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Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy's (ACT's) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2-weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.

Eisenberg, Cumberland, and Spinrad (1998; Eisenberg, Spinrad, & Cumberland, 1998) included parent-child attachment as a key dimension of the early emotion socialization environment. We examined processes linking children's early attachment with social regulation and adjustment in preadolescence in 102 community mothers, fathers, and children. Security of attachment, assessed at 2 years, using observers' Attachment Q-Set (Waters, 1987), was posited as a significant, although indirect, predictor of children's adaptive social regulation at 10 and 12 years. We proposed that security initiated paths to future social regulation by promoting children's capacities for emotion regulation in response to frustration at 3, 4.5, and 5.5 years: having to suppress a desired behavior, observed in delay tasks, to regulate anger, observed in parent-child control contexts, and a traitlike tendency to regulate anger when frustrated, rated by parents. We conceptualized adaptive social regulation at 10 and 12 years as encompassing regulation of negative emotional tone, observed in diverse parent-child interactions, parent-rated regulation of negativity in broad social interactions, and child-reported internalization of adults' values and standards of conduct. Multiple-mediation analyses documented two paths parallel for mother- and father-child relationships: From security to emotion regulation in delay tasks to internalization of adults' values, and from security to parent-rated traitlike regulation of anger to parent-rated regulation of negativity in broad social interactions. Two additional paths were present for mothers and children only. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Intimate partner violence (IPV) is a serious mental and physical health concern worldwide. Although previous research suggests that childhood maltreatment increases the risk for IPV, the underlying psychological mechanisms of this relationship are not yet entirely understood. Borderline personality (BP) features may play an important role in the cycle of violence, being associated with interpersonal violence in both childhood and adult relationships. The present study investigated whether BP features mediate the relationship between childhood maltreatment and IPV, differentiating between perpetration and victimization, and taking maladaptive stress coping and gender into account. Self-reports on IPV, childhood trauma, BP features, and maladaptive stress coping were collected in a mixed (nonclinical and clinical) sample of 703 adults (n = 537 female, n = 166 male), using an online survey. A serial mediation analysis (PROCESS) was performed to quantify the direct effect of childhood maltreatment on IPV and its indirect effects through BP features and maladaptive coping. Childhood maltreatment severity significantly positively predicted IPV perpetration as well as victimization. BP features, but not coping, partially mediated this relationship. Follow-up analyses suggest that affective instability and interpersonal disturbances (e.g., separation concerns) play an important role in IPV perpetration, while interpersonal and identity disturbances may mediate the effect of childhood maltreatment on IPV victimization. In clinical practice, attention should be paid not only to histories of childhood abuse and neglect but also to BP features, which may be possible risk factors for IPV.

Psychologists have long tried to understand why trajectories of socialization in individual parent-child dyads can be distinct, leading to adaptive or maladaptive developmental outcomes. In this article, we elucidate origins of those differences by examining the subtle yet enduring implications of early parent-child relationships in longitudinal studies of low- and high-risk families, using correlational and experimental designs, and multiple measures. Those relationships are key for socialization because they can alter cascades from children's biologically based difficult temperament to parents' negative control to negative children's outcomes, as demonstrated by social-learning theories. We suggest that those cascades unfold only in parent-child dyads whose early relationships lack positive mutuality and security. Such relationships set the tone for adversarial cascades. In contrast, early mutually positive, secure relationships initiate cooperative, effective socialization and defuse risks of negative cascades. Parents' and children's internal representations of each other may explain how such divergent sequelae unfold.

The present study demonstrates the interplay between interparental relationship satisfaction and child plasticity in the origins of internalizing problems in 99 community mothers, fathers, and children. Our cumulative measure of plasticity integrated genetics (5-HTTLPR polymorphism), psychophysiology (skin conductance level), and observed behavior (inhibition, sadness, joy). The interaction between plasticity and interparental relationship satisfaction reflected differential susceptibility. Compared with low-plasticity peers, high-plasticity children had more internalizing problems from 5.5 to 12 years when the interparental relationship at 4.5 years was acrimonious, but fewer problems when it was harmonious. Further, almost half of the children in this sample were "differentially affected" by the interaction such that greater plasticity was associated with fewer internalizing problems when their parents had a harmonious relationship, a key feature of differential susceptibility. (PsycINFO Database Record

Early secure attachment plays a key role in socialization by inaugurating a long-term mutual positive, collaborative interpersonal orientation within the parent-child dyad. We report findings from Family Study (community mothers, fathers, and children, from age 2 to 12, N = 102, 51 girls) and Play Study (exclusively low-income mothers and children, from age 3.5 to 7, N = 186, 90 girls). We examined links among observed secure attachment at toddler age, child and parent receptive, willing stance to each other, observed in parent-child contexts at early school age, and developmental outcomes. The developmental outcomes included parent-rated child antisocial behavior problems and observed positive mutuality with regard to conflict issues at age 12 in Family Study, and mother-rated child antisocial behavior problems and observed child regard for rules and moral self at age 7 in Play Study. In mother-child relationships, the child's willing stance mediated indirect effects of child security on positive mutuality in Family Study and on all outcomes in Play Study. In father-child relationships, both the child's and the parent's willing stance mediated indirect effects of child security on both outcomes. Early security initiates an adaptive developmental cascade by enlisting the child and the parent as active, willingly receptive and cooperative agents in the socialization process. Implications for children's parenting interventions are noted.

Despite the acknowledged significance of callous-unemotional (CU) traits in developmental psychopathology, few studies have examined their early antecedents in typically developing children, in long-term longitudinal designs, using observational measures. In 102 community mothers, fathers, and children (N = 51 girls), we examined main and interactive effects of children’s fearless temperament and low concern about transgressions from toddler to early school age as predictors of CU traits in middle childhood and early preadolescence. In laboratory paradigms, we observed children’s concern about breaking valuable objects (twice at each age of 2, 3, 4.5, 5.5, and 6.5 years) and about hurting the parent (twice at each age of 2, 3, and 4.5 years). We observed fearless temperament during scripted exposure to novel and mildly threatening objects and events (twice at each age of 2, 3, 4.5, and 5.5 years). Mothers and fathers rated children’s CU traits and externalizing behavior problems at ages 8, 10, and 12. Children’s low concern about both types of transgressions predicted CU traits, but those effects were qualified by the expected interactions with fearless temperament: Among relatively fearless children, those who were unconcerned about transgressions were at the highest risk for CU traits, even after controlling for the strong overlap between CU traits and externalizing problems. For fearful children, variation in concern about transgressions was unrelated to CU traits. Those interactions were not significant in the prediction of externalizing problems. The study highlights a potentially unique etiology of CU traits in early development.

OBJECTIVE: Even when medical treatments are limited, supporting patients' coping strategies could improve their quality of life. Greater understanding of patients' coping strategies, and influencing factors, can aid developing such support. We examined the prevalence of coping strategies and associated variables.METHODS: We used sociodemographic and baseline data from the ACTION trial, including measures of Denial, Acceptance, and Problem-focused coping (COPE; Brief COPE inventory), of patients with advanced cancer from six European countries. Clinicians provided clinical information. Linear mixed models with clustering at hospital level were used.RESULTS: Data from 675 patients with stage III/IV lung (342, 51%) or stage IV colorectal (333, 49%) cancer were used; mean age 66 (10 SD) years. Overall, patients scored low on Denial and high on Acceptance and Problem-focused coping. Older age was associated with higher scores on Denial than younger age (β = 0.05; CI[0.023; 0.074]), and patients from Italy (β = 1.57 CI[0.760; 2.388]) and Denmark (β = 1.82 CI[0.881; 2.750]) scored higher on Denial than patients in other countries.CONCLUSIONS: Patients with advanced cancer predominantly used Acceptance and Problem-focused coping, and Denial to a lesser extent. Since the studied coping strategies of patients with advanced cancer vary between subpopulations, we recommend taking these factors into account when developing tailored interventions to support patients' coping strategies.

Background Patients and healthcare professionals describe patients’ readiness for advance care planning (ACP) as an indicator for whether or not to start ACP conversations. Nevertheless, it is unclear how readiness manifests and develops throughout an ACP conversation. This study explores patients’ readiness during an ACP conversation. Methods A qualitative study using content analysis of structured ACP conversations between a trained facilitator, a patient with advanced colorectal or lung cancer and a relative. Conversations were conducted in the Netherlands as part of the international ACTION trial. Analysis was supported by NVivo 11. Results Transcripts of thirteen ACP conversations were included. All patients expressed both signs of not being ready and being ready within one conversation. Signs of being ready included answering questions on a personal level or demonstrating a realistic understanding of one’s disease. Signs of not being ready included limiting one’s perspective to the here and now or indicating a preference not to talk about an ACP-related topic. Signs of not being ready were especially seen when future oriented topics such as ‘complications’ and ‘hope’ were discussed. Patients could more easily elaborate on less future orientated topics as ‘good life’ and ‘earlier experiences with illness’. Despite signs of not being ready patients were able to continue the conversation. Conclusion Patients do not have to be ready for all elements of ACP to be able to participate in an ACP conversation. Healthcare professionals should be aware of patients’ ability to alternate in readiness depending on the topic that is discussed.

Background Writing an Advance Directive (AD) is often seen as a part of Advance Care Planning (ACP). ADs may include specific preferences regarding future care and treatment and information that provides a context for healthcare professionals and relatives in case they have to make decisions for the patient. The aim of this study was to get insight into the content of ADs as completed by patients with advanced cancer who participated in ACP conversations. Methods A content analysis and descriptive statistics were conducted to describe the content of the completed My Preferences forms, an AD used in the intervention arm of the ACTION trial, testing the effectiveness of the ACTION Respecting Choices ACP intervention. Results In total, 33% of 439 patients who received the ACTION RC ACP intervention completed a My Preferences form. Document completion varied per country: 9.6% (United Kingdom), 21% (Denmark), 27.6% (Belgium), 43.8% (the Netherlands), 61.3% (Italy) and 64.3% (Slovenia). Content analysis showed that ‘maintaining normal life’ and ‘experiencing meaningful relationships’ were important for patients to live well. Fears and worries mainly concerned disease progression, pain or becoming dependent. Patients hoped for prolongation of life and to be looked after by healthcare professionals. Most patients preferred to be resuscitated and 44% of the patients expressed maximizing comfort as their goal of future care. Most patients preferred ‘home’ as final place of care. Conclusions My Preferences forms provide some insights into patients’ perspectives and preferences. However, understanding the reasoning behind preferences requires conversations with patients.

Although infant attachment has been long seen as key for development, its long-term effects may be complex. Attachment may be a catalyst or moderator of future developmental sequelae rather than a source of main effects. In 102 mothers, fathers, and infants, attachment was assessed at 15 months; children's negativity (rejection of parental rules and modeling attempts) at 25, 38, 52, and 67 months; and developmental outcomes (the child's parent-rated externalizing problems and the parent-child observed relationship quality) at ages 10 and 12. In both mother-child and father-child relationships, children's higher negativity was associated with more detrimental outcomes but only in dyads with formerly insecure infants. Infant insecurity appears to amplify detrimental cascades, whereas infant security appears to defuse such risks.

Young children's disregard for conduct rules (failing to experience discomfort following transgressions and violating adults' prohibitions) often foreshadows future antisocial trajectories, perhaps in part because it elicits more power-assertive parental discipline, which in turn promotes children's antisocial behavior. This process may be particularly likely for children with low skin conductance level (SCL). In 102 two-parent community families, we tested a model in which children's SCL, assessed at 8 years, was posed as a moderator of the cascade from children's disregard for conduct rules at 4.5 years to parents' power assertion at 5.5 and 6.5 years to antisocial behavior at 10 and 12 years. Children's disregard for conduct rules was observed in scripted laboratory paradigms, parents' power assertion was observed in discipline contexts, and children's antisocial behavior was rated by parents. Conditional process analyses revealed that the developmental cascade from early disregard for rules to future parental power assertion to antisocial outcomes occurred only for the children with low SCL (below median), but not their high-SCL (above median) peers. By elucidating the specific interplay among children's disregard for rules, the parenting they receive, and their psychophysiology, this study represents a developmentally informed, multilevel approach to early etiology of antisocial behavior.

Taxometric investigation of scripted attachment representations in lateadolescence and adulthood suggests that variations in secure base script knowledge consist of differences in degree (dimensional latent structure) rather than differences in kind (categorical latent structure). However, the latent structure of secure base script knowledge in younger cohorts has gone unexplored. This study presents a downward extension of prior taxometric work using the middle childhood version of the Attachment Script Assessment in a cross-sectional sample of 639 normative-risk children (age 8 to 13 years; M = 10.77, SD = 1.06). Results suggest that secure base script knowledge in middle childhood is categorically distributed. Taxometric curves revealed three distinct taxa, highlighting discontinuity in the latent structure of scripted attachment representations across development. ispartof: Child Development vol:90 issue:3 pages:694-707 ispartof: location:United States status: published

Rapidly growing research on parental mind-mindedness, a tendency to treat one's young child as a psychological agent and an individual with a mind, internal mental states, and emotions, has demonstrated significant links among parents' mind-mindedness, their parenting, and multiple aspects of children's development. This prospective longitudinal study of 102 community mothers, fathers, and infants, followed from 7 months to 10 years, contributes to research on mind-mindedness by addressing several existing gaps and limitations. We examine mechanisms that account for associations between parents' early mind-mindedness and children's future attachment security, using robust behavioral measures. Teams of trained observers coded parents' mind-minded comments to their infants at 7 months during naturalistic interactions, parents' responsiveness in naturalistic interactions and in elicited imitation tasks at 15 months, and children's security, using Attachment Q-Set at 2 years and Iowa Attachment Behavioral Coding at 10 years. Sequential mediation analyses supported a model of a developmental path from parents' appropriate mind-minded comments in infancy to children's security at age 10. For mothers and children, the path was mediated first through responsiveness at 15 months and then security at 2 years. For fathers and children, the path was mediated through attachment security at 2 years. Parents' nonattuned mind-minded comments had no effects on responsiveness or security. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Middle childhood is a relative lacuna in behavioral attachment research. We examined antecedents, correlates, and implications of parent-child attachment at age 10 in a longitudinal study of community families from a Midwestern US state (N = 102, mothers, fathers, and children). Dimensions of security, avoidance, ambivalence, and disorganization of children's attachment to each parent were observed in lengthy naturalistic interactions and assessed using Iowa Attachment Behavioral Coding (IABC). IABC scores were meaningfully associated with history of parental responsiveness (7-80 months) and with earlier and concurrent attachment security, assessed with other established instruments (parent- and observer-rated Attachment Q-Set at 25 months, children's reports at age 8 and 10). Structural equation modeling analyses revealed that the overall history of responsive care was meaningfully associated with Security, Avoidance, and Disorganization at age 10, in both mother-child and father-child relationships, and that most recent care uniquely predicted Security. IABC scores were also meaningfully related to a broad range of measures of child adaptation at ages 10-12. Cumulative history of children's security from infancy to middle childhood, integrating measures across relationships and methodologies, also predicted child adaptation at ages 10-12.

In a change from the once-dominant view of children as passive in the parent-led process of socialization, children are now seen as active agents who can considerably influence that process. However, these newer perspectives typically focus on the child's antagonistic influence, due either to a difficult temperament or aversive, resistant, negative behaviors that elicit adversarial responses from the parent and lead to future coercive cascades in the relationship. Children's capacity to act as receptive, willing, even enthusiastic, active socialization agents is largely overlooked. Informed by attachment theory and other relational perspectives, we depict children as able to adopt an active willing stance and to exert robust positive influence in the mutually cooperative socialization enterprise. A longitudinal study of 100 community families (mothers, fathers, and children) demonstrates that willing stance (a) is a latent construct, observable in diverse parent–child contexts, parallel at 38, 52, and 67 months and longitudinally stable; (b) originates within an early secure parent–child relationship at 25 months; and (c) promotes a positive future cascade toward adaptive outcomes at age 10. The outcomes include the parent's observed and child-reported positive, responsive behavior, as well as child-reported internal obligation to obey the parent and parent-reported low level of child behavior problems. The construct of willing stance has implications for basic research in typical socialization and in developmental psychopathology as well as for prevention and intervention.

Although attachment security has been associated with children's rule-compatible conduct, the mechanism through which attachment influences early regard for rules is not well established. We hypothesized that effortful control would mediate the link between security and indicators of children's emerging regard for rules (discomfort following rule violations, internalization of parents' and experimenter's rules, few externalizing behaviors). In a longitudinal study, the Attachment Q-Set was completed by parents, effortful control was observed, and Regard for Rules was observed and rated by parents. The proposed model fit the data well: Children's security to mothers predicted their effortful control, which in turn had a direct link to a greater Regard for Rules. Children's security with fathers did not predict effortful control. The mother-child relationship appears particularly important for positive developmental cascades of self-regulation and socialization.

We followed 100 community families from toddler age to preadolescence. Each mother– and father–child dyad was observed at 25, 38, 52, 67, and 80 months (10 hr/child) to assess positive and power-assertive parenting. At age 10 (N = 82), we obtained parent- and child-reported outcome measures of children's acceptance of parental socialization: cooperation with parental monitoring, negative attitude toward substance use, internalization of adult values, and callous–unemotional tendencies. Children who carried a short serotonin transporter linked polymorphic region gene (5-HTTLPR) allele and were highly anger prone, based on anger observed in laboratory from 25 to 80 months, were classified as high in biobehavioral risk. The remaining children were classified as low in biobehavioral risk. Biobehavioral risk moderated links between parenting history and outcomes. For low-risk children, parenting measures were unrelated to outcomes. For children high in biobehavioral risk, variations in positive parenting predicted cooperation with monitoring and negative attitude toward substance use, and variations in power-assertive parenting predicted internalization of adult values and callous–unemotional tendencies. Suboptimal parenting combined with high biobehavioral risk resulted in the poorest outcomes. The effect for attitude toward substance use supported differential susceptibility: children high in biobehavioral risk who received optimal parenting had a more adaptive outcome than their low-risk peers. The remaining effects were consistent with diathesis–stress.

Parent–child relationships are critical in development, but much remains to be learned about the mechanisms of their impact. We examined the early parent–child relationship as a moderator of the developmental trajectory from children's affective and behavioral responses to transgressions to future antisocial, externalizing behavior problems in the Family Study (102 community mothers, fathers, and infants, followed through age 8) and the Play Study (186 low-income, diverse mothers and toddlers, followed for 10 months). The relationship quality was indexed by attachment security in the Family Study and maternal responsiveness in the Play Study. Responses to transgressions (tense discomfort and reparation) were observed in laboratory mishaps wherein children believed they had damaged a valued object. Antisocial outcomes were rated by parents. In both studies, early relationships moderated the future developmental trajectory: diminished tense discomfort predicted more antisocial outcomes, but only in insecure or unresponsive relationships. That risk was defused in secure or responsive relationships. Moderated mediation analyses in the Family Study indicated that the links between diminished tense discomfort and future antisocial behavior in insecure parent–child dyads were mediated by stronger discipline pressure from parents. By indirectly influencing future developmental sequelae, early relationships may increase or decrease the probability that the parent–child dyad will embark on a path toward antisocial outcomes.

BackgroundAdvance care planning (ACP) supports patients in identifying and documenting their preferences and timely discussing them with their relatives and healthcare professionals (HCPs). Since the British Thoracic Society encourages ACP in chronic respiratory disease, the objective was to systematically review ACP practice in chronic respiratory disease, attitudes of patients and HCPs and barriers and facilitators related to engagement in ACP.MethodsWe systematically searched 12 electronic databases for empirical studies on ACP in adults with chronic respiratory diseases. Identified studies underwent full review and data extraction.ResultsOf 2509 studies, 21 were eligible: 10 were quantitative studies. Although a majority of patients was interested in engaging in ACP, ACP was rarely carried out. Many HCPs acknowledged the importance of ACP but were hesitant to initiate it. Barriers to engagement in ACP were the complex disease course of patients with chronic respiratory diseases, HCPs’ concern of taking away patients’ hopes and lack of continuity of care. The identification of trigger points and training of HCPs on how to communicate sensitive topics were identified as facilitators to engagement in ACP.ConclusionsIn conclusion, ACP is surprisingly uncommon in chronic respiratory disease, possibly due to the complex disease course of chronic respiratory diseases and ambivalence of both patients and HCPs to engage in ACP. Providing patients with information about their disease can help meeting their needs. Additionally, support of HCPs through identification of trigger points, training and system-related changes can facilitate engagement in ACP.Systematic review registration numberCRD42016039787.

Parents' personality was examined as a moderator of the impact of demographic risk on parenting in a longitudinal study (N = 102 families). Parents' personality and demographic risk (i.e., education level, age, family income, and family size) were assessed when children were infants, and parents' power assertion, warmth, and positive affect were observed in naturalistic interactions 2.5 years later. Parents' personality moderated the adverse impact of demographic risk on parenting. For parents who had memories of unstable and unhappy childhood experiences and who reported low conventionality, higher risk was linked to more power assertion, but there was no such link for those parents who recalled happy childhood experiences and who embraced conventions. For both parents who lacked a sense of optimism and social trust, and for fathers who reported low conventionality, higher risk was linked to less affectively positive parenting, but there was no such link for parents who were optimistic and trusting or for fathers who were conventional. Higher risk was linked to more power assertion, but only for mothers low in Extraversion and for fathers high in Neuroticism.

A developmental cascade from positive early parent-child relationship to child security with the parent to adaptive socialization outcomes, proposed in attachment theory and often implicitly accepted but rarely formally tested, was examined in 100 mothers, fathers, and children followed from toddler age to preadolescence. Parent-child Mutually Responsive Orientation (MRO) was observed in lengthy interactions at 38, 52, 67, and 80 months; children reported their security with parents at age 8. Socialization outcomes (parent- and child-reported cooperation with parental monitoring and teacher-reported school competence) were assessed at age 10. Mediation was tested with PROCESS (Hayes, 2013). The parent-child history of MRO significantly predicted both mother-child and father-child security. For mother-child dyads, security mediated links between history of MRO and cooperation with maternal monitoring and school competence, controlling for developmental continuity of the studied constructs. For father-child dyads, the mediation effect was not evident.

We examined children's attachment security with their mothers and fathers in a community sample (N = 100). At 25 months, mothers, fathers, and trained observers completed Attachment Q-Set (AQS). At 100 months, children completed Kerns Security Scale (KSS) for each parent. Children's adaptation (behavior problems and competence in broader ecologies of school and peer group, child- and parent-reported) was assessed at 100 months. Generally, the child's security with the mother and father was modestly to robustly concordant across both relationships, depending on the assessment method. Observers' AQS security scores predicted children's self-reported security six years later. For children with low AQS security scores with mothers, variations in security with fathers had significant implications for adaptation. Those whose security with fathers was also low reported the most behavior problems and were seen as least competent in broader ecologies, but those whose security with fathers was high reported few problems and were seen as competent. Observer-rated security with fathers predicted children's higher competence in broader ecologies, both self- and parent-reported. A cumulative index of the history of security from toddler age to middle childhood, integrating measures across both relationships and diverse methodologies, was significantly associated with positive adaptation at 100 months.

Although children's active role in socialization has been long acknowledged, relevant research has typically focused on children's difficult temperament or negative behaviors that elicit coercive and adversarial processes, largely overlooking their capacity to act as positive, willing, even enthusiastic, active socialization agents. We studied the willing, receptive stance toward their mothers in a low-income sample of 186 children who were 24 to 44 months old. Confirmatory factor analysis supported a latent construct of willing stance, manifested as children's responsiveness to mothers in naturalistic interactions, responsive imitation in teaching contexts, and committed compliance with maternal prohibitions, all observed in the laboratory. Structural equation modeling analyses confirmed that ecological adversity undermined maternal responsiveness, and responsiveness, in turn, was linked to children's willing stance. A compromised willing stance predicted externalizing behavior problems, assessed 10 months later, and fully mediated the links between maternal responsiveness and those outcomes. Ecological adversity had a direct, unmediated effect on internalizing behavior problems. Considering children's active role as willing, receptive agents capable of embracing parental influence can lead to a more complete understanding of detrimental mechanisms that link ecological adversity with antisocial developmental pathways. It can also inform research on the normative socialization process, consistent with the objectives of developmental psychopathology.

Background Growing research on children's traits as moderators of links between parenting and developmental outcomes has shown that variations in positivity, warmth, or responsiveness in parent–child relationships are particularly consequential for temperamentally difficult or biologically vulnerable children. But very few studies have addressed the moderating role of children's callous-unemotional (CU) traits, a known serious risk factor for antisocial cascades. We examined children's CU traits as moderators of links between parent–child Mutually Responsive Orientation (MRO) and shared positive affect and future externalizing behavior problems. Methods Participants included 100 two-parent community families of normally developing children, followed longitudinally. MRO and shared positive affect in mother–child and father–child dyads were observed in lengthy, diverse naturalistic contexts when children were 38 and 52 months. Both parents rated children's CU traits at 67 months and their externalizing behavior problems (Oppositional Defiant Disorder and Conduct Disorder) at 67, 80, and 100 months. Results Children's CU traits moderated links between early positive parent–child relationships and children's future externalizing behavior problems, even after controlling for strong continuity of those problems. For children with elevated CU traits, higher mother–child MRO and father–child shared positive affect predicted a decrease in mother-reported future behavior problems. There were no significant associations for children with relatively lower CU scores. Conclusions Positive qualities for early relationships, potentially different for mother–child and father–child dyads, can serve as potent factors that decrease probability of antisocial developmental cascades for children who are at risk due to elevated CU traits.

This multimethod study of mothers and toddlers (a) examined the effectiveness of a play-based intervention (child-oriented play vs. play-as-usual) on children's cooperation with their mothers and socioemotional competence; (b) introduced a robust new measure of maternal engagement in the intervention, reflected in the dose of child-oriented play the mother delivered to the child; and (c) examined ecological factors that predicted maternal engagement, and the effect of engagement on the outcomes. Low-income mothers (N = 186, 11% Latino, 27% minority) were randomized into child-oriented play group or play-as-usual group, participated in 8 play sessions, and played daily with their children for 10 weeks. Microscopic coding of mothers' behavior in play sessions assessed the dose of child-oriented play delivered to children; mothers' diaries assessed time in daily play. Children's cooperation with maternal control, observed in the laboratory, and mother-rated competence were measured before randomization (Pretest), after play sessions (Posttest 1), and 6 months later (Posttest 2). Children in both groups made significant gains in both outcomes. The gains in cooperation appeared longer lasting in child-oriented play group. Both groups made significantly greater gains than a "historical community control" group, an unrelated longitudinal study without any intervention. Structural equation analyses revealed that married mothers and those with fewer children delivered higher doses of child-oriented play, and those doses predicted children's higher cooperation and competence, with the effects of earlier scores covaried. The dose of time spent in daily play had no effect. Child-oriented play may be a promising, effective, and inexpensive means of promoting toddlers' positive development.

Effortful control (EC), the capacity to deliberately suppress a dominant response and perform a subdominant response, rapidly developing in toddler and preschool age, has been shown to be a robust predictor of children’s adjustment. Not settled, however, is whether a view of EC as a heterogeneous rather than unidimensional construct may offer advantages in the context of predicting diverse developmental outcomes. This study focused on the potential distinction between “hot” EC function (delay-of-gratification tasks that called for suppressing an emotionally charged response) and more abstract “cool” EC functions (motor inhibition tasks, suppressing-initiating response or Go-No Go tasks, and effortful attention or Stroop-like tasks). Children (N = 100) were observed performing EC tasks at 38 and 52 months. Mothers, fathers, and teachers rated children’s behavior problems and academic performance at 67, 80, and 100 months, and children participated in a clinical interview at 100 months. Structural Equation Modeling (SEM) analyses with latent variables produced consistent findings across all informants: Children’s scores in “hot” EC tasks, presumably engaging emotion regulation skills, predicted behavior problems but not academic performance, whereas their scores in “cool” EC tasks, specifically those engaging effortful attention, predicted academic performance but not behavior problems. The models of EC as a heterogeneous construct offered some advantages over the unidimensional models. Methodological and clinical implications of the findings are discussed.

Background: The parent–child relationship is considered important for children’s future conscience, and conscience is seen as protecting them from disruptive behavior problems, but specific mechanisms of this developmental process are rarely studied. Methods: This multi-trait multi-method study examined, in a longitudinal design, paths linking early maternal responsiveness to the child with the child’s future conscience and disruptive behavior in 102 mother–child dyads. We tested a conceptual model where maternal responsiveness to the child, observed at 7 and 15 months, engenders a responsive stance in the child, observed at 25 and 38 months; that stance, in turn, becomes enduring and generalized, promoting multiple aspects of the child’s conscience, observed at 52 months. In turn, conscience serves as a protective factor from disruptive behavior problems, rated by mothers and fathers at 67 months. Results: The postulated paths were examined using sequential regressions and mediation effects were tested using bootstrapping analyses. Child responsive stance at 25–38 months fully mediated the link between maternal responsiveness in infancy and conscience at 52 months, and conscience fully mediated the link between child responsive stance and future disruptive behavior at 67 months. Conclusions: Examination of developmental links among early maternal behavior, the child’s responsive stance toward the mother, conscience, and disruptive behavior is a promising step toward elucidating mechanisms of children’s adaptive and maladaptive trajectories.

This study investigates attitude change toward older people by patient educators and inservice trainers of patient educators who attended national training programs in which the instructional design was affectively as well as cognitively oriented. The subjects represented nursing, physical and occupational therapy, social work, and health education. Using the mean ratings, comparisons were made between the positive and negative scores on the pre and post-administrations of the Kogan Old People Scales. Results indicate positive attitude scores increased at all programs and negative . attitudes decreased at four of the five programs. The conclusion is that programs designed for health care providers who work with the elderly can achieve positive shifts in attitudes toward the elderly if that is one of the instructional design considerations.

Because hospice is still considered a fairly new and innovative concept in the United States (Munley, 1983; Torrens, 1984), attempts to provide a systematic method of identifying factors le...