Friday Factoid: Parental Decision Making in Youth Football

The beginning of August welcomes the return of school and, for many Americans, the arrival of fall sports. The humid summer gives way to crisp fall days and the return of youth football. The sounds of whistles and pads cracking will echo throughout numerous practice fields. A recent study has explored the parental factors that have led parents to either allowing or not allowing their child to participate in the sport of football.

Murphy, Askew, and Sumner (2017) note the decline of Pop Warner youth football by 9.5% from 2010 to 2012 (Murphy, Eskew, & Sumner, 2017, p. 232). The authors hypothesize that the leading cause of the decline of youth football participation stems from parental fear of head injuries, but this cause has not been empirically proven before this study.  The authors note that, while football has inherent risks, it also has benefits such as physical, psychological, and social benefits which include benefits not found in other sports. In response, football league officials have made attempts to make the game safer by rule changes and coaching education (Murphy et al., 2017). Furthermore, additional advances have been made in the prevention, evaluation, and management of concussions.

The authors recruited a total of 685 participants (parents) who had one child playing football, with the majority being women (79.1%). A Likert scale was used to determine factors that led to the decrease and decision making in youth football participation. Four factors predicted a parent’s intention to let his or her child play football. They included social norms, attitude towards youth football participation, behavioral control, and the perceived risk of concussion (Murphy et al., 2017, p. 240). The study aimed to create a theoretical platform for future interventions that can promote football participation (Murphy et al., 2017, p. 240). It appears the authors were successful at obtaining the main factors that determine whether or not a parent will allow their child to participate in youth football. In turn, coaches and administrators can continue progressive safety measures to ensure the viability of the game going forward.

References
Murphy, A. M., Eskew, K. L., & Sumner, K. E. (2017). Parents’ intentions to allow youth football participation: Perceived concussion risk and the theory of planned behavior. Sport, Exercise, and Performance Psychology, 6(3), 230-242. https://doi.org///doi.org/10.1037/spy0000102.supp

Chris Morrison, M.A.
WKPIC Doctoral Intern

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Friday Factoid: Dog Days of Summer

Pictured: Cam Morrison

Studying the history of psychoanalysis, I came across an interesting fact regarding Sigmund Freud. Freud was very fond of a Chow dog he eloquently named “Jofi.”  Jofi had a calming effect both on Freud and his patients. During therapy sessions, Jofi would often lie on the floor and consult with Freud regarding the anxiety level of his patients (Beck, 2012). If patients were calm, the dog would sit close to the patient, but she would move to the other side of the room if the patient were anxious. Jofi could also perfectly time the end of therapy sessions and would go to the door at approximately 50 after the hour (Beck, 2012). Freud loved his beloved dog, Jofi, and was distraught at her passing. Pets can become endearing members of our families.  They hold an extraordinary place in our lives and our memories. Psychologists have explored the remarkable relationship between dogs and humans. These findings are especially significant in psychoanalytic studies.
According to Bennett Roth (2005), dogs, through projection, can represent warded-off aspects of unconsciousness, such as hostility, aggression, and sexuality. Other psychologists like Bettelheim (1977) note that children identify with animals to work out psychological conflicts related to maturation. Dogs may also serve as objects of identification, projection, and displacement in a client’s psychoanalytic treatment (Ponder, 2019, p. 29).

Ponder’s article provided a case vignette of a 43-year-old female client, with a history of anorexia and a controlling mother, who grew to identify with a dog she rescued at a local shelter. Her dog would eventually become emaciated and incontinent several years later (Ponder, 2019). After many sessions discussing the futility of the dog’s recovery the clinician informed the client that she should put the dog down whereby the client states, “I sure hope people don’t feel like that about me because I’m incontinent too” (Ponder, 2019, p. 33). As a result of countertransference, the client came to a therapy session a month later in urine soaked shorts as an act of hostility towards the clinician. The client was eventually able to regain control of her own life with the addition of two more animals and additional therapy, but the powerful psychoanalytic themes of projection, transference, and countertransference should be noted.

I can personally attest to the importance and bond I feel with our family dog named Cameron or “Cam” as we call him. He is a ball of pure energy and joy. He is the only one in the family, beside me, that appreciates foreign detective shows in subtitles on Netflix. Cam’s bark is my family’s wake-up call in the morning and warning call of possible intruders at night. He will bark excessively when my children are being loud or doing something they are not supposed to. Cam never abandons me when I work late at night or get up early in the morning. His presence is both gentle and soothing, much like Freud’s Jofi. All of this is remarkable considering Cam weighs 6 lbs. and has four legs. You can imagine my sadness when I came home for the weekend to find Cam laying in his bed with reduced respiration and lethargy. It appeared he was dying, and the onset was both sudden and scary. Bowlby teaches us that love and attachment cannot exist without loss. Fortunately for us, Cam required two veterinarian visits and some medication before he was able to recover. The result for my family was relief and gratitude for the restoration of his health.

Psychology teaches us a vital link that exists between pets and humans. The psychoanalytic literature suggests that the human psyche can manifest relationship qualities onto their pets including pathology and displacement. Whether it’s fair for humans to anthropomorphize their dogs is up for debate. However, much like Freud’s beloved Jofi, animals should hold a special place in the heart of peoplekind.

References
Beck, M. (2012). Beside Freud’s Couch, a Chow Named Jofi. Retrieved from https://www.wsj.com/articles/SB10001424052748703886904576031630124087362

Ponder, J. (2019). Patients’ use of dogs as objects of identification, projection, and displacement. Psychoanalytic Psychology, 36, 29-35. https://doi.org/doi.org/10.1037/pap0000164

Roth, B. (2005). Pets and psychoanalysis: A clinical contribution. . Psychoanalytic Review, 92, 453-468. https://doi.org/dx.doi.org/10.1521/prev.92.3.453 .66541

Chris Morrison, M.A.
WKPIC Doctoral Intern

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Friday Factoids: The Return of the Lion King

The summer heat falls slowly upon those of us in the bluegrass during this time of year. It is important to note that many of us find a respite in the swimming holes, mountain streams, or numerous lakes in the area. However, indoor activities, such as attending a summer movie, are also an excellent strategy to get out of the weather. Those of us in the practice of psychology may receive a break from the weather by attending a film but cannot escape the presence of Freud in the movie dynamics. One of the most anticipated Disney films soon to be released this summer is The Lion King. The Lion King’s popularity is due to the main character’s quest for existential meaning combined with his search for universal truth.

Kegerreis (2013) examined the psychoanalytic aspects of the film and came up with some critical concepts that embody the spirit of the Disney characters meshed with Freudian concepts in the original 1994 film. The main character, Simba, is born as the center of infantile narcissism and omnipotence (Kegerreis, 2013). Simba’s omnipotence and narcissism give way to a false sense of self whereby he decides to seek out trouble in the elephant graveyard. After the death of his father,  Simba has to confront death and the futility of his swagger. The author notes that we all must move on from infantile fantasy into a reality-based existence (Kegerreis, 2013, p. 334).

Simba, in The Lion King, is a representative microcosm of the life challenges afforded to many of us. He overcomes guilt, shame, and depression and learns to come to terms with his past. The film is a coming of age tale that leaves a lasting impact on all ages alike. The psychological components, including Freudian concepts, are accentuated in the film and provide a learning tool for those of us who practice the field of psychology.

References
Kegerreis, S. (2013). Freud and Klein in The Lion King. Journal of Child Psychotherapy, 39, 334-335. https://doi.org/dx.doi.org/10.1080/0075417X.2013.846583

Chris Morrison, M.A.
WKPIC Doctoral Intern

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Article Review: Khoury, B., Lecomte, T., Gaudiano, B. A., & Paquin, K. (2013) Mindfulness interventions for schizophrenia: A meta-analysis.

Mindfulness is a diverse concept which originated in the eastern traditions and has taken on new life in operational definitions in psychology, including de-centering, awareness of sensations, and openness to inner experiences. These labels for mindfulness have a strong place in the “third wave” of cognitive behavioral interventions such as Acceptance and Commitment Therapy (Khoury, Lecomte, Gaudiano, Paquin, 2013). The purpose of these treatments is not on reduction of symptoms such as eliminating or lessening presence of hallucinations or delusions. Instead, the focus of interventions is addressing the interplay of the individual and their psychotic experiences. An example of this concept would be making individuals aware of their experiences and to identify them as transient but also as separate and have a feeling of “not me” from their other parts of their life.

Cognitive Behavioral Therapy for psychosis (CBTp) is one of the more widely studied and approved treatments (Khoury et al., 2013). It is designed to have individuals test and challenge their beliefs in behavioral experiments. In contrast, mindfulness interventions have three main areas to address these symptoms. The first area is for mindfulness mediation-based protocols, the second is acceptance-based protocols, and the third is compassion-based. It is belief that, through refocusing attention, one’s emotions can be better regulated.  Therefore, treatment is based on reduction of distress.

Meta-analysis of 13 studies are moderately effective in pre-post studies. The effect sizes were shown to be small to moderate. Schizophrenia is hallmarked by two sets of symptoms either lacking something such as motivation (negative symptoms) or the presence of symptoms in everyday living (positive symptoms). Treatment for positive symptoms was shown to have a weaker effect than treatment for negative symptoms, affective symptoms, and quality of life. The researchers suggested that, to achieve these effects, therapy is recommended to be tailored to the severity of the individual’s issues. Unfortunately, the meta-analysis could not determine the mechanism for the improvements in quality of living or why these mindfulness interventions are effective. Future research was suggested to determine any moderating factors and other influences on why mindfulness works against distress in schizophrenia.

References:
Khoury, B., Lecomte, T., Gaudiano, B. A., & Paquin, K. (2013) Mindfulness interventions for schizophrenia: A meta-analysis. Schizophrenia Research, 150(1), 175-184.

Andrew Goebel, MS, LPA (Temp)
WKPIC Doctoral Intern

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Friday Factoids: Well That’s Depressing: Analysis of Depression Data Shows Increased Rate of the Disorder

Depression is one of the most common mood disorders. Nationally representative data was analyzed between 2005 and 2014 to determine disparities focusing on this condition (Todd & Teitler, 2018) . The data was split by gender and levels of education. Across the time of the study, prevalence of depression increased across the board. Those who were least educated had a greater likelihood of experiencing moderate to severe depression. Within the most educated, likelihood for the condition increased in women but decreased in men. Treatment for the condition had also changed, showing those with the least amount of education either had a decrease (especially among women) or stability in their receiving of treatment. Within the higher educational individuals, women had steady access to treatment; whereas, men increased receiving of treatment. Therefore, depression is steadily increasing among Americans with treatment disparities, continuing as documented in past research.

References:
Todd, M. & Teitler, J.  (2018). Darker day? Recent trends in depression disparities among U.S. adults. American Journal of Orthopsychiatry,10.1037/ort0000370

Andrew Goebel, MS, LPA (Temp)
WKPIC Doctoral Intern

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Article Review: Browne, J., Mueser, K. T., Meyer-Kalos, P., Gottlieb, J.D., Estroff, S. E., & Penn, D. L. (2019). The therapeutic alliance in individual resiliency training for first episode psychosis: Relationship with treatment outcomes and therapy participation.

When thinking about attending therapy, people sometimes have different worries come to mind. Am I going to like my therapist?  What if I do not get along with my therapist?  Is this the best fit and can the best fit with a therapist affect my outcome?  Research has shown that the therapeutic alliance is an important part of the change process as it helps allow the client to engage in a more meaningful fashion in therapy (Tsai et al., 2019).  The current study is looking to see how the therapeutic alliance impacts individuals who are in therapy who are experiencing a first episode psychosis (FEP).

Research has been conducted on the specialized early intervention services with individuals who have experienced the first episode psychosis.  The previous research has examined why there has been a high amount of dropouts in the early intervention services.  Research has shown that there has been around 30% of a drop out rate for individuals who receive early intervention services for a first episode psychosis (Dixon, Holoshitz, & Nossel, 2016).  The previous research that has been conducted has looked at other factors that might have contributed to the dropout rate in this population and what could be viewed as a risk factor in the future.  Previous research has focused on factors such as substance use, not having a support system involved in treatment, past forensic history, and less severe illness severity (Conus et al., 2010; Miller et al., 2009).  The current research wanted to look at the therapeutic alliance relationship as a factor in the outcome for individuals who have experienced a first episode psychosis.  The research wanted to look at how the alliance impacts the recovery of the individual (for instance, the psychological well-being, quality of life, and mental health recovery) and if the alliance impacted participation in therapy (Browne et al., 2019).

The research found that overall a better alliance between the therapist and the patient was related to better outcomes with the patient (Browne et al., 2019).  The better outcomes included the patient experiencing an increase in their psychological well-being, quality of life at the end of treatment, and mental health recovery (Browne et al., 2019).   Previous research has suggested that one of the reasons why stronger therapeutic alliance is helpful is that the therapists who created stronger alliances helped the patients master their skills which created greater improvement, and the therapists therapy skills might have played a roll, as well (Zilcha-Mano, 2017).

References
Browne, J., Mueser, K. T., Meyer-Kalos, P., Gottlieb, J.D., Estroff, S. E., & Penn, D. L. (2019).  The therapeutic alliance in individual resiliency training for first episode psychosis:  Relationship with treatment outcomes and therapy participation.  Journal of Consulting and clinical Psychology

Conus, P., Lambert, M., Cotton, S., Bonsack, C., McGorry, P.D., & Schimmelmann, B. G. (2010).  Rate and predictors of service disengagement in an epidemiological first-episode psychosis cohort.  Schizophrenia Research, 118, 256-263.

Dixon, L. B., Holoshitz, Y., & Nossel, I. (2016). Treatment engagement of individuals experiencing mental illness:  Review and update.  World Psychiatry, 15, 13-20.

Tsai, M., Yoo, D., Hardebeck, E. J., Loudon, M. P., & Kohlenberg, R.J. (2019).  Creating safe, evocative, attuned, and mutually vulnerable therapeutic beginnings:  Strategies from functional analytic psychotherapy.  Psychotherapy, 56(1), 55-61.

Zilcha-Mano, S. (2017).  Is t he alliance really therapeutic?  Revisiting this question in light of recent methodological advances.  American Psychologist, 72, 311-325.

Hannah Sutherland, MA, LPA (Temp)
WKPIC Doctoral Intern

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Friday Factoid: How Bad Do I Hurt, Mommy: Gender Bias in Adult Perception of Pediatric Pain

Assessing a child’s pain is a crucial aspect of pediatrics. Adults are those who are typically the advocates and voices for children when speaking to doctors about pain and the potential management of such pain. Examination of over 500 online participants determined that there is the potential for bias in stereotyping based on gender (Earp et al., 2019). Participants were presented with a video that showed a 5-year-old having their finger pricked. The child in the video was given a gender-neutral appearance and either called “Samantha” for a girl and “Samuel” for a boy depending on the study condition. Those who rated the boy’s, “Samuel’s,” pain showed that it was significantly higher than the girl’s pain.  Women participants were shown to be more likely than men to underestimate girls’ pain. The researchers proposed an explanation of explicit gender stereotypes of stoicism and tolerance of pain in boys. Conversely, the researches posited that stereotypes assume girls are more emotive, which influenced how adults perceive the child’s pain. Therefore, our perceptions of pain for children may be socially and culturally determined which could impact how parents and others describe children’s experiences to health providers.

References
Earp, B. D., Monrad, J.T., LaFrance, M., Bargh, J. A., & Cohen, L. L. & Richeson, J. A. (2019). Gender bias in pediatric pain assessment Journal of Pediatric Psychology, 44(4), 403-414.DOI: 10.1093/jpepsy/jsy104

Andrew Goebel, MS, LPA (Temp)
WKPIC Doctoral Intern

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Friday Factoid: Sleep Is Not What It Used To Be: Change in Sleep Trends

Analyzing the data of 398 participants aged 18 to 84, Americans reported getting less sleep than they were 15 years ago (Sheehand, Frochen, Walsemann & Ailshire, 2019). Sleep was categorized into three separate groups:  ≤6 hours (short sleep), 7-8 (adequate sleep), and ≥9 hours. Results showed that sleep patterns were relatively steady for short-term sleep from 2004 to 2012 and steadily declined beginning in 2013. Those individuals who were sleeping less then 6 hours were mainly Hispanic and non-Hispanic black. Across the study period, sleeping less than 6 hours increased by 7 points for Hispanic individuals and 6.5 percentage points among black respondents. Those with the lowest reduction in sleep were white respondents who only had a 2-point increase. Reduction in sleep has been shown to be connected with adverse health effects. The widening gap among white and non-white populations may have consequences for racial and ethnic health disparities.

References
Sheehan, C. M., Frochen, S. E., Walsemann, K. M., & Ailshire, J.A.  (2019). Are U.S. adults reporting less sleep?: Findings from sleep duration trends in the national health interview survey, 2004-2017. Sleep, 42 (2)

Andrew Goebel, MS, LPA (Temp)
WKPIC Doctoral Intern

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Friday Factoid: Stability When Unstable: Borderline Personality Disorder May Have Elements that Change Over Time

Borderline Personality Disorder is generally perceived as an unchanging condition which has very little ebb and flow to its course. However, longitudinal data presents a different perspective when looked over a 10-year time span. The Collaborative Longitudinal Personality Disorders Study conducted research on at least 668 patients administering 5 semi-structured interviews over the course of a decade (Conway, Hopwood, Morey, & Skodol, 2018). Through analyzing these interviews, it was determined that about 45% of the individual differences in the disorder’s severity is determined by stable elements. Of these stable elements, they were associated with personality traits such as neuroticism and environmental factors such as childhood abuse. As for the time-varying elements, these factors wax and wane depending on other factors, such as substance abuse. Overall, the study shows that there are varying elements to a condition that otherwise is thought of as a trait based and stable condition.

References
Conway, C. C., Hopwood, C. J., Morey, L. C., & Skodol, A. E.  (2018). Borderline personality disorder is equally trait-like and state-like over ten years in adult psychiatric patients. Journal of Abnormal Psychology, 127 (6), 590-601.

Andrew Goebel, MS, LPA (Temp)
WKPIC Doctoral Intern

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Friday Factoid: Combating Stress with Mindfulness

Stress is the most significant risk factor for expenditures in healthcare (Azagba & Sharaf, 2011). Mindfulness-based (MB) interventions, specifically Mindfulness-Based Stress Reduction (MBSR) are one approach to efficiently dealing with stress (Shapiro, Astin, Bishop, & Cordova, 2005). Jon Kabat-Zinn developed MBSR at the University of Massachusetts Medical School in 1979 with the goal of helping patients with chronic pain and illness cope more effectively with their distressing symptoms (Dobkin, Irving, & Amar, 2011). Since 1979, over 24,000 individuals have completed this formal training program. The program focuses on incorporating intensive mindfulness training into daily life and has demonstrated reproducible reductions in both psychological and medical symptoms across a wide range of conditions. In many instances, these changes remain for up to four years after treatment (University of Massachusetts Medical School, 2017). MBSR research, supporting benefits of its practice, has steadily accumulated over the past thirty-seven years (Malpass et al., 2011).

References

Azagba, S., & Sharaf, M. F. (2011). The effect of job stress on smoking and alcohol consumption. Health Economics Review, 1(1), 15. doi:10.1186/2191-1991-1-15

Dobkin, P. L., Irving, J. A., & Amar, S. (2011). For whom may participation in a mindfulness-based stress reduction program be contraindicated? Mindfulness, 3(1), 44-50. doi:10.1007/s12671-011-0079-9

Malpass, A., Carel, H., Ridd, M., Shaw, A., Kessler, D., Sharp, D., Wallond, J. (2012).Transforming the perceptual situation: A meta-ethnography of qualitative work reporting patients’ experiences of mindfulness-based approaches. 60–75. https://doi.org/10.1007/s12671-011-0081-2

Shapiro, S. L., Astin, J. A., Bishop, S. R., & Cordova, M. (2005). Mindfulness-Based Stress Reduction for health care professionals: Results from a randomized trial. International Journal of Stress Management12(2), 164-176. doi:10.1037/1072-5245.12.2.164

University of Massachusetts Medical School. (2017). History of MBSR. Retrieved from http://www.umassmed.edu/cfm/mindfulness-based-programs/mbsr-courses/about-mbsr/history-of-mbsr/

Blake Palmer, MA, LPA
Doctoral Psychology Intern

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