American Journal of Orthopsychiatry

The American Journal of Orthopsychiatry: Proud tradition, promising future.
Since 1930, the American Journal of Orthopsychiatry (AJO) has been the flagship journal of the American Orthopsychiatric Association and today continues to foster development of interdisciplinary theory and research designed to inform practice and policy advocacy. This transitional editorial expresses appreciation to contributors, highlights issues and activities of the journal, and passes the torch to the new editors. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Obituary: Jane Knitzer (1941–2009).
Presents an obituary for Jane Knitzer. Knitzer obtained her degrees from Wellesley College and Harvard University, and received a postdoctoral fellowship from the National Institute of Mental Health. This was followed by an assistant professorship in the Department of Human Development and Family Studies at the College of Human Ecology at Cornell University, and then a position as a senior policy specialist with the Children’s Defense Fund. During this time, she wrote several landmark documents in child policy that had a tremendous impact on the field of children’s mental health. She was the founding director of the Institute for Child and Youth Policy Studies as part of Statewide Youth Advocacy and also an adjunct professor at the Graduate School of Education and Human Development at the University of Rochester. Next, she returned to New York City, where she was a senior research scientist and later a dean of the Division of Research, Demonstration and Policy at Bank Street College of Education. Other positions included working for the National Center for Children in Poverty and serving as president of Division 37, Child, Youth and Family Services, American Psychological Association. Knitzer's legacy is in the disciplines that span children’s services: child health, child development, early childhood, mental health, child welfare, juvenile justice, and public health. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Discrepant feeling rules and unscripted emotion work: Women coping with termination for fetal anomaly.
The sociology of emotion is rapidly evolving and has implications for medical settings. Advancing medical technologies create new contexts for decision-making and emotional reaction that are framed by “feeling rules.” Feeling rules guide not only behavior, but also how one believes one should feel, thereby causing one to attempt to bring one’s authentic feelings into line with perceived feeling rules. Using qualitative data, the theoretical existence of feeling rules in pregnancy and prenatal testing is confirmed. Further examination extends this analysis: at times of technological development feeling rules are often discrepant, leaving patients with unscripted emotion work. Data from a study of women who interrupted anomalous pregnancies indicate that feeling rules are unclear when competing feeling rules are operating during times of societal and technological change. Because much of this occurs below the level of consciousness, medical and psychological services providers need to be aware of potential discrepancies in feeling rules and assist patients in identifying the salient feeling rules. Patients’ struggles ease when they can recognize the discrepancies and assess their implications for decision-making and emotional response. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM-V): Consider the later life context.
The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition (DSM–IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Intimate partner and general aggression perpetration among combat veterans presenting to a posttraumatic stress disorder clinic.
This study examined rates and correlates of intimate partner and general aggression perpetration among 236 male combat veterans seeking services in a Veteran’s Affairs posttraumatic stress disorder (PTSD) clinic. Approximately 33% of those in an intimate relationship reported perpetrating partner physical aggression in the previous year, and 91% reported partner psychological aggression. Comparable rates were found for general aggression perpetration among partnered and nonpartnered veterans. PTSD symptoms as well as symptoms of depression were associated with aggression across subgroups and forms of aggression, and PTSD symptoms reflecting arousal and lack of control were generally the strongest predictor of aggression. Findings indicate a need for additional aggression screening and intervention development for this population, and highlight the targeting of heightened arousal and lack of behavioral control in aggression interventions. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Strengthening prevention performance using technology: A formative evaluation of interactive Getting To Outcomes®.
Communities face challenges implementing evidence-based prevention programs. To help, policymakers are exploring how to build community-level capacity for prevention for thousands of organizations or communities across the United States. This article reports on a formative evaluation within 2 states’ prevention systems of an Internet system designed to build capacity on a large scale, interactive Getting To Outcomes® (iGTO). In Tennessee, 30 coalitions were randomly assigned to receive either the iGTO system or nothing. In Missouri, 18 coalitions receiving iGTO were compared with 8 like coalitions who did not receive iGTO. The primary outcome was iGTO’s impact on the performance of the coalitions’ programs, assessed through interviews at baseline and after a year of iGTO implementation. Analyses suggest that iGTO-programs improved their performance of prevention practices over non-iGTO programs. Semi-structured interviews of iGTO users and state-level stakeholders showed that iGTO was adopted by most iGTO-assigned coalitions, albeit in mostly an elementary fashion. Perceptions of the iGTO system were mixed. The findings suggest that more comprehensive integration requires that state leadership also use iGTO and provide more support for its use at the local level. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Emotion regulation as a mediator of the relation between emotion socialization and deliberate self-harm.
This study examined (a) whether retrospective reports of specific parent responses to sadness (i.e., reward, punishment, neglect, override, magnification) were related to deliberate self-harm (DSH) and (b) whether difficulties regulating emotions (i.e., difficulties monitoring, evaluating, and modifying emotions) mediated those relations. One hundred eighteen college students completed measures of parental emotion socialization, emotion regulation difficulties, and DSH. Parental reward and override of sadness were directly related to lower DSH scores. Parental punishment and neglect of sadness were related to higher DSH scores, and these associations were mediated by difficulties evaluating emotions. In other words, parental punishment and neglect of sadness may place individuals at risk for DSH by fostering negative evaluations of emotional experiences and the belief that nothing can be done to effectively manage emotions. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Social support and mental health among college students.
This study is the first, to our knowledge, to evaluate the relationship between mental health and social support in a large, random sample of college students. A Web-based survey was administered at a large, public university, with 1,378 students completing the measures in this analysis (response rate = 57%). The results support our hypothesis that students with characteristics differing from most other students, such as minority race or ethnicity, international status, and low socioeconomic status, are at greater risk of social isolation. In addition, the authors found that students with lower quality social support, as measured by the Multidimensional Scale of Perceived Social Support, were more likely to experience mental health problems, including a sixfold risk of depressive symptoms relative to students with high quality social support. These results may help administrators and health providers to identify more effectively the population of students at high risk for mental illness and develop effective interventions to address this significant and growing public health issue. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Social and psychological well-being in lesbians, gay men, and bisexuals: The effects of race, gender, age, and sexual identity.
Using a social stress perspective, the authors studied the mental health effects of added burden related to socially disadvantaged status (being African American or Latino, female, young, and identifying as bisexual vs. gay or lesbian) in a community sample of 396 self-identified lesbian, gay, and bisexual (LGB) adults. Mental health outcomes were social and psychological well-being contrasted with depressive symptoms. When mental health deficiencies by disadvantaged social status were detected, the authors examined whether LGB community connectedness and positive sexual identity valence played a mediating role, reducing the social status disparity in outcome. The authors found different patterns when looking at social versus psychological well-being and positive versus negative mental health outcomes. Bisexuality and young age, but not gender and racial/ethnic minority status, were associated with decreased social well-being. In bisexuals, this relationship was mediated by community connectedness and sexual identity valence. Although no differences in social or psychological well-being were found by gender, female gender was associated with depressed mood. The authors conclude that there is limited support for an additive stress model. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Age of minority sexual orientation development and risk of childhood maltreatment and suicide attempts in women.
Women with minority sexual orientations (e.g., lesbian, bisexual) are more likely than heterosexual women to report histories of childhood maltreatment and attempted suicide; however, the importance of the timing of minority sexual orientation development in contributing to this increased risk is uncertain. This study investigated relationships between self-reported ages of achieving minority sexual orientation development milestones (first awareness of same-gender attractions, disclosure of a minority sexual orientation to another person, and same-gender sexual contact), and childhood maltreatment and suicide attempt experiences in a sample of 2,001 women recruited from multiple-community sources. Younger age of minority sexual orientation development milestones was positively linked to self-reported recall of childhood maltreatment experiences, and to a childhood suicide attempt. After adjusting for differences in maltreatment, the odds of suicide attempt attributable to younger age of sexual orientation development milestones was reduced by 50 to 65%, suggesting that maltreatment may account for about half of the elevated risk for childhood suicide attempts among women with early minority sexual orientation development. Implications for services, interventions, and further research to address maltreatment disparities for sexual minorities are discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Parents’ evaluation of adoption success: A follow-up study of intercountry and domestic adoptions.
Parents of 165 children adopted from Romania and 52 children adopted from within the United Kingdom rated the success of the adoptions when the children were 11 years old. As was the case at two earlier study waves, satisfaction was found to be extremely high. Both positive and negative assessments were generally stable between ages 6 and 11, although for the children who had more problems there was an increase in negative evaluation, albeit within an overall positive picture. Parents’ evaluations were somewhat more negative for this group of children; however, parents reported that having the child as part of their family was very rewarding. Negative evaluation was not directly related to age at placement, but appeared to be a reflection of the later-placed children’s higher rates of problem behavior. As found at earlier assessment waves, child factors, in particular conduct problems and inattention or overactivity, were key in predicting parental evaluations at age 11, as were four domains closely associated with institutional deprivation, namely cognitive impairment, quasi-autistic patterns, inattention or overactivity, and disinhibited attachment. The findings emphasize the need for early intervention for children in severely deprived conditions, and for access to postadoption services that target the particular problem behaviors the children may exhibit. (PsycINFO Database Record (c) 2009 APA, all rights reserved)
Children with co-occurring anxiety and externalizing disorders: Family risks and implications for competence.
This study used data from 340 mother–child dyads to examine characteristics of children with co-occurring diagnoses of anxiety and externalizing disorders and compared them with children with a sole diagnosis or no diagnosis. Comparisons were made using 4 child-diagnostic groups: anxiety-only, externalizing-only, co-occurrence, and no-problem groups. Most mothers were characterized by low income and histories of psychiatric diagnoses during the child’s lifetime. Analyses using multinomial logistic regressions found the incidence of co-occurring childhood disorders to be significantly linked with maternal affective/anxiety disorders during the child’s lifetime. In exploring implications for developmental competence, we found the co-occurrence group to have the lowest level of adaptive functioning among the 4 groups, faring significantly worse than the no-problem group on both academic achievement and intelligence as assessed by standardized tests. Findings underscore the importance of considering co-occurring behavior problems as a distinct phenomenon when examining children’s developmental outcomes. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

American Journal of Orthopsychiatry - Vol 79, Iss 4