pubmed using placebo, pain, and the names of neurological disorders as keywords. Methodological quality was assessed using a pre-existing checklist. Data about the magnitude of the placebo effect were extracted from the included reviews and were commented in a narrative form. Results: 11 articles were included in this review. Placebo treatments showed weak effects in central neuropathic pain (pain reduction from 0.44 to 0.66 on a 0-10 scale) and moderate effects in postherpetic neuralgia (1.16), in diabetic peripheral neuropathy (1.45), and in pain associated to HIV (1.82). Moderate effects were also found on pain due to fibromyalgia and migraine; only weak short-term effects were found in complex regional pain syndrome. Confounding variables might have influenced these results. Clinical implications: These estimates should be interpreted with caution, but underscore that the placebo effect can be exploited in neurorehabilitation programs. It is not necessary to conceal its use from the patient. Knowledge of placebo mechanisms can be used to shape the doctor-patient relationship, to reduce the use of analgesic drugs and to train the patient to become an active agent of the therapy.
Family-based treatment for transition age youth: parental self-efficacy and caregiver accommodation
Dimitropoulos, Gina; Landers, Ashley L.; Freeman, Victoria E.; Novick, Jason; Cullen, Olivia; Engelberg, Marla; Steinegger, Cathleen; Le Grange, Daniel (2018-06-06)
Background Family-Based Treatment (FBT) is the first line of care in paediatric treatment while adult programs focus on individualized models of care. Transition age youth (TAY) with Anorexia Nervosa (AN) are in a unique life stage and between systems of care. As such, they and their caregivers may benefit from specialized, developmentally tailored models of treatment. Methods The primary purpose of this study was to assess if parental self-efficacy and caregiver accommodation changed in caregivers during the course of FBT-TAY for AN. The secondary aim was to determine if changes in parental self-efficacy and caregiver accommodation contributed to improvements in eating disorder behaviour and weight restoration in the transition age youth with AN. Twenty-six participants (ages 16–22) and 39 caregivers were recruited. Caregivers completed the Parents versus Anorexia Scale and Accommodation and Enabling Scale for Eating Disorders at baseline, end-of-treatment (EOT), and 3 months follow-up. Results Unbalanced repeated measures designs for parental self-efficacy and caregiver accommodation towards illness behaviours were conducted using generalized estimation equations. Parental self-efficacy increased from baseline to EOT, although not significantly (p = .398). Parental self-efficacy significantly increased from baseline to 3 months post-treatment (p = .002). Caregiver accommodation towards the illness significantly decreased from baseline to EOT (p = 0.0001), but not from baseline to 3 months post-treatment (p = 1.000). Stepwise ordinary least squares regression estimates of eating disorder behaviour and weight restoration did not show that changes in parental-self efficacy and caregiver accommodation predict eating disorder behaviour or weight restoration at EOT or 3 months post-treatment. Conclusions Our findings demonstrate, albeit preliminary at this stage, that FBT-TAY promotes positive increases in parental self-efficacy and assists caregivers in decreasing their accommodation to illness behaviours for transition age youth with AN. However, changes in the parental factors did not influence changes in eating and weight in the transition age youth.

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